Tales from Officeland

1. I had to give bad news to an adorable couple, who I was very excited to see pregnant as she is the sister of another of my patients. She was in the process of miscarrying :(
2. I saw a patient postpartum, who's baby I caught. She's doing very well with breastfeeding and looks great. The baby is beautiful of course. Her and her husbadn had given me a wonderful thank you card, an announcement, and a gift card - suuuweet! I love cards and gifts - they certainly aren't necessary - but are always very appreciated :p
3. I spoke with my favorite nut. She's the sister of a friend of mine. This friend (I sometimes have to question how much a friend she is!) sent her sister to me with the warning that she was a nut. She has mental health issues but manages them pretty well, goes to school full-time as does her partner, has a great dry sense of humor. She can drive me crazy but I admire her for being a pretty tough cookie. Anyhoo, she had been in the hospital with pain issues r/t GI issues (intentionally being vague). We were medicating her, hydrating her, and trying to figure out everything wrong with her....physically anyway. The midwife on call went to see her then came to the office and proceeded to tell me how they did a UDS on her and maybe she's a drug addict and why are we drugging this baby and why aren't the docs managing her blah blah blah. This is Ms. It's-Not-About-Us,-But-About-the-Patients. We could also call her Ms. Holier-Than-Thou. She really was p*ssing me off because of her attitude. This is 'my' patient, quit dogging her out. She may be a nut but she ain't a drug addict just because she has mental health issues. I pointed out that we had been seeing this patient since 5 weeks pregnant and not once had she presented with a complaint or request for pain meds. And she's more than halfway through the pregnancy. Back off B*tch! Anyway, she talked to one of the docs to decide what to do with her as the surgeon said no surgery and apparently the GI doc talked to the surgeon and decided he didn't need to come see her?????!!!!! WTF???? Our doc said send her home for the weekend and then refer her to the perinatologist. WTF??? Why? This is totally non-pregnant related. She needs the GI consult. So guess what I'm gonna do when I see her next week? Off to the GI doc.
4. I think I only said drink more water twice on one office day.
5. I saw a lady for what was supposed to be a new OB but apparently she had miscarried a couple days prior. She came for her appointment anyway. I sussed out the sitch and it sounded like everything was proceeding appropriately. We discussed grief. We talked about trying again and timing for that. I suggested bringing her back for a WWE in a couple weeks. She declined for religious reasons. She told me that she didn't do paps and would return when she was pregnant. Ok. Whatever. I can respect that as long a woman understands the risks and benefits of testing. I am no longer 'shocked' by out of the ordinary preferences. I'm growing so much :) Not just my a$$ either.
6. I saw a doctor patient (because I apparently had a slot open) who was around 29weeks complaining of low pressure, white discharge, peeing frequently, and not feeling the baby move as much for several days. It's her third baby. Um. ok. So I evaluate - lots of fluid in the vaginal vault. Did you have intercourse recently? Yep, the night before. Well, there ya go! No ROM. I explain about common discomforts of pregnancy...i.e. does it feel like the baby is going to fall out when you walk. She looks at me with shock and says yes. As if she is amazed that I know what she is talking about. I explain about pelvic floor muscles and multiple pregnancies. I put her on the monitor. Looks gorgeous. Lots of "contractions" - you know...every 30 seconds, very jagged looking. You labor nurses and midwives know what I'm getting at. Fake contractions! I palpated...not a dayum thing! Go home hun...chill. Come see your doctor next week and drive him crazy..I have enough pain-in-the-a$$es of my own.
7. I saw a young patient who had HELLP syndrome with her last pregnancy. She complained about having to stay in the hospital for a week after the birth, being induced, etc. She's really looking forward to doing things her way this time. I said, "If all is well, we do it your way. If all is not well, we do it our way". I hope we get to do it her way!
8. I saw a new OB, who is late in the pregnancy and a nut. She has schizo among other issues. I use the term 'nut' affectionately (so don't flame me, I have mentally ill people in my family and I just might be one of em!). This one was hospitalized at the beginning of the pregnancy for trying to kill herself. Her other baby died a couple months out from accidental ayphixia. And she laughed when talking about it. She said she worried that it was her fault for having the blanket in the crib. And laughed. I understand that it was likely r/t her mental status and meds but it was still creepy. It happened last year. Can anyone say social services?