I went back to see my endocrinologist last week, for the first time since he told me he didn't want to see me again. He told me that I could come back when I wasn't pregnant, but that if I wasn't prepared to see him every month and follow his recommendations during my pregnancy, he didn't want to be responsible for my care. He also disapproves of me getting pregnant again, which reveals a more fundamental ideological disagreement between the two of us than just, "how many times I need to have my A1C checked while I'm pregnant?"
Well, I'm not pregnant any more, and I could have just found a new endocrinologist, but I can see lots of advantages to this one. First of all, he's been my doctor since the day I was diagnosed with diabetes. Second, for all but about 4 years when I lived in St. Louis, he's been my doctor. Third, he has told me before that he knows I can manage my own blood sugars, so he's unlikely to run roughshod over my intuitions. And fourth, I can get to his office, have my appointment, and be back to my house in one hour.
So it was with some fear and trembling, but I decided to go back and see if we could just agree to disagree. Next time I want to have a baby, I'll find someone else.
I was jumpy from the minute I walked in the door, and listening for a hushed whisper to fall over the women behind the counter about the defiant, non-compliant patient that just walked in. (It never did). Every time the door to the back of the office opened, I caught my breath a little. Finally, the nurse called me back.
My doctor's first words to me when he came in the exam room were: "I'm so mad at you," but he had a big smile on his face, and the words were accompanied by a hug [slightly awkward]. It was merely his way of opening the conversation, and not trying to pretend nothing had happened.
He proceeded to affirm, as a wise father might say to his teenage daughter, "I know you'll do it your own way," and "I can't make you do anything you don't want to do"; "I'm just here to give you information," and "please be careful."
I explained that we really couldn't pay for visits every month when I was pregnant, but that perhaps I underestimated his willingness to accommodate my circumstances. I told him that I was doing my absolute best to manage my blood sugars so my children wouldn't hurt for it, and that we were comfortable abstaining if the need to prevent pregnancy arose.
And, at the end of the conversation, I told him about my son's multicystic dysplastic kidney (which is something I swore I wouldn't do, to avoid giving him fodder for making me feel guilty about hurting my child!), and asked whether he thought it might be related to my diabetes. He said he knew of no association between MCDK and diabetes, and that I had absolutely no reason to feel guilty about it, especially since my blood sugars were so well-managed.
Right before he left the room, he looked at my baby, sighed, smiled, and said, "these are the things that make being a physician worthwhile."
Phew. Happy ending/new start.