2013-12-10

The first midwife appointment was today.  The husband and I dithered a bit over whether he should come.  I asked two friends for advice.  One said he should come to show he is supportive, to meet the midwife, and to give his medical history.  One said he shouldn’t bother as it is a long appointment which he will be barely involved with.  We went with yes, to show willing and because I have been so ill that he wants to be more involved with my care than usual.

So well, it was OK.  I liked the midwife enough, she seemed very nice.  But the appointment was confusing and it is a good job I already knew what to expect and how the system works because all of that wasn’t explained.  She didn’t even explain what a midwife was and what her role would be, for example.

The appointment lasted maybe an hour.

The first part was a questionnaire.  This mainly covered medical history, but the way the midwife administered it was through a series of seemingly open questions that actually had secret boundaries around them designed to confuse me and trip me up.  For example a correct answer to ‘Have you any significant medical history to note?’ is not ‘I had whooping cough when I was 25’ despite them being obsessed with whooping cough and whooping cough vaccines.  A correct answer to ‘Is there any significant medical history in your family?’ is not ‘My dad died of a heart attack’.  I kept having to ask ‘what sort of thing are you interested in?’  It made me feel like a fool.

Of relevance to my pregnancy, it is important to note that my Mum had nausea and vomiting throughout, was hospitalised for 10 weeks for high blood pressure, and had a caesarean as I was transverse lie.  I’m glad I asked my Mum about this, as I think it flags me up for them to watch out for these things.

It was interesting how the system was not set up to accommodate IVF.  Despite us being able to give the midwife:

– An exact date of conception

– An exact date of embryo transfer and embryo age on that day

– The date of a scan where the embryo was measured against expected gestation and it was bang on to the day…

The midwife still had to ‘make up’ a date for my last period to put in instead.  You’ll recall that with IVF your periods are in no way related to when they do the transfers and so on, the date she had to enter was entirely arbitrary.  Frickin residual infertility again, rubbing in our faces how we are different and abnormal.

The midwife also asked how many IVFs we’d done and we said three she said that wasn’t too bad.  Easy for her to say.

Then don’t get me started on the nausea.  I’m down to about three hours of nausea per day, and I can do one activity per day then I’m wiped out.  I’m working part-time, from bed.  I can’t exercise.  I’ve cancelled all social events.  I don’t know if I have to live with this or if I can try another drug.  The midwife was sort of sympathetic, but also clearly of the view that nausea in pregnancy is normal so I should shut up.  I tried several times to get advice on this and bring the conversation back to it in the hope of getting a steer on what I should expect.  She suggested ginger, sea bands and homeopathy.  So I knew she was not appreciating the gravity of the situation.  She suggested I see how I am in a few weeks.    She made it clear that I should not be bothering obstetric triage with such minutia.

The midwife then took my blood pressure, a urine sample, and some blood.

This highlighted that I also have three issues that will negatively affect every single appointment I go to with the midwife:

– I don’t have veins near the surface, it is very hard to take blood from me.

– I always have traces of blood in my urine.  I’ve been investigated and they don’t know why.  So if they do a dip test they can’t know if there is a problem or not.

– I have ‘white coat syndrome’.  Don’t ask me why, it is not at all conscious, but the first two times anyone takes a blood pressure reading from me it comes out high.  Then it goes down to normal.  Again I’ve been investigated and there’s nothing underlying.  This makes it hard for them to guage whether I have high blood pressure.

Overall I felt like a very difficult patient.  I don’t mean to be.  I don’t want to be.  I can’t help it.

So that was it.  We were given dates of when to come back, dates for classes (May), a blue folder of my notes to bring to each appointment, and a packet of booklets.  It was an OK appointment.  Sort of.

Back to the husband thing, well actually his involvement was probably about 60 seconds of the appointment stating his phone number and anything he knew about his mother’s pregnancy.  And, in fact, the midwife didn’t even say hello to him or ask his name.  He was a spare part unfortunately.

After the appointment I thought a lot about the nausea, and chatted with the husband, and in the end I decided to ignore the advice of the midwife and get in touch with obstetric triage again.  When I was there they had said I should get in touch if I didn’t see significant improvement and they assured me I should be able to go back to normal activities.  I decided to give them a ring rather than waste their time going in, and this was the right thing to do.  They were able to bring up my notes straight away, and although they clearly had no real interest in me as I was not vomiting they told me to go to my GP and ask for a different drug called Procesprozine (sp?).  They suggested that if my GP was not well versed in nausea and vomiting in pregnancy the GP could phone them, and they could both advise them and fax them the protocol showing how my treatment should be escalated.

I called the GP to make an appointment.  Obviously couldn’t get one in days, so will need to phone in for an emergency appointment tomorrow.  Unhelpful.

Advertisements