The world of medicine is like a bubble. A lot of people THINK they know what goes on there, but unless you're down in the trenches it's unlikely you do. So here is my semi-anonymous blog, here to tell you what really goes on in the life of a medical resident.

Saturday, March 25, 2006

Update on "Mary"

Mary came into the office last week for her first offical prenatal appointment. That's the one we schedule at 12 weeks (give or take), right at the end of the first trimester. The reason this date was particularly significant for Mary was because the great majority of miscarriages happen before the end of the first trimester. She was past the first hurdle.

Her cone biopsy was 6 weeks ago. The margins were clear (i.e. they got all the cancer on her cervix). She hasn't had any bleeding or cramping, and has been feeling increasingly pregnant.

There are still more hurdles to overcome. She might end up with an 'incompetent cervix', which is a cervix that is unable to support a pregnancy to term. She is at high risk of preterm labour. There's no predicting how her cervix may respond to the weight of the growing fetus. She has opted to have a c-section to be scheduled a few weeks before her due date on the advice of the oncologist.

But we found the heart rate with the doppler. Mary's face softened as she heard the strong heart tapping away at a perfectly normal 155 beats per minute. She had already admitted to be that due to their reluctance to get too hopeful, her and her husband hadn't really let themselves get attached to this growing baby inside of her.

I asked her if she'd like an ultrasound. There isn't really a medically indicated reason for one at this time-- it's a bit late for a dating ultrasound, and far too early for one to check the fetal anatomy or the position of the placenta. But I thought she needed one for her own well-being... not just to confirm that all was well, but I secretly hoped that if her and her husband actually got to SEE this little miracle, they'd let themselves get excited about it. As though seeing it on a screen would make it real. She accepted.

So far, so good. In the words of Mary herself... cautious optimism.

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Blogger Carina said...

Oh, all that sounds so good. Clear margins, good healthy heart, she's on the right road. *sigh* Nothing's better than hearing that heart for the first time except for when you feel the first good kick you can't convince yourself is anything else. :D

9:09 AM

Blogger Ron said...

i can only hope that any doctor that deals with any health issue i may have, will have the same caring heart that you have.
dont change.

9:35 PM

Blogger Kim said...

Great news!!!!!!

I'll keep praying.....

3:34 AM

Blogger Jen said...

Just wanted to let you know that I really enjoy reading your blog. It's very interesting to see this side of medicine! Hope you don't mind that I've linked you in my blog. Feel free to stop by and comment.

11:31 AM

Blogger Bob said...

Wishing Mary all the best!

3:44 PM

Anonymous Anonymous said...

A friend of mine was born to a similar situation - I'm not too familiar with the specifics, but his mother (a physician) had something like a dozen tumors in her uterus and cervix, and had never had children. She took a huge risk and opted to keep the uterus instead of removing it to be able to have a child. She had my friend soon after, but it turns out she had contracted Hep. B from the blood she received in the operation. Amazing woman, always has a smile on her face.

4:30 AM


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