Yesterday was BUSY. I left home before eight am to drive to my doctors appointments in the city an hour away and didn’t return until well after eleven thirty that night. First, the appointments. Excuse my French and I’m trying to swear less and I swear (heh) that I’ll kick it before baby comes in October but yesterday morning seriously deserves a giant HOLY SHITBALLS!
What follows is a long and at times disjointed and probably on the whole, poorly written, account of my day. I’ve put the majority of it after the jump because, well, as previously mentioned it’s long. And disjointed. And poorly written. FAIR WARNING.
Yesterday I had two separate appointments with two separate fetal medicine specialists, these were the people who were supposed to be able to shed a little more light on what effect (if any) my kidney condition is having on the dear little Demon Baby, and also to give a final recommendation yay or nay for a home birth.
My midwives requested the consult and said that they usually defer to the specialists in decisions like these, so I knew that on the line rested all my hippy dreams of birthing this child in my living room surrounded by beeswax candles, with Gus softly licking himself in the corner.
Shit was about to get real.
I arrived at the medical centre after winding my way through rush hour traffic, glad that Adam had encouraged (read: yelled at me) to leave a half hour earlier than I intended. I made my way to Entrance 93 (yes, apparently there are 92 OTHER entrances and possibly more because I don’t even think 93 was the last one).
Before I go on I have to explain that I am a good patient. A model patient in fact. (This isn’t bragging, it’s actually quite horrible and I wish I could stop).
I have had an incredible number of interactions with Doctors and healthcare professionals over the past five years, I understand that their jobs can be demanding and stressful and hectic and I owe them so much -I literally would not be able to survive without them- and so I have made it my mission of sorts to try and make at least the small portion of their day that involves interacting with me, as pleasant as possible.
In short, I attempt to become the best!patient!ever!, with the unfortunate result that I’m not a great advocate for myself.
As soon as I step through those hospital doors I turn into this soft spoken, meekly smiling, obedient little patient-person who nods politely and agrees amenably with everything the person in the white coat is saying, regardless of my actual feelings on the matter. I don’t want to be difficult, I don’t want to challenge their authority, I can’t seem to speak up and give my opinion (even when, as is the case most times, I know more than they do about my condition)
I don’t know how this all started and I don’t know how I can stop it and truth be told it’s one of the reasons I like Adam to come with me to some appointments, he’s not afraid to be a bit of a dick to get his questions answered, to ask why until he’s satisfied with the response.
But Adam wasn’t there yesterday. And honestly that may have been a good thing because again, HOLY SHITBALLS.
First the assembly line of bureaucracy. I go to check in and am assigned a card and a patient record and told to report to Desk #3. I smile and obediently waddle over to Desk #3 where I am passed off to a burly nurse who takes me by the elbow and leads me into a little room off to the side of the reception area. Here she teaches me how to weigh myself (a lesson during which I pay attention so closely, and nod so attentively that you would swear I’d never seen a scale before) and take a urine sample to test for, well I don’t actually know what for because I never asked.
The nurse shows me in how to properly do the test.
“You don’t want to just jam the strip in there” she instructs gruffly, “It’ll hit the bottom and flick pee into your face. Don’t ask me how I know that, just trust me and dip the test strip in gently.”
I laugh and nod, march into the bathroom. It seems simple enough, I have to pee into a stryofoam cup, dip the test strip, dump the urine sample and then bring the strip back to her so she can interpret the results.
As she leaves the room however, I start panicking. I don’t have to pee. Like, at all.
I haven’t had anything to drink since I woke up. The well is empty.
I start to sweat, and sit there nervously for a few moments trying to will myself into peeing. I imagine waterfalls and long car rides, I think about drinking a huge coffee, a litre of cola in a crowded movie theatre and then finally, finally, after the longest five minutes of my life, in which I become more and more anxious imagining the nurse standing outside the bathroom door waiting impatiently and all but tapping her foot , I manage to fill the little cup halfway.
This feels like an achievement on par with graduating university. I stand up with a swelling sense of accomplishment and feel like I should curtsey, make an acceptance speech. I settle for whispering “We did it, Baby!” and happily high fiving my belly.
I flush the toilet and wash my hands. As the toilet is nearing the end of its gurgling flush I realize I haven’t disposed of the sample yet and I quickly grab the cup and dump its contents into the toilet bowl. Then I turn around and start to dry my hands on a rough swath of paper towel when I see it, the test strip – the UNUSED test strip – lying innocently on the counter.
I stand there in shock, staring at the tiny strip of paper with all of its colourful squares. My sweating increases tenfold. How can this be?!
How after all of that, the instruction, the not-peeing, the STILL not-peeing, the finally-peeing, the fetal high-five, how after all of that could I then forget to do the actual test that I was collecting the precious pee FOR?
I couldn’t believe I had wasted the entirety of my hard won urine sample, that scant cup of precious gold that took such immense reserves of mind fuckery to produce!
I stood there in the bathroom of this gigantic hospital and felt tears well up in my eyes; I am failing as a patient! I can’t even pee into a cup!
I cannot, nay, WILL NOT face the nurse and admit that I couldn’t do what was required of me, or worse, that I could do it but dumped the entire sample LIKE AN IDIOT without testing it first. I take a deep breath and head to the toilet again.
If I die tomorrow I would like someone to mention at my funeral that on June 29, 2012 I managed to produce not one, but TWO decent urine samples completely out of thin air. It was like squeezing blood from a stone Internets, I manifested those samples from the sheer strength of my own willpower, the overpowering determination to be a good patient at all costs.
I finally emerged from the bathroom, rattled and sweaty, exhausted from the mental gymnastics but holding the used test strip aloft like a trophy. “BEHOLD!” I felt like shouting, “I have peed!”
Nurse Burly looks considerably less impressed, glances at the strip and makes some notes in my chart, then leads me down a winding maze of hallways to my first appointment.
The first appointment was unremarkable. I answered approximately 87 million questions about my kidney disease, family history, medications, morning sickness, Adam’s health, support system, internet search history and how often I think about Ryan Gosling (too often, okay?).
Three doctors made up the interrogation team, and all were kind and respectful and seemingly interested in my condition, genuinely wanting to help. All the same, each of them stated by stating that they knew nothing about my condition, had never heard of it before. I’m starting to get used to this.
After the 87 millionth question they finished the appointment by checking the baby’s heartbeat (a galloping 160 bpm), measuring my fundal heights (“Perfect”, the doctor murmured as she retracted the measuring tape), doing my blood pressure and then leaving the room to confer while I sat in a puddle of my rapidly cooling sweat, wondering if I had “passed.”
When they returned, the general consensus was that a home birth was out. The head specialist took great pains to convey that they weren’t anti-midwife, they had great respect for midwifery and saw no reason why I couldn’t continue under a midwifes care during pregnancy and birth, but that in their expert opinions I should give birth in a hospital where there were appropriate facilities to deal with the (unlikely) event of dropping electrolyte levels, necessity for IV fluids or (worst case scenario) cardiac resuscitation in the event of heart failure (a rare possibility, but not completely impossible given my condition.)
I nodded obediently and thanked them for their time, then followed a different, less burly nurse to Desk #1, where I sat and waited for a few minutes before following another nurse to another admitting desk, and sat and waited for a few more minutes before finally following a different doctor to an exam room that was an exact mirror image of the one before it.
The doctor introduced himself and then proceeded to ask me the exact same questions that the other three doctors had asked. All 87 million. I answered them again, he took my blood pressure again, he measured my belly again, and then felt my legs for swelling, listened to my heart, examined my carotid artery.
All of this was pretty ho-hum (and I swear I am getting to the point, very very soon!) and then, THEN he went to get his boss, she who shall now be renamed HOLY SHITBALLS!
When they came into the exam room she looked like she was on her way to lunch, coat on and purse slung over her shoulder. With short no-nonsense hair and a deep sigh she slid into the desk chair and impatiently waved her hand at the other doctor to begin.
He then recited verbatim the entire history I had just given him, stopping periodically to answer the questions she interrupted to ask.
“When was she diagnosed?”
“*deep sigh* 23 YEARS ago? Or age 23?”
“Oh sorry, age 23”
“How has her pregnancy progressed?”
“Nausea and vomiting during the first trimester, patient reports it has since abated and is currently in good health.”
“Personal history? Where is the personal history?”
“Oh sorry, four sisters one brother. Sister age 26 is similarly affected. No drinking or drug use. Husband unaffected and in good health”
On and on it went, the two of them speaking about me back and forth as though I weren’t even in the room.
I sat in stunned silence as this went on for about five minutes. She hadn’t even looked at me yet.
At one point she barked
“Obstetrician. WHO is her obstetrician?”
The doctor stammered “Uh, she isn’t seeing an OB she’s currently under the care of a midwife.”
“Oh good god.” HOLY SHITBALLS exclaimed with a sigh of contempt and, placing her glasses on top of her head, finally turned her attention to me.
“What is your midwifes name?” she inquired sharply “Um, there are three of them in the practice,” I began nervously, “I think the referring midwife was Dr. XX but-”
“NO.” she interrupted emphatically, “Not ‘DOCTOR’ anything. Midwives aren’t doctors. They haven’t been to medical school, they cannot practice medicine. All they know how to do is deliver babies. That’s it.”
This last part was spoken so contemptuously, with so much disdain that I was shocked into momentary silence.
This pause allowed HOLY SHITBALLS to continue.
“WHY are you seeing a midwife? It’s ridiculous! Do you know who midwives are for? Midwives are for people with perfect pregnancies. YOU do not have have a perfect pregnancy. They shouldn’t even be seeing you and the fact that they are is COMPLETELY irresponsible.”
At this point even the model patient in me was getting a little pissed.
“They are seeing me,” I managed to squeak, “Because my nephrologist- who has managed my care for the past five years – deemed my pregnancy low-risk. He sees no issue with me being under a midwife’s care.”
“Hmph” she grunted, before slouching back into her chair and turning her attention back to the male doctor, “We’ll see.”
I could not fucking believe this woman. I hated her. I hated her so very, very much and wanted to first punch her in the throat and then get up and waddle angrily out of this exam room and past all of the other exam rooms and away from this goddamn hospital and never come back.
But instead I continued to sit there. Listening and nodding. I kind of detest myself for that.
The rest of the appointment was similarly enraging. She was dismissive and rude and openly contemptuous.
She ended by giving me a requisition for an ECG, concurring that I needed to deliver in a hospital, recommending I ditch the midwives (they who “only” know how to deliver babies, I mean totally, right? What use could they possibly be when I am preparing to DELIVER A FUCKING BABY?) and then swanning out of the room without so much as shaking my hand.
The male doctor gave a little sigh, squeezed me on the shoulder and lead me back to Desk #1.
As I walked out of the medical centre I felt like I had been slammed against a brick wall repeatedly for forty-five minutes. I walked to my car, numbly opened the door, got inside and started bawling.
Like I said. It was a long day.
After I got my shit together I met up with my friend Kris, we had an amazing afternoon catching up over lunch at a sweet little restaurant, later I met Adam and one of his friends for a football game and I spent the evening sitting in the nosebleeds eating cheesy nachos and cheering for a team whose name I barely knew.
So, the rest of the day was amazing but I still couldn’t get over that woman.
It’s the first time I have felt that degree of tension between doctor and midwife. I have read about it, heard about it, but thus far every single doctor I have seen in this pregnancy (and it’s been about 12 at this point) has gone out of their way to express their support of midwives and my decision to be under their care. Even in the cases where I could tell that they didn’t entirely agree with the midwifery model, wouldn’t ever choose that route for themselves or their loved ones, they were still always careful to express their respect for my decision.
Besides ruminating over HOLY SHITBALLS, regretting not standing up for myself better, not saying something to defend my team of my midwives and the amazing work that they do, besides all of that I am trying to let go of home birth.
I would be lying if I said I wasn’t disappointed.
I know I could do it.
I feel strongly, SO strongly that I could do it.
I feel it’s a better decision for me in spite of (and even perhaps because of) my kidney condition. But the perfect patient in me, and also perhaps the mother slowly developing in me, just can’t go against these doctors orders, these better-safe-than-sorry recommendations.
Because what if?
So I’m trying to look on the bright side, I’m starting small lists in my head filled with all of the positive aspects to a hospital birth, even if it is an hour and a half away from where we live.
The list is still small (so far it consists of “1. No possibility of Gus accidentally eating the afterbirth.) but I know that it will grow as the months pass, until finally I am happy and excited and grateful to have this opportunity, to have access to these options.
But I swear to you internets, if I see HOLY SHITBALLS anywhere NEAR me during my labour, I will personally strange the perfect patient inside of me and unleash the full wrath of the Demon Baby upon her shoulders.
Because fuck her, my pregnancy IS perfect. Fuck her for saying otherwise and god damn it I will prove her wrong.