37 weeks 4 days

Just a quickie. Yeah, no, not really.

I would really recommend reading all three parts of Murgdan's birth story over at Conceive This! (link at right). It is remarkable. I'm writing this in a semi-rage.

Her story made me want to post about some things I've been avoiding writing about. It's the way that I feel that I've been treated as a patient at my clinic. Why have I been hesitant to discuss it? Because I have this hang up about whining. I mean my own whining, not the whining of others, which I usually feel is totally justified. I feel guilty about complaining about any aspect of this experience because I worked so hard to get here. And then there's the guilt about those that had to work even harder to get here. The guilt about those who never do. There are worse experiences in life.

I do realize that I am more critical than the typical patient because I am a nurse practitioner. I practice in a different specialty, but I know how patients should be treated. While my annoyances have been minor, after reading Murgdan's tale, I now see what the potential consequences of my "easy-going" personality, and I cannot let this put me or my family at risk. I also realize that "easy-going" for me actually means "afraid to ask for what I want or need because I don't want to make people angry". Screw that!

We've known for a while that the boys would have to be delivered via c-section because of their positions, whether planned or unplanned. I've come to terms with the reality that I will not likely experience a natural birth ever, ever. This is fine. I am content, and frankly, knowing the exact days of conception and birth is a control freak's wet dream. I'm glad to know it will most likely go smoothly. I really expect it to be a mellow, calm affair. However, one phrase from nursing school keeps ringing in my mind: "forget the birth plan, because it sets patients up for failure". So here I am, with what appears to be a simple plan, with that phrase ringing in my ears and with my subtle distrust of my care providers...what's a girl to do? All of that and knowing that c-sections aren't great for anyone unless they are needed...and I'm in the category that needs one...arrrgghhh. It makes me want to cry.

So what's been so annoying? Trivial stuff. They've forgotten that I'm a healthcare provider. They've forgotten that I had IVF at their very clinic. I've only seen my assigned doctor 3 times. I only saw him the 3rd time because I politely said to the nurse, who is another issue, "am I seeing Dr. R today?" I'm scheduled to see him and then someone else always walks in. I'm considered a high risk patient, but things have been going so well that I have been treated like the boring patient that I really, and thankfully, am. I know this is okay from a clinical perspective, but from a patient care perspective, it sucks. I should not have been assigned to the high risk clinic automatically. Also, they should have told me every time that I wasn't seeing the provider I was scheduled with. We do this at our clinic, and I'm really proud. I have been tested for syphilis 4 times in the past 2 years. Ready? I don't have syphilis!!! Save the system some freakin' money! They use the wrong sized blood pressure cuff. The nurse calls me "cinnamon" which makes me think she can't read. When she calls it out into a crowded waiting room, I say loudly for all to hear, "that's NOT my name". Patients will find a way to get back at you... She put my 12 weeks pregnant weight as my pre-pregnancy weight, which makes me worried that no one cares that I've gained 80 pounds. The due date is off by 3 days (they have one that is 3 days later) which I've brought up several times because I'm worried that they are going to wait too long to take them out. The boys' weight discrepancy doesn't seem to be an issue for them, but they should have noticed that it is for me because I've asked about it so many times. None of these things is that important, right? But it makes me distrustful, and that is important.

So, I've been practicing not expecting too much and trying not to fear these people. I know, as a clinician, that they can get babies out and help them if they need it. As a clinician I have access to more information than a typical patient, so I know that there is no reason to take healthy twins prior to 38 weeks, even though a quick Goog search would lead you to believe otherwise. (it lead me to believe it all this time, until I delved deeper when I was in an insomniac panic about them being inside of me too long because no one would listen to me about the due date and I read the actual studies). The other lie that the Goog tells is that twins are "more mature" at earlier gestational ages, there is no evidence to back this up. It was disproven. Premies are premies, near-termers are near-termers. I just want them here for selfish reasons. I figured out that the docs don't care that I will be 38 weeks 5 days, just that I will be in my 38th week. As a lactation consultant, I want 38 weekers, because 37 weekers often have trouble at breast. So, I hang onto these things to make myself trust.

So what is the consequence of feeling a little distrustful? I'm going to lie to get another ultrasound. I've suggested and requested and have been rejected for what I feel are inadequate reasons. I really want another growth scan. My research says it's warranted and I'm tired of them doing things to me that are really not needed in spite of me saying no, yet not getting things that may be needed because I'm just a patient making a suggestion (as a healthcare provider, I know these games go on all of the time, the ignore and pat the patient on the back game)(I've been told that patients like me because I explain everything to them, pros, cons, sometimes taking their suggestions, sometimes not, but always telling them why and never treating them like they don't know what they are talking about even when they really, really don't and I'm glad). It's really frustrating to be treated like you don't know anything when you have the same degree that your provider does. So at our non-stress test on Tuesday, I'm going to tell them that I think baby A turned head down...and hey! Why don't we check their estimated weights while we're at it? I think it will work. Sick, but I need to know if smaller twin is okay to make it to June 7 because I am his mother.

Courtesy. Reading the chart. Treating patients like individuals. Making sure patients never feel brushed off. Notice the patient or at least pretend to. Make sure at least one person in the clinic knows the patient's entire story and that the patient knows you talk to that person. Simple lessons I've taken to heart.

What other lesson? I'll be polite when I have to, but not when I don't have to. Politeness for politeness sake? Bah! No one has to like me.

Now I will wallow in the guilt of complaining. Bah!!!