I cannot forget the excitement when I saw the positive line on the pregnancy test! I think many mamas can relate to that.
I was a graduate student in University of California, Davis back then. So to confirm and start prenatal care, first I went to the student health center on campus. My health insurance required that. After I gave my urine cup in the lab, I was waiting in the exam room when a nurse practitioner entered. Nurse practitioner was somewhat nervous: not surprising, probably she had given many pregnancy diagnosis to many women who did not wish. She first placed a piece of paper on the desk. Nothing was written. Then in a nervous face, she asked, “do you intend to get pregnant?” and I said “YES!!” then she flipped the paper that had a big “+” mark, “Congratulations, you are pregnant!”
This was actually only the second time I went to the student health since I came to the US. I didn’t see a doctor for five years! I had no idea about the complication of health insurance system in the US then. Now that side of journey had started, too.
The referral person asked me where do you want to give birth. Without much thought, I chose the nearest and only hospital in town. The she arranged the first prenatal appointment and there my husband and I went.
I saw a nurse midwife. She explained that in the hospital’s birthing center, they offer water birth with midwife. That sounded very cool! Both my hubby and I were very excited of that and I started to imagine. Then she started physical exam. Touching my neck, she said, “Hmmm…it’s a bit large. Do you have thyroid disease?” I said “No”. And she started to tell several symptoms like loose stool, fatigue, etc….I had them. I blamed my loose bowel to alcohol, and fatigue for lack of exercise. To overcome, I walked about an hour in the morning and by the time I arrive at the lab, I was exhausted and ended up resting in the backroom of women’s restroom. Only solution I thought was, “I need to do more exercise.”
But suddenly what midwife told fit into pieces. She ordered thyroid panel blood test and we left making the appointment for the next prenatal visit. Then the next day, the hospital called me that I have hyperthyroid and they can’t deliver my baby because it was such a high risk, and that another hospital in the same group about 40 minutes drive from where I live, can. She also said that I need to see an endocrinologist. The hospital group didn’t have an endocrinologist locally, so they suggested to go see different medical group, run by UC Davis.
Now I came back to the referral room in the student health. This time my heart was heavy. There was only one endocrinologist in town so they arranged appointment to see her. At the first appointment, she told me what I already knew: I have hyperthyroidism and my pregnancy is high risk. She made a referral to a perinatologist, who is very famous for her genetic diagnosis work. Well, I knew a thing or two about genetics: I was a Ph.D. student in molecular genetics then. But what happened at the molecular level and what was happening in my body were somehow disconnected. The endocrinologist immediately started on Propylthiouracil – or PTU for short – second commonly used medication for hyperthyroidism. Most commonly used one is methimazole, but because it was teratogenic, I couldn’t take it. Suddenly, I started studying FDA’s pregnancy category – both PTU and methimazole was category C – that is, unless absolutely necessary, the medication shouldn’t be used during pregnancy. I was devastated. Did I have to give up this pregnancy? Will I have miscarriage? I was overwhelmed with these ideas. Anyway, she ordered additional blood test and I left.
The next thing was to see a perinatologist. I had to go back to the student health again to get referral.
To be continued.