Difference of Opinion

My new OB/GYN and I are having a serious difference of opinion. She thinks I am totally nuts, and I can't bring myself to agree with her. To understand this unfortunate disagreement, you'll need a little bit of Lois history. For those of you new to the ups and downs of the Hogan family, allow me to do a quick refresher of what my pregnancy with Lois was like. It's an action packed story full of heros and villians, with the same person sometimes playing both roles. Those of you who lived through this serene and joyful (*cough) period of my life have permission to skip to the end. I think, like me, you probably don't want to relive those dark days.

The story begins with the world's best OB/GYN, my friend Dr. A in Christiansburg. Dr. A was my hero - having guided me through 2 miscarriages and a mucocelle tumor in my appendix that proved difficult to diagnose. When I became pregnant with Lois, she made it her mission to help me avoid the overwhelming anxiety she knew threatened to swallow me whole. She did an ultrasound of Lois every week from 6 weeks until I reached the magic 12 week mark when I could relax and allow myself to believe I was actually going to have a baby. Dr. A would be worthy of a "10" on my medical doctor rating scale, but for this one unfortunate conversation we had. When it came time to discuss prenatal testing, I told her I wasn't interested. I'm not going to say she talked me into it - but her arguments were convincing and I trusted her implicitly. So at exactly 12 weeks gestation, I walked into Dr. Dickhead's office for a nuchal translucency test, where my bubble of pregnancy giddiness got a serious popping.

This prenatal test may be new to some of you. It involves measuring the skin at the back of the baby's neck at 11-14 weeks gestation. Normal measurements are anything up to 2 mm. Lois's neck was off the charts with a whopping 5.9mm. So what does that mean? Well, at that point of your pregnancy about all they can tell you is that your kid has a fat neck - which could mean LOTS of things - including certain death. I was back at Dr. Dickhead's office a week later because he feared Lois had developed something called Hydrops Fatalis. (When a condition has the word"fatal" in it's name, it's time for a full on panic). Lois never developed Hydrops, but there was still no answer as to why her neck was huge - except that the risk of Lois having some kind of chromosomal abnormality was very high. We were told she had a 1 in 3 chance of having Down Syndrome, which went in one ear and out the other. It was her risk of the more serious trisomies - the fatal ones - that scared me to death. And I lived in mortal fear for the next 6 weeks that she would quietly die before our next ultrasound.

At 18 weeks, I was back with my "main man" Dr. D for an amniocentesis - but after a totally normal level II ultrasound, I declined. All seemed normal - except for the ever present fat neck. She showed no signs - they're called soft markers - of any chromosomal abnormality of any kind. Not even Down Syndrome, the sneaky little thing. It was at this appointment - when I refused to have the amnio - that Dr. Dickhead gave me his infamous "she'll be a burden to society" line. I hated his guts that day. I left there thinking I would never have to see him again. and I'm pretty sure I even announced that to him in the middle of the hallway. When the door to his clinic shut behind me that day, I think I took my first deep breath in 6 weeks.

Fast forward about 4 weeks, and guess where I ended up? Back with the Dickmeister. Dr. A. couldn't get past Lois's fat neck, and didn't like it that I was happily going along thinking everything was normal. So she sent me back to Roanoke to see his royal poopiness. He did the first of what would end up being a neverending battery of Biophysical Profiles (BPP). It's really just a detailed ultrasound where they look at numerous facets of fetal "wellbeing" - kind of like an Apgar test in utero. Lois always got 10 out of 10. But the blood flow through her umbilical cord was a bit wonky. So I'd leave the office with a scheduled follow up appointment for a week later. And a week later, Lois would get a 10 out of 10, the blood flow would look weird, and I'd schedule another follow up. Keep in mind, this doctor I'm seeing makes my skin crawl. I had to resist the urge to punch him in the face at every appointment.

And then came the fateful day when Dr. Dickhead left on a two week vacation, and Lois's biophysical profile score came back as a 2. Thank goodness Jay was with me. They sent me straight to the hospital, and when I got there, a team of nurses and doctors were prepared to deliver Lois on the spot. This was at 31 weeks. Scary stuff, people. She was only half baked. I kept imagining chocolate chip cookies taken out of the oven 5 minutes too soon. Not a pretty picture. By the time they had prepped me for a C-section, given me a nasty injection of steroids to bulk up Lois's lungs, and made sure Jay wasn't beating me (??), Lois decided to get her act together and scored a 10 on her next BPP. Crisis averted. But now the questions started. What was going on with Lois to make her score a 2? Should I be hospitalized and monitored? Sent home? And my doctor, the one who should be making these decisions, was jumping off of cliffs in Montana.

For the next two days they monitored Lois's heartbeat, performed BPPs every day, and generally sat around with their thumbs up their butts. They didn't know what to do with me, and Dr. Dickhead was AWOL in the Sierra Nevadas. Lois continued to score well on the BPPs, but she wasn't moving much, and her heart rate would sometimes inexplicably slow down- a deceleration or D-cell. For some reason, they let me go home on a Wednesday with a scheduled follow up appointment on Friday. Thankfully, my Mom had come to help us - and we spent that Thursday shopping and having a nice lunch out. But the seed that had been planted in my mind at 12 weeks - that something was terribly wrong with my child - had been given a large dose of fertilizer. I was beyond scared. I hadn't felt Lois move at all that day. And when Jay came home I literally fell into his arms and cried like I'd never cried before.

On Friday, we went for a non-stress test. They strap a belt on your gut and monitor the baby's heart rate and movements. Lois wasn't moving. They gave me a soda to drink. Lois didn't move. They gave me another soda. Nothing. They held a contraption to my belly that made a loud noise to wake Lois up. Guess what? Nothing. I remember feeling like I couldn't get up. I was paralyzed with fear.

Once again, I'm rushing to the hospital and when I arrive and they start monitoring Lois, she's decided it might be OK to move a little. (This stubborn streak has followed her into toddlerhood, I'm afraid.) But they admit me, and tell me it looks like I'll be there until it's time to deliver Lois - possibly 7 weeks. I spend my days and nights strapped to 2 monitors that track her heartrate and contractions, an oxygen mask, an IV constantly running fluids into me, and these delightful booties on my feet to simulate walking so I don't develop a clot. Keep in mind, I'm 33 weeks pregnant and have to pee every 10 minutes. And all the while, Lois's heart rate continues to take unexplained dips - that seem to be getting longer and longer. That sometimes result in nurses rushing into my room in the middle of the night and throwing me onto my side. And my doctor continues to vacation.

One night my cheese completely slid off my cracker and I jumped up out of bed and starting tearing monitors off of me - I was going home. I couldn't take it anymore. Thankfully, Jay was beside me and stopped me from ripping out my IV and storming off in my hospital gown. Frankly friends, it wasn't one of my finer moments. But I think we can all only take so much before we reach our breaking point. I was done. An emotional wreck. The fat lady was singing.

Somehow Jay picked up my cheese and got it back on the cracker. But as he left for work the next morning, he left a sniveling pile of bones behind him. I've said it before, I'm NOT a crier - but that morning I could do nothing but cry. My ultrasound tech friend arrived to do Lois's 500th BPP and as we were making idle chit chat, she was suddenly called away. When she returned, it was with the news that a woman had arrived at the hospital - 33 weeks pregnant like I was - and they couldn't find the baby's heart beat. To say that was sobering news, is an understatement. I stopped crying that morning - and didn't cry again until I heard Lois's first cry as she entered the world.

Dr. Stinkface returned from his vacation on a Monday, and on Tuesday found the time to visit me in the hospital. She was born that night at 8:01pm by Cesarean. He saw the tracings of her heart and made the decision to deliver her. She was 7 weeks premature, but totally healthy - with a few minor exceptions which we'll save for another post. The reason she stopped moving? The reason her heart rate kept slowing down? The reason the blood flow through her umbilical cord was odd? No one knows. It's a total mystery what went on in my uterus. Sure wish Lois could tell us.

I was in constant communication with Dr. A during this entire debacle - although she was back in Blacksburg and unable to be my official doctor anymore. She called me shortly after Lois's arrival to say congratulations - and to tell me that regardless of how I felt about him, Dr. Dickhead had saved Lois's life. If he hadn't been monitoring her closely, Lois would have quietly died - as I feared she might. And the woman that arrived in the emergency room with no fetal heart beat would have been me. To this day, the thought of that can bring me to my knees.

And now we've come to the present day and the little disagreement between me and my current OB/GYN (who's rating is falling further and further down the scale as we speak). I had a lousy experience being pregnant with Lois. I can't honestly say I spent a single day of that pregnancy free of fear. So being pregnant again has been difficult for me, emotionally. Don't get me wrong, I can't wait for the little guy to get here. But tell me how I'm supposed to fully surrender myself to the notion that this pregnancy will be different?

So far it's a text book pregnancy. Generic. Normal. But how do I know that whatever caused Lois to FREAK OUT at 31 weeks isn't going to happen again? I don't. And so I can feel the fear starting to creep back in. I'm always on high alert to notice his movements. And if a few hours pass and I haven't felt anything? I can almost feel the cheese starting to tilt on the cracker's edge.

So at my last appointment with my new OB/GYN, I mentioned these concerns. Her conclusion? I have "issues." That's a direct quote. ( I asked her if she had written that in my file as a diagnosis.) Here are a few more highlights from our conversation:

"I'm obviously not going to be able to convince you to not have anxiety about this."

"Lois came 7 weeks early because she is genetically abnormal."

"I have no reason to monitor this baby."

(That old urge to punch a doctor in the face is returning. I'm still working on a nasty nickname for her. That always seems to help.)

So she thinks I'm nuts. And I think I'm just desperate to bring a second healthy child into the world. I'm not asking to have weekly ultrasounds - weekly BPPs - be placed on bed rest for the next 3 months (although that doesn't sound TOO bad). I just want to know that if I sense a decrease in movement, she will investigate it and not pat me on the head and send me home with a juice box and a kick count chart. It's obvious to me that this woman had 2 normal, run of the mill pregnancies. Because I think if she had ever been as close as I had to losing her child, she'd lend me a more compassionate ear. When you end up on the wrong side of the odds, you never again ask yourself - Why me? Because you know the real question is - Why NOT me?

Yes, my friends. I should find a new doctor. But I'm thinking that maybe I'll stick with her and let her keep Dr. Dickhead company at the bottom of the scale. He's been lonely.

Exciting Lois news and new pictures to follow in the next few days....stay tuned.