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Re: Thank you for your kindness !
From: jwang,MD (anonymous@obgyn.net)
Wed, 27 Sep 2000 04:23:39 -0500 (CDT)
Hope,
I am relieved to see that you are coming back. Kelly has given you
great answers to your concerns. As you can tell, she's a smart and
caring person.
Now, you need to concentrate on feeling better and keeping you and the
baby healthy. Where to start is a good question, but I would venture to
say to talk with your ob. Since you said you have seen a number of
them, call to set up an appointment with the one you are most
comfortable with - here your collegial status should be a help. Let
him/her know what's been going through your mind. Once you express
that, you will find that your fears don't sound unreasonable, nor do
your wishes for increased surveillance. I tend to get very liberal with
the use of US when there's a history of a loss. A picture is worth a
billion words in those situations.
Talk to your psychiatrist as well. At this point, there will need to be
direct and open lines of communication between all of you.
If you need help, let us know. I think you could give us more private
info through the obgyn.net administrator, if you felt the need.
Keep us in the loop.
At Tue, 26 Sep 2000, Hope wrote:
>
>Dear friends and colleagues,
>Thank you so much for caring so much about someone you don't even know.
>I never knew how much caring there was in the world. Oh how I wish I
>had doctors and friends like you in the "real world".
>I honestly don't know what to do. I truly do love this baby, as I love
>them all. I have no idea why I can't be a stronger person, and act
>accordingly.
>I wish I had an Obgyn who would promise me frequent ultrasounds, perhaps
>even an elective c-section at 37 weeks, and that would not mandate me to
>breastfeed. But above all I wish I had an obgyn who would be supportive
>and understanding of my needs for medication.
>I have not told my prenatal caretaker about my feelings or my concerns,
>or my medication, in part for the fear of beeing laughed at, in part for
>the fear that the baby would be taken away from me by social services,
>or someone. To me that would be worse than death itself.
>Perhaps its my profession that has lead the obgyn to trat me more like a
>colleague and less like a person, I don't know. But I know I would need
>to start an SSRI now, but know of the withdrawal risks for the baby at
>birth. I also know I need some benzodiazepines, but am aware of the
>floppy infant syndrome risk. It is so hard to accept that due to my
>weakness, if you will, my baby will have to suffer.
>I thank you for your offers to help me; I just don't know how that
>should be executed. I have tried contacting my therapist via email, but
>have not received a reply so far. I have no one Obgyn; that is not the
>custom here; they change at every visit to the hospital. And the last
>obgyn just told me to write myself sickleave if I felt like it, said the
>ac was too small, and SGA ?, and said she hoped I didn't deliver before
>week 32. In addition she tested me for Chlamydia (as a possible cause
>for the premature contractions), without my consent, something I found
>to be very insulting.
>Whom do you feel I should contact; my shrink, or an unknown obgyn ? What
>are your opinions on the risks associated with the anxiolytic and SSRI
>use in this case ? How do you feel the remainder of the pregnancy should
>be monitored ? And do you think an elective c-section or induction at 37
>weeks would be contraindicated ? Obviously I know you cannot answer the
>questions as treating physicians, but I would appreciate your guidance.
>I accept your offers to help me find hope and treatment with a greatful
>heart. Thank you so much for being so generous with your time and your
>caring.
>With kind regards, and a glimpse of hope for the better,
>Hope
>
>--
>With kind regards, Hope Larsen
>
--
J Wang, M.D
Assitant Clinical Prof.
Tufts University School of Medicine
>**Note: Opinions expressed here are for educational purposes only
>and, as such, do not constitute a physician-patient relationship.
>This information is not intended to supplant the need for you to
>consult with your physician prior to choosing therapeutic options
>and/or interventions.>
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