Saturday, February 28, 2015

A Human Level

In 2009, I asked my primary care doctor if she would prescribe PrEP for me so that I could conceive a child. Her answer was a devout NO. You can read my blog post about it here.

With the recent articles, videos, and book on our story and the subject of PrEP for women, I often wonder how that doctor feels about my story today and the role she played during the journey.  Would she still say NO today? Does she feel vilified?

I can certainly see the reasoning for her initial refusal to prescribe PrEP for me.

She was a primary care doctor, not an HIV specialist, and the global discussion on HIV and prevention options were not as "mainstream" as they are now. Even today, I imagine a lot of primary care doctors are not up to date on their information regarding HIV prevention strategies (other than condom use), but we are hearing more about it in the mainstream than we did before. It was 2009 when I talked to her about prescribing PrEP.  The iPrEx study didn't announce its findings until late 2010, and PrEP wasn't approved as an HIV prevention tool by the FDA until 2012.

I don't fault her for not wanting to prescribe me something that was not yet approved by the FDA. But, I resent her judgmental tone, and lack of dialogue on the subject. I feel the responsible thing would have been to have a discussion with me about resources or alternative ways we could get pregnant, I was just too upset to push for this discussion with her at the time.

I wonder if deep down, she might have thought that our wanting a child was selfish and irresponsible. People write these sort of things to me all the time in the blog comments, I don't publish them because its such an ignorant response, but through my blog, I know first hand that a lot of people feel those with HIV don't deserve a chance at love, or parenthood.

I wonder if she's read the articles and book or seen the videos.  I wonder how she feels knowing that I was able to achieve my dream. I can only hope that she's learned not to stand in the way of someone else's dream.

The medical field is so prescriptive and scientific that, at times, it doesn't allow for humanity. If she would have taken a moment longer with me....asked more specific questions, I know her and I could have found a way to have a heartfelt conversation about my desire to have a baby. Doesn't mean she would have changed her mind, but we would have connected on a different level...a human level.

I've had the wonderful opportunity to speak to medical providers in classrooms and on panels and I always remind them to really listen and connect with their patients. Doctors connecting with patients on a human level is so important. It builds trust. It allows for patients to process their own illness, or a family member's medical condition. It allows a doctor to see links or patterns of behavior, to get a "hunch' that could lead to completely different diagnosis. It helps us hear each other, understand each other. It makes doctors better doctors, and patients better patients.

And at the very least, it makes us human...and don't we all need a bit more human connection these days?

Sunday, February 8, 2015

PrEP on the way!

About two weeks ago, I went to an appointment to see about getting a prescription for PrEP.  I kept putting it off, thinking that if more time went by, I would become comfortable with the idea of unprotected sex to conceive without PrEP.  But I couldn't get comfortable with it, so to the appointment I went.

I was scared that I'd have another experience of the doctor refusing to prescribe it, and then hurling ignorant judgmental statements at me for even considering having unprotected sex with my husband...PrEP or no PrEP. But if we want to have another baby, then I'd just have to deal with whatever came up at the appointment. So, I called and the woman who answered seemed a bit rushed...I told her I'd like to make an appointment with the Dr. She asked what was the nature of my wanting an appointment. I said, "I'd like to get a prescription for PrEP."

Suddenly I was aware of my pounding heartbeat, and held breath, waiting for her response. She said, "Oh, you can see the Physician's Assistant (PA) for that, we can get you in sooner that way." Oh my goodness. The relief. The acceptance. The lack of judgement.

As the appointment date drew closer, I began to have a fear that I would seem out of place in the waiting room.  You see, this doctor treats many HIV (and non-HIV) patients in the Castro District of San Francisco. I thought I'd be sitting in a room full of burly men with large mustaches, tight leather pants, and studded black boots. And they'd all look at little ole' me and wonder what in the hell I was doing there.

But, the patients in the waiting room all looked "normal." And I judgmental of me! What is "normal" anyway?

Needless to say, the PA ordered some blood work and then told me if all is normal on the blood work, she will send the prescription electronically to my pharmacy. She made sure I knew to take it every day, get blood work done every 3 months, and to be aware of side effects.

As I walked out of the office, I felt relieved that it went so well, and once again realized that the fight to have a baby with my husband was behind me...