In Defence of Modern Medicine

July 8, 2010 at 5:16 am (Uncategorized)

I did the amniocentesis test yesterday, hence no post, as Llew very sweetly insisted on taking the day off work, and had very firm ideas involving feet being up and any and all work being suspended for the day (although in the event he himself ended up hunched over my laptop for the better part of it). I was forced onto the couch with magazines and matinees – not a bad private hospital, this, especially since I didn’t actually need to lie completely prone – there was nothing from which to recover. I wasn’t about to volunteer to help anyone move furniture, but I was perfectly all right, merely stunned by the hysteria surrounding the amniocentesis having actually just been through one. Ergo, I thought I’d try to counter the rumours and fears with my own experience, because I think sometimes modern medicine gets a pretty raw deal, and personally, I think it deserves far, far better. It’s modern medicine, after all, that’s gotten Llew and me this far, and as far as we’re concerned it deserves a big rap.

The person who performs an amnio has a lot to do with how well it goes, as does the environment in which it’s performed. Let’s not underestimate the significance of what’s happening, and I am not at all cavalier about it: a needle is injected through a woman’s belly straight into the amniotic sac, and a good measure of fluid is extracted (Llew was fascinated and alarmed by just how much was taken). All of this happens in necessarily close proximity to the 15-18-week old foetus (in our case, 16.5). It’s delicate work. It’s a sensitive site. And there are risks, primarily of infection and miscarriage. However, and this is a massive ‘however,’ those risks are monumentally mitigated by the expertise of the practitioner in question. In other words, get a specialist to do a specialist job.

It’s expensive making that choice, make no mistake, and many people who might very much like an amnio via the private system simply can’t afford one – but the money involved is a different matter altogether, and one that deserves its own very long post about the way healthcare in this country is becoming more and more an issue of class, something we Australians love to claim doesn’t trouble our society. Well, bollocks. It’s a dangerous lie to pretend we don’t have class issues around health and education when we patently do. But if we can put this vexed matter of the moola aside for the purposes of this post (I know that’s cheating and totally inadequate, but it’s a much bigger and more complicated beast than I can manage without a great deal more reflection), then I would say from our point of view that having the amnio was worth every cent.

We went to the Kent St branch of Sydney Ultrasound for Women, and the moment we began our consultation with the specialist, G, I felt completely at ease. On the question of his personal experience conducting amnios, G was happy to oblige, telling us that for him, an amnio is the simplest of all procedures, since he now predominantly works on heart valves and performs other mindboggling surgical work on babies still in utero. So a needle through a belly? Yeah, he’s got that covered. Yes, he said, of course you still have to be careful, yes, you need to know what to avoid, what to look for, and what to expect, but yes, he absolutely knows what he’s doing, and he does it all the time. Right there is what we were paying for, and my only question then became, ‘So where do I sign?’

We are the beneficiaries, living in this age, of so much medical scientific endeavour, and I for one am happy to make the most of it. I find it curious that so many people seem to have such deep suspicions and fears of modern or conventional medicine, often championing instead alternative therapies and the sorts of ancient practices that came about when they still burned and drowned women on suspicion of witchcraft – in other words, when they didn’t know any better. We know so much more now, and so much better – both what makes us tick and what makes the clock stop – but there remains a pretty widespread resistance to people in white coats. I can totally understand people trying alternatives when conventional treatment, for whatever reason, doesn’t work. And as with life in general, people must follow their own treatment path – everyone must decide what course of action is right for them. I’m just saying that for me, I find it intriguing that some people actively forego modern techniques altogether in favour of treatments without any science to back them up. That’s just not my personality – if I don’t have the expertise myself, I look to the people who do. An enormous amount of money, time and resources is invested in modern medical research – the breakthroughs and improvements to so many treatment areas are absolutely astonishing – and I’m really happy and incredibly grateful to be able to take advantage of the work these supremely qualified and hardworking men and women do.

All my hackles were raised a little while ago when a very, very dear and well-meaning friend of mine sent me a text saying blah blah blah and oh yes, her genius naturopath was just recently telling her about the risks of IVF-pregnant women flying, so perhaps it’s best if I don’t. I fired off a furious response that was really intended for the naturopath herself, who has no right, in my opinion, because she has no relevant qualifications – none – to dispense this sort of advice. I’m not saying naturopathic remedies have no value, I’m only saying naturopaths should stick within their remit – that woman had no business at all filling my friend’s head with her own unqualified opinion. I have spoken to both IVF and obstetric specialists about this very question, and their view is that beyond the intervention itself, IVF pregnancies proceed like any other. I know to whom I prefer to listen. My friend prefers to listen to the naturopath, and that’s her choice, but I do wonder if it’s the same ‘genius’ (she actually referred to her as a genius in the text) that had my friend eliminate dairy from her diet, because anything that involves eliminating an entire food group just gives me pause.

Anyway, back to the amnio. The needle smarts going in, no question. It’s briefly uncomfortable. I also copped an extra needle in the behind because of my blood group, B Negative. It too is what you’d expect – a jab. But that’s it. G and his able assistants talked us through absolutely everything that was happening both before and during the procedure. The invasive aspect of it lasted no more than two minutes. I felt nothing out of the ordinary immediately following the amnio, nor for the remainder of the day. In the SUFW pamplet on amniocentesis, in answer to the question on everyone’s lips, ‘Is there a risk to my pregnancy?’, they have this to say:

Miscarriage may occur following amniocentesis, but at SUFW we have been able to minimise this risk. Our own figures show that the risk of miscarriage is as low as 0.25 to 0.33%. That’s a 99.75% chance that no miscarriage will occur due to the procedure.

And you know what? Those odds are good enough for me. I’m really, really glad I did it, especially since the lab called earlier to tell me we can now “rule out” Down’s Syndrome and cystic fibrosis. We have to wait two weeks for the chromosomal test results, which I really want for my own peace of mind, but Llew and I are both already breathing easier for these preliminary findings, which means our little friend is probably already breathing a little easier too.

I just think it’s important to note that I heard a lot of uninformed things about amniocentesis testing once I began asking around about it. There’s a lot of anxiety and fear around this test, usually based on risk figures that are massively distorted by wildly different testing conditions. The risks are not insignificant by any stretch, nor are they imaginary, and I am not trying to discount them. I’m only saying that I personally pursued the path of seeking specialist advice and specialist treatment, and I’d do it again in a shot.

If anyone out there is thinking of having one but has been totally spooked by well-intentioned friends and family, I would just say consider removing yourself from the chatter, and asking the experts what they think, because the procedure itself is nothing to fear. Dr Google? No thanks. I’m going straight to my main man G.

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15 Comments

  1. Pete said,

    Yay for the expertise in administering it and for the great result. You’ve sold me on this procedure (not that I would be the one making the decision if we got to that stage).

  2. doctordi said,

    Pete, I love a bit of expertise, I really do. I find it very reassuring being around incredibly capable people. And the results thus far are a huge relief. But I do really believe everyone must forge their own path, and L – who knows a thing or two about women’s health herself! – will no doubt have her own views on the amnio question. It was the right step for us, but I know it’s a difficult area, and we didn’t make the decision lightly ourselves.

  3. davidrochester said,

    Very, very glad you got such a good result — and that you had such wonderful professionals there to do it.

    I will admit to being suspicious of a lot of modern medicine — but mostly in how it overprescribes drugs for things that should be taken care of with nutrition, exercise, and self-care (such as emotional/psychological self-care). But for the “mechanical” end of medical advances, I have immense respect. The things they can do nowadays to test, repair, and diagnose are amazing.

  4. doctordi said,

    Actually, David, I am in *complete* agreement with you about the prescription epidemic. Outside of my two IVF cycles, I just don’t take any drugs at all usually, we don’t even have aspirin in the house, so they’re simply not part of my thinking, but of course you’re quite right. Children on multiple prescriptions in particular send a shiver down my spine. I don’t think drugs should be any doctor’s first recourse – interestingly, my GP, my obstetrician AND my IVF specialist all encouraged us to go away and keep trying naturally for a long time – no one strong-armed us into IVF, it was treated by all three as a last resort. And I found that suited our own beliefs about treatment. I think I’d question any doctor whose first thought was to whip out the prescription pad.

  5. Lilian Nattel said,

    Great news, Di, and I’m so glad that it was a positive experience in good hands.

    • doctordi said,

      Lilian, it really was a positive experience… the three people who attended to us all made us feel safe and informed and supported. I couldn’t have asked for more.

  6. Fiona Wood said,

    Agree – about horrible inequities in health and education – and about the good sense of utilizing the best expertise available to you. What a reassuring read for anyone with an amnio pending!

    • doctordi said,

      Hello, Fiona! Well, I am honoured that you have taken the plunge! Yes, the growing inequality in both areas of Australian life are of pretty major concern to me and many others, and I don’t feel like it’s something anyone in government is even admitting, let alone interrogating in any meaningful sense. Are we the only ones who are worried about this widening gap?

      Yeah, I really wanted to reassure anyone who happens upon this post as part of an internet search. There are simple ways to mitigate the risks, and people should know that.

  7. Norwichrocks said,

    I’m with both you and David on the prescription epidemic, as well as on the good sense of going to the specialists for the ‘mechanical’ side of modern medicine. Many thousands of people over hundreds of years have dedicated their professional lives to improving medical practices and the progress we have made is impressive (even if its availability is still, in many cases, limited by means).

    And, like, whew! on the results 🙂

    • doctordi said,

      BIG phew, Woo!!! Big time relief. I am really looking forward to the chromosomal results coming in too – the value of that reassurance is just priceless.

      Yeah, I think the availability being so dependent on means really, really sucks. When there is existing science to help people and save lives, there is something obscene about its being withheld for mercantile reasons.

  8. Olga said,

    Hi there,
    Thankyou for that beautiful article. I am in Sydney too. I am due to have my amniocentesis in three weeks time and I just wanted to confirm with you if it was Greg kesby that you were talking about.
    Thankyou for help,
    Olga

  9. Paris said,

    I need to have an amniocentesis too and trying to find the right doctor it has been just a nightmare for us. And I was going to ask the same question that Olga just did. Was Dr Greg Kesby who did yours?
    thankyou.

  10. DoctorDi said,

    Hi ladies, and congratulations on your impending arrivals. Yes, Greg Kesby was the specialist in question. He was excellent. You’ll know as soon as you meet him you’re in safe hands. Best of luck with the amnio, the result and the birth.

  11. Leah said,

    Thank you so much for this article. I have search & read so much on this topic & this is the best (and most reassuring!) point of view I have found. I have my first Amnio with SUFW (Dr Rob Robertson) in 10 days & I’m so nervous/stressed/worried about the Amnio procedure and the miscarriage risk & the results (so much to worry about!).
    Thank you again,
    L

    • doctordi said,

      Leah, I really hope the amnio goes well for you and that you get the desired result. I know what a stressful, worrying time it is and I really am pleased to think I have mitigated against some small portion of your understandable anxiety. They’ll take good care of you. Of that I am positive. Best wishes to you.

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