Like pulling teeth…

I think everyone knows by now that I used to be a journalist. A big part of that job is doing research and really just being “in the know”. I like being in the know. That was one of my favorite parts of the job. You have no idea how excited I would get when an e-mail from the governor’s office would come to my inbox informing me that he would be in Bakersfield and I knew before most people in Bakersfield.

So now that I’m not doing that anymore it doesn’t mean that my desire to know what is going on in the world has diminished at all. This is especially true of my body. I mean why else do you think I’m reading tons of pregnancy books?

Yesterday I decided to call my OB’s office so I could get my lab results from my last thyroid check. I didn’t want to push the whole issue with the midwife with the receptionist on the phone so I just said that I had been doing research into my two conditions (HG and hyperthyroidism) and that I wanted to know what my levels were so I could compare them to what I had found.

Nurse/Receptionist: “You’re not doing research on the Internet are you?”
(Which meant I had to lie more… I’m not a fan of lying.)
Me: “No… well… sort of. There’s a research foundation for what I have and they have a lot of information and studies on their website and I wanted to compare my lab results with the studies on their site (which is true, the HER website has lots of good information and I have wanted to compare my stuff to their studies). I also have a couple pregnancy and medical books with information.”
Nurse: “Well, OK. I guess we can send you the information. Do you want it by mail?”
Me: “Yes, that would be fine.”
Nurse: “OK, well let me get your phone number so I can give it to them in case they have any problems with this.”

Any problems with this? This is my lab work. I’m entitled to be able to look at the results by California law. Why in the heck does this have to be such a process? I think everyone should get copies of their lab work afterwards. We should be informed about what is going on with our bodies. Our primary care doctor always tells Stephen where his TSH levels are at for his thyroid disorder. Why am I not allowed to know mine?

Well anyway, this morning I get a call from my OB’s personal nurse.

Nurse: “Why is it that you want the results?”
Me: “I’ve been doing research and I want to compare my TSH levels to other people that have been studied with my condition.”
Nurse: “Compare to other people… Hmm… OK, well I need you to come in and sign a document release form. Can you do that?”
Me: “Yes, that’s fine.”
Nurse: “OK well I’ll have the paperwork ready for you and then get permission from the doctor to release this information.”
Me: “That’s fine.”

Five minutes later I get another call.

Nurse: “The doctor wants to know if you’re still feeling nauseaus.”
Me: “Yes.”
Nurse: “OK, hold on a second.”

Next thing I know I’m being tranferred to my doctor. We proceed to have a very pleasant conversation about my condition.

OB: “So how is the nausea for you lately? Well, actually I’m mainly concerned about the vomitting.”
Me: “It’s OK. I still throw up about once or twice a week and I feel nauseaus off and on most days.”
OB: “Well we could up your PTU dosage if you want. We still have some room to increase it without affecting the baby at this point. You might see some relief from the symptoms if we do that. However, I’m really comfortable with the dosage you are at now because it is a very low dosage and decreases the risks to the baby.”
Me: “Yeah, it’s not too bad. I am eating regular meals about three times a day though and getting in plenty of fluids.”
OB: “OK I feel comfortable with that caloric intake. If you really wanted to we could still up the PTU, but I’d rather not if you can deal with your symptoms. Your TSH levels are at .04, so that is still in the low range, but it is at least detectable at this point. Before the PTU your levels were not even detectable.”
Me: “Oh, OK well that’s good to know. I just wanted to know what the levels were at. I’m pretty much able to manage my symptoms by taking Phenergan at night too. The Zofran was great when I was really sick, but now I don’t like the Zofran because I really feel like it just stops up my whole digestive system. The only real side effect of the Phenergan is that it makes me sleepy, but if I take it at night I’m going to sleep anyway so it isn’t a big deal.”
OB: “You could also use a pill cutter and cut the Phenergan in half to get a lower dose during the day if you wanted which would reduce the side effects.”
Me: “OK, well that’s good to know. Well thanks for talking to me. I just wanted to know what my levels were at and be informed.”
OB: “Being an informed patient is good. I like that you take an active role in your health. How do you want us to get you the information? Do you want us to fax it or mail it or can you come in to get it.”
Me: “Oh well, since you just told me what the levels were on the phone I don’t need you to waste paper. I just wanted to know what they were and now I know. So thanks.”
OB: “Alright, well we’ll see you soon. Looks like you have an appointment next week.”
Me: “Yep. See you then.”

Anyway, called our midwife and let her know the levels. She said that she didn’t have her diagnostic book right in front of her, but knew from the research she had done that my levels seemed to be in a good place and also didn’t recommend me increasing my PTU dosage. She said she’d call me back this afternoon after she had a chance to look over some information. She said she’d discussed it with the other midwives in town and there shouldn’t be any restrictions for me having a homebirth.

Also, I talked to her yesterday about some of the fears that were instilled in us by the nurse at Stephen’s work. Well prior to that I did some research too.

Fear #1: Post-partum hemorrhage
Research on the subject said…
-Almost all cases are caused by doctors pulling out the placenta instead of letting it be delivered naturally.
-Bloodwork ahead of time can show if your blood is less likely to clot. If that is the case, there are supplements you can take to help.
-Midwives have all the same first response stuff that they would use in a hospital and are trained to deal with this situation.
-Breastfeeding right away helps your body naturally release some hormones that tell it to stop the bleeding (which is not always a normal hospital practice).

Then I confirmed with our midwife that she carries the same two drugs that the hospital would use to stop the bleeding and that she knows how to deal with it. She also carries oxygen.

Fear #2: HG going wacky during labor
I asked on the HG message board about HG and labor. For some women they did throw up during labor and for others they felt better than they had the whole pregnancy. So there didn’t seem to be a correlation between having HG and how you felt in labor. There are also several women with HG on different message board I’m on that is more about natural family living. These ladies all said that I should make sure my midwife has the stuff for IVs and that I should just take my nausea meds if I do feel nauseaus. I wanted to get their opinion because they are much more pro-home birth than most of the people on the HG board.

So I checked this with the midwife and she said she does carry and is trained in IV stuff, but if she has a patient that is at the point where they are so dehydrated they need an IV started that she would probably recommend transport to the hospital at that point. She also said it would be fine for me to take my prescription nausea meds and that it wouldn’t interfere with labor/delivery.

I also decided that I wasn’t going to research every possible thing that could go wrong. I don’t want to scare myself. I just decided to go back to the idea and empowerment that I’ve gotten from reading everything that I have which is that birth is a natural process, God designed women’s bodies to do this, and the midwifery model of care has been proven in countless studies to have better outcomes. I also decided to stick with the initial instinct that I had after our meeting with the midwife which was “that this is what I wanted to do, that it would be completely safe and she was the right person to be with me through the whole process.”

So I think you know by now what my decision is.


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