Medicine

On Thursday I went to the OB to get my sutures out, and ended up being admitted. Surprise, surprise! There was a little infected material at the surface of my incision. Because it was around the sutures, she felt that there were two possibilities:

It could have just been some surface infection around the sutures themselves, which would clear up with a little care and cleanliness after removing the sutures.

Or it could have been that there was infection present so deep that it had taken the two weeks since I was sown up to make it's way to the surface.

She wanted to be sure, but in no way wanted to open my thrice-nearly-healed (and thrice re-opened) incision again! I was sent for a CAT scan, which would reveal any puss pockets that might be lingering. And they did find what the reading radiologist called an abscess BEHIND my uterus. So, I spent the night and was to be re-evaluated in the morning, which would determine whether it could be drained externally or if I would have to be opened up.




This hospital was immaculately clean, but old school for sure! This is where I was to deliver, had I gone full term, but the OB wing has been remodeled. I saw it - it's very nice.

Thankfully, in the morning the on site radiologist read the results and actually felt it might not be an abscess, but rather just some loose fluid, which would be normal in that area in a woman my age, having had several recent procedures. They did a CAT scan and found it to be true that at least some of the fluid did disburse when I changed positions. The remaining fluid was drained via a long needle (which is always fun since Lidocaine does not work on me) and sent to the lab. The biopsy came back negative for any infection, and I got to come home! Hooray!

They are keeping a close eye on the incision to make sure the last bit heals well, but all indications are that within 10 days to two weeks, I should be healed - finally. Then I will receive the prestigious award for World's Longest C-section Recovery, at exactly seven weeks duration.

So, what did I learn during this brief stay? In Ann Arbor I had immediately learned many things about myself, health, and doctors which helped me to grow. But yesterday I was corrected (by a doctor) and told that what I had all along been calling "Better Safe Than Sorry Medicine" is actually referred to as "Cover Your Butt Medicine" by those who are honest.

It was as if the scattered pieces of the puzzle that had been laid out in front of me for the past two months all suddenly came together. The radiologist who re-read my results yesterday morning explained that when it had been sent off the evening before (because it was after 5 and he - the local guy - was already gone), that the reading radiologist knew by the doctor's request that he was specifically looking for an abscess. So, sure enough, he saw one. Not just because of natural human behavior, but as the radiologist explained, because if he called what he saw an abscess, he couldn't be hurt if it came back as some thing less. Basically it should have never been classified as such because it did not "have a wall around it" as abscesses characteristically do.

This situation was not at all shocking, and I rather appreciated the extra caution after having been through so much, but it got me thinking about the many other situations during the past two months where doctors were afraid to recommend what they really felt was best because it carried the slightest bit of uncertainty with it. One prime example is when we were first in Marquette, before I was transported to Ann Arbor, and the doctor suggested I take drugs to stop contractions. We began to ask some questions, as we always do when time allows, so that we understand why things are being recommended and what outcome they hope to see as a result. We asked what the point would be of taking drugs specifically aimed at stopping contractions, when my uterus was not and had never been contracting. Additionally, no one had any suspicion that it would begin to contract, as there was now no pressure on my cervix, neither my body nor the babies were in distress, and I was fully stable. As we talked, the doctor revealed bit by bit that there were unfavorable side effects to the drug, that it was "experimental" before 27 weeks gestation and there was therefore no data to support that it would do anything to help me even if I WAS contracting, and finally that if it was his wife in my shoes, that he would NOT recommend this drug for her.

This is but one example of many conversations that went exactly this way with doctors in three hospitals over two months. All of the conversations were pleasant and we got along fabulously with every doctor we were blessed to deal with. But what I saw yesterday was that none of these conversations moved in this informative and open direction until we purposefully led it there! We didn't know the answers to the questions, and didn't need any special education or ability to inquire in order to ask them. They were the doctors - the professionals who had the answers - but we didn't get them (the answers) until we started asking questions.

I had let this knowledge lie dormant in the back of my mind all this time until yesterday - perhaps because I harbored no negative feelings for any doc I had dealt with and didn't want to entertain the idea that anyone had not given us the best care possible. But after yesterday's enlightening discussion with the Honest Radiologist, I knew that in each situation where I, Sarah or Tessa needed care, that the doctors had routinely recommended the most precautionary care possible. They often offered drugs and treatments that, after I asked questions and we discussed things in depth, were seen to be unnecessary and even useless. We would then opt against those things and the doctors would say "I agree; good decision!" I suppose I did at some point think to myself, "Well, why did you ever offer that option!?!?" But until yesterday I never realized that during my entire experience, and through three hospitals and innumerable doctors, that they each were at first suggesting the very most intrusive and precautionary care possible, while leaving the opting out of any choice completely up to ME - presumably so that the responsibility for declining that care would rest with ME.

It always comforted me that we were in charge - that we never had any god-complex doctors, that we were never told that we didn't have a choice. But I would have liked to been able to get straight to what they actually thought was best - what they would treat their own self, wife, or child with - without all the rigmarole. I don't like that our sick culture puts them in a position where they feel the necessity to offer care they don't support, just so that no one can come back and say they didn't do everything possible. I never wanted anyone to do "everything possible", but rather what was best and most beneficial. "Everything possible" is unnecessary overkill that benefits no one, raises false hope, and as all things related to the wonderfully complex body - has side effects.

Is this something that can change? Can we reinstitute a time where doctors didn't have to care for patients in ways that are less than straight-forward just so that doctors can continue to exist at all? And what of the people who don't ask any questions? Do the doctors stop short of an unnecessary procedure or drug and say "Oh, wait a minute, dude. I didn't REALLY think this was good for you, I just offered it so that you could have the option to have everything possible." Of course not! I know this because there were times in my care and in Tessa's where I asked no questions. And in those times I was hopeful about that treatment I had asked no questions about, but wondered why I could see on their faces that it was just another trick they pulled out of the bag, but not really something they expected to work. So, I do know what happens when you ask no questions - you just get the full gamut, complete with less understanding and confidence, and more side effects and secondary problems.

Can this be changed? And how did we get here?

I have immeasurable respect for my doctors and especially Tessa's doctors, who showed me time and time again that they were brilliant, cared for us deeply, and were doing something they loved because they could help others. And I feel for them that they are trapped in a system where they have to compromise their integrity (at times) to survive.