CAN A WOMAN SWITCH OBSTETRICIANS IN THE MIDDLE OF HER PREGNANCY?
I was in my fifth month when I found out my mother had breast cancer and had to have a mastectomy. I became worried and nervous and totally preoccupied with her operation and recovery. In the middle of everything I went for my regular doctors visit and my obstetrician suddenly couldn't find the baby's heartbeat. He said that my uterus was smaller than it should be and perhaps the baby had died. He told me to return in two weeks for more testing.
The stress in my life was so severe I didn't know what to do. Someone at my husband's office gave us the name of the doctor who had delivered his son and in a panic I made an appointment with the new doctor. He used an ultrasound technique to show me that the baby was fine and I remained with him until the birth of my healthy little girl.
I just want to say that I don't think I would have worried about my original doctor if he had not been so offhanded about my baby's life. I wouldn't have thought it a good idea to change obstetricians during a pregnancy, but I'm very glad I did.
N.K.
Scranton, Pennsylvania
This woman could have continued to trust her doctor if he had only explained the newer methods for determining whether or not a baby is alive. She didn't have to wait two or three weeks to find out. Amniocentesis or ultrasonography could have told her almost immediately.
Amniocentesis is the withdrawal and analysis of a sample of the amniotic fluid around the fetus. Ultrasonography is a high-frequency acoustical way of getting X-ray-type pictures of what's going on inside the uterus with no harmful effects on a mother or her child. High-frequency sound is projected into the body and the sound waves return, like an echo in the Grand Canyon, to produce a reflection of the fetus on a television-like screen. A woman can glance at the screen and see the fetus moving, just like on live TV.
If for some reason the baby had been dead, this woman would not have had to carry it to term. A doctor can induce early labor with a new type of prostaglandin suppository. So the emotional stress of living with a lifeless unborn can be removed right away. There was no reason for the doctor to send her home to suffer, unless, of course, he wanted her to switch obstetricians.
Whenever a pregnant woman starts to mistrust her obstetrician, she should reflect on her feelings and discuss them with her family. Does she want to see another doctor? If she honestly feels she does, she must not hesitate.
In the past few years I've been to three doctors and they've all told me the same thing. I have unusually high blood pressure. However, one at a time they dismissed this finding. The first doctor put his hand on my shoulder and said, "You're just nervous, honey." The two other doctors told me, "Learn to take life a little easier."
Meanwhile, I also suffer from menstrual cramps and these doctors suggested that I take birth control pills to alleviate the pain. Since I had read the pros and cons of the pill I decided against it.
I made an appointment with a fourth doctor, and finally I think I have found someone who stands out from the crowd. He said that even compensating for the fact that I may be nervous in a doctor's office, my blood pressure was very high. He gave me an EKG which showed no abnormalities, but he emphasized the importance of blood pressure pills. I began taking them and now my pressure is normal.
This doctor told me that if I had taken the birth control pills, with my high blood pressure, I "wouldn't be here today." I'm so happy I trusted myself instead of those thoughtless doctors.
F.M.
Point Pleasant, New Jersey
This very alert and informed woman was saved by her own intuition and because she was listening to her body. Her experiences show the importance of reading as much as you can and feeling, inside, what's right for you.
Today, many women only consult one doctor, a gynecologist, for all their problems. A gynecologist has become a primary physician to such a great extent that medical students are being encouraged to learn more general medicine when they're training in gynecology. That doesn't mean that a gynecologist should treat heart problems, but he should check your blood pressure on every visit, and send you to a cardiovascular specialist if there are any signs of trouble.
A woman should get full value from every meeting with her doctor. If he forgets to take your blood pressure, remind him. Ask him what it is and write it down so you can make a comparison the next time.
It's indisputable malpractice to put someone with high blood pressure on birth control pills. If this courageous woman hadn't listened to herself, as her current doctor told her, she might have been dead. Fortunately, today she's a living example for everyone to follow.
I am fifty, well into menopause, and on my fifth doctor in fifteen years. I don't take hormones, am a firm believer in vitamins, and I've held onto my organs, but it has been a fight. Every doctor wants me to part with all or part of my reproductive system. They say that if my organs are removed I won't have to worry about them becoming a source of cancer. This seems like outright malpractice. The doctors might as well have suggested that I cut off my finger so I wont break a nail.
My latest Pap test was fine as usual. I dont know why these doctors think that just because a woman has reached menopause she wants to lose part of her body! I feel great.
D.W.
Chicago, Illinois
For years, this woman has been trying to find a doctor she can trust. One certainly has to doubt the need for surgery since it's now fifteen years since the first suggestion was made and she's still fine. Judging from the letter, there appears to be no pathology and only her intuition saved her from a knife-happy .surgeon.
Many doctors like to suggest that women who reach menopause have hysterectomies just to avoid the possibility of getting cancer in the uterus and ovaries. There's absolutely no reason for this surgery. Yes, doctors should do everything possible to reduce the risk of cancer, but no organs should be considered optional. We don't remove lungs to eliminate lung cancer, so it should follow that we don't take out a woman's uterus to prevent uterine cancer.
Fortunately, when it comes to cancer of the uterus, there are ways to detect the disease at an early stage. The Pap smear for cervical cancer, abnormal bleeding after change of life for uterine cancerboth offer warnings. There are as yet few methods to determine the development of ovarian cancer, but we do know that almost 7,500 healthy ovaries would have to be removed in order to prevent one death! With this ratio, ovarian surgery should hardly be encouraged. In the overall view, only 2.7 of the 10,000 yearly deaths from ovarian cancer would be prevented, but how many physical and emotional problems would the removed ovaries cause? There are no figures to answer that question.
Ms. W's story shows that women must keep searching for several opinions until they find someone they can trust. Hopefully, this fifth doctor will be the one to make the difference for her. If women never stop being active partners in their own health care, always take on positive attitudes, and keep themselves fit with exercise, diet, and vitamins, the level of unnecessary surgery could be greatly reduced.
IT'S NOT ALL BAD
So far I've presented letters from women who have had difficulties finding physicians they can trust. Their plights are real, but there are good doctors out there for them. Many excellent physicians are treating women who write letters of appreciation, notes of praise, thanks, and love.
Recently a woman wrote these touching words to the doctor who had performed her myomectomy, an operation to remove her fibroid tumors:
The experience of being operated on and of slowly recovering has taught me my body's limits as well as its strengths. There is no memory that I need to suppress or push aside.
I'm not sure which contributed more to my feelings of comfort and security: my complete confidence in your knowledge and skill, or my pleasure in your cheerful, reassuring manner. I shall never forget how I felt as I was wheeled into the operating roomas if I were surrounded by people who cared about me and knew exactly what they were doing. I could face this trial with utter serenity. And I can't tell you how nice it was to know that after a day of pain and discouragement, your smiling face would appear in my roomweekends and all to comfort and cheer me.
Finally, it was obvious even to an amateur like me that both your abilities and your niceness had earned you the respect of the people most qualified to judge the nurses and doctors you work with.
For where there is love of man, there is also love of the art. For some patients, though conscious that their condition is perilous, recover their health simply through their contentment with the goodness of the physician.
Hippocrates
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Women's Health