Medically Unnecessary

Published by Bethany on September 11, 2018September 11, 2018

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Medically Unnecessary – not “reasonable and necessary for the diagnosis or treatment of illness or injury.”

When I stumbled into wellstar urgent care on July 1st, it was for viral symptoms–lethargy, congestion, couldn’t-move-without-hacking type stuff. I had held off for a few weeks, expecting the virus to run course, but finally relented. Maybe it was bacterial, or at least I could get approval to take something besides Tylenol or Bendaryl.

When the physician on call immediately sent John and I straight to Piedmont L and D–due to blood pressure–I was confused. Aside from the virus, I felt fine. I had just started to feel the boys kick. We didn’t even know where Labor and Delivery was. Several hours later, I was admitted, not for my evil virus, but for high blood pressure.

“But I don’t have high blood pressure,” I argued.

Yes, it measures high when I’m in the doctors office, but it’s white coat syndrome.

Sure it was high when I was undergoing IVF, but the situation was stressful.

And, yeah, it was high during the first trimester, but it’s because of a medication I was on, since discontinued.

After a few days in the hospital, labs and 24 hour urine showed nothing much amiss. I felt less like death, and discovered Piedmont Hospital has the best vegetable soup I’ve ever tasted. Baby Boy B was growing slowly, but blood flow to the cord was good. So I went home. Everything was fine. I flew to the midwest solo without second thought; we went to the lake and continued to live life. I planned events around the release of my book. I bought a blood pressure cuff but didn’t use it.

A letter from our insurance company deemed my admission “medically unnecessary,” and they refused to pay for thousands in room and board expenses. It was frustrating, but I secretly wondered if they were right.

A month later at my scan, we were about to leave when my Maternal Fetal Medicine specialist–who I’d come to think of as overly strict–placed her hand on my arm.

“I can’t let you leave with that blood pressure reading.”

Her statement was so unexpected, I couldn’t muster a good argument. Again, I felt fine. The babies were getting great blood flow via the ultrasound. It was too early. I had too much to do. At least last admission I’d felt horrible, which helped me mentally justify time in the hospital. Now, the last thing I wanted was to rack up thousands more in expenses, all for something that just was.

My blood pressure has never hurt anything whether it’s high or not. Why should this time be different?

I just hiked the mountain with Bailey last week!

The boys are active and kicking!

We checked into L and D again. More 24-hour urine, more veggie soup, and more expensive consults later, everything seemed fine. I was sent home, this time on blood pressure medication and modified bedrest. Another infuriating “medically unnecessary” letter from United Healthcare came, causing me to wonder how anyone besides the Kardashians can afford a baby.

This time I checked my blood pressure at home and it was good. Mostly. I mean, if I lay on my side, had no caffeine, was completely silent for ten minutes, and made sure no one spoke to me; if my arm was straight and elevated, and I thought about warm beaches and cuddling with pup-pup; I could manage to produce a reading in the borderline range. Mostly.

We went to the lake one last time. I was compliant with my bedrest though I drew the line at getting people to bring me things, or do things around the house I could easily do. It seemed indulgent, excessive. I scheduled my next OB and MFM appointments, now weekly, to coincide with the drive home. Which meant I arrived at the hospital with a suitcase in my car, something I was thankful for later.

Baby Boy B, Alexander, had fallen off the growth curve, and was basically not growing. I’d be staying until delivery. This time I was accepting. My own health issues weren’t enough to get my attention, but I knew in my heart that I now belonged in the hospital. Still, I was only at 28 weeks, and my goal was to make it to 31 or 32 for their health.

I settled in–primed a few essentials to my room. I got on a regular schedule of my favorite soup and salad, had some visitors. The Courage to Tri panel, which I was so looking forward to, went on without me, thanks to the efforts of my awesome panel ladies, John, and Tim.

But only one week later, things escalated. I had gotten upset the night prior, hadn’t slept, and the following morning, my readings were off the charts. My MFM said to tell John to come up now. He called our parents, and mine started driving up from Florida. John’s came up to the hospital.

There was debate over whether I should be delivered. John and I voted to wait. Besides the horrible headache from IV blood pressure meds, I generally felt fine and believed that the boys would be better off cooking longer.

Several hours later, the situation hadn’t improved, and my MFM broke the news. “We’re going to deliver you today,” she said.

I had a mandatory C-section at 2:30 PM. Ethan Avery Rutledge, Baby Boy A, was delivered first at 2 lbs 14 oz. The five minutes it took for Alexander Battle, my tiny Baby Boy B at less than two lbs, to follow suit, seemed an eternity. They held him up and I saw him for one brief second, he squawked, then was whisked away.

Alex’s placenta was not healthy. It came out in pieces. My body’s super high blood pressure was a warning sign. Although I deemed everything that came before “medically unnecessary,” I’m so thankful that my layperson’s opinion was overruled. And I’m thankful for my “overly strict” doctor’s mandate to deliver.

Three weeks later, Ethan—our Baby Boy A who hogged all the groceries—is thriving in the NICU. Alexander has had a rockier start. Today is my birthday and their 32 week birthday, the day we originally hoped to bring them into the world. Though we undoubtedly have many challenges ahead, we’re all here and alive today. Beyond that, what more can you really ask for?

We’re so appreciative of all the support from friends and family. And I thank God for the expert opinions that overruled mine, that we were in the right place at the right time, that we weren’t far away when things got dire, and that Alex was able to survive the rigors of delivery, and is now under the expert care of the NICU physicians and nurses. Happy Birthday to all of us!

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