Friday, October 13, 2006

Where to begin?

I have to apologize (once again) for not updating this in a more timely fashion, but I have spent this week either lounging about the house, hoping I wouldn't bleed any more, or else rushing off to one darned HMO appointment after another. Including the infamous "phantom appointment," which was by far the most annoying of the lot.

On Tuesday, I was supposed to go in for an ultrasound in the Medical Imaging department (ordered for me by my female doc on Friday when she had trouble finding the second twin), but I woke up that morning and toddled off to the john, as usual, only to discover a disconcerting amount of blood. Of course, any blood disconcerts me these days. In point of fact, there was probably less than a teaspoon there, but then, it was bright red. So I called and re-scheduled the appointment for Thursday at 11:20, and took myself back to bed for the morning. After three hours of reading the paper and being bored, I got back up, and voila! no more blood. Good enough, I decided. (I did have just a tiny bit more bleeding late that same evening, but it was so little that it hardly seemed worth mentioning.)

That day, I also got a phone call from the HMO informing me I had flunked my one-hour blood glucose test. (What I get for not studying, I guess!) The upper limit was supposed to be 139, and mine came in at 156. So I was slated for the three-hour version, which involves fasting overnight, having a blood draw, then drinking the Orange Drink of Doom (ODOD) and having blood draws at one, two, and three hours. (Are you counting? That's four sticks in my vulnerable little arms.) You're also not allowed to leave the premises, since excess activity might invalidate the numbers. Joy, joy. I decided I'd do that on Thursday, and just get it and the ultrasound out of the way all at once.

In between, I sulked. Reading up on gestational diabetes left me certain I'll be forced to cut out most of the foods I think of as "recreational." No more sweets -- ice cream, vanilla malts (waaaaah!), that lovely dense and gooey lemon bread from Trader Joe's, Mentos, warm blackberry pie a la mode -- and perhaps worst of all, fruit. I love fruit. I have been popping green grapes during this pregnancy like they were about to be discontinued. Not to mention the beautiful golden pears from our pear tree. And what about our yummy cherry tomatoes?! Oh, no! They're loaded with sugar, and here in northern California, our bushes are still producing in abundance. Waaaah, indeed.

On Wednesday, I made a tactical error and called Nurse Completely Useless (you see she's been promoted) to ask about the bleeding. The female doc on Friday had said to "let them know" if I had any bleeding or pain, so I was following instructions. Nurse Useless was out, so I left a message, but we connected by cell phone on Thursday morning, while I was lounging around in the lobby of the HMO during my three-hour glucose test.

The worst thing about the glucose test was, frankly, getting up early enough to shoehorn it in before my 11:20 u/s. But I managed that feat, then submitted my arm for puncturing and manfully drank the ODOD. I was trying find a comfortable position on my chair, and also trying to get interested in Robert Penn Warren's ALL THE KING'S MEN (which is slow going in the first chapter), when Nurse Useless called. I told her what the doc had said about reporting bleeding. Useless's interpretation of that was that if I had bleeding, I should call in and make an appointment for that day, and come in as soon as possible.

Meekly, I mentioned that that Dr. Enterprise had told me that the best thing to do about minor bleeding was to get horizontal immediately, and of course monitor it to see if it continues. I pointed out that hopping in the car and running up to the HMO (not a short trip since we're on the other side of town) was not exactly getting horizontal.

If Nurse Useless blogs somewhere, she has now labeled me as "Patient Annoys the Crap Out of Me." She immediately got testy, and wanted to know why I had called her if I knew better than her? Of course, I had called because she told me to call if I had any questions, way back when we first met. (I'll bet she's rueing that now!) But I began wondering the same thing, really -- why I bother to call this woman. I think I'll be making most of my own appointments from now on, and calling someone else for advice.

In any case, the three hours of my test went by with no further interruption, and ALL THE KING'S MEN turns out to be a pretty good yarn. It's framed as a story of Southern politics in the 1930's, but it's actually a meditation on what it means to be a person. (That sounds wretched, doesn't it? But the first-person narrator, a smart-ass who has Failed to Live Up to Expectations, is very interesting.) At 10:20, I dutifully chugged my 16 oz of water, and at 11:20, freed at last from the clutches of the glucose test, I waddled over to Medical Imaging for the u/s.

They had no record of an appointment for me on that day.

They did have an appointment for me on the previous day, Wednesday, at the same time, and then my 19w u/s on Nov. 13. But nothing for Thursday.

Let me remind you that although I had just power-snarfed a package of peanut butter crackers, I had had nothing else in my belly since the night before but a fizzy orange drink and a lot of water. And I'm a cranky preggo lady. I was loaded for bear.

The very young lady at the desk (with a stud! in! her! lip! Ouch!) was apologetic but insistant: no, I didn't have an appointment. And I had missed the one the day before, she pointed out reproachfully. I knew beyond a certainty that I had never made one for Wednesday, but finally allowed as how -- possibly -- I had not made the one I thought for Thursday. Maybe. I didn't have my notes with me, so I finally chalked it all up to placenta brain and made another appointment for the following day (grrrrr!).

As a reward for not going postal on the young lady with a stud, I stopped on the way home for a Whopper with cheese, and placated the voice in my head telling me that white bread isn't good for glucose levels by taking the top bun off and eating the Whopper open-face (still very tasty!). At home, I had barely walked through the door when the phone rang. It was the young lady with a stud, telling me she had made an appointment for me for the u/s for that afternoon at one o'clock and could I please come back in? (It was by then 12:30.)

And then I did explode. NO!! NO, I could NOT turn right around and come back up there for an ultrasound that I should have had this morning, ESPECIALLY when I had already made an appointment for the next day! (I never did find out what in her little pea-brain made her think this was a good idea.) I hung up on her and discovered that she had left ten calls and hang-ups on my answering machine, trying to get me to come back up there that day. I still have no idea what that was all about. But I was further incensed when I looked up my notes and found, written very neatly, my booked appointment for Thursday, Oct. 12 at 11:20. Just as I had told them. And I believe myself rather than them, since I had not written just "Thursday," nor just "Oct. 12," but both of them together, something I rarely do unless someone else reads it off to me that way.


Exhausted, I decided to take a nap -- and was awakened twice by phone calls from various departments of the HMO. After giving up on the nap as a bad job, I decided to try and clarify the whole bleeding thing (as in, what I'm supposed to do if I start again) by calling the HMO's Advice Line. The RN there told me that after the first trimester, protocol for bleeding of any kind was to see a doctor. Well, I said naively, I'm going to have an ultrasound tomorrow so that should take care of that, right?


A little while later, I got yet another call from the HMO -- this from Nurse C, who I've dealt with before. Nurse C is actually quite nice, has a good head on her shoulders, and has a slightly jaundiced view of her employer (which I've come to appreciate more and more lately). The Advice Line nurse had apparently ratted me out to her, and she was tasked with trying to get me in to see a doctor. Protocol, she said, called for me to see one of the so-called "high risk" doctors, but Dr. Blinky wasn't available. So she tried to pawn off one of the other high risk doctors on me-- yes, a male whom I didn't know. (As you may recall if you've read my other posts, I have an extreme aversion to hopping up on the table and flashing my cooter for male doctors that I'm not well acquainted with.)

I just lost it. I had had ALL I WANTED of my HMO by that time in the day. And that was the last straw. I told her so in no uncertain terms, and to Nurse C's credit, she handled it very diplomatically. She finally got me to agree to see a female doctor (one I hadn't seen before, but at least not a male), and she agreed with me that it was totally ridiculous that there isn't one female doctor on their high risk team. She also pointed out that Dr. Blinky has a lot to say about who gets hired around there, so if I felt like putting a flea in his ear about that, she wouldn't try and stop me.

Darn it. I hate it when people are quiet and reasonable at me. It's like fighting Play Doh. We left it at that -- I thought -- except that half an hour later, who else should call, but Dr. Blinky himself?

I thought he was going to give me grief, but we actually had quite a good conversation. We discussed my aversion to flashing the old cooter for strange males (and no, I didn't put it quite like that), and he went above and beyond what I expected by saying that as far as he was concerned, there was no reason in the world why I couldn't have the female doc that I saw on Friday as my primary OB, with him on the sidelines to consult as necessary. I told him that Nurse Useless had said I couldn't have her, since she was part-time. He told me that "part time" is a relative thing when it comes to OB's. He said that your average full-time OB puts in 80 hours a week, and the average "part time" OB puts in 50 hours a week.

I have to say, the man is good. I went from spitting nails to actually having sympathy for Dr. Blinky and Co. I mean, after all, who would want to be an OB these days? Hours like that, patients who want to take your head off, or sue you for the least little thing, and who needs the grief?

We left it at that ... and I'm going to leave it at that for tonight, since I have just started spotting a tiny bit, so it's probably time to toodle off to bed. As for what happened today: It was much better all around, and I found out that the babies are doing just fine. (Yayyyyy!!!) More on that tomorrow.


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