Thursday, March 4, 2010

The Voice of Doom

I need to find a new Primary Care Physician, or at least actually see my PCP versus making due with the nurse practitioner.  I am convinced that the NP I currently make appointments with sees only doom and gloom--even with the most benign of symptoms.  

Up to this point the NP has 1) lost the results of a pap smear (curse you!!), 2) implied infidelity on the part of my husband, and 3) in general been a bit unprofessional (in case you couldn't pick that out from point 2).  I, however, am obviously a creature of habit and a bit of a sadist, because I keep coming back for more poor treatment.  I seem to be too lazy to research other options and go through all that initial paperwork hassle.

Recently, I made an appointment for a non-pregnancy, non-critical,  blood test.  On Monday, I met with the NP to talk about the lab results.  Instead of talking about the lab results I had scheduled and in which I was interested, the NP started in on my iron level results.  Supposedly, I had an outstanding order (at least 9 months old) for blood work to check my iron levels (back in my pre-pregnancy days when I was being treated for anemia) and so they had ran tests for that as well (even though it was unnecessary and unasked for).

The results of the iron blood work was this: I was seriously, seriously anemic.  At death's door anemic.  The kind of anemia that would result in me needing a blood transfusion after labor and delivery.  The NP was very, very grave.  Had no one been checking my iron levels, she asked.  Who was my OB?  On learning that I was seeing a midwife, a look of disapproval and incredulity appeared on her visage.  Did I not realize the seriousness of this?

NP: This is very, very serious. It is very important that your midwife be aware of how critically low your iron levels are.  You must start iron supplements right away, but it probably won't help much since you are so near the end of your pregnancy.  It takes 6 months at least to correct for low iron levels.

You can only imagine my reaction.  Who cared about the other lab results (which were inconclusive incidentally.  Nor did she know what the next steps should be) when obviously my baby and I were at such risk?  I spent the evening bemoaning the fact that I would be risked out of a birth center birth and that I would instead have to deliver at a hospital where I would be subjected to all sorts of medical interventions.  Mr. F. made valiant attempts to talk me off the cliff by suggesting that I wait to worry until I could actually talk to the midwife (which happened to be the next day).  I think though that it is impossible to talk sense to a scared, pregnant woman.      

I approached my midwife appointment the next day with extreme trepidation.  I handed them the lab results and with a voice devoid of all hope, asked them what their thoughts were.   

Midwife: Oh, these results aren't too bad. 
Lady Susan: What!?
Midwife: Pregnant women often show something we call pseudoanemia.  Pregnant woman have increased blood flow with an increase in plasma, so it will appear as if you are anemic when you really aren't.
Lady Susan: *stunned silence*
Midwife: Sure, if you were a normal, non-pregnant woman or even a man, these levels might be quite low, but we see levels like these all the time in our field.
Lady Susan: So I won't get risked out of the birth center?
Midwife: With these levels? No.  Normally, we don't check iron levels after 28 weeks if the results show that your levels are o.k., which yours did.  However, since now they are a touch lower (and for all we know this could be completely normal), we will just supplement with an iron pill and double check your levels in about a week to make sure they are still o.k.
Lady Susan: *exhales a sigh of relief*

So, I guess baby and I are not in danger of  bleeding to death and needing emergency blood transfusions.  Or at least it is impossible to tell at this point in the game.  Instead, my body is responding like a typical woman in the last month of her pregnancy.  Which brings me to a point.  There seems to be two type of medical professionals: those who think that your body is broken unless proven otherwise, and those who think your body is perfectly normal unless strong evidence to the contrary.  The NP seems to belong in the former while my midwives are from the latter school of thought.  So, obviously, I need to find a new PCP.  One who doesn't relish in being the Voice of Doom.


Carol said...

I agree with your analysis on the two types of medical professionals...and it is definitely more fun to see those in class 2. I miss my family practitioner from Pullman. He always calmed me down when I came in freaked out about something...and in your first pregnancy, just about anything freaks you out. (or at least it did to me.) :)

Ange said...

From what my dr. has said your midwife is correct. You should be just fine:)

Janssen said...

That is so ludicrous. What a nut that NP is.


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