My psychiatrist faxed the bloodwork results to my midwives. I'm still not sure why, except that since she kept saying "I want you to have a copy to show your midwife" I assumed it was something relevant to my prenatal care, and therefore told her to fax it to them when she suggested I drive downtown, pay for parking, and pick up the stupid thing myself.
So... the "deficiencies"? My vitamin B12 is at a level that the lab guidelines classify as "possibly indicating deficiency", and my TSH (thyroid stimulating hormone) is 3.25, right in the middle of the lab's "normal" range of 0.5-5.0. The doctor's note on the front, addressed to my midwives, states that "patient should be started immediately on intramuscular B12 injections, and should be referred to Dr. Y___ for endocrinology follow-up."
Now, before any of you Google MDs start typing out your responses, let me say that I understand that both the B12 guidelines and the TSH range have been recently (or not-so-recently) criticized as being outdated and inaccurate, and doctors are advocating revamping and tightening the guidelines. The current guidelines, it seems, originally included a number of people who had what were called "subclinical" cases of deficiency or whatever.
HOWEVER... neither of these bloodwork results is alarming enough to warrant calling a patient and insisting that she needs to come in the next day to discuss, all said in a panicky tone of voice. And to my mind, neither of these things needs to be addressed right this second, when I'm 39 weeks pregnant and I'm likely to be facing wildly fluctuating hormone levels in the next little while. And finally, neither of these things is something that my midwives can or should really address. They can't make the direct referral to edocrinology, and they don't have the expertise in thyroid stuff to know whether they should. IM B12 injections are also not within their scope of practice, I think. So why on earth did my psychiatrist a) freak me out with her whole "I need to see you tomorrow" drama, and b) suggest/insist on involving my midwives?
I feel like the answer is to accept that my psychiatrist is generally high-strung and anxious, and either ask my family doc for a new psychiatric referral or brace myself for more lapses in common sense.
What would you do? And would you bitch out the psychiatrist, if you were me?
Source: http://of-course-youll-get-pregnant.blogspot.com/2010/06/whiskey-tango-foxtrot.html
No comments:
Post a Comment