Miracles

Read When the System Fails first.

I should warn that this will be graphic. I have edited it down a bit but I think that describing how badly this labor went is important. Please be aware you may cringe as you read. I know I more than cringed when it all happened.
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April 3rd 0700 hrs

Blood splatters when the LPN tries to get my IV in. The sheets are soaked and need to be replaced. Someone comes in to mop the floor. Only one other time had I ever seen so much blood. I overhear someone saying something about popping a vein. I don't care - I am finally being induced.

"We are projecting a 36 to 48 hour labor. Your body is not ready for this yet." My current Doctor tells me. I have heard this a countless number of times - well 4 - each time I had been sent in to be induced. Two days. Two days and it would be over. I focus on that part.

In the early evening, I am told I can eat because we have at least another full day to go."Go to your meeting," I tell C. There was a steering committee meeting that night and there was no point in sitting in the hospital. A new nurse finally comes in to start the pitocin drip. Whatever pill they had tried three times made absolutely no difference in prepping my body for labor and delivery.

Around 8 o'clock in the evening, my nurse hurries into the room. My mom quickly moves to my bedside concerned by the urgency readable on my nurse's face. The nurse moves my belly from side to side - trying to knead it. She instructs me to move in the hospital bed, rolling my large stomach from left to right and back again. I had been having contractions. I could feel them but I didn't think they hurt (I have a pretty good pain tolerance). With every contraction, Logan's heart would drop and would then have trouble coming back up. I am put on oxygen. My mom calls my husband who is just about to walk out of his meeting and within fifteen minutes he arrives.

Soon after I am told I can take off the oxygen and I feel comfortable enough for my mom to leave for the night. I tell C to get some sleep on the couch. He had been getting little rest over the recent weeks.

Some time later my nurse comes back in, puts me back on oxygen and turns my pitocin drip back down. This is a problem. My labor couldn't progress because they could not increase the pitocin because Logan's heart couldn't handle it. The oxygen stressed me out so my blood pressure would not remain normal (or as close to normal as possible). It is around 10 o'clock when I ask about a C-section. My nurse said that was most likely but that the doctor wanted to do a vaginal birth. I ask her to express my concern over the situation and she said she would get him. She soon returns and tells me that my doctor has put all necessary personnel on "stand-by" for a c-section. I text message my mom (I couldn't talk on the phone due to oxygen) and she heads back to the hospital.

I do not remember much about the next several hours. I finally fell asleep and I don't remember anyone waking me up to check on me.

While my husband was asleep on the couch in the room, my mom rested in the glider in the corner. She cannot say what it was, but 'something" came over her and she felt a need to move across the room and to sit by my monitor. She looked at the screen and noticed my contractions were coming hard and fast and couldn't believe that I was sleeping. I wasn't moving. I had finally given in to sleep. Then, she looked to Logan's monitor and panic set in her. His heart rate was at 40, then 30, then 20. She watched the door. No one came.

In seconds she was in the hall, the nurses were gathered around talking together. No one was paying attention. "Is anyone watching my daughter's monitor?" she shouted. My nurse looked over and terror covered her face.

I woke up to my body being lifted by 7 or 8 nurses. I was being poked, turned violently from side to side, oxygen on my face, tears beginning to fall, my body beginning to uncontrollably shake, heat rushing through me as my pressure soared. Logan's heart was failing and my pressure was no longer reading. My husband woke up to me on all fours (hands and feet), bare behind in the air, as multiple nurses tried desperately to find his son's heart beat.

"Thud.......................................................................................................................................................................................................................................Thud."

It was low, it was weak. But it was there.

While on all fours paperwork was placed below my face and a pen in my hand. The water dripping from my eyes and the mucus mixing with the moist oxygen pouring down my face covered the pages. I was instructed to sign each one with little explanation as to what they were. Another nurse stepped on a stool and removed my jewelry while I balanced my now 200 pound body on my hands and feet feeling like I would collapse at any moment. Horrible pain shot through my legs as their color became too purple. My arms threatened to fail below me. All the nurses then, together, flipped me back over and one nurse inserted a catheter without any anesthetic. I screamed with everything in me as two nurses tried to hold me still as the wretched pain ripped through my lower body. My husband stood by my side and held onto whatever part of me he could. My mom stood beside him with tears in her eyes, praying desperately behind them.

I entered the OR where the Nurse anesthetist had two nurses try their best to hold me still so she could insert a spinal block. My body could not stop shaking. I had been pumped with drugs to prep me to surgery too quickly and my blood pressure would not stop rising. It was a horrible combination. I had no control. Then a new nurse stood before me. I had only seen her once, briefly, and she asked the other nurses to move. I could hear the panic in the background as the other nurses talked "quietly" about what staff was missing, how Logan was going too long without oxygen, how they couldn't get a hold of the pediatrician, how this baby had to come out "NOW". I heard it all and I couldn't speak as sheer panic coursed through every vein that was pumping blood too quickly and with too much difficulty through my body. My heart quite literally felt like it would burst from the pressure inside of it. She put her hand to my face then pulled me towards her. She cradled my body to her chest and a calm came over every part of me for the tiniest second and the needle pierced my skin going just where it was meant to into my spine. Then, she was gone.

Two nurses pushed my body - and I mean PUSHED - onto the OR table. My doctor entered the room, obviously recently woken up, providing only an apology for not being able to give a "vaginal delivery". He pinched me, asked if I could feel it, listened for my no and then cut. He cut at 6:29 the morning of April 4th, 2008 and my son was born at 6:31.

I was not draped on the table, my arms were not tied down, my husband was not there. I couldn't speak. My lips were shaking too much and my mind was moving too quickly. I prayed. I prayed like I have never prayed in my life and I did not stop until I heard my son cry. That moment, the tears poured down my face, my eyes closed, I bit my lip and I thanked the Lord. The nurses began to check Logan - the pediatrician was not there. "There is the doc," my doctor said relieved as a man in blue with a mask over his face entered the room.

It was not Logan's doctor. It was my husband. He had missed it.

I do not remember leaving the OR. I do not remember the first twelve hours of my son's life. I do not remember the first time my husband tried to put him in my arms. I do not know what he looked like when he entered this world. I did not get to kiss him, or touch him, or count his fingers and toes. I did not get to know those moments. I will never know them.

They were taken from me.
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It took my OBGYN with Eli nearly two hours to cut through and repair the damage to my uterus from Logan's delivery. Because of the great care of this man, I can have one more child someday - much further down the road so I can heal.

There is no doubt in my mind that what happened to me was the direct fault of those responsible for my care. There is also no doubt in my mind that miracles occured on that morning. The "something" that came over my mother when she moved to my monitor was a miracle. The nurse that cradled me and calmed my body so that my son could be taken out in time was a miracle. The fact that my son and I are alive and able to share in this life is, without question in my mind, a miracle.

We should not have survived. My son should not have been able to hold on. The last fetal heart rate I saw of him was 17. My body would not have been able to sustain the trauma of a still birth. We should not be here.

We are.

Thank God for miracles.

I thank God for my son.

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