On Tuesday morning I awoke from a bad dream in which this baby’s heart had stopped. It came out of the blue and shook me to my bones. I had been intending to cancel this Friday’s (today’s) upcoming ultrasound because it is so close to when I will see Dr. Braverman on Monday. The dream caused enough unrest for me not to follow through on the cancellation plan. I am going for ultrasound number three later today. The lump in my throat as I type those words is palpable.
On Wednesday morning I called my general practitioner’s office the second they opened to ask if I could pick up a copy of my ultrasound report from last Friday to send to Dr. Braverman (and to add to my binder of personal health records because that’s the kind of obsessive behaviour that turns my crank). After leaving a detailed message for my doctor’s amazing nurse/assistant and getting a clarifying phone call from a complete stranger who happens to be sitting at said nurse/assistant’s desk this week (hopefully because said nurse is on vacation), I spent the day waiting and waiting and waiting.
Mid-afternoon I left another message. Very late in the day I got an alarming call back. The stranger had spoken to my doctor who reportedly said:
* she didn’t think that weekly or biweekly ultrasounds were medically necessary (even though she never told me that when she requisitioned them for me on November 10, 2014);
* she remains concerned that our public health care provider may refuse to cover the costs of these ultrasounds and therefore they may not be insured services (presumably because they are not medically necessary in my doctor’s current opinion (?));
* she was not comfortable giving me any more of my personal health records without consulting the clinic’s medico-legal representatives; and
* I may have to complete some paperwork, wait and pay some money to obtain my records but my doctor and the stranger would not be able to tell me anything further until Thursday because the medico-legal people had left for the day.
To say I was upset and stressed out by this development is an understatement. To say the timing was terrible is trite. The tailspin and fury that followed ruined my evening and disrupted my sleep. Deep down, I felt abandoned by my doctor – the same doctor who has seen me through all but the very first of our eight pregnancy losses, the same doctor with whom I have shared both of my comprehensive immune diagnosis and monitoring reports from Dr. Braverman – and fearful that this is the kind of crap I will be facing throughout this pregnancy if we are fortunate enough to see it continue.
I raged against what I have come to behold as a hateful Canadian public health care system. The irony is not lost on me that the LP and I pay a disproportionately high amount for this abysmal system (clearly for others’ use of it since my own access to it has been thwarted at many turns and remains tenuous with respect to the current pregnancy apparently). Once again I found myself saying I would rather pay for private health insurance and have the option to truly choose my care providers and care than live here under this oppressive regime of sub-par care and doctors more concerned about getting paid for their services in a model that wants to refuse payment for anything that may not be “medically necessary” in their draconian view.
In case you fear l lost my mind and am now incarcerated because I brought an assault rifle to either my doctor’s or the public health provider’s office (because I contemplated it – do these people who mess with me at this point forget I am completely hormonal and jacked up on steroids?), there is – or may be, time will tell – a less unpleasant ending to this story than the above would suggest possible.
Yesterday the stranger from my doctor’s office called and said:
* I could pick up last Friday’s report;
* it was the last report my doctor would provide free of charge;
* my doctor had prepared a new requisition to replace the one she gave me on November 10, 2014 in which she instructed the sonography lab to fax a copy of all future reports to Dr. Braverman directly; and
* it is up to the labs whether they comply with this instruction. If they don’t I will have to call each time, pay a small fee for the reports and drive to pick up copies from my doctor’s office.
I don’t mind the small fee. I cannot erase from my memory and anxiety banks the comment that my doctor does not think these ultrasounds are medically necessary. I am still reeling from that and feeling very unsettled about the implications of this comment for my present and future care prospects here at home. I am left with a flurry of questions that – as evidenced by the time of this post – have woken and kept me up at night.
Has she put this in my chart? What else does she think is medically unnecessary? Did she even read the Braverman diagnostic and treatment reports? Does she even believe I have autoimmune conditions that have been responsible for much of our painful reproductive medical history? Will she be sharing her opinions with my ObGyn when she transfers my care to him if this pregnancy progresses?
Why can nothing – or seemingly little – on this journey for us be simple and free of unnecessary stress?
UPDATE: Today’s ultrasound went very well and offered some deeply appreciated reassurance. Baby was measuring ahead (8w4d) at 19.8 mm (I think – I was sneaking an unauthorized peek). That’s almost double from last Friday – the little one had a big growth spurt this past week! Her/his little heart was thumping along at 181 and 179 bpm. The little one also waved its itty bitty leg buds at me and showed off a big old cranium filled with a whole lot of invisible space at the moment.
My cervix is still long and closed (yay!) and I saw the very early stages of the placenta forming. The technician suspects it will be posterior (the Miracle Toddler had an anterior placenta) so that should be interesting if it comes to pass. I have no experience with this but I’ve read that one feels more and earlier movement and is less likely to suffer back labour with a posterior placenta. Sounds good to me!