Shoot 'Em Up, Doc. Eventually.

With Kevin out of town shooting ANTM, I'm killing time with a very busy medical week that involves five blood draws, an interview, and some unpleasant abstentions from eating.

Monday, I had my 3-hour glucose tolerance test -- the second step in determining whether I have developed gestational diabetes. The first is a one-hour test in which you chug a sugary beverage and then get your blood taken an hour later, and I flunked that by a slim eight-point margin and was thus forced to schedule the marathon session. It required three days of pleasant carb-binging in which I had to eat pasta, potatoes, bread, or rice with every meal -- which was neither a struggle nor a particular departure, as I'm of the mind that all this carb-fearing crap right now is insane -- and then a hellacious 16 hours during which I could eat nothing, 12 hours in which only "moderate" water was allowed, and four hours during which no water could pass my lips at all. You would think such tests would be performed in padded cells, so that the lab workers would be protected from the violently hungry and dehydrated pregnant ladies who want nothing more than to go all HULK SMASH on the world. Instead, I just went to a boring little lab at the hospital, gave blood so they could read my fasting blood-sugar level, pounded ten ounces of a drink that tastes like souped-up flat Sprite (not as bad as it could be, but surprisingly gross to chug in less than five minutes), and then waited for three blood draws at one-hour intervals. By the time I gave my last vial at 12:30, the needle was barely out of my arm before the Fiber Bar was out of my purse and halfway down my throat. It was behavior almost worthy of excommunication.

Tuesday, I got the results: I passed. GOD BLESS. Although as complications go I'd take gestational diabetes over anything else, I'm still not that upset to avoid having to prick my finger multiple times a day just so I can see what my blood is saying. Especially because I'm pretty sure my blood would be saying, "Please leave me in your body. PLEASE. I'm fucking serious."

At the end of the week is another checkup with my blood doctor, to make sure my anemia isn't getting unmanageable -- athough, after a slow downward spiral, my numbers rebounded at our last visit and I'm not overly fatigued, so I'm optimistic that test will go well. If it doesn't, we're looking at weekly shots and infusions (so that the iron bypasses my digestive tract), but I have no reason to suspect that it will have gone downhill again so quickly that we'll leap there right away.

Tomorrow, though, is the big dog, the one about which I'm most nervous: The meeting with our prospective pediatrician. You need one in place and on-record before you give birth, because that person comes to examine the babies within 24 hours of the birth, and the hospital isn't wild about randomly assigning one. But I'm antsy because we don't have a huge amount of choice. With our health plan, we only get 100 percent coverage if we pick a doctor who is contracted with Motion Picture (the company the editors' union uses, through which we get Blue Shield), and in our area that number totals... three. Simply accepting Blue Shield isn't enough; the doctor has to be on Motion Picture's approved list, and what's more, we have to get an official referral from Motion Picture or else we won't get the benefits. They make it hard. And of those three options, only one definitely has privileges at St. Ritter's Please Don't Let That Happen To Me Hospital. That's the other thing you learn: Your doctor has to be affiliated. You don't just get to mix and match.

The interview is sort of a big deal for me. It matters because of vaccinations and autism.

Before I go any further: Yes, I know, there's no proven link -- and there is absolutely no unbiased study out there that parents can turn to for information -- and yes, Kevin and I fully plan to vaccinate our children. We know that already. Those diseases aren't going away. Without wanting to ignite any tensions among my readers, because I don't want to judge another person's experience with this issu, the point of view I have is: to bypass vaccinations ourselves effectively places the burden of disease prevention on every OTHER parent out there, as if to say, "The risk is too great for MY precious babies, but I sure hope you put YOUR kids in the line of fire or else we're all getting rubella."

For me, the issue is two-fold. I have a very autistic niece, and I know that autism is much more common in boys. It's hard to say what family connection there is or isn't -- maybe there's none -- but it's reason enough for me to be responsible about how we proceed here. I have no intention of being foolhardy; I want to be cautious. I want to try and space out the vaccines. I'd like to split up measles, mumps, and rubella, rather than lumping them all together. I want a doctor who is willing to be flexible with the CDC's recommended schedule, who will respect that I am not acting rashly and that I am a work in progress, reading whatever I can about this issue, and am I'm not some obsessed Jenny McCarthy fan who insists that she is the final authority on whether to give my children shots. I want someone who will consider adjusting the vaccination schedule to my children's gestational age, since they will likely be preemies and I don't want their little bodies unduly overwhelmed too soon or too often with a pile of shots.

Above all, I want to be heard. But this is such a hot-button issue, and I've heard lots of horror stories about parents trying to discuss this with their practitioners, only to be waved off with lectures about the CDC and how the research is bunk and with rigid adherences to The Way It's Done. It's as if the word "vaccine" causes some doctors to become all glassy-eyed, or worse, suspicious that you are some kind of dangerous radical. When really, we're all just scared parents, and some of us have family histories that give us reason to tread carefully.

So what I'm looking for here is a conversation. That's all. I want us to be partners on stuff like this, and doctor-patient on the rest. I don't need him asking my opinion on a diagnosis but I would like him to respect that when you've been part of a family that's been touched by autism -- and experiencing just as many struggles as triumphs, if not more -- you are within your rights to step a bit more slowly into the unknown. Or at least that's what I believe; here's hoping he's with me.

Comments

[Sheila]

What you said sounds totally reasonable to me. You might help ward off the "glassy-eyed" reaction if you lead with something like, "My husband and I are definitely planning to vaccinate our children. However, based on our family history and the chance that our babies will be premature, we were hoping that there could be some flexibility with the scheduling and spacing of all the vaccines." If the doctor still gets his back up after an opening like that, then you know what you're in for. Good luck! We only visited one pediatrician and we love him so it does work out sometimes!

[Leigh]

It's really interested reading about the US system of labour & delivery and pediatric care. I'm from New Zealand and our health system is so different, that reading about you having to choose between only 3 doctors is quite strange to me. Hopefully your meeting tomorrow goes well and the doctor is willing to listen to you and be flexible. I have never thought to ask for each vaccination to be separate. But I didn't have to get the vaccinations done at a certain time. We have the timeline for when vaccinations should be given, but its just a guideline. My youngest daughter was about a month or so late getting one set of vaccinations done and they just push the next scheduled one back. And even then, I get to make the appointment, so if I want to wait a few more months, it's up to me.

Sorry for being so rambly and if you are still reading this comment, well done you!! But as I said, as someone not living in the US, the rigidness of your health care system bewilders me. Anyway, good luck with the pediatrician appointment. :)

[Heather]

Well, I CAN go to other doctors -- anyone who takes Blue Shield, I get some percentage of the treatments covered and I pay a co-pay at every doctor's appointment. But for 100 percent coverage, yeah, the particular options with my plan as far as doctors go are more limited. And with twins, I'd like to get the best financial deal that I can -- although if I end up with zero confidence in any of the three doctors, I'll suck it up and take the monetary hit if it means going to one we like.

That said... yeah, our healthcare system is all f'ed up. I'm really just grateful we have insurance. I spent four hours in Labor & Delivery a month or so ago and it would've $850 if I were paying; can you imagine what a stay with an actual birth and recovery would be?

[Marisa]

Good luck with the pediatrician! We're following Dr. Sears's delayed schedule (from the Vaccine Book, great read) and our pediatrician has been 100% supportive of that. I have read some real horror stories of unsupportive doctors, so I hope you find one that works with you,.

[Terra]

Well, I'm de-lurking to give you some vaccine support. I really hope one of these doctors works out for you, because I drove myself nuts and spent MONTHS trying to find a doctor who would accept delayed vaccinations, or whatever I chose. It is a really difficult decision, especially when you are super pregnant and they want you to have the ped. in place before the birth. I finally ended up finding a great practice of family doctors, who seem to be more laid back than peds. overall, BUT I drive an hour to get there. Also, I know autism is the big buzz with vaccines, but there are other issues, especially with premature or immune compromised children. I wish you lots of luck finding a great doctor for your boys.

[Leslie]

Basically, what you need now is a pediatrician to examine the babies for release from the hospital. If all goes well (and I am putting my money on that!), it's pretty simple. You can always switch to another pediatrician later if you decide you would be more comfortable elsewhere.

When my baby was born, we had a pediatrician ... who was not at all responsive to working as a partner with me and my husband in determining care for our daughter. After one particularly ghastly event, in which I was told that I "read too many of those women's magazines," we switched our child's care to our family doctor - and were very happy with him. In fact, our now 26 year old daughter had her first child a year ago, and she and her husband and their baby all see that same doctor still.

[Anna]

First, hooray for passing the gestational diabetes test!

Second, hooray for preparing to initiate conversations about vaccines! We delayed the schedule for my daughter, and it's worked out well. One thing I found very useful was just to tell the doc that I wanted advice and info to better make my decisions. I've found that a doctor is much more receptive when you let them know you value their opinions and need their help. Even if it means ultimately not taking the advice they give.

Also, in case you run in to some problems, just a reminder that in the state of CA it is legal to avoid vaccines based on a personal philosophical objection. Many other states insist on a religious and/or health objection to delay and/or avoid them. I ran into this when enrolling my daughter in pre-school. I signed a waiver, or wrote a letter outlining my objection, and we were good to go. We're in crunchy NorCal, though, so that might make a diff.

Sorry for the novel. Happy to email convo if you'd like.

[Emily]

I wanted to second the recommendation for Dr. Sears Vaccine Book. I felt like he gave a pretty fair overview of the different vaccinations that are out there, and he also includes specific information about ingredients in different brans of vaccine for each disease. This is really helpful if you're trying to avoid certain ingredients.

When we went to our pediatrician armed with the book and the alternate schedule, she was very willing to listen to us and follow the delayed and spaced out schedule. I think it was clear to her that we had done our research and were not, as you put it, obsessed Jenny McCarthy fans who were more interested in hysterics than science.

Good luck!

[Dawn Crawford - CCIC Communications Manager]

What a great post - thank you so much for being so honest about parental fears about vaccines. I do hope that more doctors are open to the conversation about vaccines.

I work for a pro-vaccine organization (that isn't pharma funded) in Colorado and I hope that you consider vaccinating your baby on the CDC schedule just because we know that delaying vaccines just leaves your baby's health open to disease. We know that the vaccine schedule is a tested, tried and true system to protect your baby's health. You have so much to worry about caring for your baby, the tested vaccines shouldn't be one of them.

Have a great pregnancy!

[Jay Gordon]

Dawn, the docs who write the papers you cite have accepted pharma money.

Technically, YOU are not funded by Pharma, but indirectly, you are.

Best,

Jay

[Heather]

I think that's the scary thing for parents -- there is no unbiased info out there. Parents with anecdotal evidence are convinced they're right, doctors are convinced they're right, some of the studies come from tainted sources, some of the articles lambasting those studies have come from authors with grudges and/or conflicts of interest. It's so hard.

[Dawn Crawford - CCIC Communications Manager]

Heather, that is a great point. It's hard for us all to admit but money, unfortunately, makes this world go round. Everyone, including Dr. Jay, is financially benefiting from vaccines in one way or another. We do not take pharma money directly and of course we do apply for grants that are to promote pro-vaccine information. It's all so sticky, but are here for the health of children.

Heather, we just want you, and all moms, to get all the information you need to make a solid decision in the health of you children. We hope that you weigh celebrity with science and make the decision that is best for your family.