A Tale of Two Doctors Visits

It was the closest to a visit to a US doctor´s office I have had.  It was the farthest from a visit to a US doctor´s office I have had. 

I have already written some about one of my trips to the family doctor, but that visit was put into even starker relief after having gone to the OB/GYN office yesterday.

We were all ready to go the OB/GYN office on Tuesday when we got a call saying the doctor had an emergency and had to cancel.  Because she has a solo practice this is perfectly understandable (after all, if I have an emergency I darn well want her to cancel a simple office visit with someone else), but we were really looking forward to meeting Doctora Lucia and deciding whether she would be "the one" for us.  (The good news is, our rescheduled appointment for today went off without a hitch, and we think she will be great.)  Even this simple start (or mis-start) began our notes to self...

N2S: Dra Lucia -

1. Takes appointments, therefore can call when she will not be available for said appointment.

So on Wednesday we hopped in a cab to go to our appointment, and when we arrived we seemed to be in a sort of medical district of sorts.  It is very common to have areas of the city devoted to particular businesses, so this made sense, it is just that our previous experience with this idea included the "area where you go to hire a mariachi band" or the "area where you can find rockers and gliders for sale on the street".  At any rate, the address was a buildng that said Continental Medical Center and had a number of offices within it along with clinic/lab on the first floor. 

N2S: Clinic/Lab -

2. Neither doctor´s office takes any lab specimens themselves (only blood pressure, weight and temperature), but with Dra Lucia you can walk downstairs and go to a lab that will email you the results while a trip to a separate clinic is required for any tests with Dra. Lilia.

As we sat in the air conditioned waiting room for our appointment we watched a flat screen, high definition TV until the receptionst called my name and took down all my information and put it into a computer.  After the nurse took my medical history we went in to see the doctor who spoke English with us, put our telephone numbers into her iPhone and proceeded to tell us that it would be fine if we chose to have the baby in the States, she would not be offended, as many of her patients chose to do so.

N2S:  Whoa buddy -

3. Toto, we are not in Kansas anymore.

After lots of questions about her philosophy regarding natural birth vs. cesareans (the rate for c-sections in Colombia is quite high, though not really far different from the US these days) and episiotemies, about birthing classes and what the atmosphere for delivery would be, we went into her (separate) examination room.  She did a sonogram in her office (lower resolution, but hey) and assured us all looked good so far.

Of course the other big difference was the payment on the way out.  At Dra. Lilia´s office we pay $10,000 COP per consult (that´s around $5 USD).  Wednesday we shelled out $140,000 COP ($70 USD) for the privilege of said air conditioning, flat screen, iPhone, and computer.  Give a little, take a little more...  Still, we are glad for the kindness and capability of both doctors.  We are glad for the continuing reports of good health for Peanut.  And we are glad for the mixture/gamut of experiences we are having that reflect well the tensions and variations of life for people in Colombia.

(As a side note, in trying to find photos for this post, there were remarkably few - and I avoid saying zero only because I am not totally positive - pictures of doctors when I google just doctor.  Lady doctor...why have to do that?)

A Kick or Not a Kick, That is the Question

In theory I am at the point where I can feel Peanut start to move around and kick.  In reality, I'm not sure if I have yet or not.  The books and websites all say that the initial movements are sometimes hard to distinguish (especially in your first pregnancy), but that it can feel like butterflies in your tummy or popcorn popping or a goldfish swimming around.  I personally don't like thinking about Peanut the goldfish, but anyway...

Right now in the evenings I sometimes think I feel some bumping around in my belly, but because I am trying so hard to figure out whether it is real or just gas (attractive, I know) I have trouble deciding if I am just making it all up.  I know that soon enough I will feel something that makes it very clear, but until then you can tell when I am trying to determine what is going on because this totally engrossed but confused look comes over my face.  Some of you will argue that expression is not so uncommon as to be helpful, but whatever.

The reality is, for me at least, markers of progress are really important.  It is such a completely bizarre thing to imagine that there is something else living inside of you (sounds too much like Sigourney Weaver and Aliens...) that sometimes it is just too hard to believe.  Your first sign, of course, is that your period stops.  After that though, it is amazing how quickly you can doubt whether the little stick you tinkled on told you the truth or not.  You don't look different, you don't feel different, and the whole thing really does seem a little science fiction, come down to it.

So to some degree I was relieved to have a little morning sickness.  It was another marker - a way to know things are on track.  Let's be clear that the relief one feels at the next step taken is quickly triumphed by the prayer that the nausea end, and fast, but (for me) there was at least a moment of comfort in the midst of the uneasy queasies.

But now that has passed (thanks be to God), and my belly is not really a full-on "I'm pregnant, get out of my way" belly as of yet.  It can still be confused for my own gordita (little fattiness, see previous post), so again you start to wonder...is there really something in there?  It sounds silly, I know, but it is amazing how fast your brain can deny all the ultrasounds and doctor's appointments and wonder if this can all possibly be true.  Which means, I look forward to the kicks.  At least for the first few days - until I want to get some sleep and Peanut is up for jazzercise.  My enthusiasm may dampen a little then, but hey, it can't be worse than worshiping the porcelain god was...right?  (Right?)

April Checkup

Today we went back to the doctor's office for our monthly checkup, and all seems to be well.  We have a really nice doctor that I like a lot, but the visits are pretty different than those I might expect if I were going to my doctor in the United States.  We are also going to a more "popular" clinic than we might in the States (popular in Colombia referring more to folks with lower economic resources), so my comparisons are not particularly equivalent as I have always had private, insurance-covered health care.

I could name a variety of things that strike me as odd or just distinctive, but I think the main difference for me revolves around time.  In the United States my doctor made appointments.  She did not always manage to get me in at the precise time we scheduled, but she was always within shouting distance, and I only had to read People magazine for 15 minutes or so before someone attended to me.  Here, Dr. Lily does not take people by appointment.  It is strictly first come, first serve.  Hence, if you show up at 10am when her office hours begin on Saturday, you could easily wait until 11:45am before you even get into her office.  It all depends on how many other people showed up to see her on that day.

What struck me most today about this was how annoyed I could get just waiting there.  Rather than just sigh loudly, I started to think about what was so frustrating to me.  After all, it is not as if she suddenly changed the system on me, and it is not as if I had anything particularly pressing to do -- I was simply perturbed at having to wait.

And then I remembered going to the VA clinic with a homeless guest from Room in the Inn in Nashville and waiting the better part of the morning.  I thought about how much longer it takes us to catch the bus rather than find a taxi to get to and from work.  I thought about the hours-long line one can find at the emergency room or the day-long journey to get social services in Chicago for someone needing help from First United's Walk-In Ministry, or here in Barranquilla the mountain of people outside the stadium here when the government gives out a measly $30,000 COP ($15 USD) subsidy to families from lower economic backgrounds, and I realized that I was irritated because I have always had enough money to avoid such waiting.  Being poor (which, let's be clear, Richard and I are not) takes time.

It was a good reminder that I remain a deeply privileged person, and that such privilege rears its head in all sorts of forms - including internal disconnects when I choose not to exercise that privilege.  Don't worry about Peanut.  I have total confidence in Dr. Lily, and I am glad that someone of her care and quality attends to people in more difficult circumstances, as well as to privileged North Americans like myself.  And when we finally did get in to see her, she was pleased by how much Peanut seems to have grown and we were tickled to hear 140 beats per minute from our still en-stomached friend.

We have our first official obstetrician-gynecologist visit/interview on Tuesday, so keep up the good thoughts!

Chillin in the 13th Week

Here is our Peanut in his/her second ultrasound.  There is a pretty awesome leg stretch in the video to keep an eye out for, and when things get bouncy it is because we were poking on my belly to wake up the bean!

Here's the video...



13 weeks from Richard Williams on Vimeo.

Watch closely for some serious arm and leg stretching!

¡Hola Bebé!

I always heard about pregnant women in the United States who had folks they did not even know come up to them asking (or not asking) to pat their stomachs.  I always thought, "How can someone think that is okay?" and "Don't people have any  boundaries?  I mean geesh...."  According to a friend of mine in the States, when men come up to her and touch her belly, she just reaches out and touches theirs in the same way and that pretty much ends that.

Well...wouldn't work here.

At 18 weeks I don't really even look all that pregnant most days, and I am still wearing my regular clothes (which were a little bit big after I lost some weight in my first few months), but that doesn't stop folks here from patting my belly and greeting Peanut with a rousing "¡Hola Bebé!".  Because I do not really show yet, so far these are all people I know, but I don't know whether it will stay that way or not.  I doubt I will cotton to having an ear to my belly (which I get now), but I may have to answer more questions like the one I got today - "That's the baby, right?  Or is that just your belly fat?"  Nice...

Surprisingly all this has not really bothered me.  Taken me off guard?  Yes.  But I think it is probably helping keep all this real for me.  Since the nausea has passed (thanks be to God) and the kicking hasn't really begun, sometimes I wonder myself if the pooch on my belly is really a baby or if it is just my belly fat.  The greetings are kind of nice in a way, and it is just what happens here.  I walk in a room and I get greeted twice.  I get a kiss on my cheek (regular greeting) with a simultaneous rub on my belly (special for Peanut).  And everyone asks how we are doing.

Funniest perhaps is Señor Antonio, the head of the organization ANDESCOL (Association of Displaced People of Colombia) in the Department of Atlántico (the state in which Barranquilla is located).  Every time he sees me he asks how Peanut and I are doing, but every time he says Richard he says, "Uh huh, and Richard, are you taking care of them?"  And God forbid if Richard isn't around when he comes by because that means the next time he is going to get it from Antonio - wanting to know where he was and why he was not helping out with Mamie and the bebé.

At any rate, we are blessed to have so many people concerned for us, and I am grateful that Peanut is bound to have a village and a half to take care of him/her.  In fact, I think I am clearer here than I would be anywhere that I am merely a steward of the Peanut, because he/she will belong to everyone here and just hang out in our house I think.  And actually, I'm good with that.