Wednesday, 11 August 2004

21W 2D 出産前検診で医者の診察を受ける Antenatal clinic

今朝は子宮筋腫と血尿(腎臓)について医者に判断してもらうために行った。昨日に続き Royal London Hospital。今日は外来病棟の Antinatal (出産前)クリニックだ。10時半の予約だったが、私がついた頃にはもう、待合室がいっぱい。まず、検尿と血圧を測ってもらう。その後、待合室で順番を待つのだが、予約時間なんてないも同然。今日の担当の医者は、昨日私を診てくれた美人のインド系の女医さんを含めて5人ぐらいいたと思うが、3時間待ってようやく医者に会えた。


子宮筋腫については特に何もつっこまなかった。昨日から症状はどうですかと聞かれたぐらい。下腹部痛が子宮筋腫のせいなら、昨日の処置でとりあえずは様子見だからだろう。今回の痛みが引けばもう、大丈夫なのか聞くと、担当の女医さんは「子宮筋腫が原因なら、妊娠中、悪化することはあってもよくなることはない」と言った。出血や破水がなく、痛み止めが効いている限りはそれで耐えなさいだって。ベッドに安静にするのと、会社に行く事も特に変わりはないので、大丈夫だと思ったら出社しろと。今日はこの後会社に行ったが。痛み止め、きのうは3錠飲んだが、やっぱりあまり飲みたくないので今朝は飲んでいない。まだ痛みはあるが、少しよくなったかもしれない。


それよりも彼女が診察でポイントを置いたのは、今日の検尿でまた血尿があったこと。今日は+++と血液量が2ヶ月前の+、数週間前やきのうの++と比べて増えていた。今朝、私もトイレで、ちょっと血尿が混ざっているなあと見た目でも感じた。家族に腎臓疾患の遺伝があること、6歳の時にしょう紅熱、リウマチ熱を同時にやってから(両方とも溶連菌という細菌感染だと昨日調べて初めて知った)、腎臓を悪くして、慢性腎炎と診断され12歳まで毎月通院していたことを説明。膀胱炎になりやすく、膀胱の超音波検査を去年したが、腎臓はやったことがないと言うと、腎臓の超音波検査、腎機能検査のための血液検査をアレンジしてくれた。超音波検査は3週間後だが、採血はすっかりお馴染みの血液検査ルームへ直行して済ませた。


腎臓障害があると、胎児の成長が遅れる場合があるとかで、28,32,36週にもそれぞれ、赤ちゃんの超音波検査を追加でやることにもなった。子宮筋腫もあることだし、超音波検査を頻繁にやることはいいことかもしれない。それにしても、子宮筋腫と出産方法の関連などについては何も触れなかったなあ。子宮筋腫があると早産になったり、帝王切開になったりするらしいのに、それは検査しなくてよかったのだろうか。私も気がつかなくて質問しなかったが、これは10 月の次回のAntinatal アポのときに忘れずに聞くことにしよう。


それにしても、子供の頃の病気が今になってこんなに重要になるとは…。子宮筋腫もある意味そうだ。10代から生理痛がひどかったこと、トイレが近いことなどもほぼ、子宮筋腫に原因があったはず。早めに取っておけばよかった。



Went to the Royal London Hospital to see a doctor for my kidney and fibroids problems. It's the Antenatal clinic in the Out Patient building. I had a 10.30 appointment but waited for 3 hours before seeing a doctor. There were so many pregnant women waiting for their turn. Just after arriving the hospital, we were called for urine sample and blood pressure. There must have been about 5 doctors including the Indian female doctor I saw yesterday.


The doctor who saw me did not specially check my fibroids. She asked me how I felt today as she had known that I visited the Labour Ward yesterday. When I asked her if I would not have to worry about my pains any longer once these pains were gone, she said, 'If the cause was fibroids, it will never get better till the end of pregnancy.' As long as the pain killers work and no bleeding nor water breaking, that's it. I will have to put up with the pains. Staying in bed and going to work will not make any difference, she added. I anyway went to work after this appointment. In fact, I have not taken any pain killers today. Even though I have been told that these tables are ok for the pregnant, I do not want to take much. I only took 3 tablets yesterday. I still have some pain but feel better now.


The doctor rather concentrated on my kidney problem. Some blood trace was again found in my urine sample today. The indicator showed +++. About 2 months ago, it was only +, and a couple of weeks ago, it was ++. I myself thought urine looked a bit darker this morning and I knew some blood was in it from my experience.


I told the doctor my medical history. I had rhumatic fever and scarlet fever at the same time when I was 6, which triggered my kidney problem. The problem in English direct translation is 'Chronic Kidney Inflammation' but probably 'IgA nephropathy'?? Then I used to go to hospital once a month for check-up till I was 12. By the way, I only found that both fevers are caused by Streptococcus. We have a family history of kidney problem. It includes my maternal granddad, mom, brother and one of my cousins. I tend to get cystitis and I had my bladder scanned last year, the result was Ok. The doctor arranged a blood test and kidney ultra sound for just in case.


According to the doctor, if pregnant women have problems in kidneys, the baby growth may slow down. She also arranged 3 extra baby scan in the 28, 32 and 36 weeks. This sounds good for me as I am also worried about fibroids and if the baby and probably fibroids are closely checked, it will be helpful.


I was a bit unsatisfied with the consultation today as she was not concern much about my fibroids. I know fibroids sometimes cause premature birth or caesarean, but is it ok to just overlook this problem? Well, I also did not realise this while seeing the doctor. My next antenatal appointment is in October and I will remind the doctor to examine it.


I was quite surprised by the fact that my health problems when/since I was child now cause a little bit of complication. Kidney problem and fibroids as well. I have had always heavy period ache and the interval between toilets are quite short... weak bladder. They must have been both because of the fibroids. I should have had taken them out earlier.




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