doctors, tricare, etc.... (long)

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doctors, tricare, etc.... (long)

Postby andyra99 » Oct 01, 2009 10:17 am

we are new to the military, and currently we are stationed in a pretty isolated area. i don't know much about the doctors in our little town, but i do know that they won't even let anyone try a VBAC. (if you want to try that, you have to drive about three hours before you can find a doc that will let you attempt it.) with my last pregnancy, i was contracting fairly regularly every day since 38 weeks, and was still only dilated to a 1 at 41 weeks. they gave me cervadil and something else, and it didn't do anything. so i had to have a c-section. and my doctor let me know that there is a good chance that could happen every time.

we have since moved, and i'm nervous about what kind of care i would get if i were to become pregnant regarding:

1 - c-sections. my old doctor told me he never has told a woman she needs to stop having babies due to c-sections. he said that if a doc tells me that (and there are no other complications involved) then i should find a different doctor. i'm scared of having a baby here and getting some doctor who is behind the times (come on, no VBACs?) and who will do a crummy job on my c-section and thus limit the number of kids i can have.

2 - i'm afraid of what kind of care is available should i have hg again. last time was rough, but we got through. i had a doctor who was not afraid of prescribing meds, and a husband who was able to help out. this time my husband will be active duty, undergoing rigorous training, and i won't have much of his help because he'll be gone so much. in addition, i have a baby to take care of. if the care available in town is no good, i'll have to make the three hour drive to get care. i know people do that, though, and i'd love to hear from people who have been in that situation.

i guess i'm not too sure what exactly i'm asking, but any thoughts anyone has regarding c-sections, tricare (i'm on prime), or having hg in an isolated area would be welcome! i have a six month-old little guy right now, and i'm loving every minute of having him around. i'm not pregnant right now, but i am hoping to be within this coming next year. last time i wasn't very prepared for everything, and i want to do things different this time around.

thanks!
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Postby carybear » Oct 01, 2009 2:53 pm

okay one problem with Prime is that unless there are NO doctors in the area who are OB's you HAVE to use their doctors. if you are on or near a base my guess would be that you'd have to use an army doc unless there are no ob's on staff then they'll let you choose an off base doc. but that is still compltetely up to them who'll they'll cover.

I never had problems with getting meds from tricare. Well, except that I needed more zofran than they would cover and my dr's nurse didn't ever call in asking for an over ride. so in that regard it sucked! There is also the possiblity that the base pharmacy will not have Zofran and then you'll have to pay a copay to get it.

Now going off vbac discussions, have you actually talked to the dr's in the area or are you going off what other girls have told you? if so, how recently were they pregnant? the doctors do change. I have no idea how frequently were you are, but changes do occour.

One thing to consider, if it's financially feesable. get off prime. yeah you'll have copays but usually you can then pick your doc more easily.

Good luck, and don't feel weird about interviewing ob's. you want to make sure you get one that fits. If you have more questions I'm happy to help answer them. I'm a military wife too.
Luvs to all,
CaryAnn
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Postby aaronsmommy » Oct 01, 2009 8:12 pm

"No VBACs" is certainly not equivalent to "behind the times" and also not unusual at all. I live in a large suburban community, nobody does VBACs here. The hospitals changed their policies about 4 or 5 years ago and they all did them before that. 3 did it because of the unwillingness of the anesthesiologists to be "immediately available" as the national standards have dictated, and one because their malpractice carrier told them they wouldn't cover VBACs anymore. It really doesn't have anything to do with the competency of the doctors (or even their views on VBACs in many cases)

Also, although it is nice to have a doctor with experience with hg, sometimes you may get even better care with a doctor who has no experience but with a willingness to research, learn, listen and try new things. Some people have had horrible experiences with doctors with "experience" who insist that they use the same treatments with every patient and are unwilling to be flexible if things don't work. Doctors in small towns often have specialists they can call on for advice if they can't handle a problem. Sometimes you might have to see that specialist once or twice, but the rest of the time you stay at home and your doctor might call them with questions as needed.

Will you be seeing a military doctor or civilian? Can you get in to be seen before pg so you can see if the doctor is someone you could be comfortable with? Here, you can self refer to an ob/gyn in private practice for your pap smear and that is often a good time to get to know your doctor. Otherwise you can ask for a referral from the base.
Aimee

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