Glory Loeppky, a 32-year-old married mother of a premature infant, has an appointment with her family practice physician this morning, for a postpartum checkup. Although she has already been seen by the obstetrician who delivered her baby by Cesarean section, a checkup with a family physician is also routinely scheduled from 4 to 6 weeks postpartum. Glory was a passenger in the vehicle with her husband when a motor vehicle accident occurred 5 weeks ago. This led to the premature birth of her daughter, Emily Grace, who remains in neonatal care at Fayette General Hospital. Glory also sustained a deep laceration wound to her thigh and an injury to her thumb, which were treated in the ER upon her arrival there.
"Hello, there," said Dr. Antoine in a friendly tone as he entered one of his examination rooms at Mary Ezra Mahoney Clinic. Glory was sitting on the examining table, wearing a paper gown, waiting for him. She smiled back at him. He took a seat at his desk and logged in on his computer to pull up her medical record.
"It's good to see you again, Dr. Antoine."
"So, how's that new baby of yours?" he inquired cheerfully. "Doing well? Still in NICU?" Glory explained that the staff at Fayette General Hospital had told her that Emily Grace was doing "remarkably well" given the circumstances of her very early premature birth. The baby had been moved to a step-down unit, the neonatal nursery. Dr. Antoine nodded and expressed his pleasure at hearing this, understanding what it meant to Glory.
"I have to get another pediatrician," Glory continued. "My HMO says I have to take the baby to one of the doctors in its network once she's discharged from the hospital. Dr. Jasper was there at Fayette General when Emily Grace was born, so they're going to allow him to continue her care as long as she's there."
"All right then, Glory, let's talk about you and your health now." Dr. Antoine stood up and walked over to take her TPR and BP. He talked as he worked. "I see my medical assistant weighed you today and that you've lost some of that baby weight already."
Glory smiled and told him she had lost nearly 10 pounds in 5 weeks; she wondered if that was normal, or a combination of normal and her running back and forth to the hospital and helping her husband to get moving around the home. He agreed with the latter.
"Are you getting any sleep? Eating regularly?" Dr. Antoine asked. Glory confirmed that these issues were not posing a problem for her, but she expected her sleep to be reduced once the baby came home. Again, Dr. Antoine nodded his agreement. Then he asked about the status of her bowel movements and her ability to void. She confirmed that the frequency and consistency of her bowel ...