All or nothing

It’s been over a month since I last posted. I didn’t plan for such a long break. My mind has just been racing so much, I’ve been finding it hard to put my thoughts into intelligible sentences. I’ll try harder now.

These past 3+ years of trying to grow our family, I estimate I’ve met with about 10 different Ob/Gyns and REs and 4 different GPs (not including the countless doctors I’ve met with at hospital ’emergency’ consultations – usually follow-ups from miscarriages -, as those must have been close to 20).

Prior to this, my experience with doctors in this country, in over 6 years, consisted of one bad case of stomach flu and one strong cold. So, I could say I had very little familiarity with the health care system or even the local culture surrounding health care.

I had plenty of experience, though, in my own home country. I’ve had more than my fair share of illnesses and ailments throughout my childhood and teenage years, many serious enough doctors were afraid I wouldn’t make it out alive.

My first serious condition was a strong pneumonia when I was about 4 months old. Since then, my paediatrician was aware of my deficient immune system and tried all he could to avoid serious infections. I had extra doses of the normal vaccines, plasma transfusions and weekly injections. Seeing doctors, having my blood draw and taking painful penicillin injections were so routine to me as early as age 4, I didn’t realise it wasn’t so for everyone else.

Despite my doctor’s best efforts, I had almost all common childhood diseases: from chickenpox to rubella, mumps and even whooping cough, among many others – most of which I’d been vaccinated against. Each time I’d spend days or weeks in bed, mostly unconscious and burning with fever; much stronger reactions than other kids, including my siblings, had to the same diseases. I missed so many school days every year, I was legally required to fail; but being first in my class despite it all, my teachers would usually fake my attendance card so I was allowed to pass grade.

My mum struggled a lot, taking care of my sister and I, looking after my older (half-) siblings and working full-time, while my father travelled for work, up to weeks at a time. It wasn’t easy on her, but it wasn’t easy on myself either. Besides these diseases, I’d commonly fall ill with serious throat infections and bronchitis. Or, I’d get skin infections from staph or strep bacteria, which were both painful and quite disgusting looking, so not the best for a teenager’s self-esteem.

My paediatrician used to say all would go away by the time I got married. He was quite right. I got better and stronger each year, and today most people can only see a perfectly healthy young woman; they find it hard to believe my childhood stories.

Stories such as the time I was 6 years old and had a routine blood test; however, for the first time on a new lab. Upon results, the lab contacted my mum asking to rerun the tests as they believed I had leukaemia. My mum panicked, but my paediatrician took over, explaining to the lab there’s nothing to worry about, these were my ‘normal’ levels.

Or when a year after that, having been through several plasma transfusions, my doctor contacted my mum saying they’d been notified some of the blood from these lots were contaminated with HIV and I needed to get tested. We immediately set off several thousand kilometres by plane, as in those years – mid to late 80’s – HIV testing was only available on two labs around the country. When we finally met with the doctor who was taking my blood sample, he examined me and told my mum: “We’re going to do the test, but given her appearance (I was extremely skinny and ill-looking) and immune deficiency history, it’ll just be pro forma, as I’m sure she’s positive“.

It took about a week to get the results. I was only 7 then, but clearly remember this time. We’re staying at my aunt’s, and the days between that examination and the final result my mum spent locked up in the bedroom, crying, while my aunt tried to distract me. I couldn’t understand why my mum couldn’t look at me straight. Results finally came and were negative. The irresponsible doctor got quite an earful from my mum and we went back home, carrying on.

By age 15, I was regularly travelling across the country by myself to see an asthma and allergy specialist. It’s accurate to say, thus, I have plenty of experience discussing health matters with doctors, even from a young age. Being the ever curious child and teenager, I was used to asking all kinds of questions to physicians, genuinely interested in understanding my condition in particular and the human body in general. My doctors always answered me in a polite and encouraging way. I never had reasons to doubt them.

After months of unsuccessfully trying to conceive, I went to see an Ob/Gyn to attest whether I was regularly ovulating, since my cycles were getting longer and longer and I had been warned of possibly having PCOS in my teenage years, due to my polycystic-looking ovaries and very strong, irregular menses.

I went to this first consultation armed with questions and requests, given my past experience with my own health care in my home country. This doctor, however, got easily offended by my (in my head, innocent) questions and was rude from day one. I couldn’t understand what I could have been doing so wrong.

About 4 months later, in the third appointment, he told me all my blood tests were normal and suggested to do a HSG to check my tubes since it had been about a year I’d stopped birth control. I was feeling so frustrated with the slow pace of testing here, I asked him to also check my progesterone levels at 7dpo, to confirm ovulation and make sure there was no luteal phase issues. This request was received by the doctor as an unexpected threat, to which he responded by getting up from his chair and yelling at me. I was so shocked with his reaction to what I perceived as a simple question, I didn’t know what to do but cry, sobbing heavily, while he continued screaming at my face for a good 10 minutes.

After I wiped my tears and found strength to politely share I was worried about having been intermittently bleeding for over a week, since around ovulation, and that the bleeding was becoming stronger, he dismissed me and told me I worry too much and should just go home and wait for the HSG appointment in a month from then.

Unsatisfied with his treatment and knowing my body, I decided to take a pregnancy test a few days later, since the bleeding wouldn’t stop. It was positive. That was my first pregnancy and it turned out to be ectopic. Had I followed his advice and blindly waited for a month, most likely my tube would have burst and I would have undergone a much more dangerous emergency surgery.

But when I returned to his office for another scan, after my HCG result had come back at 10000 even though no pregnancy was seen in the uterus two days prior, the midwife was certain the pregnancy was ectopic. She went out to speak to the doctor, but he never even came out to see us. He didn’t offer us any words of compassion, nor did he apologise for ignoring my concerns. He let it all in the hands of the midwife. I never saw him again since that yelling episode.

I wish I could say his behaviour was an exception, but it turned out to be a cautionary tale of what I would encounter from then on. Most doctors we saw were not compassionate, dismissed all of my worries and questions and were downright rude. Maybe it’s all a big cultural misunderstanding, but my experience have been disappointing at best.

It’s only to be expected, then, that after 3 years of such treatment, I started getting used to it, stopped asking too many questions and accepted whatever was thrown my way, even when I didn’t quite understand the doctor’s logic or didn’t quite agree with it. I was tired and defeated.

My faith in the medical community and in my own gut was restored a month ago, at last.

I booked a free 10-minute Skype consultation with Dr. Braverman but didn’t get my hopes too high. I thought 10 minutes were not enough to even go through someone’s full history, so this free consultation was probably more of a publicity stunt than a real doctor’s opinion.

It turned out it was nothing like I expected. He seemed genuinely interested in our history, asking several questions and not at all rushing the consultation. I was amazed how every question he asked me, every frustration he shared with the local doctors’ actions and answers, were the exactly same ones I’ve had all these years. It was as if he was reading from my notebook of unanswered questions. But not only that, every explanation or theory he shared was based on rational thinking and logic. His approach to medicine was ultimately scientific, which is what I’ve been missing all this time. When we finished the call, I only had one thought in my head: this was the doctor I’ve been looking for all these years.

I’m not here to say he’s the right doctor for everyone and I can’t even comment on his treatment as he hasn’t treated me yet, but his attitude was exactly what I would expect from a competent doctor, one I could really trust. My husband was equally positively impressed. If this was a publicity stunt, it certainly worked on us.

Although we were so excited by this initial consultation, when we received the full fee schedule from the clinic, we had to take time to think it through. He charges extra fees throughout the pregnancy, which combined with testing fees and treatment costs abroad (Spain) can quickly add up and drain out all our savings before we get our much waited baby. It took us several weeks of talks and thinking over to come to a decision.

We finally decided to go ahead with the initial testing and diagnosis with him. This much we can afford, and I really need a complete diagnosis at this point, for my peace of mind. After getting his results and treatment recommendation, we can then decide whether to go ahead and follow his treatment plan or continue with the (much cheaper) doctors here.

We’re both tired and in need of a clear path forward. We’re ready to give our all. It’s all or nothing now.