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‘Absolutely correct. Good. Let’s meet Mrs Hanson.’
Judith Hanson was all smiles as she walked in, and when Theo introduced Nita she immediately agreed to let the student sit in on their discussions.
‘I see from your notes that you were diagnosed ten months ago, and your lupus was stable and in remission before you became pregnant,’ Theo said.
She nodded. ‘And I’m so pleased I was diagnosed—at least now I know why I had the three miscarriages.’
‘Have you had a chance to talk to your family doctor or your rheumatologist?’ Theo asked.
She nodded. ‘And I’ve read up about it. I know there’s a greater risk of the baby being stillborn if my kidneys are affected, and the baby might also grow slowly. The baby might have congenital heart problems—but the figures are one in a thousand, and I don’t have the Rho antibodies that put my baby at greatest risk.’
‘You’re twelve weeks at the moment,’ he said.
‘Yes, and, touch wood, I haven’t had a flare-up. I know that around forty per cent of women get worse, forty per cent stay as they are and twenty per cent go into complete remission during pregnancy.’
She really had done her research. Theo was impressed. ‘There’s also the possibility of a flare-up after the birth,’ he said.
‘Especially the second and eighth week after the birth—and it’s most likely to affect my skin, joints and muscles.’ She nodded. ‘I’m going to get my mum to come and stay with me during those two weeks, just in case.’
‘Sounds sensible.’ But what amazed him most was that Mrs Hanson knew all the risks but had still been prepared to put herself through it for the sake of having a child. The same kind of bravery that Madison would show. The kind of bravery he somehow needed to learn. ‘I’m impressed that you’ve read so much.’
‘If you know what’s going on, it takes most of the worry out and means the risks are calculated—you know where you are,’ she said simply.
‘So you probably already know I’ll want to see you more often than my mums-to-be who don’t have any complications,’ he said. ‘I’ll also be talking to your rheumatologist and giving him regular updates. We’ll be keeping an eye on your blood pressure—and I’m afraid I’ll need extra blood tests, too.’
She nodded. ‘I’ve got a list of the signs for pregnancy-induced hypertension—and I don’t smoke or drink, I’m sensible about getting enough rest, and my diet is disgustingly healthy.’
He smiled. ‘You know your stuff. Good.’ He glanced through her notes. ‘I’m happy with your blood pressure, there’s no sign of any protein in your urine, and the blood-test results won’t be back for a couple of days. I don’t have any worries about you right now—but if you notice any changes in your condition or you have any worries at all, you’ll come straight to me, yes?’
‘Absolutely. I really want this baby, Mr Petrakis. When we lost our third baby, Frankie and I were devastated. But this little one’s going to be just fine. I know it.’ Mrs Hanson cradled her abdomen protectively.
‘I should warn you,’ he said gently, ‘that you’re less likely than the average mum to have a normal delivery. If you’re ill or the baby’s showing signs of distress, we’ll need to do a section.’
She smiled. ‘That’s fine. I’m not taking any risks with the baby.’
‘Or with yourself,’ he added. ‘Is there anything you’d like to ask me or Nita about?’
Mrs Hanson shook her head. ‘Everything’s fine. I’m not worried about anything.’
‘Good. Would you mind if Nita examined you?’
‘Not at all.’ She hopped up onto the couch, lay back and allowed Nita to bare her abdomen and examine her.
He double-checked Nita’s findings, confirmed them, and let her write them up in the notes; she turned pink with pleasure.
And then it was the end of his morning’s clinic.
‘You were brilliant,’ Nita said.
He shrugged. ‘No, Mrs Hanson was very well informed—and that’s definitely something to encourage in our high-risk mums. The more they know, the more aware they are of any changes in their condition that aren’t quite right, the better it will be because they’ll come to us early enough for us to help effectively.’
‘I still think you were brilliant.’ She took a deep breath. ‘Theo, you’ve been so good with me, helped me so much…I was wondering, um, can I take you out to dinner tonight?’ The words came out in a rush.
