Wednesday, July 4, 2012

6 years ago this week

Six years ago last week, towards the end of it, I was frantic. Happy too, but mostly frantic. My hunch from the weekend before that, when I suddenly threw up my breakfast only to feel absolutely fine the very next moment, proved right-- I was pregnant. So I called my GYN. At my regular appointment several months before we'd discussed my history and the fact that we were planning to begin trying come summer. She'd said that while they do not routinely check progesterone levels and don't tend to prescribe progesterone supplementation, she understood why I would be nervous given my history, and so she would put a note in my file to do these things for me when the time comes. Ha! Because when I called to talk to ask her for testing and supplementation, she just flat out told me that there is no conclusive data that supplementation helps, and they just don't do that. Yes, sure, but we talked about this, and you were supposed to do this for me. The worst part was, of course, that I was relying on her and did not have anyone else I could call up on a Thursday afternoon to try to get these things straightened out. Her response was something about how she would never say that and how she thought I would probably want a doctor who would be a better match for me. No shit.

To be fair, I received a letter from her a while later where she acknowledged that she did find the notation from our visit in the file, and she even sent me a prescription for progesterone. Though she still thought I'd want a different doctor. Again, lady, no shit.

By the time I got the letter, her behavior still stung, but not nearly as much because by then, though I did not know it yet, I had already spoken on the phone to the most important medical professionals of the next six years, and maybe, not to be grandiose or anything, maybe of my entire life. And between her leaving me to fend for myself and that first phone call with Nurse Kind, there was another doctor, to whom I will be forever grateful for his kindness and professionalism, which put together helped me keep my head on through the next week.

After I hung up with the GYN of poor memory, I needed to find someone who'd help. I called my friend Natalie. I didn't really want to tell anyone yet, but I met her OB/GYN a few years before, when she and her husband asked me to come with them to her second, now planned c-section. (Not two years before that she'd labored for a day and a half, pushed for several hours, and ended up with an emergency c-section.) Dr. N radiated confidence. He was funny, and you could tell he loved his job. You could also tell he was on the ball. That morning he bent the rules for us, for my friends, because he could see just how nervous Natalie's husband was-- he allowed a second non-medical person, me, into the OR. Moral support and all that.

So when I called Natalie, frantic, from my car, I wanted to know whether she thought Dr. N would be able to help. Natalie was also at my house when I threw up the previous weekend, so she wasn't shocked when I called. She called Dr. N, then I called Dr. N, and then he ordered the tests and wrote me a script for progesterone. That test and two repeat tests later, hCG was rising like gangbusters, but progesterone was not, it was actually sliding, slowly. This is where the professionalism comes in-- after that third test, Dr. N called to say that he thought I probably needed a high risk doctor, and that he was not, and did I have someone I could call? By that time I was already planning to call the practice where I was when I had Monkey, but it was so nice to be treated with this level of care and consideration.

When I called the practice they told me that the doctor I had when I was pregnant with Monkey had left the state, and I needed to pick someone else. They also said I was in luck-- they had this new high risk doctor, he just started, and so his schedule was fairly open still. He came from Texas and was very nice. Would I like to go with him? I had no idea just how in luck I was when I ambivalently accepted this new doctor. I also said I had concerns, and they said a nurse would call. Nurse Kind called later that day, took my history, and listened to my concerns. Dr. Best called later to say he wasn't convinced by the research that progesterone supplementation actually helped, but that there is no reason not to do it, given my history. He upped my suppository dosage, but didn't want to go to injectables because of the slightly higher risk to me later on in the pregnancy that was associated with that formulation. I hadn't yet laid eyes on him, but he was already talking my kind of medical language-- evidence-based, but not dogmatic, thoughtful and considerate, but not pandering. I liked him and I knew I could trust him. When I met both him and Nurse Kind later, I only liked them more. And it didn't hurt any that he was just about the most handsome man I've ever seen in person. (Think this is why he ended up on the practice's promotional poster? Nah, probably just a coincidence...)

That pregnancy was A. Which means that Dr. Best and Nurse Kind have been there for three out of the four of my children. They have also met Monkey and ask about her all the time. They understand. Knowing they are my team made the last two pregnancies, while certainly not easy, something I could deal with. In fact, knowing they are my team is what made it possible for me to even think that I could handle another go round, given the ups and downs of the pregnancy with the Cub.

Yesterday was my last appointment for the pregnancy. If all goes according to plan, I will see Dr. Best tomorrow before my induction (he's around, though he's not officially working on the floor), and both of them at the 6 week appointment. Nurse Kind asked that I send pictures from time to time. She walked in with that oh, wow misty look, and I suspect I looked like that too. We sat there talking about 6 years ago and that first phone call. She said she'll be keeping tabs on us on Thursday. Man, I am going to miss her.

Even Dr. Best was a little misty, though with a good dose of mischievous too, joking about me joking with him and the new tech who was, I gather, just getting acclimated with the practice. She's nice, though I hope I get to see their usual tech, K, again. I am going to miss her too. Dr. Best was talking about how well he thought I was doing this time around, how from his point of view this has been a qualitatively different pregnancy, in terms of my fears and anxiety levels. I said not exactly as far as the daily normal base level, but that this time there have been far fewer actual reasons for freakouts, and so I've had fewer above that already difficult to take normal. Interestingly, his perception is that I was also more freaked out during my pregnancy with A than now. I probably was, to some degree, because I had that crazy premonition and was constantly waiting for something bad to happen.

Dr. Best was also very pleased yesterday that my cervix is getting ready to get this show on the road-- I am more than 3 cm already, anterior, and 50%. So if me make it all the way to tomorrow's scheduled induction, he thinks it will be a fairly easy process. But, he said, you know you don't have to wait. I know, I know.

I want this to be done. I hope this is the end of my reproductive phase, and I hope it's a happy end. I am also wistful. Or maybe mindful is the word. I am grateful to be here. I am grateful for the people who helped me get here. I am a little sad about what this road has looked like. I love all my children-- the two here, who despite what they sometimes say, are crazy about each other, get along better than most siblings I've seen, and who are waiting, mostly patiently, along with us; the one we are all waiting to meet, the strong baby girl who rolls more than she kicks and tends to hide her face on ultrasounds; and my beautiful first son, who I miss every day, the one who never got to be oh, so many things. I want to feel this place fully, and I want to remember what this place felt like. Which is why I am happy to see that the sun is peaking out after the gray and wet morning here-- we were planning on taking some family pictures today, and if the sun keeps, we'll be able to do that outside.

Happy July 4th, everyone!


Tash said...

Isn't it odd, my shoulder muscles and hips were hurting yesterday, and they scorched with pain at one point picking up Ale and I realized this is from picking him up/putting him down all the time. And he isn't even as heavy as Bella was at this age.

And then, I was pregnant.

It really hit me how bizarre this curious walk is going to be, with Ale turning the age Bella was when all the shit went down.

Happy 4th, here's hoping the induction isn't necessary, or at least not much of it is! And let me tell you: the relief on the other side, to be totally, totally done with reproductive bullshit, is really mind-numbing. It's amazing how much of our brains that stuff takes up.

See you on the flip side . . . .

ellie said...

Thinking of you, saying prayers for all to be well. {{hugs}}

Hope's Mama said...

I feel so sad thinking about being "done". I don't feel done, not at all, but we just can't do it again, for so many reasons.
I am thinking of you every day.

delphi said...

I'm here and still reading, though the years have lessened the things I have to say. Waiting for good news.

Anonymous said...

Thinking of you Julia

erica said...

Having a good, kind, trustworthy medical team is invaluable, and I'm so glad you have these people on your side.

And - wow! - hoping hard for you that the induction (if needed) goes as well and safely as it possibly can.