Re: Doctors in US (long)

[Henrietta Louise]

Being one of the complainers, I do have to say that I am not offended.
I wish like heck that I never had that ultrasound, because then I would
just be having a normal pregnancy right now.

And, I understand that doctors are just covering their arses with
recommendations for all the tests. It is part of the reason that
medical care in the U. S. is so expensive. When somebody presents in
the ER with epigastric pain, they are put through all the GI tests after
the cardiac ones have ruled out anything.

Of course, this is easily said rationally. But, when you have a doctor
saying, "YOU have a high risk of blah, blah, blah. WE can treat it by
blah,blah,blah," it is hard to think rationally.

I will even go further to say that I am emotionally fragile with this
pregnancy. I had a missed abortion 2 years ago, and I lost a son around
6 years ago. If something goes bad with this pregnancy, I am pretty sure
that we won't try again. And, I don't want to be in a situation where I
said, "If only I had....."

But at this point, further testing really won't change the outcome, just
allow me to know sooner if there is something wrong. I think I may have
my ultrasound next week but will decline the CVS and amnio and any later
ultrasounds.

Regards,
Henrietta
#4's edd: March 22, 2004

[Astromum]

Henrietta Louise wrote:
<snips>
> I will even go further to say that I am emotionally fragile with this
> pregnancy. I had a missed abortion 2 years ago, and I lost a son around
> 6 years ago. If something goes bad with this pregnancy, I am pretty sure
> that we won't try again. And, I don't want to be in a situation where I
> said, "If only I had....."

IME pregnancies are by far the most emotional 'bodily' experience a
woman can have. Besides all the hormonal effects, there is this enormous
expectation and tension, and the realization that you cannot do all that
much to influence the outcome (especially in the early weeks).

Don't be too hard on yourself. People make mistakes. It is way too
easy to say 'If only...', since you don't know beforehand what you know
afterwards. If you knew what kind of guy he was, you would never have
gone to this dr in the first place, but you didn't, so you went. You do
what you feel is right at the time. Most times it turns out for the best,
sometimes it doesn't, and we learn from both experiences.

> But at this point, further testing really won't change the outcome, just
> allow me to know sooner if there is something wrong. I think I may have
> my ultrasound next week but will decline the CVS and amnio and any later
> ultrasounds.

And of course, you can also change your mind about this if you
feel like it. That's the good thing of having free choice...
I really hope you can get the midwife to take over, they are
often so much more realistic about this.

BTW: where would this ng be if we didn't have the occasional vent
about OB/GYNs? :)

--
-- Ilse
mom to Olaf (07/15/2002)
TTC #2
"What's the use of brains if you are a girl?"
Aletta Jacobs, first Dutch woman to receive a PhD

[Ericka Kammerer]

Astromum wrote:

> Kimme mik wrote:

>> Lawsuits have
>> bee filed and won due to doctors not performing testing and babies
>> beingborn with problems.
>
> Couldn't the parents have gone to a doctor for a second opinion?
> There are probably cases where this is justified, but isn't it also
> a task of the parents to ensure that they get the best possible
> care? E.g. if I would have a baby with Down's syndrome at the age
> of 25, could I sue my doc for not having done an amnio, even though
> my age is well outside the 'risky' range?


It's getting very murky on issues like this. Unfortunately,
in the US, one's ability to sue for malpractice is based more on
whether the doctor did what most other doctors do rather than
on whether the doctor did what the best available medical evidence
says is right. At the moment, most doctors don't do amnios
routinely for women under 35...but when and if that changes and
the age creeps downward, doctors are legally at risk if they
don't do what everyone else is doing. IIRC, there was a lawsuit
in Canada where a doctor was penalized for not discovering
a birth defect in time to allow for termination. I think
this is definitely a very bad path to head down.


> The problem here is that all medical advice is based on scientific studies


If only!


> and in science you need a handle for quantifying your results. This handle
> is statistics. Example: I am an astronomer, I look at objects that are all
> unique, but put a bunch of them with similar properties together, and you
> will find trends. Same for medical studies: all pregnant women share a
> common
> property (pregnancy), and gaining weight is part of pregnancy. That isn't
> less true simply because one woman gains 10lb and another gains 60lb. I
> agree that each person is unique, but a large part of the medical successes
> of the last decades is based on this statistical approach, so don't be too
> harsh on it.


That's definitely true as far as it goes. Unfortunately,
many doctors and patients don't really understand the implications
of the studies. I can't believe how many doctors will rely only
on point estimates and don't even take any account of variance!
So while I agree that the statistics, when proper methods are
used and the results are interpreted correctly, are very useful,
I think it's unfortunately true that statistics are often based
on poor methods and are interpreted inaccurately. So much of
the time you *do* have to take recommendations with a grain of
salt.

Best wishes,
Ericka

[Ericka Kammerer]

Astromum wrote:

> Ericka Kammerer wrote:
>
>> Astromum wrote:
>>
>>> The problem here is that all medical advice is based on scientific
>>> studies
>>
>> If only!
>
> Let me rephrase:
> medical advice *should be* based on scientific studies
> Unfortunately, statistics can work either way, and you can
> always 'bend' the results in a direction that you prefer.


;-) And sometimes they ignore the results of research
all together. There are plenty of instances where medical
research clearly indicates one thing while the opposite
remains common practice. That's the part that really gets
my goat.


Best wishes,

Ericka