Transcript of 24th Session between Charles Balis, M.D. and Ms. Sylvia Bows, Monday, December 23th, 1996 at 4 pm.

Ms. Bows: Hello Doctor. I guess you heard.
Dr. Balis: Hello Sylvia. Tom left me a message that you were in the hospital all weekend.
Ms. Bows: I just came home this afternoon.
Dr. Balis: How are you doing?
Ms. Bows: I'm scared.
Dr. Balis: You're home. That means Dr. Malleson thought it was safe for you to leave the hospital.
Ms. Bows: I'm still scared. If they're born now, they'd have no chance of survival. And what short life they would have would be spent in excruciating pain hooked up to life support systems. I couldn't even hold them. My touch, even my presence, would overstimulate their nervous systems and make them sick.
Dr. Balis: Sylvia, you are okay for now. The twins are okay too. It sounds like you've been reading too much. You have to be very strong now and try to keep yourself relaxed and calm.
Ms. Bows: It's so easy to say and so hard to do. My mind just keeps wandering. I can't get the image of a tiny premature baby all strapped up in a giant incubator fighting for its life. I just can't bear it. In the emergency room at the hospital, they were checking me out with ultrasound equipment and they got this really haunting picture of the face of one of the twins. Here I'll show you.
Dr. Balis: It's a remarkable picture.
Ms. Bows: I can't get this image out of my mind Doctor. I want so much for these babies to be healthy, to have wonderful lives...
Dr. Balis: Every day counts now. Every day your boys are growing bigger and stronger.
Ms. Bows: I just have to keep my legs crossed.
Dr. Balis: There you go! That's the fighting spirit.
Ms. Bows: You know, I didn't even know that there was something wrong?
Dr. Balis: Why did you decide to go to the hospital?
Ms. Bows: Tom's sister is visiting for the holidays. On Friday night during dinner I just mentioned that I wasn't feeling very well. I mean nothing too bad. Just a bit crampy but not bad enough to even take a pain pill. I don't even know why I mentioned it. I think I might have used it as an excuse to go to bed early and not socialize with Tom's family. But on Saturday morning I felt worse. Still not bad enough to call a doctor. Just not feeling right. Tom's sister saw me and kept asking me questions about what kind of pain it was and just how it felt. And finally she insisted that I should call Doctor Malleson. I thought it was ridiculous to disturb him on a Saturday morning for nothing. But she went to Tom and Tom got very upset and insisted that we call him right away. Doctor Malleson was on call so I didn't have to feel very guilty when he asked me to come in "and just take a look" as he put it. His argument was that it wouldn't take that long to check and if it was nothing I could think of it as an outing--since I don't get to go out of the house anymore I should even enjoy it. But if I didn't come in and there was something wrong I would never forgive myself. So Tom drove me into the emergency room.
Dr. Balis: Tom mentioned that you had contractions.
Ms. Bows: Apparently that was what my pains were all about. I was having a series of rather strong contractions but since I'm still so early on in my pregnancy they just felt like light cramps to me.
Dr. Balis: Does Doctor Malleson think that you are in early labor?
Ms. Bows: He never used that term. He just gave me an injection of something to stop the contractions...
Dr. Balis: A tocolitic, Terbutaline Sulfate. He mentioned it.
Ms. Bows: Right. And they kept me in the hospital in the delivery ward for two days to make sure that my contractions subsided. It was horrible to be surrounded by all these women in labor. They were all there to have their babies and I was there to keep mine in. I wish they had a special place for women in my situation. Someplace as far away from the delivery rooms as one could get.
Dr. Balis: Were you the only one who was there not to deliver?
Ms. Bows: I don't know. I was too sick to ask really.
Dr. Balis: I noticed that you're breathing rather hard and your hand is shaking. Did Dr. Malleson tell you to expect these symptoms?
Ms. Bows: No. I don't know. The nurse mentioned something about my heart beating faster while I'm taking this medicine.
Dr. Balis: I see. Are you taking the Terbutaline orally now?
Ms. Bows: Yes. Do you want to see the box?
Dr. Balis: Yes please.
Ms. Bows: Here. But there's nothing on it but the name. I got my instructions verbally.
Dr. Balis: Hmm. Did you talk to Doctor Malleson about feeling this way?
Ms. Bows: I told him in the hospital that I wasn't feeling too well.
Dr. Balis: What did he say?
Ms. Bows: He told me that I'll get used to it. It was just an initial reaction and it would go away after a few days.
Dr. Balis: Can you give me your hand please?
Ms. Bows: What do you want to do?
Dr. Balis: I just want to take your pulse. Hold still for just a minute.
Ms. Bows: Okay.
Dr. Balis: Your pulse is about 130 beats per minute. That's pretty high.
Ms. Bows: Is there something wrong with the babies?
Dr. Balis: I don't think so. Can you tell me all your symptoms?
Ms. Bows: I can feel my heart beating. Even in my fingertips.
Dr. Balis: Okay. Anything else?
Ms. Bows: It's a little bit hard to breathe. Like there is a weight on my chest.
Dr. Balis: Do you feel a little shaky?
Ms. Bows: You mean my hands?
Dr. Balis: I can see your hands are. How does the rest of you feel?
Ms. Bows: I feel sort of weak. But I think I'm just very tired. I didn't get much rest in the hospital--every time I got to fall asleep, a nurse would come in to take my vital signs and check on the babies.
Dr. Balis: The hospitals have never been known as a restful vacation spot.
Ms. Bows: No I guess not. But I didn't really get any sleep in the last couple of days. And I've really been worried sick--that baby face. I can see it every time I close my eyes.
Dr. Balis: Well maybe that's it. When did you came back from the hospital?
Ms. Bows: A couple of hours ago.
Dr. Balis: Did they check your vital signs just before you left?
Ms. Bows: I told you--that's all they did for the last couple of days.
Dr. Balis: You probably just have to get some sleep.
Ms. Bows: If it wasn't for Tom, I'd have been eating that horrible hospital food too.
Dr. Balis: Did Tom stay with you the entire time?
Ms. Bows: He never went home. They have these roll-out cots and Tom slept in my room the last two nights.
Dr. Balis: That was very nice.
Ms. Bows: He really came through for me--dealing with all the doctors and nurses and everything. I don't know what I would have done without him.
Dr. Balis: I'm glad he was with you.
Ms. Bows: Actually me too.
Dr. Balis: Look, you clearly need to get some sleep. So why don't we make this a short session? I'll see you next week. Okay?
Ms. Bows: Next Tuesday is New Year's Eve.
Dr. Balis: Hmm. How about Monday?
Ms. Bows: Okay.
Dr. Balis: I'll come to see you in the afternoon around four?
Ms. Bows: Yes please. Thank you Doctor for being so understanding.
Dr. Balis: Try to get some sleep and let me know if you still not feeling well. In fact call Doctor Malleson tomorrow if you still feel the way you do today. Okay?
Ms. Bows: Tomorrow's Christmas Eve.
Dr. Balis: I'm sure there will be someone on call in his office.
Ms. Bows: If I still feel this way...
Dr. Balis: Is Tom at home?
Ms. Bows: I think so, why?
Dr. Balis: I want to tell him that he should call Doctor Mal...
Ms. Bows: I'm a big girl Doctor. I can call myself.
Dr. Balis: Okay. Have a Merry Christmas and I'll see you next week.
Ms. Bows: Thank you Doctor and Merry Christmas to you to.
Dr. Balis: Goodbye Sylvia.
Ms. Bows: Goodbye.
Arrow, Straight, Left, Earlier Arrow, Straight, Right, Later

Button to Dr. Balis' Notes Doctor Balis' Notes on this Session
Button to Sylvia Bows' Ultrasound Images Sylvia Bows' Ultrasounds

Button to Sylvia Bows' Transcripts Transcripts of Sylvia Bows' Therapy Sessions
Button to Sylvia Bows' Patient File Sylvia Bows' Patient File

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