Sunday, July 23, 2006

Measure twice, diagnose once

Life at the hospital has reached a sort of steady-state of routine and expectations. Gone are the acute fears walking in each day and being worried that some sort of life-threatening complication would have popped up overnight, although I still call every morning to make sure that there will be no nasty surprises when we first see him. The staff knows that they shouldn't call us unless it's something big, because there's nothing more unnerving than a call from the hospital. I remember sometime in the first week getting a call at 11 at night from a NP over a change in a pressure setting on his vent. In retrospect, this seems unbelievable. Why would you call about something like that?

The more I think back about some of what has happened, and then talk to other friends who have had pregnancies recently, I have become convinced that doctors and nurses are unaware of the psychological trauma they inflict by tossing off potential diagnoses. A couple who are friends of ours, for example, had a scare in their recent pregnancy where a preliminary blood test indicated a greatly increased chance of certain neurological and developmental birth defects. For a week they agonized about what this meant for the future of their child, imagining the repercussions to their dreams and aspirations. A week later, upon going for a follow up, it was discovered that the first abnormal test result was due to a mathematical error in calculating the acceptable results for the baby's gestational age and not to a discovered defect. Oops! I also heard another similar story involving a bad initial measurement in an ultrasound; for a weekend they had to consider all the bad scenarios, but when they had the followup testing, they found that the original test results were wrong (and worse, they found that the supposed "marker" for the defect is not a reliable one anyway).

I definitely appreciate the emphasis now in giving patients all the information out there, but don't know how you can go out and face a couple of parents without double-checking your math, for example. Don't they know how much it freaks people out to tell us, well, anything? Even hearing the term "tracheotomy" had me a little juiced.

Woody continues to do well. He's up another 10 g to 1820g today. We're hanging out with him and holding him and generally playing with him. Maggie has had a pretty bad cold this last week and has had to stay away from him, so now that she's doing better we feel better about spending more time with him.


At 7:33 PM, Anonymous Aunt Susan said...

Hi! Look what happens when I leave the blog for a week! So glad to hear all of the good news. Keep your strength up and I hope Maggie feels better. GREAT aunt Jeannie kept me up on the news while I was away. But I must say I am happy to be back and able to check the blog myself. I am so happy for all of you... love and kisses to the boy.

At 8:43 PM, Anonymous Dad/Sherri said...

Thought we'd point out what Aunt Susan omitted - she's celebrating her 40th birthday today by returning from Florida to read your blog and find out about W.X.! Is that devotion or what?

At 10:17 PM, Anonymous Anonymous said...

Keep on keeping on ya'll

Glad that Maggie is starting to feel better. Good to see that Woody continues to outpace expectations.



At 10:49 PM, Anonymous jared said...

I tend to think that something so great as to be labeled a "psychological trauma" is not necessarily inflicted by a doctor's diagnosis alone, but rather must be a combination of the diagnosis plus excessive worry over uncontrollable occurrences. Whether said worry is reasonable or un-, well, that's the perennial question for the litihators.

Much love to doctoring...
Much love to worrysome parents...
Much love for the tao.

At 7:27 PM, Blogger kafkaesque said...

I have nothing specific to say about this entry but I am well pleased to see the progress. Support and good thoughts from Andrea and I.


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