Saturday, February 28, 2009

Reflections on Self-Education in Healthcare

As I finish up my first trimester of pregnancy, I wanted to reflect on something important that I've learned over these past 13 weeks, that being the following: Self-education in healthcare is critical, because healthcare professionals don't know everything (and some of what they "know" is false).

Now don't go thinking this is an anti-doctor entry, because it's not. Doctors and nurses (and other healthcare professionals) are great, and we need them. But they don't have time to keep current on every facet of healthcare, and some things that they were taught in med school are outdated and/or incorrect. That's why it's so important to do one's own research rather than relying blindly on medical help.

I knew this before this pregnancy, but it came home to me especially as I watched several doctors give me false information and/or advice. Thankfully I knew the most current data and wasn't misled, but there could have been bad consequences if I had not.

I'll give you some examples of what I experienced in only a few doctors' visits:

- One doctor told me that the dosage for Unisom for treating hyperemesis is 1/2 tab per day, up to an ultimate max of 1 tab per day. The current safe max dose is 3 tabs per day, and sometimes even more depending on circumstances. Motherisk recommends STARTING with a dose of 2 tabs per day and increasing from there. A dose of 1/2-1 tab per day will usually be less than useless in a case of HG.

- One nurse told me that she and the other office girls had had to Google "hyperemesis" to find out what it was. That's not a comforting thought coming from a trained obstetrical nurse.

- Another nurse obviously had no idea what I was talking about when I called to see if her OB could help me with hyperemesis, as evidenced by the fact that she carefully constructed the rest of the conversation around not having to say the word "hyperemesis." Again, not a comforting feeling from a nurse.

- One PA told me that she prescribed mostly lemons and ginger to help with hyperemesis. If you know about hyperemesis, you know that lemons and ginger are about as effective as snake oil in treating it.

- I could not get one nurse to take me seriously about the fact that my due date was really a week later than the divinely-inspired pregnancy wheel told them, due to the fact that I do basal body temping and knew my conception date. This is the kind of thing that leads to unnecessary inductions for "overdue" babies. In the end, I actually ended up "moving" my last menstrual period date up a week to avoid the arguments.

If I had not been prepared, I would have ended up with out-of-control hyperemesis being treated in vain with lemons and ginger and futilely-low under-dosages of Unisom, with a false due date more than a week off my true due date.

Anyhow, those are just a few reflections. So.... Do your homework! Love your doctors and nurses, but don't think that they are all-knowing. Even if they tried, it would be impossible. Know your own health issues so that you can come to the table prepared rather than naive.

Sermon ended!

1 comment:

  1. Oh, this is so important! I am on an ICAN list (about their recent project of calling every hospital to see their VBAC[ban] status), and you should have heard some of the outrageous things some nurses (and even one OB) said -- that VBACs are illegal, or implying or outright saying that VBACs have a high rupture rate, and that VBACs usually end with a fetal and/or maternal death.... And they didn't know they were wrong!! Or else they didn't have a problem with lying to women! Argh!



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