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.

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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.

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To read part two click HERE