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08/23/2005

But I did like the comment about the Yoda action figure.

You know, maybe I'm a little bit touchy, but comments like these:

I can't believe that you're going there without a lawyer, and with the intent to undress.
...are starting to bother me. As well meaning as I know they are, they seem to carry the uncomfortable implication that I'm...you know, kind of dim. Foolish not to adopt an adversarial stance. Incapable of making good decisions about my own medical care.

Those things could be true, I suppose. But when you comment, I'd ask you to remember that I'm making choices based on a full understanding of the situation, which you, despite my efforts to invite you into the stirrups with me, simply can't have. That I'm an adult in full possession of my faculties and a fair amount of medical information. That I'm navigating an extremely difficult situation as best I can.

For the record, I have no intention of suing my OB. Nor do I have any intention of letting her go all Dead Ringers on my ass (although, come on, admit it, you think so, too: Jeremy Irons plus lithotomy position equals fantasy gold).

I didn't go there seeking satisfaction from her. Somehow I seem to have given that impression, though I thought I'd made it clear that I simply wanted a recap, a review of what we saw during my pregnancy, a step-by-step explanation of what happened in Connecticut. I need to know, not so I can ascribe blame or write a strongly-worded letter or sue the glittering toe rings off my well-pedicured OB, but simply so I'll know.

I don't believe my prenatal care was bungled. In looking at my records, I saw that I was mistaken about my blood pressure; while I had a couple of readings that were higher than others, there was neither a pattern of a rise nor any single reading that was cause for alarm. In fact, my blood pressure was, as it usually is, on the low side. My weight gain was normal, with no suspicious jumps. And although my OB allowed that they should have taken a urine sample on my last visit at 28 weeks — "and I don't know why it wasn't — I'll talk to [the colleague who saw me on that visit]" — in this practice they don't test for protein until 28 weeks and beyond. (Apparently the usefulness of a dipstick test for proteinuria has been called into question, especially in the absence of hypertension. Could the standard of care be changing?)

At any rate, with normal blood pressure at 28 weeks, I can't argue that I was writhing on death's doorstep much before The Incident. The scary thing about HELLP is how quickly it can set in, without any warning at all. Although it would be tidier if my doctor could point righteously to my chart saying, "See? See?!" I can't assume a dipstick at 28 weeks, almost two weeks before delivery, would have shown any proteinuria to speak of.

If anyone were to blame for all this — and I don't think anyone truly is, nor did I ever — I'd have to blame myself. When I first felt stomach pain a few days before That Fateful Day, I called my OB and made an appointment, but when the pain receded I cancelled it. If anyone was negligent — and I don't think anyone truly was — it was I, in not being willing to be inconvenienced for the good of my own health.

In summary, although I would not choose this OB to manage a complicated pregnancy in the future, I feel all right about the care I received.

The exception, of course, is her delay in contacting me after Charlie's birth. I spoke to her about that and received an apology of sorts, an acknowledgement that she should have been in touch. Yes, she should have, and a mournful nod on my part communicated everything I wanted to say on the matter.

Where I did seek satisfaction was in a review of my records from the hospital in Connecticut. I'd requested that my entire chart be sent in anticipation of this visit. Unfortunately, the records appeared to be woefully incomplete — without the lab results on my bloodwork, there was no way for her to explain just how sick I was. And that's what I wanted most.

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