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09/17/2008

Postpartum

About that six-week appointment.  First, I offer you a riotous laugh at my expense.  The nurse led me to an exam room and took my weight and blood pressure.  Then she presented me with a gown and prepared to leave the room.  I am embarrassed to say I was flummoxed.  "What's this for?" I asked.

She opened and closed her mouth a couple of times, obviously astonished that someone with my extensive reproductive accomplishments could still be so adorably naive.  But given my six-week checkup after Charlie's birth, which involved only a quick lowering of my waistband as I sat by his isolette, I'd honestly thought the doctor was going to give my incision a cursory glance, ask me if I wanted to discuss birth control, and hustle on his way.  What can I say?  Thick file, thick patient.

No such luck.  But I'm getting ahead of myself.  My OB breezed in exactly as he had in the hospital, asking without preamble, "What questions do you have?"

And I burst into tears and asked, "How come I can't keep my pants on?"

(Okay, no, I didn't.  But I will say that I've come to a greater appreciation for my once-upon-a-time local RE, who does his patients what I now know to be the uncommon courtesy of saying, "Why don't you get dressed, and we can talk when I come back in?")

Those of you who predicted that my OB wouldn't remember the conversation I was fretting about were spot-on, considering that initially he didn't even remember I'd had gestational diabetes.  It took him a minute of scanning the top page of my file before I saw recognition dawn, followed shortly thereafter by the unmistakable hunted look I've become accustomed to seeing in medical professionals.  But he needn't have worried; I was calm and pleasant, and utterly non-confrontational, willing to let it all go.

Why?  Because Ben smiled at him.  Now, it's not that Ben's an especially good judge of character; at six weeks old he'd smile at Dick Cheney himself.  (It's not Ben's fault; he doesn't know any better.  Call me crunchy granola or whatever but I am firmly opposed to exposing babies to evil incarnate until they're at least two months old.)

But when Ben smiled at my OB, the doctor immediately dissolved into a gooey, cooing blob.  Don't get me wrong; I don't think liking babies means you're a fundamentally decent person. Why, I bet even Vice President Cheney likes babies.  (Done up nice, Texas-style.  With hush puppies and a beer.)  But witnessing this interaction reminded me of what's most important: the baby.  I have a baby.  And everything else — every daily inconvenience, every physical discomfort, every transient indignity — seems rather less important now than it did in the moment.

Putting aside my lingering resentment, then — kind of miraculous, since I bear grudges like a zucchini vine bears, uh, well, zucchini, and apparently craft metaphors like a fish crafts a bicycle — I was able to open the conversation without rancor.  I learned that when a patient has failed any of the assays on a glucose tolerance test taken outside of pregnancy, my OB's practice treats the patient as a diabetic, period. 

In 2005, back when I finally had a real postpartum checkup after bringing Charlie home, I failed two of the four blood draws, by enough that I'm considered prediabetic, but not so much as to classify me as a true diabetic according to most of the medical world.  But in obstetrical terms, that's a distinction without a difference, since pretty much anyone with insulin resistance before pregnancy will need to be treated for it during pregnancy.  And when anyone who is not currently pregnant or postmenopausal is considered a candidate for pregnancy, well, suddenly it all makes a crazy kind of sense.  (I know.  I know.  I didn't say it made the non-crazy kind.)

So that is where the hotly contested cookie crumbled: My OB treated me like a diabetic when I didn't even know I was one. And while I suspect the reasons for this would have irritated me mightily — I do enjoy a nice dudgeon, the higher, the better — I chose not to request them.  It doesn't feel important.

Easy for me to say, of course, now that I have a baby, a smiling baby, and can eat cookies if I want them, and have no plans for a future pregnancy.  (Even though my OB advised me that "strange things happen when you're not even trying," thereby earning a kneecapping from every last one of the 95% of infertile couples who don't get that storied surprise pregnancy, I don't see it happening for us.  Especially not given the merest whisper-thin smear of tissue where my good left ovary used to be, the so-called streak ovary noted in the surgical report.)

Easy for me to say now that I can answer the OB's last question to me — "So would you say it was worth it?" — without hesitation, knowing how it all turns out.

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