Persistent Pain, I Hate You

I’m at the hospital. Labour and Delivery. Again. 

I am here to get this persistent and at times debilitating pain in my upper left abdomen, just below and behind my ribcage, checked out. I have not been able to sleep more than 30 to 60 minutes at a time the past several nights (and earlier today when I desperately tried napping) before the pain wakes me up. Tylenol does nothing for it. 

There is something about constant pain and sleep deprivation that ribs me of my emotional stability and repeatedly reduces me to tears or near-tears in a flash. I feel like a lousy parent because I can’t do much with the MT and have no energy or endurance when (understandably) he is frustrated and disappointed. He was so sweet today, playing by himself and picking me a gazillion dandelions to cheer me up (I am allergic to dandelions according to my last immunologist but whatever, these are still yellow and not spewing their pestilent pollen). I was looking forward to taking him out today. That did not happen. 

I’ve seen the Resident on duty (who is very kind and remembered me from my first of these three visits to L&D back at 20 weeks) and she has said she is not too sure what to do with me as the only risks from where this pain is are blood clot (not likely since I’m on Lovenox), lungs (they checked my oxygen saturation as step one to rule that out – it was 97% – and are waiting on ordering a chest X-ray as some radiation does pass to baby), spleen and otherwise musculature.  

In Chinese medicine the spleen channel is associated with excema around the eyes (the return of which about 5 weeks ago necessitated my going back on prednisone). I wonder if there is anything to that?

I have been poked and palpated (ouch!! on the left side), had blood drawn and expressed my reservation about the X-ray unless it’s strongly recommended. If platelets are low I will likely need an ultrasound to look at the spleen. The Resident said it is very unusual for a mom to develop a spleen issue during pregnancy, however. Not impossible but unlikely. May I not be the statistical minority once again (cholestasis, which led to the MT’s emergency induction, is also a rare occurrence). 

For now we wait and see. 
Being the mystery patient kind of sucks.  At the same time, I suppose it’s better than being told there is something seriously wrong. The Resident was reassuring as well, saying that since I’m almost 34 weeks now even if something requires that Azulito/a arrive earlier than scheduled, we may not even need steroids for baby’s lungs. 

The LP and MT have been waiting for me nearby but I can’t see them. I wish they were here in this sterile room with me. I miss them and I feel a little stupid for being here as the unexplained case (again).  

My nurse, while clearly skilled, is not pleasant.  I hate drawing the chilly nurse who leaves me feeling disbelieved, as though I am a hypochondriac of a pain-wimp (I’m neither). I don’t think people with that mindset or who exude they attitude should be in this profession (or at least should not work in L&D). If I were in charge…

Anyway.  Here I am.  In the hospital. Uncomfortable. Sleep deprived. And hating on this mystery pain in my upper left quadrant.  Curse you, pain. You suck. 

As I was about to sign off the Resident returned and said the OB on call (who did my lady D&C) said we need the chest X-ray to rule out a lung issue. The Resident gave me stats on the risk and I have signed the consent. Now I wait for that and the blood test results to come back. 

Meanwhile, Azulito/a has been busy busy busy. That is the good news in all of this. 

Fingers crossed that we get some answers and a way to let me sleep before this little person makes a long-awaited arrival. 

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As the Baby Turns – 32w1d and Counting

The fun continues!

Baby Azulito/a has officially turned into head-down position. That may be mostly pointless considering that unless this placenta previa and risk of placenta accreta situation resolves itself, I will be having surgery to deliver this baby but I understand that in Chinese Medicine having baby aligned vertically is important regardless of the delivery method so I’m counting this as a blessing. At least until the baby turns again (which could happen, the little one hasn’t been the most compliant with plans to date).

At yesterday’s OB appointment I was reminded that I’m at risk of having an emergency hysterectomy following the baby’s delivery if my imperfect placenta does not release from the wall of my uterus (or has invaded it, which can be difficult to determine on ultrasound with certainty, I’m told). I know that my OB has to make sure that I understand that this is a risk but I could have lived without the reminder. It is much easier not to worry about something when the last time it was mentioned is more than 3 months ago. The risk of this happening is not great – which is awesome – but the fact that it is a risk at all brings me to my knees every time I think about it. Plan: Do not think about it. And no visits to Dr. Google.

I have been coughing so hard from the respiratory flu I contracted (thank you, LP) a few weeks ago that I’ve pulled muscles and am now experiencing the equivalent of bruised ribs on both sides (worse on the left). This was confirmed by my OB yesterday as being just that and not something more serious, thankfully. Still, the coughing gets me up every night and has worn me out most days. My kingdom for some cough syrup or a good sedative.

I’m now 32 weeks which means about 5 weeks to go. Yesterday I discovered that the scheduled caesarean was mis-scheduled for almost 39 weeks. I felt and heard the panic in my voice as I challenged the date at my OB appointment. I barely contained myself from bursting into tears with my OB. He immediately acknowledged this was not in accordance with his instructions (his instructions were 37 or 37.5 weeks), said he’d have the surgery rescheduled and left a note on my chart instructing the staff to call me with the correct date. The risk of going to 39 weeks is stillbirth, of course, and my anxiety over that has been at an all-time high this past month so I really did not need that emotional kick in the cajones yesterday. I have yet to receive a phone call and I will be calling tomorrow if I have not heard by then. Call me distinctly unhappy about this hiccup.

In other news, I have our next follow-up and first biophysical profile (BPP) ultrasound with the Perinatology (Maternal Fetal Medicine) Clinic at our local women’s hospital later this morning (very soon, in fact). I am praying that baby Azulito/a passes that test with flying colours because more worries is something I can live without. I am also scheduled to speak with the Pediatric Urologist about those enlarged kidneys, what they could mean, how any medical issue with them might get diagnosed after delivery and what treatments could be required if they are not simply “large normal” or don’t resolve on their own as everyone hopes.

The LP is in trial today so I’m going it alone at these two medical appointments (same with yesterday’s little chat about placenta accreta, hysterectomy and messed up delivery dates). This is probably better for him in the sense that he is able to stress and worry less when he is not face-to-face with these realities but I do wish things were otherwise and he could be with me. My nerves feel jangled.

On that note and how to unjangle: Later today, I will be seeing an energy healer whom I’ve never met before. She’s trained in Reiki, Yuen Method and Trilotherapy. If any of you have experience with the latter two practices, I’d love to hear from you! My long-time TCMD and acupuncturist recommended I see this woman after I admitted to being at a breaking point last week emotionally from being sick with the flu, sick with morning sickness that has debilitated me despite the drugs lately, and being scared of this baby not making it out of me alive. She suggested it did not seem to be something physical in origin but energetic or spiritual. I’ve been warned that this healer is “a little out there”. We shall see. It cannot hurt. I hope.

Finally, tonight the LP and I are going on a date (!?!) to celebrate our fifth wedding anniversary. When we got married, I wanted to go to Italy and be married with two witnesses and nothing else. The LP wanted a big wedding. We did the latter and the deal was that by our 5th anniversary we’d make that trip to Italy that I wanted (I really wanted to get married on the Amalfi coast. Cliché perhaps, I know, but call me romantic and in need of an exotic honeymoon). Well, that’s not going to happen. This is our fifth and we are so in debt as a result of the past two and a half years of trying to have a second living child that a trip to Europe is out of the question. Maybe for our tenth?

It’s weird to think about the fact that we’ve been together for over 8 years… almost 9 years though officially only eight and a half… we have been through so much, suffered so many heartaches and heartbreaks. We each wear many scars from our prior lives and from the wounds that came with forging a life and trying to build a family together. I started trying to get pregnant before we were even married… wow. It has been a rather lengthy and complicated journey. Ten pregnancies later, here I am… praying that baby Azulito/a comes home in our arms, safe and sound, in another 5-ish weeks and celebrating five years of marriage to my soul mate.

Excuse me whilst I wipe away the tears.

It will be a busy day. Wish us luck. Please.

Revelations

It has been a while since I have updated, in part because nothing really eventful has been happening with this pregnancy – a blessing for which I am tremendously grateful – and because a great deal has been happening in the rest of my life.

 

My most recent ultrasound was almost two weeks ago at 25 weeks.  Baby was measuring on track and was estimated to be weighing in at 2 lbs 2 oz (give or take 5 oz).  For 25 weeks that sounded pretty good to me.  The technician spent considerable time trying to show me why it was not possible our baby has Spina Bifida. I wanted to tell him that I’ve moved on and did not welcome an opportunity to relive the stress that the positive screen for SB caused but I kept my mouth shut, mostly because I could see that he meant well and was trying to be reassuring.  He cross-examined me about why I was being monitored, however, compelling me to reconsider my compassion for his supposed good intentions. 

 

Why do technicians feel the need to grill me about my medical history and my understanding of why I am having extra ultrasounds when they have my chart and invariably say “yes, I read that” when I say we have had many pregnancy losses (8 in total and I hope that ends the count)?   This has happened to me four times during this pregnancy so far, all with different technicians (so it’s not just one sadistic creature doing this).  The second time I actually asked if the tech had read my chart.  She said yes, but she wanted to know what I understood.  Next time, I am not going to play this charade.  If you want to know why I am there, ask the referring physician and stop making me recount my medical history, my loss history, my immune issues and the issues with my placenta. It’s in the chart.  Read it, shut up and do your job.  

 

Funny, I did not realize how bitter I am about the cross-examination routine until I started describing it here.  At least now I know that it upsets me and I will be drawing a very clear, firm boundary should it happen again.  You hear that Universe?  Harumph!

 

Back to the medical update: The placenta is still located both in an anterior and posterior position which means the Placenta Previa diagnosis remains.  The tech thought maybe the placenta had moved but when he showed me where it was in relation to the cervix, it looked exactly the same to me and he was really guessing from reading my chart rather than comparing images from the prior scan to the one he was doing.  He also said that blood flow to the placenta does not change once it’s measured around 20 weeks (which is not true) so I am not putting much stock in his thoughts about the Previa issue when the OB reported it to remain an issue.

 

I am still on Prednisone but have weaned down to 7.5 mg and on Thursday I will drop down to 5 mg and next week Thursday to 2.5 mg.  I will be entirely Prednisone-free in two and a half weeks.  Yay!  I may have a sip of wine to celebrate!  I have three more Intralipid IV treatments and after that the only medication on which I will remain is Lovenox (enoxaparin sodium).  Yay!  I may have a second sip of wine after the Intralipid treatments are done.  You pregnancy purists, pretend you didn’t read that.  

 

As I hover over the threshold into the third trimester, I must confess that I am ready for this pregnancy to end.  Not soon – please do not let this baby come before 34 weeks, Universe, please – but when it ends (which won’t be after 37 weeks in any event).   This has been the single most stressful and exhausting period of my entire life (more stressful than trying to work, complete law school and visit/care for my dying mother; more stressful than articling while escaping a violent partner and rebuilding my life, more stressful and exhausting than the various traumas I experienced living abroad).  I read some of my blogging sisters’ musings about missing their babies being in their wombs or not wanting their pregnancies to end on one level and I feel both sad (because I think it evidences something I am clearly missing out on) and totally unable to relate.  

 

I do not want to come across as ungrateful.  Yeesh, writing that sentence alone made my eyes flood with tears.  I am more grateful than words could ever convey to have carried this baby as far as this and to hopefully be birthing this baby in the next couple of months.  I *love* feeling Azulito(a) kick and wriggle and perform Jujitsu inside of me.  That said, I would trade the in-my-tummy gymnastics for a healthy baby in my arms and an opportunity to get my body back, try to figure out my immune system and get it back onto some kind of healthy plane of existence again, and be on leave from work spending time with the Miracle Toddler and our new addition free from the current daily anxieties about everything that my crappy placenta and my zealous immune system could cause to go wrong with either baby or me, the aching hips and back and neck and shoulders and head, the daily blood pressure checks and injections, the crazy pregnancy dreams, the anxiety of being completely underproductive at work for reasons beyond my control, etcetera, etcetera, etcetera.  

 

As deeply grateful as I am, I have had enough of this roller coaster ride.  I will happily disembark when that time comes (which hopefully is not for at least 7 more weeks!).

 

In other news, the LP and I are in counseling (brought about in large part by the stress and other side effects that the last 2 years have caused). I am glad we are getting help.  I am not ready to blog about it here and may never choose to do that, but I am feeling good about this move and grateful that the LP is taking part voluntarily despite the fact that the issues we are examining dig to really deep, very challenging places in him.  I see this baby as having been and being a catalyst for tremendous change not only in me but in my marriage and in the LP.  The Miracle Toddler will also be facing great big changes soon and I hope he can find it within himself to still say “I love your baby, Mommy” then as he does now (though I will forgive him if from time to time that’s simply too much to ask of a toddler).  I suppose when I envisioned Azulito(a) communicating that s/he chose us because of something to do with “education”, I did not imagine the learning would be so profound this early.  At least I know I was not wrong in interpreting the message that way.  This most certainly has been an education.  And then some.  I have a feeling there is plenty of learning yet to unfold.

 

On that note, I want to thank each of you who read this blog for your support, interest, encouragement, love, kindness and – to those of you who share them, your words.  I will be forever grateful and hope that whatever I may bring to you is some compensation for the time and energy you have shared with me.  I wish you all the best, always.

Curveball #47: I “failed” the first test for Gestational Diabetes

Because life and this pregnancy have not mounted enough hurdles in my path yet, today I found out that I “failed” the GDM (Gestational Diabetes Mellitus) test I took last week as requisitioned by my MFM (maternal fetal medicine specialist). The cut-off for “normal” is 7.7 mmol/l. Anything equal to or greater than 11.0 results in an automatic diagnosis of GDM. Mine was 10.7. Not great.

I was uncharacteristically upset about this all morning. I have taken the previa and even the risk of placenta accreta diagnoses more-or-less in stride, but this GDM news had me throwing a pity party and angry with the Universe and God (why me? why now? why this? can’t you cut me a break for a few weeks here?). Things may not be as bad as I feel right now, apparently. I asked Dr. Braverman if he thinks there is any chance this could change (assuming I fail the second test, the fasting 2-hour test, this Thursday, which my Ob considered somewhat likely given I’m still on 40 mg of Prednisone until at least next week) assuming I can get off the steroids or remain stable immunologically on a lower dose (say 20 mg). He said that he’s not a fan of testing and treating GDM before 24 weeks as a firm diagnosis because many patients no longer have blood sugar metabolism issues after they stop Prednisone (which he aims for by 24 weeks if possible).

We saw my ObGyn for the first time this pregnancy this morning. He was awesome at its finest, being supportive of the work we’ve done with Dr. Braverman, explaining what the MFM wrote in her report on last Wednesday’s ultrasound, and generally discussing in a calm, non-alarmist fashion the pros and cons of everything we are doing to keep this pregnancy going and my health risks and those to baby as low as possible. He is always non-alarmist and never condescends to the LP and I, which I appreciate. Today was no exception. He said he will be doing his job and is comfortable letting Braverman call the shots on the immune meds front and to work with the MFM in any further recommendations she may have as she monitors baby and me going forward.

Do you hear that, Azulito/a? We have a team in place for you!

Even though my GP has not yet transferred my care so my OB’s nurse had to look up some of my test results and reports, I decided immediately after our appointment this morning to cancel my last scheduled appointment with my GP and say so long to the stress that is having to wrestle with her disbelief and exasperating “not medically necessary” nonsensical comments at each appointment. Hasta luego o casi nunca, doctora! There is a headache I can live without.

It is such a relief to have a team of doctors taking us seriously and all aiming for a common goal – to support me and this baby to be as safe and healthy as possible until the optimal time for Azulito/a to make her/his entrance into the world outside my womb.

In closing out this wee update, I want to give the Miracle Toddler and the LP a big shout-out.

The LP has been very loving and kind and trying hard to parent as a team with the novel challenges the Miracle Toddler has been mounting of late. Despite having four trials (one lasting over two months) scheduled in March through June and a crazy busy practice generally, he has come with me to all of the scary appointments lately. For this I am deeply grateful. Even if he says almost nothing, his presence lends me strength and a calm I dearly need (the irony of this is lost on most of you but given that the LP is one of the most highly-strung humans I have ever met, trust me when I say there is some irony in this).

The Miracle Toddler has made generous and heartfelt offerings of his own. He has moved me to tears (only rarely of frustration). His newest thing is to tell me multiple times every day that (a) he loves me (and his daddy); and (b) he loves this baby. When I talked to him on the phone from New York yesterday he said “is baby still in your tummy?” and “I love your baby” when I confirmed that baby was still there. I think he likes it when I tell him that I believe he will be the best big brother ever (in case anyone wants to challenge me for using hierarchical language, please note that as the MT’s mother I own without shame or reservation that I will – without hesitation – award him first place even if your kid is a more capable or equally loving sibling. In case you’re wondering, I would expect no less of you.). It melts my heart every time he says “I love your baby” and “I love you, Mom.”

And that, my friends, is enough to keep me going, potential GDM diagnosis and all of the other hiccups and messy stuff being what they may.

Yet Another Rant About Western Medical and Canadian Public Health Care Bureaucracy

On Thursday afternoon we had a follow-up detailed anatomy (anomaly) scan to last Wednesday’s emergency ultrasound intended to assess whether Azulito/a had any visible anatomical abnormalities that would confirm (or refute) the positive test result for alpha-fetoprotein I received last week Tuesday, indicating elevated risk of Spina Bifida or Anencephaly (or other open neural tube defect).

Thursday’s ultrasound was performed by Mary Poppins. Her pleasant bubbly nature is the only kind thing I can say about the entire experience. She started by asking me if I knew why I was there. Suppressing an urge to plant a fist in her throat and rip out a handful of the hair carefully tousled and tied atop her head, I responded with “You have not read my chart, have you?” as I heard the LP shuffle his feet in the chair at the foot of the examination table on which I was lying.

She assured me she had viewed my last ultrasound but that she liked “to hear from patients”. Trying not to roll my eyes and pinning my fists beneath me so as to avoid risk of assault charges, I recited in 7 seconds or less why we were there on Thursday and why we’d been there the week before. I did not get into the fact that this was pregnancy number 10 for us and that the LP and I suffer from what would surely be diagnosed as some form of ultrasound- and pregnancy-loss-induced post-traumatic stress disorder and could be just get on with it already and let me see what the hell she was looking at (she refused to let me see the screen until the end when I got to see the cutesy baby stuff that people who only get one or two ultrasounds always want to see).

I was upset, scared and angry. In my gut I immediately knew things were not going to go well before she even began the ultrasound. Things ended much worse than I could have expected. She refused to let us talk to the doctor, saying he was busy and needed time to compare last week’s report and images to this week’s. She said we had to wait for him to do that, write up his report, send it to our doctor and make time to speak with my doctor once she received the report.

My doctor is still off work sick (this is two weeks now – did she have a bloody breakdown or catch an infectious disease? For heaven’s sake already!). We went to her office immediately after being rebuffed at the ultrasound clinic. First available appointment with my (about to be fired) doctor is February 12, 2015. Perfect. Universe, are you kidding me?

As a child, I loved Mary Poppins. On Thursday, I wanted to pummel her.

To keep what could otherwise be a long story very short, we learned…. Well…. Nothing. Not entirely true. We learned that Azulito/a has adorable hands and feet. How delightful. Is my outrage and anxiety projecting itself between the lines here? I ask because it is leaping up like bile from my gut and lapping at the back of my teeth as I type this.

Don’t get me wrong, Azulito/a. I love your feet. And your hands. And your little button nose. I love everything about you and am doing everything I can to bring you safely into this world. But what I really wanted to know – what the LP and I really needed to hear was that at 18 weeks the doctor – not Mary Poppins – still could not see any abnormalities consistent with a finding of Spina Bifida or other open neural tube defect.

Mary Poppins not only refused to get the doctor for us to speak with. She refused to tell us how big Azulito/a was measuring so we would be able to assess if the growth was on track from last week in a desperate measure to draw assurance from anything she had scanned in the follow-up that the doctor had recommended. Her secrecy triggered many prior ultrasound experiences in which technicians have either acted evasive and refused to tell me or, when the LP has been with me, to tell us anything or the times when the technicians have outright lied to me (the best one being “I just need a moment to find the heartbeat we saw last time”. Yeah, that never actually happened and I knew the baby had died all the while she kept telling me that lie.)

The LP said “if she’d seen something she would have gotten the doctor” at first but I pointed out that with all of the complications we had with the Miracle Toddler’s pregnancy, not once did the technician ever let on a single issue – we were always blind-sided by the report when my doctor would go over it with me or us later. Upon recalling that, his anxiety level shot up, too. This was very different than last week when they were eager to comply with our (in my view, completely reasonable) request to speak to the doctor and the doctor was candid and forthright in saying the scan was earlier than they’d like, technically difficult and not perfect but did not reveal any abnormalities.

I want to believe everything is going to be okay or at least not fatal or near-disastrous. I truly do. But nothing about what happened on Thursday or what’s been going on in my mind since then is making that easy.

I am no stranger to the bureaucracy of our public health care system. I defended doctors in this regime against litigation and complaints for several years. I have hired and worked with doctors, nurses, others in the Western medical field as experts. I get the CYA protocol that underscores every move every professional makes. And that only makes me more anxious. Because everyone likes to share good news. The lips get sealed when the news is less revelatory.

In short, I am scared. And deeply enraged by the inhumanity of the system in which we are forced – because there is no alternative to the public health system where we live – to accept “care”. If I did not need these people as much as I do right now, I would be writing a scathing letter of complaint to the Colleges of each of the medical professionals by whom I feel utterly and repeatedly let down right now. But for now, that is not in the cards. I hope in time good news will overshadow the bad and I will let go of this outrage, hurt, silence, terror and anxiety and those complaints will go by the wayside.

I know, making them might improve things for others. That’s what my mother would say were she still alive. But I don’t need to be a crusader here. I am barely making it through each day when the stress levels are as high as they have been lately. Besides, I am not convinced another complaint or two or twenty-seven would make one lick of difference in the long run. Experience has taught me that is just not how those complaints work. The doctors and others who get them suffer momentarily, but their Colleges do nothing or next to nothing. And systemically, nothing changes.

And on that sour note, I end the hostile portion of this post.

Now on to something a little sweeter. A note to you, our dear baby. We love you, Azulito/a. Please be okay.

What is next? We attend the Perinatology Clinic next Wednesday, February 4th, for a Level II Ultrasound and to speak with one of the perinatologists there (I will not leave until that happens) about the positive screen, elevated aFP and whether that ultrasound and the ones this and last week suggest any neural tube problems. If so they will offer us amniocentesis. If not I hope this ends our current foray into yet another experience I would not wish on any expectant parent.

Some Good News to Start a New Week

This will be brief but much more upbeat than my last couple of posts.

Today’s ultrasound brought some much needed relief. Azulito/a is measuring a full week ahead, looking like a teeny person (except in 3d when s/he appears rather alien), and had a heart rate of 176 this morning.

I know we are not out of the woods but for today I am both deeply grateful and viscerally relieved. I hope that measuring big is not a sign of something bad I don’t know about (since I’ve always measured behind even in our one ultimately successful pregnancy). I’ve asked Dr. B to avoid any more unnecessary surprises but I truly hope his answer is along the lines of “of course not” rather than “only if it when…”

Thank you all so very much for your warmth, friendship, support, love and company. You really do make a difference.

Bureaucracy and Unnecessary Stress – Updated with Ultrasound Results

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?

Ugh.

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!