Decision Point

I made it to the stop light between the blood doctor's office, and the baby doctors' practice.  It was at the red light I felt the warm, silent tears falling down my face.

I had been back at school all week.  I guess Pat is huge, as it is now the first thing people see or comment on.  We had a training on the southside of town in the morning, and I left early to make it back for my blood doctor appointment on the northside.

I wasn't really nervous about going back to the blood doctor.  I already knew my platelets were low.   I knew the Dr. Saleh was going to come up with a plan.  But somewhere, down deep, I knew I wasn't ready to face what that plan meant.

Dr. Saleh's nurse always comes in to see me first.  My bruised and swollen knuckles concerned her, but I am a petite person with a pound or more of water in my fingers.  The bruising comes from the pressure, and ITP complications.  My feet, which I am now calling elephant cankles, look bad, but don't hurt.  She looks at me with pity as she squeezes my legs, just for them to turn color, and show that I am storing enough water for a small nation.

Dr. Saleh comes in while we are just talking.  He shakes his head and looks down as he enters.  I swallowed hard.  I would not cry in this room.  I haven't cried in the 6 years I have been seeing Dr. Saleh, and I would not start now. 

He does his normal body checks.  He asks me to make a fist, which I know, he knows I can't do.  He checks my nose, which was cauterized a few years back to stop the daily nose bleeds.  He checks the back of my throat which he says is spotty.  That just shows thin blood.  No major bruises but some random cuts on both legs, I am still not sure how I got them.  Just him rubbing on one of the cuts, opens it, and he shakes his head as it shows him I am not clotting appropriately.  I already knew all of this.  I know all the signs, and what they mean.  Nothing has surprised me.

He steps back from the high table I am sitting, and leans against the counter.  He has my counts in front of him.  He let me know I am down to 43.  43,000....  To have a successful, uncomplicated labor I need to be at 50.  The following conversation took place

Me - "So what is the plan?"
Dr. - " We are going to do Prednisone."
Me - "Is there nothing else?  Please.  You know how much I hate that drug."  I had to swallow hard as I knew my eyes were starting to well up.
Dr. - "Amanda, you know your body won't react to anything else.  We have tried everything else.  We can't do a chemo right now.  You are doing everything in your lifestyle to combat it.  We only have a few more weeks.  We have to make sure you can complete labor."
Me - "I understand" My voice starts to shake "Prednisone is just such a terrible drug.  It did terrible things to me, physically and mentally.  What will it do to the baby?"
Dr. - "There are complications.  A few.  The pharmacist can give you a list. Most of them won't affect the baby because you are so far along.  Something like cleft palette won't be a concern because your baby has already developed further than that" At this point he could see I was getting stressed and upset.  I felt my own breathing shortening.  "Amanda, we have no options here.  We knew this would be a problem from the beginning.  You are so far along, you are lucky.  Let's just get through these last 3 weeks."

At this point I was just staring at the floor.   I had shut down. I was defeated.  I had nothing more to say.

Dr. Saleh left me with his nurse.  She was just trying to comfort me.  We talked it out a little bit.  I greatly appreciate the care, and heart they have there. 

I left the room.  It wasn't until I was on my way to the the baby doctor, to drop off all my paper work from Dr. Saleh, that I realized I was in a position I never wanted to be in.

Jacob and I didn't try for children for quite a few reasons.  Jacob never wanted to have children if it left a chance of me getting sick again.  I never wanted to bring an innocent child into the world if there was a chance it would be sick.  And yet here I am.  I am faced to choose between my own health and the health of an innocent, unborn child.  How can I be asked to make this choice?  How can I know what the right answer is?  Take Prednisone and possibly hurt the baby, don't take it, and I might have major complications.  If I take it, am I selfish, thinking only of myself?  Don't take it, and am I saying I am willing to put myself at risk for my unborn child?

I am so upset, sad, disappointed I am here, at this decision point. 

I didn't see any doctors at the baby doctors, just dropped off paper work.  I got back in the car, and drove myself back to my school.  The tears were still silently streaming down my face as I pulled into the parking lot.  I parked the car and looked at the passenger seat, and there sat the Prednisone prescription.  I am a strong person.  I sat back in my seat, and wiped my face.  I tucked my hair behind my ears, and grabbed my purse.  I opened the door.  As I walked through the parking lot, I held my head high.  I had made my decision.