What should I ask for?

[crissy1213]

I have an OB appointment at 1:40pm.(right now it's 10:38am Alaska) Last Monday my right shoulder blade started to hurt (figured I slept goofy) but it has been on fire since and nothing makes it better. Then about Friday night My right side has started the same type of pain. Yesterday and today I have had diarrhea and I am dry heaving since I woke up. I feel like crap just all around crap.

I am 24+5weeks, diagnosed PIH at 12weeks, and I am on Labetalol so my BP is beautiful right now 122/79. I see military doctors so its really hard to get them to listen to you and run tests. They are tylenol3 prescribe happy... if anything hurts thats what they give you and send you on your way.

I want to know what tests specifically I should ask for and what should I do/say if she wont listen?

I can not go off base because they won't see me without a referral or cash up front. I swear on my life this place told me that I can't go to any ER unless the baby is falling out because it won't be an emergency and my ins won't cover it. Talk about disheartening.

Thanks in advance!
Crissy

[amandaoasis]

Make sure you are insistent on getting the PIH panel including labs to see your liver function and platelet levels to check for HELLP.

Good luck...I hope they listen and everything comes back normal.

[angieb]

DH was in the military and I have sworn many times that the military health care system-at the bases that we had been stationed at (I'm sure there must be some good military doctors somewhere, we never encountered them, but we only had 2 bases)- would have let me die/killed me if he had still been in the military for my first pregnancy. There is no doubt in my mind. I am 100% certain that they wouldn't have taken me seriously until I was pretty much dead. (They missed DH's torn knee ligament for over three years even though he was having appointments at least monthly, and his problem was fairly obvious.) That doesn't help you much, but you have my sympathy for having to deal with that.

They really need to run liver enzymes tests and check your platelets. I'm normally not an advocate of making up symptoms/lying to doctors, but in the situation you are in, and knowing how crappy some of the military doctors that I have seen were, I would probably lie and say I was having dizzy spells/seeing spots/etc. etc etc. (look at the symptom list and list them off) until they take you seriously and do some tests because what you are experiencing sounds very serious to me. They should rule out your gall bladder and given how early it is, there needs to be a level III NICU nearby in case it is HELLP and you have to deliver.

Good luck and keep us updated.

Given your PIH, have they sent you to a high risk ob/MFM/peri at all? If not, I would be a pain until they send you to one who might take you more seriously.

[crissy1213]

Given your PIH, have they sent you to a high risk ob/MFM/peri at all?

No... my OB just put me on BP meds and said if they think I need to deliver earlier than 36weeks then they will send me to the hospital with a nicu which is 15 mins away.

I had PreE with my son and delivered at 38weeks too and I still feel like they don't take me seriously. Looks like I need to be a squeaky wheel. lol

Thanks again, I am def going to be persistent.

[anrmacon]

Crissy,
My dh is military and so we also have the same insurance. The insurance co. WILL pay for your er visit- bottom line. I've been to civilian and military er's thoughout my various pregnancies (and for my children) and we've never payed a penny. I switched insurance to the next level down (standard) so I would not be restriced to base for routine OB care and we only pay about $100 total out of pocket for the midwife/ob/perinatologist/delivery/radiology/labs- everything. Call the ins. company- they are MUCH more friendly and helpful than the doctors/nurses/etc. I've encountered. If you get an ins. operator who rubs you wrong, hang up and call back- it's always worked for me. ;-)

Personally, my experience with military ob clinics has been so bad that I just skip them when something is really wrong. Either go to a civilian ER or labor and delivery. I strongly suggest a call to the insurance co. to review your options for civilian care. I know money doesn't grow on trees (especially for us military spouses!) but you can't put a price on your health/life or that of your baby. I'm LOVING the freedom to choose my own medical team and knowing their credentials and their history with patients like me. Granted, my midwife is a bit overwhelmed by me, but all she does is measure my belly, use the doppler, and basic, run of the mill stuff. This is something I've been recommending to ALL my military spouse friends- I just don't trust the military healthcare system with such complex issues.

I know this is not info you asked for, but I know what a PITA it is to get military docs to pay attention to pregnant ladies in distress. I was actually told I was hormonal when my bp hit 165/98 during one of my pregnancies!!

[angieb]

With your PE history, PIH, and symptoms, I would *INSIST* that they send you to a high risk ob. Seriously, do not leave the office until they give you a referral. (And do all of the right labwork.)

That's how DH finally got his knee diagnosed (after 3 years of being given motrin, 4+ different doctors, 2 different bases- he *demanded* an MRI for his knee and they discovered the torn ligaments.) Now he gets VA disability for his knee because they let it go for so long that it's permanently messed up. Thankfully that was just his knee, but let me reiterate that it took 3 years and it was obvious. This isn't something that they have 3 years to figure out.

I hope they take you seriously and don't give you too much trouble.

[crissy1213]

Update...

Thanks everyone for the advice. I was lucky enough I didn't need to make a fuss my BP when I got there was 136/93 which is a lot higher than my 117/70s I usually have at the ob. So they sent me to L&D monitored baby ran a ton of tests and did an US. Labs came back within normal rang (which is great) but have a little bit of inflammation and this weird muscle bulge under my right rib. So I was given a muscle relaxer to get rid of the bulge and low fat diet for the gall bladder stuff. So I am hoping to steer clear of gall stones and even clearer of PreE!

Thanks a ton!