Monday, November 06, 2006

Fort Belvoir Visit

The visit offered nothing unexpected, as it pretty much confirmed our opinion of Army medical care (sorry, Pam! Not you, of course!). We packed everyone up and left our house about 12:50, and we got to the hospital right around 2:00 in light traffic. It's 35 miles on our odometer. We found Col. Canestrini's office right away, and to say his secretaries were surprised to see us is an understatement! They definitely didn't know what to do with all of us. We had walked into the office suite with an Army nurse major, and, as it turned out, she was the head of OB nurses. She was the one who basically denied our waiver, as the Colonel asks her for her recommendation. The secretary was glad to see her, and they conferred for a little while before the secretary showed us into a conference room and told us the nurse would be talking to us. The nurse brought in another nurse for reinforcements, and we all sat down to hear their explanation. Well, in a nutshell, they basically don't care that it's an hour away and it's my sixth child. They are confident that they can "manage" the end of my pregnancy so I don't go into labor at a time or place that is inconvenient (read: the Beltway). So what that means is they are planning, on one of my later appointments, to decide that I am "ready" and start my labor for me. How convenient! How thoughtful! How totally not natural and not what I am interested in. We laid out our arguments several times in several different ways: one hour is not a reasonable distance to drive for routine care. This is my sixth child, and I have quick labors. We have had 2 children who have passed meconium before birth, and one of them had serious complications because he aspirated it. But they were really not interested in them, and they kept saying that they would make sure I didn't deliver on the Beltway by starting my labor for me while I was at an appointment. We mentioned our concern that Bob would not be able to get home in time to drive me to the hospital and here was their idea: I drop the kids off at a neighbor's house and drive myself. Yes! One hour at least of driving while in labor! What a good, safe idea! So obviously they were not really full of any sort of compassion for the situation. In fact, they told me that they had a woman who delivered her 7th child at the hospital who drove up from south of Fredericksburg, so over an hour away, while her husband was deployed. Wow--I certainly was impressed. Impressed with their total lack of concern for the people they are taking care of. I guess it's the Army way. Oh yes--I asked why my waiver was approved one year ago, and her answer? "I must have been on leave then." Ouch! Elizabeth said I should have asked her if she usually took vacation at Christmas, LOL.

So after beating our heads against that wall for awhile, we asked if we could appeal to Col. Canestrini, who, as it turns out, actually is the hospital commander. Well, he wasn't available, but the deputy commander came in to talk to us--a lady colonel named "Jimmie Keenen". She's had 2 babies, as she told us many times. So she walked in the door and said to me, "I can tell you right now that Col. Canestrini will not approve your waiver since you are well within our catchnet." (Yes, by all of 5 miles) So! Then she started cooing to Anna, and she asked where she was born. I told her that one year ago, our waiver was approved, so she was born at a hospital 5 minutes from our home. "Oh." Not really the response she was expecting, but she recovered quickly and again mouthed the party line that they fully expected they could deal with me, since they are so used to dealing with traffic issues, blah, blah, blah, she's had 2 babies, so she knows what she's talking about, blah, blah. And then they told us that we should go on Tricare Standard, and the nice nurse would walk us down to the Tricare office to explore that option.

We did go to the Tricare office. For maternity care on Standard, each visit is $25, as is the birth, but as soon as the baby is born, then everything falls under the regular Standard rules of a 30% copay I think it was, plus a $300 deductible. Also, it seemed that the whole family had to go on Standard if one of us switched, and we have to be on that for a year (well, Bob would probably retire before that, but still). Since Caleb has chronic allergy/asthma problems, that doesn't appeal to me, and you know as soon as we switched over, we would catch every disease in the book this winter, and at least one of the boys would break a limb or require an appendectomy or something. But still, it was so comforting to know that the higher-ups at Fort Belvoir were so concerned for us that they were willing to allow us to pay an indetermined amount of our own money to make sure I didn't have to drive myself to the hospital on the Beltway while in labor. Touching.

So here is where we stand now: we went back to the office and told Constance, the ever-so-unhelpful secretary that we would still like to get on Col. Canestrini's calendar. At this point, I don't see that we have a snowball's chance of getting him to go against what all his underlings have recommended, but you know, we can be the "persistent widow" like in Luke 18:2-5 if we must be. At least we will inconvenience them all and hopefully let them see that there are human faces and consequences behind these decisions they so blithely make. Constance once again is supposed to call us to make that appointment (we aren't holding our breath but you never know, maybe now that she has met us and seen that we are determined . . .). After we exhaust that option, we will switch my PCM to Bethesda. It is only about 2 miles closer to our house, although the opposite way on the Beltway, but frankly, I wouldn't deliver a baby at Belvoir if it was the last place around at this point. I was so not impressed with their standard of patient care. No way I want one of those nurses "helping" me! Hopefully I will have another uncomplicated pregnancy, and I just won't go in for many appointments. That's the Fort Belvoir way: "Promoting Substandard Prenatal Care By Mandating Unreasonable Driving Times". I feel like that is a more accurate motto than the one on their wall: "Dedicated to Service". What??????


Dy said...

Claire, I'm stunned. Frustrated, angry, and absolutely stunned. They're planning to induce labor, regardless of whether the baby is ready or not, just to "manage" the situation? I... I'm not going to type the things I'm thinking. Do you think a letter-writing campaign would help? Let us know if you run out of options (wouldn't want us to inundate the office and thoroughly kill your chances while you're still working on it).

You handled the situation much more calmly and graciously than I would have done. I'm really proud of you. Keep pushing, and keep praying. You're in my thoughts and prayers.


Bob & Claire said...

Yep, that is exactly what they are planning! When I used the words "force the baby" to the lady colonel, the nurses started backpedaling--"No, no, that's not what we meant . . .", but of course that IS exactly what they mean! If we ever do get to see the head colonel, I will ask him about the rate of c-section, forcepts delivery, and vacuum delivery for those whose labor has been "helped along". I'm sure he'll have no clue, but at least it will show him that we know quite well what the risks are of their big plan.

witw said...

WOW! Are there major cut backs in the Air Force? The lady who had her 7th kid and drove herself to the hospital, that is crazy. I feel sorry for her. Well, at least Bob isn't deployed. Mel

Bob & Claire said...

It's an Army hospital, Mel, and unfortunately the Army is pretty much known to not take very good care of its people. That is why Army posts are so yucky, esp. Army housing, compared to Air Force bases. The hospital itself is really old, and, frankly, yucky--I wouldn't want to deliver there if it was right next door! Bethesda is a Navy hospital, though--the one the President goes to! It is really nice and new-looking. We have always had good experiences there (that's where I went to the ER for my mastitis two times and we've been to the ER for other things. That's where Bob is routinely seen.) It's just farther than I would like to go as well (about 45 minutes not in rush hour), although it is better.

Beverly said...

Oh, Claire, I'm so sorry to hear about the troubles you're going through. What about Andrews AFB? The kids and I had our care there during the one year we lived in Maryland. Granted, it was quite close to where we lived at the time...I don't know how it is compared to the Army places, but at least it had the familiar comforts of Air Force medical care! Do keep us posted...we'll be praying, and I'd be happy to join a letter-writing campaign if it would help. *Hugs*