Friday, August 5, 2011

Medicine, schmedicine

Blah - So, baby ultrasound (21 week) this past Friday showed that "everything is great, within normal limits, BUT the left kidney is at the larger end of normal..." meaning they want to send me to a follow up appointment for ANOTHER ultrasound (this will be my third ultrasound so far this pregnancy) just to make sure his kidneys are still normal??? WTH?

I mean, I understand doctors make recommendation for follow up appointments because they want to "be sure" of things, but to me, this is a little ridiculous. When the RN called me earlier this week to tell me maternal fetal medicine would be contacting me for another follow up ultrasound, I couldn't compute at first because it doesn't make sense, everything is normal, but they want to make sure it stays normal? Then why not do 4 week ultrasounds regularly after 20 weeks for normal babies? Because it's ridiculous, that's why.

My last pregnancy I had but one ultrasound, and that was my 20 week ultrasound to measure all the organs. This pregnancy, I've already had two, the first one was apparently a "pregnancy diagnosis" ultrasound at 11 weeks, the second was the measure of the organs, which we have established EVERYTHING IS GREAT - heart and chambers are wonderful, spine is A1, brain and all the ventricles are beautiful, liver, bladder, KIDNEYS...

OK, so one kidney is greater end of normal, but still WNL. I understand doctors want to follow up ultrasound - but I honestly believe that nothing is wrong with my baby. My husband and I have prayed about it, and I have my intuition - but spiritual stuff amounts to a hill of beans in the medical world. I suppose I can understand that, because there are weirdos out there, but that doesn't mean you should discount everybody who believes in the Great Healer for crying out loud.

Even if the kidney was larger than normal, what would they do about it, except repeat ultrasounds to see if it goes down? Nothing, that's what. OK, maybe consult a urologist post birth or prescribe antibiotics if the baby has urinary retention and develops a fever, but there is nothing in the womb (that I've read about anyway) that they do for babies with large kidneys/one large kidney. In fact, I read that this is common in boys in the womb, and 9 times out of 10 means nothing and corrects itself before birth.

My big beef here is on two planes. 1) The fact that doctors, as great as your doctor may be, is almost obligated by all the power of Hippocrates and the medical world we live in, to check you to death, scan you until the cows come home, to make sure you are healthy. Well doctor, I didn't have my first pap smear until I was 26 years old, and you know what was found? NOTHING! I also was not sexually active until marriage (in any way shape or form) and married a man with the same principles. If you are sexually active young, or have HIV or a weak immune system by all means get your paps yearly, but what good would that do me? My immune system is strong and I have no risk of cancer in my family

Anyway,

Number 2) beef is that insurance only covers so much, and nobody can tell you how much tests cost. Usually, this is where I begin my "Capitalism will save American Healthcare" speech, but I will save you that for now, suffice to say that we don't know WHAT we pay, or are expected to pay, for a hospital visit, doctor visit, test, etc...

I will say, that I have been paying between $200-$300 out of pocket per ultrasound, so my wallet is not looking forward to another $200-$300 test that I don't "need" if my baby has normal kidneys (ok, one kidney slightly large end of normal, but still WNL).

The hubs and I work at one particular hospital, but we get healthcare out of network for this baby because the hospital we are going to is closer to home than the one I work at, and I am not all about driving 50 minutes to a hospital when I am in labor....SO, we are up to speed with our deductibles and how much % the insurance company will pay for my hospital delivery, but if no one can tell us precisely HOW MUCH tests cost, how can we better plan? At least if I know an ultrasound costs "this much," and my insurance will pay 70% of that cost, then I know what I will be out of pocketing, but if I don't know the actual cost of procedure, each bill in the mail is a surprise (and not a good one).

So let's say that I DO go and get this ultrasound and wouldn't you know, his kidney is a little larger, or hasn't changed and the doctor wants to do ANOTHER one in 4 weeks - besides being superfluous, as I may as well could have waiting 8 weeks or more for the test, I will have even more out of pocket expenses, and for a budding family trying to save for a house, birthdays, and Christmas, that $200-$300 really adds up - not to mention blood work required, glucose tolerance test, RhoGam injection (I'm RH-) , and whatever else they nickel and dime me for - again, it all adds up.

Plus, if they are not going to do anything in 4 weeks time, maybe send me for another test in another 4 weeks if things are abnormal, wouldn't it stand to reason that it's better to get a test 8 weeks later instead of 4? The "problem" (permitting there actual is a problem) would have more time to rectify itself, or if it has changed into a bigger problem, well, you really wouldn't be doing anything differently for me or the baby anyway (at least not according to my own research).

It's scary to think that something could be wrong with your baby if the doc's office is scared for you, but you can't lose your head. I really care about my baby, and of COURSE I want to know and fix it if there's a problem...but there is nothing really that they are going to do in utero - and I am going to have to talk to the doc about this at my next appointment, because if she absolutely convinces me that this is necessary, then we are going to do it later in the pregnancy, not sooner - there is no point. Any surgeries they do they have to wait until after birth anyway, because they sure as hell and heaven are not doing an amnio or CVS on me, or anything where they have to puncture the womb or get invasive. Forget it. 

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