"A soldier doesn't fight because he hates what is in front of him. A soldier fights because he loves what he left behind." - unknown

"God is our refuge and strength. He will protect us and make us strong" (ps 46:1). For those who will fly today, for those who are there now, and for those who will soon join the fight, Lord, shield them from all evil, strengthen their hearts, and bring them home safely.

Monday, November 1, 2010

When the System Fails

"How is your head?" my mom asked, checking on me again. She didn't just mean my head, she meant my legs, my neck, my hands. Every part of me that seemed to be growing before our eyes and increasing the ache along with it.

"It still hurts. And I can't get my ring off." I had taken my engagement ring off the night before, thank goodness. But I didn't want to take my wedding band off. She had told me that I needed to take it off but I just couldn't - emotionally that is. Now I really couldn't - physically. It was stuck. I tried lotion, butter, oil. You name it and I tried it. It didn't budge. I headed down the street to the after hours care center. I was in town for a couple baby showers and had little option as to where I could go. Of course I spent two hours (and then two weeks) back and forth on the phone with Tricare because they kept "losing my paperwork" approving the visit which is a battle I eventually gave up on. During my visit, my ring had to be cut in two places and pried apart with two pairs of plyers. When it was being cut, my finger was turning blue. My body became swollen that quickly. I gained 5 pounds that day, and ten that week. Something was wrong.

My mother called my old ob-gyn and asked if he would see me. Without hesitating, he said to come in right away. It was the third time she had taken my blood pressure. This wasn't weird to me. The last two appointments I had the tech's at the Army Community Hospital took my blood pressure three or four times. I didn't pay attention. I didn't know anything was going on. At my last appointment, in late December, my midwife told me I was "taking advantage of my pregnancy" and referred me to a nutritionist. This was now early February, and I hadn't had an appointment in between and didn't have one scheduled til later into the month.

My doctor came into the room immediately after I had sat onto the exam table. "Has anyone said anything about your blood pressure, Megan?"

"Um, no." I replied, not really understanding the reason for the question. "They take it a lot."

"And they haven't said ANYTHING about it?" he asked with a very confused look on his face, moving his eyes from me, to the chart, to me again.

"Nope. My midwife just said I was getting fat," I told him plainly - not wanting to relive my anger on that day.

"Seriously?" He asked - obviously as surprised as I was but for a different reason. "I need to run a test," he continued. "It won't take long. We can do it in the office."

I was lying on my left side as instructed to do waiting for the result. I began to sit up when he entered the room and was quickly instructed to remain lying down. "You have protein, Meg. Do you know know what preeclampsia is?"

I had skipped over that section in the book. I never thought it would apply to me. My mom's eyes looked from him to me with the greatest concern on her face.

"It must have presented itself really early," he began. "I don't know how they could have missed it. Did they run any tests after checking your pressure?" I shook my head, still lying on the exam table. Not comfortable to say the least. He started mumbling - looking at the chart, then looking at me, then looking at my mom. He didn't want to let me travel back to Tennessee. That was out of the question to me. I was not going to spend the last two months of my pregnancy separated from my husband. He was debating admitting me - hospital bed rest. It was THAT bad. After arranging for my husband to fly down to New Orleans to drive me back, he agreed to let me go with strict instructions for a physician (not a midwife) to contact him when I arrived. He said not to wait, to go to the hospital the very next day.

The midwives at the Army Community Hospital didn't care. They didn't contact my doctor. Didn't check my test results. Didn't even assign me to a doctor until I fought - and fought hard. Then, that doctor left for her next duty station and I was never transferred to another physician until I called every single day with my blood pressure reading and symptoms. I was sent in to be induced four times - each time being turned away from some other doctor. I was on strictest bed rest, two minute showers (sitting in the shower) every other day, lying on my left side the entire day, strict diet, no standing, no walking. But if you asked them, I still wasn't preeclamptic. Every other day I was instructed to report to the hospital for monitoring and eventually I found out no one was even checking my results. Every other day, I got dressed, walked to and from my car, in and out of a hospital, all while on supposed "strictest bed rest." Towards the end of my pregnancy, the moment I stood my legs turned purple, tingled, and began to go numb. My hands went numb constantly. Yet every time I was sent to be induced, I was told by the next doctor who got to make that call that I was not a priority.

This is how the army healthcare system works (or at least did for me). You don't have a real doctor - and you don't have the same doctor. I saw three doctors and four midwives over my pregnancy. Only one midwife could remember who I was the entire pregnancy. She was the one who told me how to fight the system, and that I needed to fight the system for my own safety.

The third time I was sent downstairs from the women's clinic to be induced my blood pressure was terrifying. The last time it read it was 210 over 110. I should have been dead - or have at least suffered a stroke. They didn't believe the machine could possibly be right so they continued to try to take my pressure again and again. My arm was blue - not purple - it itched, it was convulsing, and I felt shooting pains. I had to scream and fight to take the cuff off myself to get them to stop trying to take it. My pressure wouldn't even read on the machine. My doctor came in saying that my protein levels were off the chart and this baby needed to come out "NOW." I was instructed to go down to labor and delivering. I was not given a wheel chair. I walked.

After lying in the equivalent to a closet for nearly two hours, a doctor came in. He quickly said I was not his priority and sent me home. He did not care that I had been sent by a doctor upstairs. He said it was his call and he wouldn't risk having three women in labor (there were three beds open) come in and have to turn one away for someone he had induced.

When we left, I could barely walk because my body wouldn't stop shaking. My husband tried his best to support my now nearly 200 pound body to the car.

This was a Monday. On Thursday, I entered labor and delivery with my pillow, bags, and husband and said I was not going home. It was then that our real nightmare would begin.


There are things I know now that I didn't know then. Patient Advocacy is an Army Family's best friend. USE them. Had I, I would have been there daily. With Tricare - ALL pregnancy and post natal appointments are covered under prime AND standard care. If you enter another hospital, through the ER, with problems in your pregnancy Tricare has to cover the care you receive. I was told by the doctors at this Army Community Hospital that I could not change. The Tricare office told me I could not change without the written consent from the doctor on post. You Have Rights. Patient Advocacy can let you know what those rights are and can help be sure that you are protected, well cared for, and receiving everything you need. Most major hospitals have patient advocates familiar with Tricare and the Military healthcare system. They, too, can and will help. Speak out. It wasn't until I was willing to fight hard, yelling into the face of a LTC midwife, with my husband at my side, that I ever even saw a physician. I called every single morning with my readings. I did not stop fighting - but I needed to fight more and I needed to fight sooner. I didn't realize that I could. I didn't realize the other options available to me. Be aware of what is out there. I know women who have had good prenatal care at this hospital. It doesn't happen to everyone - but it does happen to some of us. Protect yourself. Protect your family. I was healthy and petite. I worked full-time, ate well, and was active. I was not taking advantage of my pregnancy.

Understand the system. Work the system - or it will work you.

To read part two click HERE


  1. OMG Megan this hits so close to home and I thank the lord I am not at BACH this time. Same stuff happen to me. I was already 32+ weeks when I moved to Ft Campbell and I was already feeling sick and those damn nurses, doctors were just awful taking short cuts didn't care about a thing. At my civilian dr I did a urine sample every visit but here nothing and when I ask they looked at me like I was crazy! My Blood pressure was so high too and they just kept taking it and taking it and then actually said it must be reading wrong!! This was every appt. My last appt already past me due date my pressure was through the roof and the midwife was very concerned told me to go to NST and she was getting a dr to admit me to induce me. I said for sure this is it and she was like yes you need to have this baby now! Eric was in the middle of being issued his gear for deployment and had to get it done so I called my mom told her to hurry up and Eric left to get things done. I was in the process of getting an IV my arm bracelet and the nurse told me to go get something to eat and come back and I would have a room! When I came back 15 minutes later, Yeah we don't have room you need to go home pee in this jug all night and then call back tomorrow to make sure we have a bed! WTF I was alone at this point and just starting crying as contractions started and she said sorry honey oh but if your water breaks please come back! Anyways, finally the next evening they tested my pee jug and said they have never seen so much protein in someone's urine before and started to freak out that I was going to have seizures and die. After lots of medicine and stuff in between a C section which Ella shallow lots of fluid had an infection couldn't breathe and was rushed to the ICU and I didn't see her for 12 hours. Nice first birth experience. Thanks so much BACH! Ok thank for letting me vent about it too! Glad you and Logan are ok and you had a better time with Eli and I am sure I will to with this one!

    Jennifer M

  2. SO sorry this happened to you to, Jennifer. Unfortunately, it happens way too often. I had those jugs three times. Each time they didn't have a record of me doing the test previously. No results were ever recorded. My experience with a private physician with Eli was completely different. The moment I began showing signs of the disease again, my care was bumped up to the extreme. The first time I had a major headache and my pressure jumped, I had a section scheduled. It is horrible how extremely different care in the private system from the military system. Had I been more involved and had I been willing to reach out (which I was no where near yet), this could have gone differently for me. I have no recollection of the first twelve hours after Logan was born because of how drugged up I was. I didn't hold him - I physically couldn't. I don't remember the first time I saw him. I can't get that back. But that is for part two of the story. I know this pregnancy for you will be completely different - and thank God for that!

  3. I'm so angry reading this I could cry. I don't think I fully understood how bad things were for you until I was pregnant myself. I just didn't know anything about pregnancy or kids or different conditions people could have. Geeze Meg.

    I only had one issue in my pregnancy at Benning involving scheduling. They weren't even going to see me until I was 15 weeks pregnant because someone assigned me to a doc that had PCS'd and didn't tell me. I went to the patient advocate and was seen that day, but was made to feel like an idiot for just wanting someone to give me the appointment I deserved. They wanted me to wait 15 weeks before they would even check for a heartbeat or even take my BP.

    I had really bad swelling at the end. Some of it sounds like you, though not the blood pressure. I fought the midwives here each appointment. They kept telling me swelling wasn't something to worry about unless it was extreme. I quickly showed them my feet, which wouldn't bend and sometimes didn't have feeling anymore, and my ankles where skin was splitting open because there wasn't anywhere left for it to go. And I too was over 200lbs by the end of the pregnancy. I wasn't preeclamptic but I thought it might be considering how bad the swelling was.I had to almost scream to make people pay attention to me.

    Luckily our birth ended up going fantastically despite the on and off bad care I got.

  4. The scheduling really is a nuisance. I had multiple issues through pregnancy (like you - a doc PCSing and not being re-assigned), too long in between appointments, being shuffled, not falling under anyone. I am so sorry that swelling happened to you! I never would have known from your pictures. There are no pictures of me from when Logan was born because I felt so incredibly awful about how I looked. I don't have pictures of me and him until months into his life.

    I am glad you fought it, Sara. I know I told you that a million times! You have to be present and LOUD for them to get you what you need.

  5. Just something else to mention, you can elect NOT to go to the hospital on post that you are assigned to. I took my children and myself out for this very reason. We have Tricare Prime and all I had to do was go into the Tricare office at the hospital (Madigan and Ft. Lewis/JBLM) and tell them I wanted to get medical care elsewhere. They didn't argue with me one bit. They handed me a piece of paper to sign and printed out a list of in-network physicians I could see in the area. It has been a HUGE blessing to my family and I recommend it to anyone who has bad experiences like this. I could go on and on with stories too, but this has been my best move yet. :D Hope that helps!

  6. Most of the time this is true. However, in my situation, and in all, you have to get the permission from the hospital which often Tricare just does for you. If they do not have enough patients being seen on the post they will not release you. Fort Campbell would not grant this for me at the time. However, Fort Benning did but we had to wait for approval. In most cases it isn't a problem. It just depends on the post, if they are at capacity, and where you live. Our boys are seen by an in-network private physician through prime where we are now (only because we are more than a 30 minute drive form the nearest base) but we have switched me into Tricare Standard to avoid any difficulty in the future. It is not a guarantee that if you request it they will grant it. But cross your fingers and pray they do!

    I am so glad you are reading! It is great to have one more army wife sharing experiences!

  7. We have been TRICARE Standard since day one. I was living in a different city, finishing up my undergraduate when I got pregnant with our first (not that uncommon in the army!) Standard was the easier choice since I could go the dr. two minutes from my apartment. Jesse deployed to Afghanistan about 2 months into the pregnansy and then I was on my own. At 22 weeks, I started to go into labor. I had a stitch put in my cervix and was immediately put on bed rest. I saw a specialist and had regular check-ups with my OB. I had an ultrasound at every appointment(every week) to check my cervix and the baby, and had the best care possible. Fortunately, Sean was born two days after his due date with no complications. Jesse made it home 7 weeks later to a perfectly healthy wife and son. It makes me shudder to read this and think about what this could have been like for me had I been forced to go on post to BJ at Fort Polk.

    For my second pregnancy, I was living at Polk, but still had TRICARE standard. I decided not to take any chances and stayed with my original dr. who was now 2 1/2 hours away! It was comlpetely worth it not to have a horror story to share.

    we have never been Prime, and since I am on number 3 and now refuse to go on post, due to stories like this one, Standard is another option for those like me who don't feel comfortable being shuffled around like cattle during such a sensative time in our lives.

  8. We were prepared for Eli to be our last child. The military told us that we would only be able to have one more after Logan. My WONDERFUL obgyn with Eli took so much extra time to repair the damage done to my body from Logan's birth that I CAN have one more. I will not - for one second - allow another military facility to handle another of my pregnancies. I cannot imagine undergoing this with C deployed. Bless you for undergoing your pregnancy without him!

    I truly believe that in the military system far too often we become numbers (a "sponsor's" number to be exact) and they try to spend as little money as possible on each patient. Cost effectiveness is most certainly important - but a person's safety should go before that.

    The boys are prime still - and I have a BAD story from that too - but only because where we are currently they are allowed (after a ridiculous paperwork battle) to see a private physician. We have not decided what we will do once we are back at our current post. BUT, we have time to decide.


I LOVE comments! Thanks for sharing : )