During residency, I had a 39 year old female patient with back pain (what else?) who was also trying to get pregnant. She had no kids yet. I wrote her a prescription for a strong NSAID and told her, "Don't take it if you think you could be pregnant!" (The attending originally told her it was probably okay, but it's Class D, so not okay!)
She told me that she decided to put off trying to conceive until her back pain was resolved. The attending said that was probably a good idea.
I held my tongue, but I wanted to tell her to have the baby now and deal with the back pain later. She's almost 40! And it's not like back pain is something that goes away quick. We had patients with back pain since before I was born! It's not like she's waiting for a papercut to heal up. The back pain will still be waiting for her nine months from now.
As usual, I kept my mouth shut though.
haha. my first thought was that the back pain was significantly inhibiting the...ummm...efforts...of trying to (naturally) conceive. but, more seriously, its not uncommon for infertiles to take a much-needed physical & emotional break after failed treatments, miscarriages, the hormone-induced mood swings, marital stress etc... its possible she WAS taking a break but didn't want to get into the why.ReplyDelete
Well, it's fine if she had other reasons to take a break. But back pain can last a really long time.Delete
What is wrong with your attending?ReplyDelete
He/she reminds me of all the people who tell me that, despite being 37, recently diagnosed with RA, and on lots of bad drugs for it, I should have "no problem conceiving in a couple of years" after my disease is under control.
Like the diagnosis and possibility of not ever having kids isn't bad enough to deal with, I then have to listen to those ignorant comments.
Sometimes I want to punch them all in the face.
Haven't you heard? Women can have children till age 90. The only limiting factor is death.Delete
Wow. Maybe you shouldn't have kept your mouth shut? How hard is it to balance the need to be respectful with the need to keep patient's informed?ReplyDelete
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Did you actually hear the attending say those things, or did the patient just relate to you that this is what the attending told her? Patients have an interesting way of filtering what you say and turning it into what they want to hear, or whatever preconceived narrative they've developed for their problem. Whenever a patient tells me that a physician told them something weird or silly or wrong, I usually give the physician the benefit of the doubt and just assume that there was some weird communication flub at some point during that exchange.ReplyDelete
No, I was standing right next to him when he said it.Delete
Ah. ok. well, sometimes physicians just say weird and silly things... :)Delete
You didn't mention if you had done a pregnancy test. I can't tell you how many times we have had patients say they are not pregnant and they are 3 mo pregnant. So I thought that was going to be the punch line. . . SHE WAS ALREADY PREGNANT!!!! AND SHE TOOK THE MOTRIN or whatever. Well, since I had my last baby at 40, not the worst time to get pregnant. . . Just means that when I should be retiring, my kids are in college, so got to keep working. . . .ReplyDelete
Now one of my peeves with pregnant woman is when they want a handicap sticker so they don't have to walk so far. . .or a note for they gym to hold their membership. . . I tell them "HELL NO!!!!" you need to exercise! I want to tell them, I was doing an hour/day on the stair-master, swimming, and then at work pushing labor patients around in hospital beds, AND WORKING 14 DAYS IN A ROW. . . when I was 9 mo pregnant. But I bite my tongue and just remind them that exercise is wonderful and that pregnancy is not a disability.
heh im 20 weeks pregnant with twins and 39.. cant tell you how many people keep telling me not to go to the gym (despite my gym instructor being 32 weeks pregnant). apparently prenatal yoga is the only "ok" exercise... oh and apparently I need a midwife and not an ob (geee i did my 4 yrs of med school. 5 yrs of radiology residency.. and several years in practice but i agree all those doctors are just evil and moneygrubbing)Delete
I actually did have to cut back on strenuous exercise though when I was pregnant, because my aerobics routine would bring on painful contractions. Not everyone can do it.Delete