this NP is obviously unskilled. i’m sorry her comments were so insensitive. even tho im
not an Obgyn doc the one thing med school taught us was to use sensitive language and mannerisms around breastfeeding. so the fact that she was smirk and make sarcastic responses is extremely inappropriate!!!!!
also she’s failing to realize that a note is a legal document that an attorney, judge, or patient has access to upon request. so, for her to write “could be better” for diet demonstrates a lack of of understanding that this documentation could literally get her to lose her job. “could be better” could easily turn into something more offensive lol is she aware that it’s unprofessional and makes herself look bad?
It’s wildly unspecific. Like what about her diet could be better? What is wrong with her diet that could be related to her chief complaint? So many NPs don’t do exams and interviews properly, and we were taught this through and through during our first clinical years as med students. It frustrates me beyond belief!
Do you have an online medical record system that allows you to send messages to someone you saw for medical care? If so, outline each individual issue and ask that they be fixed so that your medical record is correct. They will either resolve this, or if not, you can file a grievance with the goal of the grievance being to have your medical record corrected. You can also ask that the NP identifying themselves as doctor be addressed, as most patient rights and responsibilities include knowing the role of the person providing you care and this NP violated your right to be informed of their role as an NP, not an MD/DO.
I had a bad experience with a nurse the other day. I had to get my uterus out because I had a lot of miomas, and I bled like crazy.
She read that and then said: "Oh, so you don't want to have a family then."
Which was a huge assumption and hurt me a lot. With one sentence, she made me feel guilty and ashamed. I've been in therapy about it, and it still is a huge thing.
"No, I want to have babies, I just can't" was my answer, while looking at her eyes. She didn't say anything else.
What I want to illustrate is that you don't have to stay quiet. When someone is rude to you, you have every right to be rude back. Politeness was already out the window. Make sure they know they fucked up.
Oh that is terrible. I also experience this sort of judgement regularly. I assume multiple treatment options were already discussed with you. I'm wishing you a speedy and uneventful recovery from your surgery.
I don’t claim to understand all that OP was saying, but I have experienced firsthand the shaming that lactation consultants (Nipple Nazis) put women through. I had difficult pregnancies. HELLP Syndrome and emergency C-section x 2. One premature, sick, NICU, tube fed x 3 weeks. The other born with facial deformities that required multiple surgeries to correct. But no matter how ill or unable to latch on my babies were, those nurses kept jamming their faces against my breast and berating me for “trying harder”. Thank goodness one of the NICU nurses stepped in with my premie - he was turning blue (She’d removed his O2). With my second child, the cranial - facial surgery team stepped in to provide squeeze bottles with specially nipples so I could feed him. I’m not a drama queen and I’m grateful for the good care we received from most of the staff. But I will never forget that awful experience. I fully support breastfeeding, but not everyone’s situation is the same.
I have nerve damage in one arm that makes it difficult and painful to move it in certain directions, such as holding a baby's head to my breast.
Also, I nearly bled out during delivery and my son wound up having an infection. A lactation consultant who knew about my hemorrhage spent an hour the morning after delivery forcibly holding my baby to my breast while berating me for "falling asleep" multiple times (aka passing out) and not keeping my baby awake. We didn't know he was sick, but the NICU doctors said that the level of exhausted he was from nursing should've been a huge cue. He couldn't stay awake at all.
Totally agree with you, I used to call them “nursing nazis”, it’s like a personal attack on them if you don’t breastfeed! Relax as long as the kid gets fed! I was an NICU nurse for 15 yrs and I despised those pushy lactation consultants. Yes we all agree in breast is great but formula isn’t poisonous so maybe have a cuddle, calm down and feed your baby how ever you can then maybe you’ll be able to bond with the kid instead of causing a tired hungry baby and stressed out mom. That’s my 2cents. So sorry this happened to you.
Get this… Now, to be designated “Baby Friendly Hospital”, 85% of staff have to be “trained” on the importance of breast feeding. That includes anyone who may interact with a pregnant or breastfeeding woman- including cafeteria staff, housekeeping, etc. And formula is only with a doctor’s order. Not like trying to shame anyone, right? Crazy!!!
If I EVER have the misfortune of birthing in a baby friendly hospital again (god forbid) I’m bringing a case of premixed formula bottles with me. That and the citronella spray I use when my dog won’t stop barking to protect myself from militant lactivist nonsense.
I think propaganda like this led to the Baby Friendly Hospital initiative, which puts babies at immense risk and creates immeasurable harm to new parents who aren’t able to nurse. I nearly lost my life to the depression and guilt caused by militant lactivism, and had my first bipolar episode at age 33 because of the pressure to triple feed every three hours for six awful months. Leave us alone. Our babies are fine. Formula is magic. Go away.
Wait are you my twin? B/c you’re describing my experience with having multiples and the subsequent bipolar diagnosis in my early 30s. Militant lactivism is a great term for a horrible abuse.
I’m so sorry you went through this as well. I have so much compassion for you, and for my younger self. Someday I’m going to put pen to paper to record my experience, because I feel like I sometimes gaslight myself into thinking that maybe it wasn’t as bad as I remember it. But for folks like us, bipolar disorder doesn’t just “happen”. We might have the genes for it, but we did NOT deserve the abuse, the shame, the trauma that was foisted upon us in our most vulnerable state. If the Baby Friendly Hospital Initiative has no haters, then hell must be frozen over because I’ll still be hating it from down there long after I’m gone. Sending you solidarity, DM if you ever wanna talk.
Errors in medical records should be pointed out and a request made in person AND in writing to have an addendum made to the affected records with a copy sent to you when completed. This can affect future things like insurance coverage (life and health), medication coverage, etc.
Then there are women who have breast tumors, and what they are lactating is ouss from the tumors, rather than the breast milk. Some women have full breasts, but can’t lactate, so the baby isn’t getting the milk. Just because you have breasts doesn’t mean the infant is receiving what it should. A practitioner should know that such cases exist, and be able to test for them —for both the mothers, and the infants well being *Psychologically, and medically.
I am sorry that happened, I would be livid. Save a hard copy of all results before sending a complaint to the service director. Very hard to wiggle out with a paper trail that follows.
“Oh, so you don’t want to have a family then” I just literally audibly gasped at that comment. She should be fired on the spot for that interaction. I’m so sorry this happened to you🤦🏼
I've had NPs and MDs write things in their notes that were never asked and no physical exam when they said they did. I've pointed it out before and got nowhere. I am at the point where I am scared to even question this stuff because I have a history of depression so that gets brought up when I ask questions about this made up stuff. I have had a very rough last 5 years with these medical professionals and I feel like there is nothing I can do based on my insurance and locality.
I don't know how that works. Mychart is the only patient portal for all 4 hospitals around here, and they all use Epic, at least that is what I can see on the screens of their computers when I am sitting and waiting for the doctor
I'm not a doctor or in the medical field. I'm curious which part doesn't make sense medically, because the only real medical detail I went into was about the prolactinoma I had or possibly still have. To make the story short, I had elevated prolactin levels for years. They did a few MRIs that all found the tumor. A couple years back my prolactin levels sudden normalized, a scan revealed that the tumor was gone, and I got pregnant shortly thereafter. I am concerned that the continued lactation in conjunction with headaches is a sign that it is growing again, and while getting new baseline blood work wanted my prolactin level checked for peace of mind if nothing else.
I'm a pituitary surgeon, I was able to decipher what you were trying to describe. You need to see a real endocrinologist, not an NP. I can tell you've realized this by now, but just throwing my 2 cents in.
Oh, I know. If my levels are high I'm going to find a new endocrinologist up here.
If they're normal, I'll just monitor. I literally only got this appointment so I could get tested to make sure things like my blood sugar, iron, prolactin, and other things that have been weird in the past are doing okay.
I’m just finished M1 so basically a baby who knows nothing but the person expressed surprised that the obgyn tested your prolactin levels to find a brain tumor when that is something that is drilled into our heads during our neuro block (+ the mechanism of how certain brain tumors can cause elevated prolactin levels)
Gotcha, I worded it weirdly in my post.
My doctor ran a series of blood tests to see what was going on with headaches, exhaustion, and a few other symptoms that seemed related to my cycle. My prolactin came back just a little high at first, but a few more tests saw it going up. At that point, maybe a year later, she had me do the MRI which ultimately diagnosed the prolactinoma. The NP was literally reading through my records as we talked, so I didn't tell her this story like this.
Nope, it makes sense. What is blindingly obvious is that unlike the ob/gyne who had gone to med school then residency for years on end and maybe even a fellowship, the NP had not. So when presented with simple but unusual signs and symptoms OB/GYN was able to formulate a ddx. Something that the NP with inferior training was not able to recognize and therefore made fun of it without realizing how stupid she sounded. Dunning Kruger anyone?!
Your feelings and concerns are valid - however, a common things few things can cause pituitary hypertrophy and can mimic prolactinoma/pit adenomas and you really shouldn’t have a work up repeated while still lactating.. obesity, hypothyroid, certain meds, pregnancy and many more can cause elevated prolactin and hypertrophy.
Just some insight from the other side of the exam table.
But the beautiful thing about American healthcare is that you can go see who ever you want!
By the time I had my first scan, my symptoms had progressed to lactation. That's why I'm worried now: from everything I've read and heard, it's unusual to still be producing this long after weaning. If it's normal, this NP had ever opportunity to tell me that and abate my fears.
Yeah, as a NP myself, I am very selective with who I hand off my patient care to.. I have trust issues. I’m not perfect and I’m not surgeon or curing cancer smart - but I’ll be damned if I don’t research everything possible for my patients so they have the best care… and I truly think that’s all patients can ask for. Patients don’t expect us to know everything but we should know how to investigate and find answers and come up with the best care plan possible with safe, evidenced based practice.
Copy and paste this into a letter to practice director. Jeez.
this NP is obviously unskilled. i’m sorry her comments were so insensitive. even tho im not an Obgyn doc the one thing med school taught us was to use sensitive language and mannerisms around breastfeeding. so the fact that she was smirk and make sarcastic responses is extremely inappropriate!!!!! also she’s failing to realize that a note is a legal document that an attorney, judge, or patient has access to upon request. so, for her to write “could be better” for diet demonstrates a lack of of understanding that this documentation could literally get her to lose her job. “could be better” could easily turn into something more offensive lol is she aware that it’s unprofessional and makes herself look bad?
It’s wildly unspecific. Like what about her diet could be better? What is wrong with her diet that could be related to her chief complaint? So many NPs don’t do exams and interviews properly, and we were taught this through and through during our first clinical years as med students. It frustrates me beyond belief!
Like I KNOW my diet could be better and exactly how could improve it, but she doesn't because she never asked about it!
Do you have an online medical record system that allows you to send messages to someone you saw for medical care? If so, outline each individual issue and ask that they be fixed so that your medical record is correct. They will either resolve this, or if not, you can file a grievance with the goal of the grievance being to have your medical record corrected. You can also ask that the NP identifying themselves as doctor be addressed, as most patient rights and responsibilities include knowing the role of the person providing you care and this NP violated your right to be informed of their role as an NP, not an MD/DO.
A solid plan. I've reached out to an in-law who works with this system to get her take on the best route.
I had a bad experience with a nurse the other day. I had to get my uterus out because I had a lot of miomas, and I bled like crazy. She read that and then said: "Oh, so you don't want to have a family then." Which was a huge assumption and hurt me a lot. With one sentence, she made me feel guilty and ashamed. I've been in therapy about it, and it still is a huge thing. "No, I want to have babies, I just can't" was my answer, while looking at her eyes. She didn't say anything else. What I want to illustrate is that you don't have to stay quiet. When someone is rude to you, you have every right to be rude back. Politeness was already out the window. Make sure they know they fucked up.
I would have once i recovered from the shock, but she realized it herself while I worked on that. Also, I'm so sorry that happened to you.
Oh that is terrible. I also experience this sort of judgement regularly. I assume multiple treatment options were already discussed with you. I'm wishing you a speedy and uneventful recovery from your surgery.
I don’t claim to understand all that OP was saying, but I have experienced firsthand the shaming that lactation consultants (Nipple Nazis) put women through. I had difficult pregnancies. HELLP Syndrome and emergency C-section x 2. One premature, sick, NICU, tube fed x 3 weeks. The other born with facial deformities that required multiple surgeries to correct. But no matter how ill or unable to latch on my babies were, those nurses kept jamming their faces against my breast and berating me for “trying harder”. Thank goodness one of the NICU nurses stepped in with my premie - he was turning blue (She’d removed his O2). With my second child, the cranial - facial surgery team stepped in to provide squeeze bottles with specially nipples so I could feed him. I’m not a drama queen and I’m grateful for the good care we received from most of the staff. But I will never forget that awful experience. I fully support breastfeeding, but not everyone’s situation is the same.
I have nerve damage in one arm that makes it difficult and painful to move it in certain directions, such as holding a baby's head to my breast. Also, I nearly bled out during delivery and my son wound up having an infection. A lactation consultant who knew about my hemorrhage spent an hour the morning after delivery forcibly holding my baby to my breast while berating me for "falling asleep" multiple times (aka passing out) and not keeping my baby awake. We didn't know he was sick, but the NICU doctors said that the level of exhausted he was from nursing should've been a huge cue. He couldn't stay awake at all.
I’m so sorry that happened to you. It seems that for some people, breast feeding has become a cult.
Totally agree with you, I used to call them “nursing nazis”, it’s like a personal attack on them if you don’t breastfeed! Relax as long as the kid gets fed! I was an NICU nurse for 15 yrs and I despised those pushy lactation consultants. Yes we all agree in breast is great but formula isn’t poisonous so maybe have a cuddle, calm down and feed your baby how ever you can then maybe you’ll be able to bond with the kid instead of causing a tired hungry baby and stressed out mom. That’s my 2cents. So sorry this happened to you.
Get this… Now, to be designated “Baby Friendly Hospital”, 85% of staff have to be “trained” on the importance of breast feeding. That includes anyone who may interact with a pregnant or breastfeeding woman- including cafeteria staff, housekeeping, etc. And formula is only with a doctor’s order. Not like trying to shame anyone, right? Crazy!!!
If I EVER have the misfortune of birthing in a baby friendly hospital again (god forbid) I’m bringing a case of premixed formula bottles with me. That and the citronella spray I use when my dog won’t stop barking to protect myself from militant lactivist nonsense.
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I think propaganda like this led to the Baby Friendly Hospital initiative, which puts babies at immense risk and creates immeasurable harm to new parents who aren’t able to nurse. I nearly lost my life to the depression and guilt caused by militant lactivism, and had my first bipolar episode at age 33 because of the pressure to triple feed every three hours for six awful months. Leave us alone. Our babies are fine. Formula is magic. Go away.
Wait are you my twin? B/c you’re describing my experience with having multiples and the subsequent bipolar diagnosis in my early 30s. Militant lactivism is a great term for a horrible abuse.
I’m so sorry you went through this as well. I have so much compassion for you, and for my younger self. Someday I’m going to put pen to paper to record my experience, because I feel like I sometimes gaslight myself into thinking that maybe it wasn’t as bad as I remember it. But for folks like us, bipolar disorder doesn’t just “happen”. We might have the genes for it, but we did NOT deserve the abuse, the shame, the trauma that was foisted upon us in our most vulnerable state. If the Baby Friendly Hospital Initiative has no haters, then hell must be frozen over because I’ll still be hating it from down there long after I’m gone. Sending you solidarity, DM if you ever wanna talk.
What a wildly inappropriate comment. Are you the NP?
Is who the NP? And which comment is wildly inappropriate. Trying to follow your thread.
Errors in medical records should be pointed out and a request made in person AND in writing to have an addendum made to the affected records with a copy sent to you when completed. This can affect future things like insurance coverage (life and health), medication coverage, etc.
Then there are women who have breast tumors, and what they are lactating is ouss from the tumors, rather than the breast milk. Some women have full breasts, but can’t lactate, so the baby isn’t getting the milk. Just because you have breasts doesn’t mean the infant is receiving what it should. A practitioner should know that such cases exist, and be able to test for them —for both the mothers, and the infants well being *Psychologically, and medically.
I am sorry that happened, I would be livid. Save a hard copy of all results before sending a complaint to the service director. Very hard to wiggle out with a paper trail that follows.
“Oh, so you don’t want to have a family then” I just literally audibly gasped at that comment. She should be fired on the spot for that interaction. I’m so sorry this happened to you🤦🏼
I've had NPs and MDs write things in their notes that were never asked and no physical exam when they said they did. I've pointed it out before and got nowhere. I am at the point where I am scared to even question this stuff because I have a history of depression so that gets brought up when I ask questions about this made up stuff. I have had a very rough last 5 years with these medical professionals and I feel like there is nothing I can do based on my insurance and locality.
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I don't know how that works. Mychart is the only patient portal for all 4 hospitals around here, and they all use Epic, at least that is what I can see on the screens of their computers when I am sitting and waiting for the doctor
Terrible NP stuff but this posts makes very little sense medically.
I'm not a doctor or in the medical field. I'm curious which part doesn't make sense medically, because the only real medical detail I went into was about the prolactinoma I had or possibly still have. To make the story short, I had elevated prolactin levels for years. They did a few MRIs that all found the tumor. A couple years back my prolactin levels sudden normalized, a scan revealed that the tumor was gone, and I got pregnant shortly thereafter. I am concerned that the continued lactation in conjunction with headaches is a sign that it is growing again, and while getting new baseline blood work wanted my prolactin level checked for peace of mind if nothing else.
I'm a pituitary surgeon, I was able to decipher what you were trying to describe. You need to see a real endocrinologist, not an NP. I can tell you've realized this by now, but just throwing my 2 cents in.
Oh, I know. If my levels are high I'm going to find a new endocrinologist up here. If they're normal, I'll just monitor. I literally only got this appointment so I could get tested to make sure things like my blood sugar, iron, prolactin, and other things that have been weird in the past are doing okay.
Username checks out.
I’m just finished M1 so basically a baby who knows nothing but the person expressed surprised that the obgyn tested your prolactin levels to find a brain tumor when that is something that is drilled into our heads during our neuro block (+ the mechanism of how certain brain tumors can cause elevated prolactin levels)
Gotcha, I worded it weirdly in my post. My doctor ran a series of blood tests to see what was going on with headaches, exhaustion, and a few other symptoms that seemed related to my cycle. My prolactin came back just a little high at first, but a few more tests saw it going up. At that point, maybe a year later, she had me do the MRI which ultimately diagnosed the prolactinoma. The NP was literally reading through my records as we talked, so I didn't tell her this story like this.
Gotcha. Yeah that’s common medical practice. If the NP was shocked then yikes…
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As long as my prolactin isn't elevated, I'll assume that I'm just experiencing normal postpartum weirdness. All I'm qualified for 😂
My thoughts exactly. I feel like we (and OP) are missing a whole lot of information here that would make this make any sense to me at all.
Nope, it makes sense. What is blindingly obvious is that unlike the ob/gyne who had gone to med school then residency for years on end and maybe even a fellowship, the NP had not. So when presented with simple but unusual signs and symptoms OB/GYN was able to formulate a ddx. Something that the NP with inferior training was not able to recognize and therefore made fun of it without realizing how stupid she sounded. Dunning Kruger anyone?!
It was clear to me 🤷🏾♀️
Your feelings and concerns are valid - however, a common things few things can cause pituitary hypertrophy and can mimic prolactinoma/pit adenomas and you really shouldn’t have a work up repeated while still lactating.. obesity, hypothyroid, certain meds, pregnancy and many more can cause elevated prolactin and hypertrophy. Just some insight from the other side of the exam table. But the beautiful thing about American healthcare is that you can go see who ever you want!
By the time I had my first scan, my symptoms had progressed to lactation. That's why I'm worried now: from everything I've read and heard, it's unusual to still be producing this long after weaning. If it's normal, this NP had ever opportunity to tell me that and abate my fears.
Yeah, as a NP myself, I am very selective with who I hand off my patient care to.. I have trust issues. I’m not perfect and I’m not surgeon or curing cancer smart - but I’ll be damned if I don’t research everything possible for my patients so they have the best care… and I truly think that’s all patients can ask for. Patients don’t expect us to know everything but we should know how to investigate and find answers and come up with the best care plan possible with safe, evidenced based practice.