Thursday, April 24, 2008

knowledge is power

so i had another doctor's appointment today, and it was with my favorite doctor. and well--he kind of brushed off my concerns and questions and didn't tell me a lot. he talked about scheduling an induction for me for next week, and i was like--why so soon? a month ago, the same guy was talking about letting me go for two weeks past my due date. and the explanation was the same as i keep getting from all of them: we don't like to let hypertensive patients go too far beyond their due date. to which i ask--why? what can go wrong? if the baby is fine and i am fine, then why interfere? and he didn't really answer these questions--all they tell me is that i could develop complications. and i have to say, duh. you can always develop complications--why am i any different than anyone else? no one at the practice has ever really answered that.

so he went ahead and scheduled an induction for me for next monday night, when the doctor from monday will be on call. i objected, of course, but was over-ruled with this assurance: don't worry--he's a good deliverer.



i came home to google. and after reading a LOT, i think i actually finally understand the concerns they have. and after understanding the concerns, i actually AGREE with the doctors. this baby needs to come out soon.

here's the thing: i have chronic hypertension--i have had it since i was 17 years old, and for the past 6 years (since a VERY scary BP spike that gave me an unstoppable nosebleed and a trip to the emergency room where my BP was still 172/120 two hours after the bleeding stopped--this was later described as a stroke in my nasal passage), i have been on medication for it. it's well managed. when i got pregnant, the first thing i did was change medications, and all was well. in the past month and a half, the BP has been very slowly creeping up. they upped my meds, but it's had little effect. and while my BP is still in the non-dangerous range, it IS still going up, and what's key here is the difference between what it was early in my pregnancy versus what it is now. from reading this awesome (although scary) page that actually explains this, it seems like i am developing gestational hypertension on top of my chronic hypertension. this is actually a worst case scenario for both me and for the baby. it means that in addition to the complications i already know about (pre-eclamspsia, low fetal growth, premature aging of the placenta, low amniotic fluid levels), none of which i have at all, there are also a host of complications that can develop in the 11th hour, even if my whole pregnancy has been nothing but healthy and beautiful. these are the Bad Ones (HELLP, eclampsia, and the like) that can cause seizures, liver and kidney failure, and death of me or the baby or both. the more my BP goes up, the more likely these complications become, and the longer i remain pregnant, the more my BP will go up--it's on a very predictable curve right now. the cure? get the baby out. so. yeah.

you see what i mean? what a difference it makes to know and understand that! it really IS dangerous for me to continue this pregnancy much longer, in spite of the fact that i feel fine--great even. hypertension is a hidden dragon, and if it strikes--it can happen so fast that there's no time to react.

why is it i have to figure this out for myself instead of getting it from my doctors?

and so--to that. the interesting thing here is that my monday doctor, who i still believe royally screwed up, is the only one who listens to my questions and answers them seriously. and looking back at my conversation with him after The Incident, i now get that he was actually starting to explain all this to me. he was saying that they would want to induce me soon after my due date because the complications that could arise in a case like mine were fast and unpresictable. and i think he could tell that i was too upset at the time to really hear him. he said--i think i am getting ahead of myself trying to discuss induction when you are so upset. and he was right. i just wish my doctor today had really explained the WHY of things to me better before just going ahead and scheduling the induction and kind of railroading me. all i need is communication and understanding. and oddly enough, i think i am more likely to get it from the monday doctor than from just about anyone else. so maybe the fact that my induction is scheduled with him on monday is a Good Thing.

i have been a good patient with these guys, and very cooperative. i have done EVERYTHING they have wanted me to. i have asked a ton of questions the whole way through. i have gone to every appointment, missed none, been late for none, taken the recommended classes, read the recommended reading, monitored my blood pressure at home religiously. it's a little sad that things with the doctors have become so tense and difficult here at the end. i feel like they are communicating things worse now than ever before, when i am actually developing some potentially very serious complications that, to me, warrant more explanation, not less. now is no time to NOT take the time to explain things to me. i still believe that the doctors in the practice are good doctors. i believe that they will take good care of me and the baby, no matter what happens. i just wish they would communicate my care to me better.

sometimes it is pretty hard not to look at doctors and say--i am as smart as you are, man. my degrees are just in different subjects. and it's MY body and MY child's body on the line, and you need to make me understand wtf is up. maybe i should try that...


the bottom line here is that i am feeling awesome, and the baby is doing great for now. i am having some contractions, but they haven't regulated. i am hoping and praying that i go into real labor asap and that this baby gets a chance to come on out on his own. i am hoping and praying i will be able to help him out with that without drugs or intervention of any kind. but you know what? if not, then well--he's still gotta get out of there. and if that means induction on monday, then ok. and if that means i have an emergency c-section because that induction doesn't work out, then ok, too. i just want a healthy baby and a healthy me.

and i am pretty calm. my BP is holding steady and i am checking it evvery couple of hours. i am packing things to go to the hospital as soon as it's time to go. i am hanging onto images of putting the baby's fat little feet into the sand, images of him sleeping like a bean on my chest, images of him walking unsteadily across the floor scaring the crap out of the cats... everything's gonna be alright.


Joelene said...

Hi Jackie,

I just wanted to let you know that I have been reading all along, I know I am not the best commentor. But I have enjoyed "living" this with you. You will be in my thoughts and prayers the next few days. I am glad that you have found the peace you need, to do whatever is needed. I know that must not be easy. You are an amazing strong woman, and you will be an amazing mamma. No matter how this little peanut enters the world, once you get to hold it, everything else seems less important. Happy "Birth"day Jackie and peanut!

Expected goodies soon! Send me your address again chica!

<3 jo

gray la gran said...

damn! i left a comment, and the internet/intranet gods don't like me! (ie: lodging on expense reports, or leaving bloggy comments) ....
so, with that said, i originally came here for my "dinner" recipe of dinner the other night ... and my basil is hurting, all wilty, so, i think my pasta will have dried herbs (which, whatever, the tomatoes are from cans anyways).
see you tomorrow!

gray la gran said...

ps. the part that got zapped ... i'll tell you about that later .....
just remind me i'm an angry dog on a short leash!

Em said...

When I hit 41 weeks with Baby the First, the practitioner said that we should induce the following day. When I asked her why, her response was, "Because enough's enough. What are you gonna do?" I had to ruminate over that informative gem for a few hours before I called her back for more justification. Even then, I felt somewhat underwhelmed by her response. But, I agree with Jo that once the baby gets here, the frustration with your medical care will greatly recede. Behold the awesome power of New Baby Smell.

Holding you, the Hippie, and the baby in my heart.

Anonymous said...

actually, girl, you are smarter than the doctors - from the woman who knows, worked w/enough of them:) but, they are "experts" and yes, they get into their expert mode and forget they are dealing with people. you would be quite correct to remind them of that, if only for the next woman without the brains and balls to do that. fortunately, i understood why T had to be induced and i had to stay in the bed during labor, didn't like it, but understood the necessity. and we got a healthy baby, all that matters:) hang in there, call me when you can. got all the ladies here praying for a tomorrow (26th) delivery. 26 is very significant in my life:) hugs, kisses and prayers~denise~gma:)

Laura said...

Sometimes it's very difficult to be intelligent and want/need more information. Doctors have a job and you pay for a slice of time. thankfully you have the ability to go home and look up the info to give yourself a bit of comfort. Don't hold it against them too much that you're above average intelligence. Thinking of you all three so much and wishing the greatest happiest moments of your lives. :)