OK, this posting is long overdue. I have been meaning to write about my pregnancy experience this time, but things kept popping up in my schedule. Anyway, here goes!
Jamie and I have been debating about where to go and what doctor to see this time. I know we did not write much after we had found out last time that our baby had died, so I will fill you in briefly. In August of 2007, almost a year and a half ago, I went to my OB/GYN doctor for a regular check-up. She checked the size of my belly, and then I asked her when she wanted me to have the half-way ultrasound done. She said to go ahead and do it that week, since she had to go on vacation the next week. She wanted me to come back to her that week after the ultrasound "so she can rest assured." Funny phrase, but looking back, I think she must have known something, but chose not to tell me. If she did not notice anything wrong with the size of my belly, that just tells me about her medical knowledge.
So, I went to the ultrasound place. Long lines, humiliating waiting for 1 or 2 hours, no chairs to sit on. Finally, I am taken in, the doctor stares at the screen (there is only one screen, and the doctor makes sure the patient cannot see it). Then he asked, "Did your doctor tell you why she wanted you to have an ultrasound?" "No. Why?" "Did she tell you you were measuring small?" "No, is the baby not developing properly?" "The baby died a week and a half ago." The nurse quickly told me to get dressed and to go out, and that she would have a printout form for me in a few minutes. That was it! That was all that was said and done. As if I had had a cyst in my body that now has dissolved, not a baby that had died. I don't know how I made it home; and we shared the rest of the story. Oh, and the P.S. to the story is that later in the fall I got a call from the OB/GYN. She had realized I had not seen her in 2 months, and she wanted to know where I was. I told her what had happened. She yelled at me for not calling her and telling her earlier. Then she said I MUST come and bring some papers from the clinic in Vienna saying that indeed the baby had died and I had delivered him, or she would be in big trouble. I went, and I got the same kind of attitude from her as from the ultrasound guy. She was more interested in reading the papers than talking to me. She also chastised me for not communicating to her.
Needless to say, this time both Jamie and I felt uneasy about local doctors here.First, I am not sure about their medical knowledge, and secondly, I don't know if I can trust them to tell me the truth, and thirdly, they all seem to have flunked their bedside manners class -- or maybe they do not offer this class at all here? This is getting long. Finally, we decided to go to the American Medical Center in Kiev for my first visit and to go from there. I went 2 weeks ago, and it was a wonderful experience. I was treated like a person. I had seen the doctor a couple of times before that, and she is very nice. She is Ukrainian, but she spent many years working in Africa, so her bedside manners are great and from my previous communications with her, I trust her medical knowledge. She was very happy for us and crossed me a few times (I think she is nominally orthodox). She ran a whole bunch of tests and an ultrasound, and then called me a few days later to say everything looked good. She also said that the ladies that get prenatal care from her usually deliver at a hospital in Kiev which is as close to Western standards as you can get in Ukraine. So, it was decided there and then that I would see her for my check-ups. I will have to move to Kiev when I am 36 weeks. I don't really look forward to train rides, but if this is what it is going to take to get good care, I am willing to do it. Thankfully, the train is an overnight train that leaves at 8:30pm, gets to Kiev at 9:20 am the next morning (there are beds on the train, so people go to bed and wake up in time to get ready). On the way back it's very similar. Next time I am going mid-February, and the doctor will take me to the birthing hospital to have my half-way ultrasound and also to tour the facilities.
Speaking of trips and train rides, our family will have to travel to the American Consulate in Kiev either in Feb. or March to get new passports for two of our kids. So, one of my OB/GYN visits can take place then. In April, we will be leaving the country to get visas for the two munchkins and then to go to the MTW Area retreat for all MTW missionaries in Europe and Africa. It happens every four years, and it will be in Spain this time. We will go to London, stay there a few days, get our visas, and then will go down to Spain. We will be flying out of Kiev, so there is my chance to consolidate my April check-up with the rest of our travel. Well, first we have to make it to April, don't we?
I am currently 15 1/2 weeks pregnant. I am feeling great, and feeling hungry all the time. It is almost time for me to start feeling the baby move, and I am very conscious of that, especially this is how far along I was when Matthew (our last baby) died (and I had never felt him kick). I am trusting the Lord with this whole pregnancy, knowing that He can take this baby, too, but knowing that in His original plan, this would never happen. So I keep praying that the baby will be healthy and I will make it to the end of this pregnancy without problems. Our kids pray for the baby every day, and Timmy has the same prayer every time, "Lord, I pray that the baby will live, and that it will be healthy, and that it will be a boy."
Please pray for us.
Showing posts with label Pregnant Woman and Socialized Medicine. Show all posts
Showing posts with label Pregnant Woman and Socialized Medicine. Show all posts
Wednesday, January 28, 2009
Monday, August 6, 2007
Pregnancy Diary: August 6, 2007
I went to see my OB/GYN today as an "official" (i.e. registered) patient. 
The line was small. I got in, and the doc walked out, telling the nurse to get my blood pressure. The nurse took it, and then she asked me for the other arm. I suppose she just wanted to make sure. Then the nurse told me to get out my sheet and get ready for the exam on the exam table. I forgot to bring a sheet today, so I just went ahead and lay down on the sheetless table. I wasn't going to take my sandals off, but I got reprimanded. The doctor came back, measured my waist and the top of my fundus. Then she produced an ancient-looking instrument, which looked like a tube with wide ends and a narrow middle. She pushed it against my uterus really hard (it hurt, and I let her know that, but she did not respond), and she listened to the baby's heartbeat. She did not time it, so I (or she, for that matter) have no idea what it was. She was done, and I gave her the papers from my blood work, the genetics counselor and the ultrasound. She studied them for a couple of minutes. Not a word. She just asked for copies, and I had them, so they took the originals and the copies. 
She asked me then how much I weighed, and I told her (There is no scale in the exam room). I bought a scale last week, so now I can keep my weight in check! It gives both kilograms and pounds, which is great, since I am so used to tracking my weight gain in pounds. She then looked at my urine analysis (I had taken it in last Friday). Turns out, I had elevated salt levels. She told me to take rosehips syrup 3 times daily for 10 days. I asked her if I had a UTI, and she said, "Not yet, but we need to get these levels down. If we can't, then you might have to be admitted to the hospital, so they can monitor your urine and diagnose the problem." I just looked at her and said, "OK." No reason to argue now. I thanked them, and they thanked me for the wafer cake (I always take something for them), and I went home. I miss my American doctors who are always so encouraging! I am still struggling with nausea and lack of energy, and I really would have appreciated something cheerful from my OB/GYN here. My next appointment is in 3 weeks.
The line was small. I got in, and the doc walked out, telling the nurse to get my blood pressure. The nurse took it, and then she asked me for the other arm. I suppose she just wanted to make sure. Then the nurse told me to get out my sheet and get ready for the exam on the exam table. I forgot to bring a sheet today, so I just went ahead and lay down on the sheetless table. I wasn't going to take my sandals off, but I got reprimanded. The doctor came back, measured my waist and the top of my fundus. Then she produced an ancient-looking instrument, which looked like a tube with wide ends and a narrow middle. She pushed it against my uterus really hard (it hurt, and I let her know that, but she did not respond), and she listened to the baby's heartbeat. She did not time it, so I (or she, for that matter) have no idea what it was. She was done, and I gave her the papers from my blood work, the genetics counselor and the ultrasound. She studied them for a couple of minutes. Not a word. She just asked for copies, and I had them, so they took the originals and the copies. 
She asked me then how much I weighed, and I told her (There is no scale in the exam room). I bought a scale last week, so now I can keep my weight in check! It gives both kilograms and pounds, which is great, since I am so used to tracking my weight gain in pounds. She then looked at my urine analysis (I had taken it in last Friday). Turns out, I had elevated salt levels. She told me to take rosehips syrup 3 times daily for 10 days. I asked her if I had a UTI, and she said, "Not yet, but we need to get these levels down. If we can't, then you might have to be admitted to the hospital, so they can monitor your urine and diagnose the problem." I just looked at her and said, "OK." No reason to argue now. I thanked them, and they thanked me for the wafer cake (I always take something for them), and I went home. I miss my American doctors who are always so encouraging! I am still struggling with nausea and lack of energy, and I really would have appreciated something cheerful from my OB/GYN here. My next appointment is in 3 weeks.Pictures: top -- a door to an OB/GYN room; bottom -- a bathroom stall at the clinic
Wednesday, August 1, 2007
Pregnancy Diary: July 31, 2007
This morning I went to see a genetics doctor. It turns out that a couple of blood tests that they had me run were for screening of chromosomal abnormalities (PAPP-A and beta-hcg). In the US they always asked us if we wanted to get these kinds of tests done, and we always declined. Here I found myself with results of something I didn't really want to know yet. We would rather deal with it when the baby is born. Anyway, when I had my first ultrasound, they told me to come back around 11-14 weeks to get a nuchal translucency scan (NT). Babies with chromosomal abnormalities will have some liquid in the back of their necks, and if coupled with results from blood tests, the diagnosis can be very accurate (about 90%).
I talked to my teammate, Cindie, and she offered me a new perspective: if something is wrong with the baby, we might reconsider our delivery choices/ treatment options beforehand. That was one good point that we hadn't thought about. So, last Saturday I called the Diagnostic Center to set up an appointment for ultrasound and the genetics doctor (GD). The ultrasound was booked through this week, so I just went ahead with the GD. No appointment was necessary (meaning: there will be a line to wait in).
Back to today. I tried to make it to the Diagnostic Center as close to 8 am as I could. There was a small line there already. Finally the nurse came out and took referrals and test results (here you pick up your test results and take them to your doctor). She mentioned that I did not have the ultrasound. Yes, the doctor can read the test results, but it will be better if you had an ultrasound, too. I told her that the next available appointment would be too late for NT. She said to go to the front desk and try to get one anyway (how am I supposed to do that?). I went and tried. They told me to go to Room 9 and see if they would take me. Recipe for trouble. The nurse from Room 9 said they were overbooked and there was no room. I had a feeling I was going to get this response. She took me to the front desk and told the lady behind the glass to make an appointment for me for later on. There were not openings till mid-next week. It would be too late. I went back to GD. The nurse was sitting at a desk with a computer, and the doctor was sitting right across from the door. She was a slender woman in her 50s, and she was wearing a green uniform. Since none of them introduces themselves or greets you, I started speaking and said that I had tried to get an ultrasound appointment, but I could not. The nurse (the one that had instructed me to try) said something to me. Suddenly the doctor turned to the nurse, "Will you keep talking or will you let the doctor speak with the patient?" Whoa! I sat down trying to avoid being caught in the cross-fire. But that was it. The nurse did not say a word till the end.
The doctor was a very reserved woman, a woman of very few words. She was very professional and seemed knowledgeable, but I wished she would just lighten up a bit. She asked me the usual questions, and I gave her my test results. She then started with the previous pregnancy questions, and I readily produced my handy print-out. There was a shadow of interest on her stoic face, and that was it. She started reading it, and I was wondering if there was a way to make her smile. After she was done dictating my info to the nurse, she asked me more questions about our relatives and family history. "Do you smoke, use drugs or drink large amounts of alcohol?" No. "Do you or your husband have hazardous jobs?" "Yes, raising of four children." Astounded look for a second, and then a smile. Gotcha! Well, at the end she said the test results looked good, but she wanted me to do an ultrasound this week, and wrote me a referral. She also wanted me to do yet another blood test later on and to come see her in early September (unless the ultrasound showed some abnormality).
Back to the front desk I went, showed them the referral, and the lady behind the glass found a free slot for today in Room 9. I hadn't stepped 10 feet from the window, when I ran into the nurse from Room 9 (the one that was not very helpful 30 minutes earlier). I told her that they sent me there because apparently there is an open window. "What, are they crazy?! We have 30 people waiting there!" I gave her the referral. "Let me go talk to the head ultrasound doctor and see what he says." The tone of her voice suggested little hope. She emerged 3 minutes later, with the same scowl on her face, "Make an appointment for today." And handed me my referral. It had a small mark, as if in initials, in the top left corner. The front desk lady printed out an appointment slip, informed me that it will cost me 30 grivnas ($6) and sent me off, grumbling something about the little dwarf (the nurse from Room 9 was about 4'9"). I laughed all the way to Room 9. I am witnessing quite a bit of personnel tension today J.
Back at Room 9, there was a line of about 6-7 women. They all had appointments, but I don't think one got in on time. There are always those who need to get in without the appointment. Since I had to be one of them last time, I decided I would patiently wait my turn at 11:55 am. A couple of "new Ukrainians" (rich people) came and jumped the line after talking to the nurse. Then there was a lady who did not look very comfortable. I heard the nurse say something about "the woman with contractions". She would take her after two other patients. I got up and offered my seat to the lady. She declined, but I insisted. She sat down. We started talking. She came all the way from the town of Skadovsk, which is about 2 hours south of Kherson and is on the Black Sea. She came here to deliver her baby, as she is having contractions and is over 38 weeks. When she got to the delivery hospital, however, the doctor sent her to the Diagnostic Center for an ultrasound. I know, it does not make sense.
I sat there till 12:35 pm. I would have been there longer, but I pleaded with the nurse, and she "moved me up". There are several reasons why I think they are so backed up. One, the nurse is constantly in and out of the room. She comes out after every patient and goes somewhere (don't they have intercom?). Fifty percent of the time she scolds the ladies who try to get in without the appointment "Are you crazy?! Look at the line!" or those who do not mention to her that they are carrying twins, having contractions, etc. She ends these tirades with "The head doctor is going to kill me!" The second reason I think they are so backed up is because the OB/GYN doctors here want pregnant women to have between 3 and 4 routine ultrasounds during their pregnancies. I can't figure out why a young healthy 24-year-old needs all that.
It was my turn. The room was semi-dark with relaxing background music. The doctor was a man in his 30s. I think he was the head ultrasound doctor. After I saw him, I thought that there might be a reason why the nurse acts the way she does. He, like the GD, was a man of very, very few words. He actually never acknowledged me, he just did his job. He barely opened his mouth when he spoke, and he spoke very softly on top of that. Add the background music, and I wondered how the nurse heard him at all. He moved his head as if to get a better look at what he saw on the screen. The head movements coincided with the wand movements. I tried to see the picture of my baby as it reflected off his glasses, but it did not work. So, I just lay there with my ears perked up trying to hear the verdict. His facial expression did not leave much hope. I was a little concerned at first, but after observing the same frown for 10 minutes, I relaxed. He seemed to know what he was doing, and he measured not only the NT, but also the nasal bone. He just gave the dimensions of the nasal bone, but I deduced the baby was probably OK since there was a nasal bone (it is absent in babies with abnormalities). Then he was done, and I got up. Not a word from either of them. I took a little time to put myself together hoping for instructions. Dead silence. I went out and waited outside (I had seen other ladies do it). The nurse appeared a couple of minutes later with a print out. "Next time make an appointment ahead of time!" I took the paper and studied it. It said things looked normal -- praise God!
It was after 1 pm, and it was time to go home.
I talked to my teammate, Cindie, and she offered me a new perspective: if something is wrong with the baby, we might reconsider our delivery choices/ treatment options beforehand. That was one good point that we hadn't thought about. So, last Saturday I called the Diagnostic Center to set up an appointment for ultrasound and the genetics doctor (GD). The ultrasound was booked through this week, so I just went ahead with the GD. No appointment was necessary (meaning: there will be a line to wait in).
Back to today. I tried to make it to the Diagnostic Center as close to 8 am as I could. There was a small line there already. Finally the nurse came out and took referrals and test results (here you pick up your test results and take them to your doctor). She mentioned that I did not have the ultrasound. Yes, the doctor can read the test results, but it will be better if you had an ultrasound, too. I told her that the next available appointment would be too late for NT. She said to go to the front desk and try to get one anyway (how am I supposed to do that?). I went and tried. They told me to go to Room 9 and see if they would take me. Recipe for trouble. The nurse from Room 9 said they were overbooked and there was no room. I had a feeling I was going to get this response. She took me to the front desk and told the lady behind the glass to make an appointment for me for later on. There were not openings till mid-next week. It would be too late. I went back to GD. The nurse was sitting at a desk with a computer, and the doctor was sitting right across from the door. She was a slender woman in her 50s, and she was wearing a green uniform. Since none of them introduces themselves or greets you, I started speaking and said that I had tried to get an ultrasound appointment, but I could not. The nurse (the one that had instructed me to try) said something to me. Suddenly the doctor turned to the nurse, "Will you keep talking or will you let the doctor speak with the patient?" Whoa! I sat down trying to avoid being caught in the cross-fire. But that was it. The nurse did not say a word till the end.
The doctor was a very reserved woman, a woman of very few words. She was very professional and seemed knowledgeable, but I wished she would just lighten up a bit. She asked me the usual questions, and I gave her my test results. She then started with the previous pregnancy questions, and I readily produced my handy print-out. There was a shadow of interest on her stoic face, and that was it. She started reading it, and I was wondering if there was a way to make her smile. After she was done dictating my info to the nurse, she asked me more questions about our relatives and family history. "Do you smoke, use drugs or drink large amounts of alcohol?" No. "Do you or your husband have hazardous jobs?" "Yes, raising of four children." Astounded look for a second, and then a smile. Gotcha! Well, at the end she said the test results looked good, but she wanted me to do an ultrasound this week, and wrote me a referral. She also wanted me to do yet another blood test later on and to come see her in early September (unless the ultrasound showed some abnormality).
Back to the front desk I went, showed them the referral, and the lady behind the glass found a free slot for today in Room 9. I hadn't stepped 10 feet from the window, when I ran into the nurse from Room 9 (the one that was not very helpful 30 minutes earlier). I told her that they sent me there because apparently there is an open window. "What, are they crazy?! We have 30 people waiting there!" I gave her the referral. "Let me go talk to the head ultrasound doctor and see what he says." The tone of her voice suggested little hope. She emerged 3 minutes later, with the same scowl on her face, "Make an appointment for today." And handed me my referral. It had a small mark, as if in initials, in the top left corner. The front desk lady printed out an appointment slip, informed me that it will cost me 30 grivnas ($6) and sent me off, grumbling something about the little dwarf (the nurse from Room 9 was about 4'9"). I laughed all the way to Room 9. I am witnessing quite a bit of personnel tension today J.
Back at Room 9, there was a line of about 6-7 women. They all had appointments, but I don't think one got in on time. There are always those who need to get in without the appointment. Since I had to be one of them last time, I decided I would patiently wait my turn at 11:55 am. A couple of "new Ukrainians" (rich people) came and jumped the line after talking to the nurse. Then there was a lady who did not look very comfortable. I heard the nurse say something about "the woman with contractions". She would take her after two other patients. I got up and offered my seat to the lady. She declined, but I insisted. She sat down. We started talking. She came all the way from the town of Skadovsk, which is about 2 hours south of Kherson and is on the Black Sea. She came here to deliver her baby, as she is having contractions and is over 38 weeks. When she got to the delivery hospital, however, the doctor sent her to the Diagnostic Center for an ultrasound. I know, it does not make sense.
I sat there till 12:35 pm. I would have been there longer, but I pleaded with the nurse, and she "moved me up". There are several reasons why I think they are so backed up. One, the nurse is constantly in and out of the room. She comes out after every patient and goes somewhere (don't they have intercom?). Fifty percent of the time she scolds the ladies who try to get in without the appointment "Are you crazy?! Look at the line!" or those who do not mention to her that they are carrying twins, having contractions, etc. She ends these tirades with "The head doctor is going to kill me!" The second reason I think they are so backed up is because the OB/GYN doctors here want pregnant women to have between 3 and 4 routine ultrasounds during their pregnancies. I can't figure out why a young healthy 24-year-old needs all that.
It was my turn. The room was semi-dark with relaxing background music. The doctor was a man in his 30s. I think he was the head ultrasound doctor. After I saw him, I thought that there might be a reason why the nurse acts the way she does. He, like the GD, was a man of very, very few words. He actually never acknowledged me, he just did his job. He barely opened his mouth when he spoke, and he spoke very softly on top of that. Add the background music, and I wondered how the nurse heard him at all. He moved his head as if to get a better look at what he saw on the screen. The head movements coincided with the wand movements. I tried to see the picture of my baby as it reflected off his glasses, but it did not work. So, I just lay there with my ears perked up trying to hear the verdict. His facial expression did not leave much hope. I was a little concerned at first, but after observing the same frown for 10 minutes, I relaxed. He seemed to know what he was doing, and he measured not only the NT, but also the nasal bone. He just gave the dimensions of the nasal bone, but I deduced the baby was probably OK since there was a nasal bone (it is absent in babies with abnormalities). Then he was done, and I got up. Not a word from either of them. I took a little time to put myself together hoping for instructions. Dead silence. I went out and waited outside (I had seen other ladies do it). The nurse appeared a couple of minutes later with a print out. "Next time make an appointment ahead of time!" I took the paper and studied it. It said things looked normal -- praise God!
It was after 1 pm, and it was time to go home.
Friday, July 27, 2007
More Adventures of a Pregnant Woman
Monday, July 23
I went to see the doctor a week and a half ago. I was told she was on sick leave with a broken arm. They did not know when she would be back. My Mom (who is a doctor in Russia) had advised me to get registered, so I could get medical care in cases like this. She was right. But what should I do now? Later that week I talked to the lady from church who recommended the doctor, and she said she would call her to find out. The doctor was back this Monday. I went to see her, determined to do whatever I needed to get registered. She had me write an application and to go see the "chief doctor" of the clinic. The secretary wasn’t sure I could get registered because I am not a permanent resident or a citizen here. But she told me to go ahead and pay the registration fee ($20). I came back, and the chief doctor signed my application without any questions. Praise the Lord!!! I went back to let my doctor know, and she took me to another doctor who is in charge of registering pregnant women. That doctor took me to a table in the hallway, pulled out a log book, wrote my name in three slots and told me to be there on Wednesday and to get appointment slips downstairs for 8:24 am, 8:36 am and 8:48 am. She said it very fast, and I had to ask her to repeat everything again to make sure I got it right. I wasn't really given a choice or asked if that would work with my schedule, I was just told to come at that time. I went downstairs to the registry to make an appointment and get the slip. No, I was told, you get it on the day of the appointment. Well, I just have to trust the system here (a scary thought!)
Wednesday, July 25.
This morning I woke up at 6 am worrying about missing the appointment. I left at 8 in the morning and was there at 8:20 am. There was a short line at the check-in desk. There were only two people in front of me, and I thought I was in good shape to make it to the doctor's room on time. However, my hopes slowly dissolved as I watched the registration lady chat away with another worker who was in the room with her. They seemed to not notice the growing line at the window. Finally, it was my turn. The registration lady was still talking. After about 30 seconds she turned to me, and I told her what I needed. She asked my name and registration address. I told her the address where we are renting now. She checked it on her computer. "You are not registered there!" she said. I guess they know more than what I give them credit for. I told her that the chief doctor allowed me to get medical care at the clinic. "Well, you just need to say that you live here without registration. I will write your appointment slips by hand." (?)
I hurried upstairs, since I was now 5 minutes late. The door was locked, and a lady waiting in line informed me that the doctor had to go out and take care of something. I sat down and drank some water (it was 97 yesterday with no air at the clinic). The registration doctor came about 5 minutes later, took my slips and called me in. The room had a familiar layout: it was about 11' X 8' with a window across the room from the door, two desks side by side by the window, a sink by the door and an examination chair. The doctor and a nurse were sitting at the desks. They asked me to see my application and the payment stamps which they criticized (my doc told me to tear the bottom of the page off, and this doctor did not like that. I told them I did what I had been told). Then they moved on to my residence registration questions. Have I registered with OVIR (local police department dealing with foreigners)? No, I have not registered yet, because it's too early (all foreigners have to get re-registered every six months, and we were told to do it as close to our 6-month mark as we could). They did not look very accommodating or friendly. I learned that it's better to say less here, because everything I say can and will be used against me. So, they entered my name and my temporary residence address, then my husband's name and age. Naturally they asked how we met, and I felt the ice was breaking. Everybody seems amazed at our story, but I know it was only the Lord who could put us together. The doctor then started asking me questions about my medical history, and I pulled out a sheet that I had printed out the night before with all my vaccinations and previous pregnancies. The doctor studied the paper for a few seconds. "I wish every woman came as prepared as you," she said, and I knew the conversation had turned. We talked a little about our church here, about homeschooling -- it's a shock for most people here. I knew we did not have much time, so I mostly tried to be friendly and to answer their questions as concisely as I could. The nurse measured my blood pressure and asked me to go to the scale. It was a floor scale with a moving arrow. "What does it say?" I looked at the bright red numbers at the top, "One hundred and …" They both laughed. I could not figure out what was so funny. The nurse came over. "There, the black number." I guess they needed kilograms, not pounds. At the end the nurse was giving me instructions about bloodwork and urine samples (my doctor asked me not to mentioned that I had done it already). Meanwhile, the doctor went out and brought another patient in. When the nurse was finished with me, I got up and almost bumped into the woman patient who was ready for her pelvic exam on the exam table. There was no sheet or any other covering.
I think now I am supposed to go see my doctor again. I have no idea when or if she wants to see me. Most medical workers here ooze indifference. I am getting tired of this socialized medicine.
I went to see the doctor a week and a half ago. I was told she was on sick leave with a broken arm. They did not know when she would be back. My Mom (who is a doctor in Russia) had advised me to get registered, so I could get medical care in cases like this. She was right. But what should I do now? Later that week I talked to the lady from church who recommended the doctor, and she said she would call her to find out. The doctor was back this Monday. I went to see her, determined to do whatever I needed to get registered. She had me write an application and to go see the "chief doctor" of the clinic. The secretary wasn’t sure I could get registered because I am not a permanent resident or a citizen here. But she told me to go ahead and pay the registration fee ($20). I came back, and the chief doctor signed my application without any questions. Praise the Lord!!! I went back to let my doctor know, and she took me to another doctor who is in charge of registering pregnant women. That doctor took me to a table in the hallway, pulled out a log book, wrote my name in three slots and told me to be there on Wednesday and to get appointment slips downstairs for 8:24 am, 8:36 am and 8:48 am. She said it very fast, and I had to ask her to repeat everything again to make sure I got it right. I wasn't really given a choice or asked if that would work with my schedule, I was just told to come at that time. I went downstairs to the registry to make an appointment and get the slip. No, I was told, you get it on the day of the appointment. Well, I just have to trust the system here (a scary thought!)
Wednesday, July 25.
This morning I woke up at 6 am worrying about missing the appointment. I left at 8 in the morning and was there at 8:20 am. There was a short line at the check-in desk. There were only two people in front of me, and I thought I was in good shape to make it to the doctor's room on time. However, my hopes slowly dissolved as I watched the registration lady chat away with another worker who was in the room with her. They seemed to not notice the growing line at the window. Finally, it was my turn. The registration lady was still talking. After about 30 seconds she turned to me, and I told her what I needed. She asked my name and registration address. I told her the address where we are renting now. She checked it on her computer. "You are not registered there!" she said. I guess they know more than what I give them credit for. I told her that the chief doctor allowed me to get medical care at the clinic. "Well, you just need to say that you live here without registration. I will write your appointment slips by hand." (?)
I hurried upstairs, since I was now 5 minutes late. The door was locked, and a lady waiting in line informed me that the doctor had to go out and take care of something. I sat down and drank some water (it was 97 yesterday with no air at the clinic). The registration doctor came about 5 minutes later, took my slips and called me in. The room had a familiar layout: it was about 11' X 8' with a window across the room from the door, two desks side by side by the window, a sink by the door and an examination chair. The doctor and a nurse were sitting at the desks. They asked me to see my application and the payment stamps which they criticized (my doc told me to tear the bottom of the page off, and this doctor did not like that. I told them I did what I had been told). Then they moved on to my residence registration questions. Have I registered with OVIR (local police department dealing with foreigners)? No, I have not registered yet, because it's too early (all foreigners have to get re-registered every six months, and we were told to do it as close to our 6-month mark as we could). They did not look very accommodating or friendly. I learned that it's better to say less here, because everything I say can and will be used against me. So, they entered my name and my temporary residence address, then my husband's name and age. Naturally they asked how we met, and I felt the ice was breaking. Everybody seems amazed at our story, but I know it was only the Lord who could put us together. The doctor then started asking me questions about my medical history, and I pulled out a sheet that I had printed out the night before with all my vaccinations and previous pregnancies. The doctor studied the paper for a few seconds. "I wish every woman came as prepared as you," she said, and I knew the conversation had turned. We talked a little about our church here, about homeschooling -- it's a shock for most people here. I knew we did not have much time, so I mostly tried to be friendly and to answer their questions as concisely as I could. The nurse measured my blood pressure and asked me to go to the scale. It was a floor scale with a moving arrow. "What does it say?" I looked at the bright red numbers at the top, "One hundred and …" They both laughed. I could not figure out what was so funny. The nurse came over. "There, the black number." I guess they needed kilograms, not pounds. At the end the nurse was giving me instructions about bloodwork and urine samples (my doctor asked me not to mentioned that I had done it already). Meanwhile, the doctor went out and brought another patient in. When the nurse was finished with me, I got up and almost bumped into the woman patient who was ready for her pelvic exam on the exam table. There was no sheet or any other covering.
I think now I am supposed to go see my doctor again. I have no idea when or if she wants to see me. Most medical workers here ooze indifference. I am getting tired of this socialized medicine.
Friday, July 6, 2007
More Adventures of a Pregnant Woman in a Post-Soviet Country
July 2, 2007.
Today I attempted to finish whatever the doctor told me to do. I did my best to follow the instructions on urine sample and blood work. No food since last night. I had purchased two small containers for urine (I am sorry this is so descriptive), collected it at home and left at 7:20 am to be at the lab shortly before 8 am. If you have to get a urin
e sample here, you do it at home and bring it in. When I got to the clinic, I needed to get my blood work done first. The OB/GYN nurse had instructed me to be there promptly at 8 am, or the lab tech "will run out of glass containers." I also needed to buy my own poker for taking blood from my finger, a syringe, cotton and alcohol. Armed with these items, I waited in line. I had to go to two different rooms to get it done and to pay an equivalent of $1.20. The race was on. I went to the nose-ear-throat doctor and spent about 40 minutes waiting in line. Another tricky thing: pregnant women are a separate category of patients, and they get only a short window of seeing that particular specialist. I only had from 8 am till 9 am to get in, otherwise I would have to come another day. I got there about 8:20 am. At 8:55 am I ignored the line in front of me, poked my head in the door and asked if they were still taking pregnant women. We will call you, they said. They did, in about 5 minutes. The room was large, and there were three sets of desks with people around them. At the one closest to the door two women in white (nurses?) were chatting, at the farthest table a doctor was examining a man, and I was led to the two desks in the middle. There were two women there. 
They asked me my name, age, address, and then one with the round mirror on her forehead reached under a brown piece of cloth (brown from sterilization in a hot oven) and pulled out examining tools. After a brief exam I was told that my partition between my nostrils was crooked, and that my left nostril was larger than my right one. I was tempted to say that I would pick my right nostril more from then on to help correct the problem. I was happy to be done with this part of my day. Urine lab was next.
It was located on the first floor of the building next door. I walked in and saw a dark hallway with a room to the left. In the doorway to that room stood a table with about a dozen of jars of all sorts and sizes, all filled with yellow liquid. Two lab techs were working behind the table. There were two people in the hallway, busily unwrapping their samples. (Don't forget to take the lid off!) They slammed their jars on the table. I did the same. Should I come pick up the results? No, your doctor will have them. Great! As I was leaving, I noticed another table -- it had glass jars filled with brown substance… Yuck!
Now on to see the OB/GYN doctor again. As I expected, this visit was not very productive. She again asked me about registration, and I asked her to explain to me what it was. If I get registered, I have to prepay to a hospital, but I will also get some financial subsidy from the government. I told her I would try to find out if I qualified. I think she is a little concerned that if I don't do it the usual way, I might have difficulties later if I decide to deliver here. Come back when you have all your results, she said. I left them a box of chocolates as a thank-you (a common gesture of appreciation here).
I had only two more places on my list: another lab and the Diagnostic Center for an ultrasound. I hopped on a bus and was at the lab in about 25 minutes. Finally, there was a place that gave instructions on a piece of paper nailed to the door. "1) Pay in Room 1. 2) Get your blood drawn in room 2. 3) Get results in room 7." I like that. My bill was 110 grivnas or $22. After I paid, I only had 1 grivna left, just enough for one bus ride home. The lab was nice, and I was told to pick up the results on Thursday, except one, which will be ready next Monday. Great! Fasting was over. I had grabbed a pear and a bottle of water before I left home, and it was great to be able to eat again. I turned the corner to go home, but then decided I could walk 7-8 blocks to the Diagnostic Center to try to get my ultrasound done. I got there at 11 am. I spent close to an hour standing by a wall in a dark narrow corridor, surrounded by pregnant women who waited to get in. I felt kind of bad, because most of them had made an appointment, and the Ultrasound doctor was running behind, and there I was along with a couple of other ladies who needed to get in, too, without an appointment. They took me ahead of some other ladies that had been there before I came. Did you bring a sheet or a towel to lie on? (They do not change the sheet on the patient's table.) I did -- I had seen those signs on Ultrasound rooms. The doctor was looking at the only monitor and dictating information to a nurse who was quickly typing it in. Everything looked good to the doctor (I couldn't see anything since there was no second monitor for the mom). They told me to get blood work done in 2 weeks and to go see a genetics specialist. Don't ask me why -- I think this is the latest fad there. I told them I had had some bloodwork done today. They looked at my receipt. "No, one test will not work, it's too early. Call them and cancel the test. Tell them to hold your money and that you will come next Monday." Sigh. I left and knocked on the door across the hall -- the genetics doctor. A lady in scrubs came out, and I told her that I needed to make an appointment and what the Ultrasound doctor told me about my blood tests. She confirmed that it was too early for one test and told me I needed yet another test. Yes, make an appointment to see the genetics doctor in two weeks when you have all your results. Make sure you come for another ultrasound right before you see the doctor -- we are looking for a particular thing at a particular gestation age.
Well, I was done for today! I came home at 12:20 pm tired and hungry. I did call the lab and canceled the one test (I was surprised they were very nice over the phone). Tomorrow I have to take another urine sample in. Being pregnant here is a full-time job!
Pictures: (top) the clinic where my OB/GYN doctor is located; (bottom) inside the clinic.
Today I attempted to finish whatever the doctor told me to do. I did my best to follow the instructions on urine sample and blood work. No food since last night. I had purchased two small containers for urine (I am sorry this is so descriptive), collected it at home and left at 7:20 am to be at the lab shortly before 8 am. If you have to get a urin
e sample here, you do it at home and bring it in. When I got to the clinic, I needed to get my blood work done first. The OB/GYN nurse had instructed me to be there promptly at 8 am, or the lab tech "will run out of glass containers." I also needed to buy my own poker for taking blood from my finger, a syringe, cotton and alcohol. Armed with these items, I waited in line. I had to go to two different rooms to get it done and to pay an equivalent of $1.20. The race was on. I went to the nose-ear-throat doctor and spent about 40 minutes waiting in line. Another tricky thing: pregnant women are a separate category of patients, and they get only a short window of seeing that particular specialist. I only had from 8 am till 9 am to get in, otherwise I would have to come another day. I got there about 8:20 am. At 8:55 am I ignored the line in front of me, poked my head in the door and asked if they were still taking pregnant women. We will call you, they said. They did, in about 5 minutes. The room was large, and there were three sets of desks with people around them. At the one closest to the door two women in white (nurses?) were chatting, at the farthest table a doctor was examining a man, and I was led to the two desks in the middle. There were two women there. 
They asked me my name, age, address, and then one with the round mirror on her forehead reached under a brown piece of cloth (brown from sterilization in a hot oven) and pulled out examining tools. After a brief exam I was told that my partition between my nostrils was crooked, and that my left nostril was larger than my right one. I was tempted to say that I would pick my right nostril more from then on to help correct the problem. I was happy to be done with this part of my day. Urine lab was next.It was located on the first floor of the building next door. I walked in and saw a dark hallway with a room to the left. In the doorway to that room stood a table with about a dozen of jars of all sorts and sizes, all filled with yellow liquid. Two lab techs were working behind the table. There were two people in the hallway, busily unwrapping their samples. (Don't forget to take the lid off!) They slammed their jars on the table. I did the same. Should I come pick up the results? No, your doctor will have them. Great! As I was leaving, I noticed another table -- it had glass jars filled with brown substance… Yuck!
Now on to see the OB/GYN doctor again. As I expected, this visit was not very productive. She again asked me about registration, and I asked her to explain to me what it was. If I get registered, I have to prepay to a hospital, but I will also get some financial subsidy from the government. I told her I would try to find out if I qualified. I think she is a little concerned that if I don't do it the usual way, I might have difficulties later if I decide to deliver here. Come back when you have all your results, she said. I left them a box of chocolates as a thank-you (a common gesture of appreciation here).
I had only two more places on my list: another lab and the Diagnostic Center for an ultrasound. I hopped on a bus and was at the lab in about 25 minutes. Finally, there was a place that gave instructions on a piece of paper nailed to the door. "1) Pay in Room 1. 2) Get your blood drawn in room 2. 3) Get results in room 7." I like that. My bill was 110 grivnas or $22. After I paid, I only had 1 grivna left, just enough for one bus ride home. The lab was nice, and I was told to pick up the results on Thursday, except one, which will be ready next Monday. Great! Fasting was over. I had grabbed a pear and a bottle of water before I left home, and it was great to be able to eat again. I turned the corner to go home, but then decided I could walk 7-8 blocks to the Diagnostic Center to try to get my ultrasound done. I got there at 11 am. I spent close to an hour standing by a wall in a dark narrow corridor, surrounded by pregnant women who waited to get in. I felt kind of bad, because most of them had made an appointment, and the Ultrasound doctor was running behind, and there I was along with a couple of other ladies who needed to get in, too, without an appointment. They took me ahead of some other ladies that had been there before I came. Did you bring a sheet or a towel to lie on? (They do not change the sheet on the patient's table.) I did -- I had seen those signs on Ultrasound rooms. The doctor was looking at the only monitor and dictating information to a nurse who was quickly typing it in. Everything looked good to the doctor (I couldn't see anything since there was no second monitor for the mom). They told me to get blood work done in 2 weeks and to go see a genetics specialist. Don't ask me why -- I think this is the latest fad there. I told them I had had some bloodwork done today. They looked at my receipt. "No, one test will not work, it's too early. Call them and cancel the test. Tell them to hold your money and that you will come next Monday." Sigh. I left and knocked on the door across the hall -- the genetics doctor. A lady in scrubs came out, and I told her that I needed to make an appointment and what the Ultrasound doctor told me about my blood tests. She confirmed that it was too early for one test and told me I needed yet another test. Yes, make an appointment to see the genetics doctor in two weeks when you have all your results. Make sure you come for another ultrasound right before you see the doctor -- we are looking for a particular thing at a particular gestation age.
Well, I was done for today! I came home at 12:20 pm tired and hungry. I did call the lab and canceled the one test (I was surprised they were very nice over the phone). Tomorrow I have to take another urine sample in. Being pregnant here is a full-time job!
Pictures: (top) the clinic where my OB/GYN doctor is located; (bottom) inside the clinic.
Monday, July 2, 2007
Exciting News
We found out earlier this month that Julia is pregnant. We are all excited about this and cannot wait for the baby to be born. The due date is February 8, 2008. Julia is going to try to keep up with and write about her adventures of being pregnant in Ukraine. Here is the first installment.
June 25, 2007
A church member recommended an OB/GYN doctor, and I went to see her on a Monday morning. My teammate, Melinda, kindly offered to accompany me.
Before I proceed, I will explain how socialized medicine works or used to work in the Soviet block. Every month government deducted money from every worker's salary to go toward socialized medicine. From that pool money was distributed to every clinic and hospital, and to every doctor, nurse and nurse assistant. It was also used to fund research. So, every citizen could theoretically receive medical care "for free." Great idea, but it didn't work very well. First, the money was not distributed evenly. And since all politicians lived in Moscow, the capital naturally got the lion's share of funding. Smaller cities and towns received enough to get by. Secondly, patients lost their rights to choose their doctor. You were assigned to a clinic according to where you lived. If you needed medical help, you would go to your "therapist" or general practice doctor that oversaw your particular location. If you needed to go see a specialist, your therapist would write a referral. Appointments are generally not taken, so you just have to find out when your doctor is in the office, go there, wait in line, and be seen.
Back to June 25. The doctor's office was on the second floor. We waited about 20 minutes. Two blond women in their 50s in white gowns sat across a table. They both looked at me. Which one was the doctor? I started talking and mentioned the lady who sent me (since I am not a Ukrainian citizen and am not registered here, this doctor was doing me a favor). One of the women spoke up and asked me what I wanted, and I said that I was pregnant and needed to see a doctor. "Do you want to be registered for your pregnancy?" she asked. I have no idea what it means. "What hospital are you going to?" I said I was not sure, possibly, in Kiev. "Well, should we get you registered or not? It would involve going to the director of the clinic and writing an application and bringing other paperwork." I am lost. OK, she said, you can think about it. Meanwhile, go downstairs to the pharmacy and buy some gloves, so I can do an exam. Finally something I can understand. I came back, and of course there is a line. Melinda told me just to go ahead and go in, since I already stood in line. (Melinda has been here for close to 10 years). I busted in, and the doctor saw me and smiled. She was talking to another patient, but she motioned to the examining chair, "Get undressed!" No one looked like they were going to leave the room and give me some privacy, but I spotted a small corner with vertical blinds over it, and did what I had to do. Forget a robe. I am glad I have had 4 kids and lost all my shame in the delivery room. The exam was over soon. The doctor then gave me a stack of referrals and papers to get my blood work done (in two different locations), my urine sample, an ultrasound, an EKG, and also doctors to see: a dentist, an eye doctor and an ear-nose-throat doctor. Don't ask me why. I suppose, instead of having a physical at your OB/GYN, you have to go see all these doctors. I went and had my EKG done in 2 minutes, I also saw the dentist ("Where did you get your fillings?") and an eye doctor. I was able to do about a third of what I needed to do. No one took my blood pressure or weighed me.
June 25, 2007
A church member recommended an OB/GYN doctor, and I went to see her on a Monday morning. My teammate, Melinda, kindly offered to accompany me.
Before I proceed, I will explain how socialized medicine works or used to work in the Soviet block. Every month government deducted money from every worker's salary to go toward socialized medicine. From that pool money was distributed to every clinic and hospital, and to every doctor, nurse and nurse assistant. It was also used to fund research. So, every citizen could theoretically receive medical care "for free." Great idea, but it didn't work very well. First, the money was not distributed evenly. And since all politicians lived in Moscow, the capital naturally got the lion's share of funding. Smaller cities and towns received enough to get by. Secondly, patients lost their rights to choose their doctor. You were assigned to a clinic according to where you lived. If you needed medical help, you would go to your "therapist" or general practice doctor that oversaw your particular location. If you needed to go see a specialist, your therapist would write a referral. Appointments are generally not taken, so you just have to find out when your doctor is in the office, go there, wait in line, and be seen.
Back to June 25. The doctor's office was on the second floor. We waited about 20 minutes. Two blond women in their 50s in white gowns sat across a table. They both looked at me. Which one was the doctor? I started talking and mentioned the lady who sent me (since I am not a Ukrainian citizen and am not registered here, this doctor was doing me a favor). One of the women spoke up and asked me what I wanted, and I said that I was pregnant and needed to see a doctor. "Do you want to be registered for your pregnancy?" she asked. I have no idea what it means. "What hospital are you going to?" I said I was not sure, possibly, in Kiev. "Well, should we get you registered or not? It would involve going to the director of the clinic and writing an application and bringing other paperwork." I am lost. OK, she said, you can think about it. Meanwhile, go downstairs to the pharmacy and buy some gloves, so I can do an exam. Finally something I can understand. I came back, and of course there is a line. Melinda told me just to go ahead and go in, since I already stood in line. (Melinda has been here for close to 10 years). I busted in, and the doctor saw me and smiled. She was talking to another patient, but she motioned to the examining chair, "Get undressed!" No one looked like they were going to leave the room and give me some privacy, but I spotted a small corner with vertical blinds over it, and did what I had to do. Forget a robe. I am glad I have had 4 kids and lost all my shame in the delivery room. The exam was over soon. The doctor then gave me a stack of referrals and papers to get my blood work done (in two different locations), my urine sample, an ultrasound, an EKG, and also doctors to see: a dentist, an eye doctor and an ear-nose-throat doctor. Don't ask me why. I suppose, instead of having a physical at your OB/GYN, you have to go see all these doctors. I went and had my EKG done in 2 minutes, I also saw the dentist ("Where did you get your fillings?") and an eye doctor. I was able to do about a third of what I needed to do. No one took my blood pressure or weighed me.
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