December 7, 2010

A Rush of Blood to the Heart

Today's appointment is for a fetal echocardiogram.  I'll tell you how we got here.  Some years ago, back in 2007 I went in for a flu checkup and they found a heart murmur, which resulted in ASD diagnosis.  I was lucky.  My "hole" was medium size, and a device called Amplatzer plugged it requiring nothing more than two days in the hospital and surgery done by high frequency (and carcinogenic radiation) X-rays and catheterization.

Naturally my ObGyn urged me to seek a cardiologist in the District and tied my ability to deliver vaginally to a pending cardiology examination. I laughed and skeptically took a plane to Miami to see my doctor and get an Echo.  At the time I was only 3 months pregnant and as I suspected everything looked perfect. My hole had completely sealed and I was as normal as the next person. Of course,  I've known this since my last checkup two years ago.  When I saw my ObGyn again she gave me the green light for a vaginal delivery and that's when I saw fumes coming out of my temples.  

Now that everything is back to 'normal', and it always was, she wants me to get a fetal Echo because heart defects are sometimes genetic, according to her. Mind the 'sometimes' here. Tests, tests, and more tests.  My husband calls it "CTA" or Covering Their Asses, but I feel it's more than that.  Normal is boring to them.  A normal risk-free pregnancy in this case is dull, not challenging and therefore substantially less exciting.  We all look for excitement and challenge in our careers.  But doctors take the lead.  It's the natural high of their professional life.  But these doctors are tampering with statistics.  To them many things are contentious.  When I had my ASD closure almost 4 years ago, I understood this underlying prevalence in medical diagnoses today:  find something, anything and treat it.  Do I think this fetal Echo is medically necessary?  Not really.  Is it life saving?  It remains unclear.  

Did you know that heart murmurs are fairly common in newborns and that many babies are born with a hole that closes on its own?  Mine didn't, obviously, but what is the need to see if this baby has one right this minute? I tell you , I think it's a case of doctors displaying their batches, like boys scouts proudly display theirs.

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