Letter to My Readers
Friday, November 23, 2007
Kenneth F. Trofatter, Jr., MD, PhD
A week or so back I received the comment below buried under one of my posts. It troubled me a lot, but it came at a good time, because it made me focus on some of the concerns I have had regarding my role on this site and your expectations. Please read it (and my response) and then I will explain myself…
• At Wed Nov 14, 11:06:00 AM 2007, JAY said…
Hi! I am a 17 year old girl. I recently got pregnant by my boyfriend and got up to being a month old. I didn’t tell my mother anything. I began to bleed heavily and get abdominal pain. I didn’t go to the doctor because I didn’t see a point telling my mother if I wasn’t going to have the baby. This ALL just happened about a week ago. I just stopped bleeding and I feel much better. Do you have any advice what should I do?? I know I need to go to the doctor to get checked out but I don’t want to tell my mother!
• At Fri Nov 16, 08:50:00 AM 2007, Kenneth F. Trofatter, Jr., MD, PhD said…
To Jay Nov 14: I cannot tell you what you should do regarding your mother, but sometimes, Moms are much more understanding than you might think under these circumstances. You might want to give her a chance. I do strongly recommend you see a provider who can follow-up to confirm that you are no longer pregnant, check your blood type and antibody screen, test you for sexually transmitted infections, and counsel you regarding contraception. You might not have thought of any of these things, but they are all very important for your current health and future childbearing. Oftentimes all of these services can be provided by your local health department. Good luck! Dr T
Now for my concerns. First of all, I want all of our readers to know that I have been much appreciative of your response to “Fruit of the Womb.” I never expected the number or the diversity of your comments and am flattered by the trust you have put in me. Quite honestly, I spend more time trying to answer your questions than I do on writing fresh posts! But, when I do respond, let me remind you again of the limitations of my answers. I can provide some thoughts, some information, some clarification of something you do not understand, some questions you might ask your providers, and maybe even a correct solution (given enough information) to your particular problem, but I cannot possibly understand your entire situation and I certainly CANNOT replace your own doctors (or your Moms or Dads) in providing all the answers for your care.
If you have an urgent problem or a clinical decision that has to be made in a timely fashion, this is not the place to seek help. The internet cannot take the place of real-time, face-to-face, and hands-on attention of a physician or other provider who knows you well. So, don’t be afraid to ask them your questions, the same ones you are asking me! As I tell all my patients, NO question is insignificant, although you may be surprised that the answer is often much more complicated than the question itself. If they tell you something and you do not understand, then ask them to explain it in a way that you can. Don’t ever leave your doctor’s office with big questions lingering in your heads, unless of course your doctor tells you up front that “I don’t know myself at this time.”
I am also getting to the point where I cannot answer all of your questions or I cannot respond to them in the time frame you might need. Please do not hold that against me. Many of you have very complicated medical histories and problems and even then I must frequently have more information before I can even venture a response. You are much more likely to get a response, and one in a timely fashion, if you have very specific questions in mind. Remember, this site is not set up in a way that we can easily have a running dialog with readers and, quite frankly, that would be difficult anyway since I write these posts in my free time and I have my own patient care and teaching responsibilities. I would also ask that you indulge me in one other way. Sometimes I reserve the right to hold off responding to your questions, so that I can organize my thoughts in a full regular post when it is clear that many other readers might benefit from my response. The primary purpose of this site is to provide as much information to as many people as possible!
Anyway, thanks to all of you for reading and for the feedback and questions you have raised in response to the posts. I hope you have gotten as much out of this blog as I have!
Dr T
5 Comments:
At Sat Nov 24, 07:51:00 PM 2007,
Anonymous said…
Dr. T! I think on the part of the readers, it would be appropriate for us to thank you for being such a knowledgeable & compassionate person. Your articles and answers to questions have provided hope and inspired learning at the same time. Both physicians and non-medical folks find answers and new challenges in your posts.
We thank you greatly for your time, compassion, and willingness to share knowledge!
At Wed Dec 05, 12:50:00 PM 2007,
Bekah said…
I just found your site while researching changes in insulin resistance in pregnancy. I found your posts on Diabetes in Pregnancy well-written and informative, and noticed that you intended to post a fourth article in the series, on Gestational Diabetes diagnosis, but I haven't been able to locate it? Did you end up writing this (and can point me in the right direction)? If not, would you consider following this up soon?
At Wed Dec 05, 10:05:00 PM 2007,
Anonymous said…
Hi Dr. T,
Thanks again for writing this blog and answering the questions that you do -- I love how thorough your answers are and the citations you provide.
I totally agree that the Internet can't possibly replace a relationship with a flesh-and-blood doctor, but at least in my experience, it's hard to get a good answer to a question -- because of time constraints, the fact that most doctors seem to think that patients cannot understand anything complicated, and that so much new research is happening so fast that doctors don't always have good or complete answers, and don't have time to find answers and get back to patients. If a doctor gave me a citation for a current paper to read in lieu of or as part of an answer to a question I'd asked, I would think I'd died and gone to heaven.
So thanks again for all that you do -- for people whose questions you do answer (who I'm sure are many since the answers stay around for others with the same question to find in the future). You provide a great service that many of us cannot (or don't know how to?) get from our own providers.
I look forward to continuing to read for as long as this project continues to bring you interest and satisfaction, and wish you all the best in your endeavors both inside the computer and out!
At Thu Dec 13, 02:11:00 PM 2007,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Anonymous Dec 5: Thank you so much for your thoughtful comment. I have found that one of the great challenges in medicine (and also one of the great sources of satisfaction) is being able to explain fairly complicated concepts in ways that people with different backgrounds are able to understand. It often does not take much time and is usually much appreciated. Most interactions with the patient become easier after the 'initial investment.' Of course, that requires a relatively good understanding of the issues themselves, and I think sometimes that's where providers feel insecure, even though most really shouldn't be! Patients also appreciate it when we are honest and say "I'm not sure, I'll see if I can find out more for you." Believe it or not, that's what I am trying to do on this site and I am glad you believe it is working! Thanks for reading! Dr T
At Fri Dec 14, 12:36:00 PM 2007,
Kenneth F. Trofatter, Jr., MD, PhD said…
To Bekah Dec 5: I KNOW I never completed that series and keep meaning to get back to it, so thanks for prodding me. Keep getting side-tracked by other issues, but sometime after the first of the year, I will try to finish it up. I had good intentions, but a serious case of 'flight of ideas.' Thanks for reading. Dr T
Post a Comment
<< Home