Category Archives: Doctors

Six Week Check-Up: A surprise and a chance encounter

At my 6 week check-up this week my O&G brought up the issue of contraception. His advice? Our chance of unassisted conception is so low that “if it was me, I wouldn’t bother with contraception”. Huh? Don’t get me wrong, I wasn’t honestly planning on starting the pill, messing about with condoms, or considering any other method to avoid pregnancy other than the inevitable exhaustion that comes with a new baby. But I expected my doctor to tow the party line and advise me that we should use contraception anyway. I was pleased on the one hand, but I discovered that I’m still not entirely immune to the sting from a reminder of our infertility. To be honest I guess I still haven’t entirely given up the hope of one day being able to give H the news of a genuinely surprise pregnancy, rather than us both knowing weeks in advance the exact hour I’ll be peeing on a stick.

After my check-up I went to the post-office, carrying Will in a sling. Behind me stood a pleasant woman in a burka, who admired Will and told me how lucky I was. I recognised that edge in her voice and didn’t want to her feel like she was the only woman in the world to whom motherhood didn’t come easily. Before I could decide whether or not to allude to the circumstances of Will’s conception, this conservative-looking woman standing in the middle of a very busy post office told me that she was about to undergo her second round of IVF. Maybe she just needed to get it off her chest – I myself have suffered from a pathological need to share information about our struggle to conceive – or maybe she too sensed that we had something in common. In either case, it gave me the opening to say that the baby she was admiring had been conceived with the help of fertility treatments and to sincerely wish her luck at the conclusion of our conversation.

I will probably never see this woman again, but I will always wonder if she achieved her dream.

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39 Weeks and 4 Days

I had my OB appointment yesterday – and still no news to share. The baby seems to be growing exponentially, and I must admit that I am a little concerned about how big this bub will be if I go over my due date. I really don’t want this 4 Kg baby to become a 4.5 Kg baby! I’m sure that is all thanks to my 6 foot 7 inch husband. However, the doc seems to think that the baby is in proportion to my height and is doesn’t think it should be an issue getting Bert out the old-fashioned way.

I asked the doc whether he thought labour was still far away because I’m not having any significant contractions and haven’t had a show but he feels that it’s totally irrelevant. It could be today, it could be in two weeks (gasp). At most it’s 13 days away because if I haven’t gone into labour by 10 days post dates he will induce me (or earlier if my blood pressure gets high, the baby gets too big, or the placenta isn’t working optimally). Thirteen days seems like a lifetime and I’m really hoping for a natural labour sometime in the next week – but we’ll all just have to wait and see. Ideally, like most women, I’m keen to avoid induction if possible. My mother had two children, both inductions, both of which became c-sections. Here’s hoping that history does not repeat!

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Update: nothing to update!

We had our 38 week check up today and everything is going well. The doc didn’t do an internal examination so I still have no idea if I’m dilated at all which is a little bit frustrating for someone like me who likes to be fully armed with information at all times. I’m being philosophical about being in the dark though because I know that having that information would not actually make it any easier to predict when Bert will arrive. As H says, he’ll come when he’s ready.

The plan is to switch all the bedroom furniture around tomorrow which means that on Thursday I’ll be able to finish setting up the nursery. Our doc isn’t on call over this coming weekend, so unless Bert chooses to arrive Friday, I’m hoping he’ll hold off until Monday! I have a feeling that he’s pretty content in there and won’t be making an appearance before his due date on the 30th. The silver lining of that is that our doc is on call the weekend I’m actually due, so if I go into labour any time between 5 days before and 6 days after my due date I’m fairly certain to get my own doctor for the delivery.

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Getting to Know My Couch

It is disgraceful that I’ve been home on leave for more than two weeks and still haven’t written a post about how I ended up on leave earlier than planned. Bad blogger!

I turned 30 on September 20th. In an unusually fortuitous piece of rostering, I had a four-day weekend over my birthday. In an even more surprising turn of events, H had the same four days off work. THIS NEVER HAPPENS. Fours days off, together, and over my birthday? Unbelievable.

I had a lovely weekend, filled with several birthday celebrations, including my first surprise party (which I truly did not see coming – I am thoroughly gullible). Lovely H went to a lot of effort including decorating with balloons and streamers, which is not something my macho husband has done before. My girlfriends totally spoiled me with not one but two girls-only birthday events. It was wonderful.

The downside was that I was physically much more active than I should have been. I knew that I was pushing my limits, but darn it, I’m only going to turn 30 once and I was determined to make the most of it! Work had already become a struggle – the 10 hour shifts, spent largely on my feet with lots of bending and moving, were pretty difficult on my pelvis. I was truly dreading returning to work on the Wednesday afternoon after my long weekend.

Luckily I didn’t have to!

I had my 34 week OB appointment on Wednesday morning. The moment my doc saw me waddling and wincing my way into his office he flat-out banned me from returning to work. I have to admit that I felt hugely relieved. I’d been dreaming of taking early leave ever since my pelvic instability was diagnosed, but to be honest I felt too guilty. I was rostered to work up until 36 weeks, and I guess I didn’t want to feel like I was wimping out and leaving my colleagues in the lurch. Having the doctor take the decision out of my hands took all of the pressure off me. I went into work after my appointment and was able to tell them that, rather than not coping with work, I wasn’t allowed to work. (And the added benefit is that the extra time off was sick leave rather than coming out of my maternity leave).

I quickly realised that there was simply no way I would have coped with the 80 hours of work I had been rostered to work over the 10 days following my appointment. After my birthday weekend and several weeks of powering-on through work when I really should have been taking it easy my body simply gave up. I spent the first 3 days in bed or on the couch, sleeping frequently, and infrequently painfully hobbling to the kitchen or bathroom. I felt truly disgusting. I’d been ‘keeping-on keeping-on’ for weeks, and now that I had the chance to rest, my body went on strike.

The good news is that after that much-needed period of rest I did regain a little mobility. I’m still in pain every day, but it is mostly manageable and I’m sleeping well enough at night that I rarely need an afternoon nap. I do spent a fair amount of time getting to know my couch while reading or watching DVDs, but to be honest on some days I really enjoy the enforced laziness. Although I am only allowed to use the 5 stairs to our front door once a day, that does allow me a few trips to a friend’s place, the movies, or out for a meal. With the silver lining being that I have totally given up all responsibility for vacuuming and taking the rubbish out!

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Mini-Drama, Part Three

I have been a little tardy updating you all about my Cardiology appointment – I’ve had a busy few days.

I saw the Cardiologist on Thursday, and just like my other doctors he was lovely!

The basic conclusion he came to is that I’m probably having a reactive tachycardia – that is, my heart rate is getting high as a reaction to, well, something, but that my heart is conducting properly. Because we haven’t been able to catch an episode on ECG he can’t be sure that it’s not a true arrhythmia like SVT (supraventricular tachycardia) which occurs because the heart is conducting electricity through aberrant channels.

When I saw him I had been episode-free for almost a week, and he didn’t think I needed an echo or a 24 hour monitor, but he did want me to try to catch any further episodes on the ECG (if I was at work). On Saturday my rate went up to 150 again, but despite getting an ECG within about 6 or 7 minutes my rate had returned to (almost) normal. Today my heart rate was 120 – 125 for most of the afternoon – but I was too busy to get an ECG. I do think that being at work is a risk factor – I’m pretty frantic most of the time! – but my rate did also seem a little fast lying in bed last night. However I couldn’t be bothered getting out of bed to get my watch and check my actual rate!

I did fax the ECG from Saturday to the Cardiologist, and he called me today but I missed the call. I’ seeing my OB tomorrow so I’ll discuss it with him, but to honest I’m not too worried… the idea of being referred for more appointments or investigations is more stressful than putting up with the slight discomfort that the episodes cause!

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My Morning of Medical Mayhem

After H picked me up from work I had a couple of hours at home to try to relax before heading into the hospital for my endocrinology appointment. Of course the first thing I did was wax my underarms in case I ended up scoring another ECG! Unfortunately H had a very important event on at work so he headed off early and I lay on the couch trying to stay calm and obsessively checking my heart rate.

At about 9 I headed into the city and called my obstetrician’s office on the way. They assured me that I should just come into the office whenever I had finished with my earlier appointment and my OB would see me.

I arrived at the hospital and luckily H was able to leave work to join me. There was lots of waiting… first to see my Endocrinologist, then to get my blood taken, and then to get my visual fields tested. The good news is that my endocrinologist isn’t too worried about my prolactin level. He explained that last year at a major endocrinology conference there was a session on this exact topic – how to manage pituitary microadenomas during pregnancy. Apparently there was a lot of controversy even amongst the experts but the final guidelines were that a PRL up to 4500 is acceptable (I’m only 100 above this) and that the most important investigation is visual field testing. My visual fields were normal – which effectively means that even if my adenoma has grown, it hasn’t grown enough to affect my optic nerve, which would be the sign that we needed to take further action. I’m very relieved about this because I suspect that “further action” would mean having to deliver me early and then either taking some pretty serious drugs or facing brain surgery – all things I’d quite like to avoid, thank you!

I go back this Wednesday to see him and get the results of my blood tests. Assuming all is well he probably won’t need to see me again during the pregnancy. Once the baby is born we might do another MRI just to sneak a peek at the cheeky little adenoma and obviously I’ll need to keep getting my PRL levels checked regularly but I can handle that.

I just need to say how much I appreciate having great doctors. I implicitly trust my GP and she hasn’t put a foot wrong with any of the specialists she has referred me to. My endocrinologist made a point of phoning my OB while I was there to discuss the plan and all the recent research. They also discussed my heart rate issues and agreed on what they thought would be the next best step to investigate that. After the phone call my endocrinologist commented on what a nice fellow my OB was!

And that was my next stop. After waiting in the endo clinic waiting room, pathology waiting room, and ophthalmology waiting room I headed to the adjoining hospital where my OB is based and waited in his waiting room. Thankfully we didn’t have to wait long – he saw us only about 20 minutes after we arrived, which is pretty great considering we didn’t officially have an appointment. In terms of the baby everything was great – perfect heart beat, measuring well, in the head down position, and we even got a (very brief) peek at him via ultrasound. While I was there my heart rate was fine and my BP (although a little higher than usual) was certainly within the acceptable range. We had a talk about my heart rate and discussed a few options. In the end he referred me to a cardiologist. I’ve been banned from any exercise until then, and he gave me a medical certificate because he didn’t want me working that night. I have to say I was relieved about that because after spending half the day at the hospital I wouldn’t have had much time for sleep. AND… because that shift was due to be my last for the week, I now have no more night-shifts left to work during the pregnancy! Woohoo!!!!

So, Part Three in this mini-drama will be posted at the end of next week, after I have seen the Cardiologist. Fingers crossed that all is well!

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Adding to my list of Specialists

For a (relatively) healthy and (relatively) young person, I have quite a long list of medical specialists. First there is my Endocrinologist, then my Fertility Specialist, and then my Obstetrician and Gynaecologist.

And now I can add a Cardiologist to the list.

Those of you who follow me on Twitter will have seen that I had a bit of drama on my night-shift in the early hours of Wednesday morning.

The dramas actually started during the night-shift before – which was night five of seven in a row. I think I have mentioned before that I work in an Emergency Department. I’ve recently moved back to my home base from a different hospital where I have been seconded for 6 months. My base hospital is walking distance from home and better staffed, so I was expecting this, my final week of night shift, to be easier on my mind and body than my last few sets.

Thanks to not having to drive and a slightly later start time, I was certainly getting more sleep. The pace was less frantic and there was usually time for a brief break during the shift (quite a novelty!) but I was finding myself just as exhausted, if not more so.

In the early hours of Tuesday morning I noticed that I was getting short of breath just standing up and talking. I wandered over to the nearest pulse oximeter machine and popped the probe on my finger to check the oxygen levels in my blood. My oxygen saturation were fine at 99 to 100% but I was surprised to see that my heart rate was between 120 and 130 beats per minute. I sat down to rest for a few minutes and rechecked my heart rate. It was slower but still between 105 and 110 which I thought seemed a little high but in the end I just disregarded it and went back to work – after all, heart rates do go up in pregnancy.

At about 4am the following morning a similar thing happened, but the symptoms were more pronounced. Probably since about 18 weeks of pregnancy I have occasionally been aware of a pounding heart – nothing that I would have described as palpitations, but just an awareness of my heart pounding. My heart rate always felt regular and not particularly fast so I attributed the sensation (probably quite rightly) to the fact that my heart was pumping an extra 2 litres of blood around my body compared to pre-pregnancy. However on Wednesday morning I felt decidedly off.  I had the same sensation of shortness of breath as the previous morning, to the point that I felt uncomfortable speaking in full sentences. I also felt very tight in my chest and my heart was really hammering. I put the probe on again and what do you know – my heart rate was 150! There was no way I could put that down to a normal physiological response to pregnancy. Like a nutcase, I kept on working. Within a few minutes I became very hot and started seeing spots. I went outside into the freezing air for a few minutes (which felt great) and then found a seat inside and sat down. It was 4.15 and I decided to text my dad to ask his opinion. It was 6.15 in New Zealand and I figured there was at least a 50-50 chance he was already awake.

His opinion: No this was not normal and I needed an ECG immediately and medication to slow my heart if it didn’t resolve in the next thirty minutes.

So feeling embarrassed and a little foolish I found my boss and told him what was going on. And that is how I ended up in a cubicle at work, naked from the waist up, getting an ECG. As I mentioned on Twitter, the worst part was that my underarms were due for a wax! I also had to provide a pee sample because my blood pressure was quite high (150 and I’m usually around 110). Thankfully there was only a trace of protein in my urine and my BP came back down to 130 with some rest – I’ sure it was elevated due to my anxiety. I lay on my trolley thinking about Egg and telling myself to “be Zen, be Zen”, and it did see to help my blood pressure! Thanks for the inspiration Egg!

By the time I got my ECG my heart rate was back down to 105 and looked perfectly normal (except for being slightly fast). In the end I called H to come at pick me up and take me home. I had my appointment with my Endocrinologist at 9.45 that morning and the plan was to get an emergency appointment with my Ob while I was there.

Coming up….

“My Morning of Medical Mayhem”

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