Sunday, December 27, 2009

Doctors & Nurses

Doctors & Nurses

She came to me on Christmas Eve, much like Jacob Marley (who I think technically called on the 23rd)—my favorite nurse, (we’ll call her “Marleyanne”).  She’s the one who gives the knitting lessons. 

She stood at the foot of my bed and her voice lowered.

“During your stay, one of the doctors will give you the option of going home.  Don’t take it.”

Huh?  What?  Really?  Why?

And then she was gone.

“You’re better off in here than you are out there,” the nurses keep telling me.  Which is exactly what Karen Hill says to Henry in the movie Goodfellas when she’s visiting him in prison.

“Karen, Karen!  They can whack me in here just as easily as they can out there!  Maybe even easier.”  Then he convinces her to keep smuggling him Quaaludes and salami and promises to never see his mistress again.

But I digress.

So who was this doctor?  Initially I thought Nurse Marleyanne was talking about the on-call doctor we saw the first night.  We’ll call him “Dr. Spaceman” ala 30 Rock (pronounced “spa-chem-en”). 

If you’ve never seen the show 30 Rock, Dr. Spaceman is the Hollywood doctor who says wacky things like, “Science is whatever we want it to be!” and “Would you like some [pills] before you go?  I’ve got reds, blues, purples.”

Our Dr. Spaceman said things like “I don’t see why you need to have a C-section just because the umbilical cords might get entangled.  You’ll want an epidural of course, because I might have to reach in and grab the second one.”  And then he made this very startling extended reaching and pulling gesture.

He said some interesting things, too (that actually made sense).  Like, “more monitoring isn’t necessarily better.  The more you look, the more you find and a lot of that stuff is meaningless.  But it usually leads to more interventions and all interventions carry risks.”

But Dr. Spaceman isn’t part of the High Risk Perinatal group that treats me.  That means Nurse Marleyanne was talking about someone else.

I knew she wasn’t talking about Dr. Q.  Dr. Q. worked Christmas Eve and Christmas.  

I like Dr. Q.  All the nurses do, too.  But Dr. Q. is recommending that I go to the Labor and Delivery ward at 26 weeks for 24/7 monitoring of the twins.  This is in the event that if an umbilical cord gets crimped, the monitors should catch it right away.  If the cord is truly crimped, then the doctors will have about 6 minutes to do an emergency C-section and pull out the babies. 

A crimped umbilical cord is the single element that makes the MonoMono twin situation a DEFCON 4 pregnancy.  It is not inevitable that a cord will get crimped, in fact, it is very likely that it will never happen.  But it is also not predictable or preventable and no one can promise that it won’t happen, just as no one can promise that you will never get in a car accident. 

Going to L&D is a big deal.  And going at 26 weeks, (especially if I am trying to hold out until 35 weeks) will be a miserable ordeal.  It means that I will be in a labor bed (terribly uncomfortable) even though I will never go into labor.  It means that every time the monitor can’t pick up one of the twins, someone will come in and adjust the ultrasound.  Keep in mind that right now I get monitored twice a day.  The twins are so small and move around so much that of every hour of monitoring, there are probably only twenty good minutes of both twins’ heartbeats. 

When I talk to the nurses, they all smile say the same thing.  “Dr. Q?  Oh, he’s great.”  When I tell them of his recommendation, they get very silent, purse their lips and drift back from me a little bit.  “It’s not respite,” they all say in a very low you-didn’t-hear-it-from-me voice.  Once, when two nurses were adjusting the ultrasound, chasing the Red Baby, one nurse said to the other (as if I weren’t there), “Dr. Q wants her to go to L&D next week.”  The other nurse looked down at me and said, “No sleep.”

So that’s the word from Dr. Q.  He has gently recommended that I talk to the neo-natalogist from the NICU (it’s a pediatrician for preemies) and each time she has come down I have sent her back up again.  One excuse was that I was tired.  Another time I said I wanted my husband to be here with me, as he would have more questions.  The third time she tried I said that I didn’t feel comfortable talking about this in front of Chiara (all true).  She tried her best to pretend not to look offended but still give the message that she had been put out.

I told Dr. Q, “I don’t want to see what a 24 week preemie looks like.  To me it’s like looking at a car wreck; it’s not going to help me be a safer driver.”

Dr. Q. nodded and half smiled and said, “Some people just want to know what they might be in for.”

“I’ll go back in a few weeks and see what a 28 week preemie looks like.  But not now.”

Of course my favorite doctor is Dr. Strawberry.  She was the first doctor I saw when I got here.  I hadn’t been admitted yet, but I had been on the monitors, so the first thing she did was take off her shoes and crawl onto the bed next to me.  After handing me a “favorite toy” and giving me a big hug, and she took the elastic belts and carefully laid them along my belly.

“Here are your ribbons, Miss Janine,” she said as she gently patted my leg.  “Everything’s going to be just fine, Miss Janine.  You’re going to be just fine.”

Unfortunately, “Dr. Strawberry,” as she calls herself, isn’t very qualified.  She’s barely in preschool and this is only her second trip into a hospital since she left one wrapped in a blanket nearly three years ago.  But she has a great bedside manner.  Unless she doesn’t get her nap.  Then she’s kinda cranky.

There are other doctors, but if I told you about them now, what would you read tomorrow?

© 2010 Janine Kovac 

2 comments:

  1. You Bryans and the movie references! Seriously, I expect you to weave in SNL or Disney in the next post... :)

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  2. I want to feel so sorry for you but you keep making me laugh too much! You are being faced with so many decisions. I, for one, hate making decisions (especially when high stakes are involved). But I do believe your mother's intuition is in super high gear and no one--not even the high risk defcon doctor knows more about your body than you do. Do not for a minute to allow a spirit of fear to rule. You started this pregnancy confident and I know you can hang on to it for the duration. You are doing great. The babies are doing great. And what is it with Baby Bs? Mine was always shoving her way into her sisters BPP. She remains a bit of a show off to this day.

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