Saturday, January 8, 2011

The Bad and The Ugly

I've already shared a lot of The Good about Jack's birth - and most of it was good - but now that I've had three weeks (and while I have two arms) to process all of it, I want to tell you some of the bad and the ugly.

I am a Bad Patient.  I know quite a bit, for a non-medical person, about medicine.  I question EVERYTHING, not to be a pain in the ass (although it does tend to have that side effect), but because I truly want and need to understand what's being done to me and my kids and why.  I believe that it's my responsibility to be my own advocate, and my family's advocate, when it comes to health care.  I know mistakes are made - doctors and nurses are human, after all - and I feel that the buck stops here when it comes to our health.  I have a long history of pissing off doctors and nurses, but ultimately I believe that BJ and I have made excellent decisions for our family. 

One of those decisions is that we refuse the Hepatitis B shot at birth.  As I told the nurses, "My kids aren't allowed to use IV drugs or have unprotected sex until they're at least 3 months old, so they can get that later at the doctor's office."  I got a couple eye-rolls out of that one, but no one gave me too much crap.

The crap started when the baby's nurse checked some chart and said, "He's large for his gestational age, so we need to check his blood sugar." 

"Oh?  What are you going to do if it's low?" I asked.

"Well, we'll give him some formula."

"No, you won't," I replied, "So you might as well not stick him."

I had just given birth an hour or so before this all happened, so my recollection is a bit fuzzy, but we argued about it.  I'm pretty sure I told her, "Yeah, the excuse with my oldest was that she was too small and she needed formula.  Now she's perfectly healthy and very tall for her age, and I ended up nursing her for 28 months."  I probably also mentioned the baby born in Mexico City right before an earthquake, who survived for EIGHT DAYS without food and water before being found, as an illustration of the fact that the baby was perfectly capable of surviving for a couple of days on colostrum until my milk came in.  In the end, I'm pretty sure I said, "If my doctor would like to come in and have a look at him (it was 3 am at this point), and if he thinks that something looks WRONG, then we'll intervene, but I don't see any reason to do anything at this point - he looks perfectly healthy and comfortable to me."

The nurse didn't like me much, at this point. 

So the baby's nurse left and got back up - she brought in the NICU nurse to tell me that I was an idiot (nicely, of course, with a smile on her face).  I restated my point (that I wasn't going to give him formula, so there was no reason to stick him), and she said that he might need IV fluids if I refused formula.  I again said that if we were going to do something that drastic, it would be after the doctor looked at him and said there was a problem.  Not before.

All through this, my poor mom, once a La Leche League Leader and fellow person-who-dislikes-taking-crap-from-medical-professionals was practically chewing through her tongue to keep herself from jumping in.  I was really proud of her for letting BJ and me handle it - I know it was hard for her.  If I had to watch Mary Grace, an hour after she'd just done something as hard as giving birth, get bullied like that, I don't know if I could keep my mouth shut.  I'm sure she wanted to go full Mama Grizzly on them, and we aren't even republicans, but she held back and waited until the nurse was out of the room before she gave me a big "Atta girl!" and told me that I was right.  (Good job, Mom!)

Then the baby's nurse wanted to do all the standard after-birth stuff.  As I did with both of the girls, I refused the antibiotic eye gunk.  They give it to babies because of sexually transmitted diseases that cause blindness, and while I understand that there might be women out there who could have chlamydia or gonorrhea and not know about it, I know that I am not one of them.  Neither of my other kids are blind. 

This time the nurse flat-out lied to me.  "It's not just to protect against STDs, it also prevents against e-coli and stuff.  You know, the area down there isn't exactly sterile."

My head almost exploded.  I wish I'd said, "I don't know about your area, sister, but mine is plenty clean enough, thank you very much!"  Besides, the erythromycin they use, according to my dad the nurse, isn't even effective against e-coli. 

Once again, the NICU people (two this time) had to come tell me, with a smile, what a profoundly dumb idea it was to refuse their standard procedures.  And once again, I listened to them and said, "Yes, I understand, and I still don't want the eye gunk."

In the end, we had to sign a bunch of forms saying, essentially, "We know we're idiots and we aren't going to hold the hospital responsible when our kid is blind and has low blood sugar," or something.

If I had been a first-time mom, I totally would have caved the first time they brought in the NICU nurse.  The implied threat is clear, "Do what we say, or your kid's going to end up in the NICU."  It would have made a lot more sense if they'd brought in the head nurse in charge of the mother and baby unit, but that isn't nearly as scary as saying, "NICU," or even "e-coli."  They completely took advantage of the fact that I was tired (it was 2 - 4 am when all this was happening), hurt (I'd just given birth!), and vulnerable to try to get me to do what they wanted.

Now, granted, I don't think they wanted to harm Jack - quite the opposite.  I agree that for many children, in many situations, the interventions they wanted to make would have been appropriate.  I'm sure that the eye gunk has saved many kids' vision, and that routine blood sugar checks have probably helped some children - but I did not believe that they were appropriate in our particular circumstances, and they really tried everything they could think of to undermine our right to direct the medical care of our own child.  I'm not a fan of doing things without a reason.  Since Jack wasn't showing signs of low blood sugar, and because I know that I don't have any STDs, and since I know how Hepatitis B is transmitted, there was no reason to do the things they wanted to do. 

By the way, our midwife and our doctor, who know us much better than the nurses we'd just met that night (our midwife has treated me since before the pregnancy, and we've been seeing our family doctor since 2003) agreed that there was no reason to do those things, as I knew they would.

And, lest you think I'm inflexible and I don't ever listen, I should tell you a story about a time when I initially refused something and then changed my mind when it was explained to me.  After I had MG, the nurse said, "I'll put this ice pack in your panties..." and I said, "Like hell you will!"  All I could think of was Flick from the movie The Christmas Story.  "Stuck.  Stuck!  STUCK! STUCK!!  STUCK!!!"  Well, once the nurse promised me that that wouldn't happen, I consented to the ice pack, and everything was just fine.  (Why is it that NONE of the books I read about pregnancy and birth mentioned the ice pack??)

The only other annoying thing that happened was that I had to stay in the hospital until Sunday (I went in Thursday) because my blood pressure stayed worryingly high.  On Saturday night BJ called me from home (he had gone home to help his mom with getting the girls to bed) with a couple crises - Mary Grace had a rash that he thought might be scarlet fever again, and the power was going out.  It turned out that the rash was because I had forgotten to tell Grandmother Diana that MG and bubble baths don't mix. 

The electricity was a slightly bigger problem - when we put the new siding on the back of the house our friend Jim came over and loosened the electrical connections so that we could slide the old siding out and slide the new stuff behind all the pieces that are fixed to the house, then he came back and reattached it all once we put up the new siding.  Well, something got knocked loose or something was old - I don't know exactly - but whatever the reason, the result was that the power would kind of randomly go off when the wind blew.  BJ went out there, like Fonzie, and banged on the side of the house to get it back on.  I was worried that it would go out in the night and his poor mother would be out there in the snow banging on the house, so I said, "Maybe you should stay home."

"No," BJ replied, "I need to be there with you.  It'll be ok.  I'll call Jim."

Well, we got a hold of Jim and that was all fine, he came over and fixed it, but I was still worried about Diana and the kids.  I figured that I had an entire staff of hospital personnel to help me, while she would be all by herself if BJ came back to the hospital.  Then I got smart.  "I know," I thought.  "I'll have the nurse take my blood pressure, and when it's 120/70 or something great, I'll be able to call BJ and say, 'see, I'm fine, stay there!' with greater authority."  So I called the nurse and the aide came in and took my blood pressure.

It was 160/100.

I don't know if you know anything about blood pressure, but that's BAD.

She waited a few minutes, then took it again.  159/98. 

So much for my plan.

The aide left me there, panicking in the dark, while she went to find my nurse.  I think my nurse was in Canada somewhere, because she was gone a long time.  The longer she was gone, the more I freaked out.  I actually decided that the best course of action was to lay with my finger hovering over the call button, so that if I had a seizure I had a chance of hitting the button before I croaked.

It never occurred to me that they wouldn't have left me alone if they thought I was going to die.

Then I remembered that my dad is a cardiac nurse, so I called him at work (in the middle of a crisis, not a code, but someone was trying to get out of bed or something, and he really couldn't talk right then).  He reassured me that while I would probably die of heart disease eventually, it wouldn't be that night even if my pressure was that high, and to just chill and he'd call me right back. 

My poor dad.  I wonder, if he'd been a shoe salesman instead of a nurse if I'd still be a hypochondriac.

So the nurse finally showed up after 40 minutes, and I said, "I know my pressure's going to be high because I've been lying here alone in the dark thinking I was going to die for the last 40 minutes!"  She apologized and took it again.  Still high.  We waited, and she took it again.  Still high.

"I'm going to try the one on the wall," she said.  The old-school analog machine, as opposed to the automated digital one they'd been using.

It was 120/70.

The *&@^ing machine they'd been taking my BP on all weekend was broken.  I could've gone home Friday if we'd known.

"I wondered why everyone had high blood pressure this week!" the nurse said.


And now, as Paul Harvey would say, you know the rest of the story!


Julie said...

Way to go, Amy! GOOD for YOU! And way to go, Amy's Mom, for not shoving her boot up some nurse's backside. Just THINKING of some nurse bullying Katie that way made my blood pressure rise.

Want my explanation for their behavior? (You'll notice I didn't use the word "excuse".)

Considering what I see every day on Judge Judy, "16 and Pregnant", and the news, idiots continue to breed at an alarming rate. Not knowing that you are, of course, freakishly smart, as is your husband, these nurses just assume that EVERY new mother is dumber than drain hair. They assume that they can get by with the same crap they give the teen moms (hello, herpes... hello, eye gunk) and mothers who aren't smart enough to figure out breastfeeding (hello, 16 and Pregnant... hello, formula). It's the fault of the Lowest Common Denominator. They spoil hospital practices for the rest of us, who are actually intelligent enough to care for our newborn babies without being bossed around.

I remember a nurse telling me that Austin needed formula because I was so beat up after he was born. I also remember the pissy look on her face when I said, "Like hell!" I also remember the millions of papers I had to sign when I refused to stay in the cardiac wing of the hospital because they wouldn't let Katie room in with me when I was diagnosed with PPCM. I was going to DIE if I didn't stay in the hospital and take every medication they tried to feed to me. Yet, eight years later, here I am. Awfully cute for a corpse.

Ah, the Medical Establishment. As we say in the south... bless their little ol' hearts.

But I digress. As always, YOU ROCK!

Samantha Uphold said...

((hugs)) to you and your new beautiful baby! Way to go standing up for yourself. :)

Heidi said...

Gee, and I thought I was brave for standing up (well, sitting up) and refusing the room across from the ice machine. I'd had it with my second kid and knew I would get NO sleep, so I (somewhat) politely refused. I'd never seen a nurse turn purple before... but I got a better room! You go girl!