My Coumadin Birth

Do you want to be the third??

2009-03-13T13:47:00.000-07:00

It is a good idea to check the credentials of doctor on IDFPR (Illinois Department of Professional Regulation ) site. As I was looking for a new gyn I also checked Dr Bajaj's profile.

And sure enough I see a settlement. Not unexpected, only thing is that I went here a little too late.

I again urge you to stay away from this doctor. My son is 14 months and yet not a night passes when I dont get nighmares about the hospital. The said mentioned claimant is one, I am the second, Do you want you or your wife to be the third??. Choice is yours

Please come forward

2009-02-18T14:23:00.000-08:00

I have seen several people writing about there experience with Dr Bajaj, most of them negative. Please also report them to the Edward Hospital Patient Advocate and Coordinator,

Infact please report your negative birth experince with any doctor and be the saving grace of others

And I Turned One too!

2009-02-17T08:43:00.000-08:00

Today has been a very emotional day for me. One year back at 4.00 a.m in the morning I was discovered by lab in Room 7627 of Heart Hospital, soaked in blood.

At 10 p.m the previous night, my Hb had dropped to 8.6, dispite being on oral Iron thrice a day (1000% of daily recommended dose). I had a fever of 102 and my WBC was up to 19 inspite of being on continous intravenous antibiotics. It was a week since my c section and I still had a foley between my legs.

Dr Bajaj was called who asked for a chest X ray and said she will look at me in the morning (because she had already seen me once during that 24 hour day). My dressing was changed and wound was dripping blood. I was asked to be given Tylenol and Motrin and go to sleep.

Bharat exhausted sleeps in the couch. I am no longer on telemetry. I start feeling some warm fluid running down my legs. I thought it was urine, my foley had come loose. It continues to flow. I try to wake Bharat but cant sleep. Thankfully lab came and saved me. It was my own blood running down my legs.

A second CTA revealed I had no PE or DVT. I never needed Coumadin or Heparin. I am taken to OR again to drain the abscess. This is done without anaesthesia as giving spinal could have causes paralysis.

I survived inspite of all this because of the excellent shape I was in before starting on blood thinners. Inspite of all her efforts to kill me or making me sick for life by placing IVC Filter and keeping me on thinners, I escaped with the grace of god.

Yes, I have a huge physical scar running across my abdomen, but I walk, drive, breastfeed and am with my son and family. Today is the one year annivesary of my new birthday.

I am one! and I am really happy to be One!!

My son turned one!

2009-01-10T08:37:00.000-08:00

Happy Birthday little Arnav!. I am so grateful to be able to hold you and have you with me all the time.

Breastfeeding is still going on great!.Thank god, I didnt let Dr Vimi Bajaj give me shots to stop lactation. I don't know how could I have managed to make Arnav sleep besides that.

It feels so unreal that Arnav is one, and I am still breastfeeding. And because this has been a gift that has been taken away and then returned, I always thank God as I breastfeed. Dear Lord, Thanks for giving me and my son this beautiful gift.

When do I plan to wean, Well, I am going to continue as long as god lets me, and I hope thats not anytime soon!

Convenience

2008-12-15T12:58:00.000-08:00

So I met my friend who just had a baby and she and I were talking about how inconvenient hospitals can be sometimes. All the time it seems people are walking in and out of the door to check vitals, ask questions and its hardly a conducive place for recovering.

Also since one of my friends works in the hospital, she was telling me that it is a rule for every doctor to come and see you once per every 24 hours. Wow, I didnt know that being my first time in the hospital

That reminded me one incident that I needed to share. It was POD#4 2.30 in the night and I was sleeping and so was Bharat on the recliner. The nurse use to come in every 2 hours adjust my heparin drip , antibiotic drip and leave without trying to wake me up. Then suddenly lights went up in my room. I hear someone call my name and I opened my eyes and see Dr Bajaj. My first instinct and question was Am I bleeding? To which Vimi Bajaj replies, no you are not but I had a delivery and so I came to hospital and so instead of having to come back tomorrow to hospital to check you, I thought I'll see you now. Wow, how convenient for the doctor and as for me, well does it really matters??

Plagiarism:I am a real blogger

2008-11-05T11:22:00.000-08:00

So it seems I am a real blogger:), I had my first taste of plagiarism today. My post on selecting good prenatal care providers appeared in Ryan journal today.

http://rayfordjalynn.livejournal.com/47190.html

I am glad you liked my post enough to include on your site but please give credit to the source. Thats simple basic good manners.My aim is to educate first time moms on the prudence of selecting good prenatal care and I am happy you have decided to join me in the journey. Please let me know who you are and give credit to the source

As I told to Tish Eller, the patient advocate at my hospital meeting. "Lying to me abount my condition, keeping me away from my newborn and then passing blame on one doctor whom patint has not met and is unlikely to meet "This isnt about being a good or bad doctor, This is about being a good human being.

The good parts...

2008-10-27T11:10:00.000-07:00

The experience has certainly made me a better person than I ever was. So lets focus on what I have gained from this

1. I never take things in my life for granted. I relish each day I get to spend with my baby, my husband, my family.

2. I enjoy the simple pleasures of life that I use to take for granted.

3. I live every day as it is the last day of my life.

4. I am more knowledgeable and informative about medicine, health and my rights as a patient.

5. I no longer feel I have to go to only female doctors rather I choose doctors based on there credentials.

6. I see how online ratings are manipulated as doctors make patients enter there own ratings . A positive rating will appear as soon as true ratings are put on site.

7. I can now guide my friends to choose good care providers even for low risk normal pregnancies.

8. This blog, I have always wanted to write but never was able to. The frustration of not getting information from anywhere made me put my feelings in writing.

9. I am a better person, more compassionate, more strong and more virtous. I have experience death too closely and survived it. I can take any and all life challenges.

Criteria for selecting Prenatal care

2008-10-26T13:26:00.000-07:00

The aim of this blog is to educate first time mother and specially some of my fellow Indians the importance of selecting good prenatal care.

I am an educated girl having worked at leading corporations in India and USA yet when it came to choosing doctors I never used my prudent judgement and chose one based on origin and sex. Coming from India I wanted a female Indian doctor and I chose the only one available in spite of hearing two negative reviews from my friends

1. Don't select the first prenatal provider you can get appointment for. I understand that we get nervous about going to doctors and annual pelvic exams are not routinely done in India. For many of us, we get our first pap smear on our first doctor visit. Don't let this be a deciding factor. When I conceived all doctors had a two week wait but for Vimi Bajaj and my abdominal scar is a constant reminder of how I get tripped into unnecessary interventions.

2. Your doctor does not have to belong to the same caste and country as you do. The doctor should be selected based on facilities and credentials and not color or creed

3. Inquire what the doctors take is on inductions and the doctors c section rate. Yes sometimes inductions are successful but they specify how intervention friendly the doctor is.

4. Ask about doctors take on epidurals, AROM, Use of IV and pitocin, eating and drinking during labor etc.

5. If possible, group practices are generally better. This is because if one person misses something other might be able to notice.

6. Ensure that the office staff is friendly and sufficient. Also make a note of all the services they offer and the facilities and equipment they have, At Vimi Bajaj one person takes urine samples, checks weigth gain, takes blood pressure,, makes appointment and even sweeps and cleans the room. Ensure that they have well equipped and knowledgeable nurses and friendly receptionist. As I have been to three four ob\gyn after my ordeal, I have found that most of them have in house ultrasound facilities available. This was not the case at Dr Bajaj

6. Question, When in hospital don't let doctors make you feel obligated or force them into something you don't want. When unhappy don't be afraid to ask for a second opinion. I had an attitude of having "complete faith" on my doctor. Turns out Vimi Bajaj was not worthy of this trust and faith.

Edward Plainfield: Not Needed

2008-10-21T14:00:00.000-07:00

I came across this proposal for building a new Edward Plainfield Hospital. With all due respect I dont think the New hospital is needed.

I mean Edward is resorting to equivocal reports to earn revenue for its doctors and the hospital. I was told that it is the norm at Edward to consider suspicion and respiration as PE and filing defects as DVT and to not stop anti coagulation for a year. The false PE that I had costed me an extra #75,000 in medical bills. $75,000 extra revenue for Edward and its doctors

The doctor shamelessly told me that she has done this many times and they will continue doing this. Yes people get anemia and bleed, but we always give them blood transfusions. By the time patients obtain there records, switch doctors and get repeated CTAs it is almost 3-4 months in medication and therapy. And if there is no death or permanent damage, they cant do anything about it.

A new hospital means greater number of empty hospital beds and I shudder how many more people are going to be subjected to the same kind of torture that I went through

What next?

2008-10-21T09:36:00.000-07:00

I came across this site http://www.hospitalcomplaint.com that lists the steps that one should take to resolve Quality of Care \Billing issues with the hospital.

An excellent site with concise , precise information and one that I have been using as my basis for filing complaints.

So The next step as mentioned on http://www.hospitalcomplaint.com/qci.html are
1. Filing a complaint with JCHO
2. Filing a complaint with Ministry of Health
3. And most importantly as suggested by Edward itself to
Department of Professional Regulation

Missing Answers

2008-10-20T14:14:00.000-07:00

In my quest for information, I had asked two questions to the hospital staff
1. What is the procedure for treating suspected PEs at Edward

2. Procedure for getting medical records modified.

I did not receive answer to either of those in the mail. Also as I was told that I should make a complaint with the Department of Professional Regulation about the doctors. Maybe thats the next step

Heard back from Patient Advocate

2008-10-20T14:09:00.000-07:00

So I finally did receive a letter from the patient Advocate:

1. My letter has been forwarded to Vice President of Medical Affairs

2. As mentioned before, the case was forwarded to Peer Review Committe and their recommendation is confidential

3. As doctors as not employees of hospital, I am encouraged to speak to my doctors about my plan of care

But I have already told you that doctors are not ready to talk. Vimi Bajaj tried to torture me physically when I asked for my records And the cardiologist who treated me with anticoagulants Stanley Clark did not visit me once it was determined that no PE\DVT exists. I was sent a different cardiologist to inform me about the same.

Still waiting from Patient Advocate

2008-10-17T09:38:00.001-07:00

My blog and my story is a quest of getting justice without going on to the legal system. No amount of money can bring back the pain I endured and the time I lost with my baby. I believe that is the way to go to empower not only pregnant women but to people in general about the medical system

Yes things can go wrong, Yes there are risks but often these are avoidable had doctors been more proactive. The entire emphasis is giving more and more unnecessary medication as "Hospital beds that are filled are revenue streams"

So anyway, I had received a letter from patient advocate of the Edward hospital in late September that my case would be reviewed by the committee on Oct 8th and I would receive a written response

I had a subsequent meeting with her on Oct 1st and she was one of the nicest person I had met at Edward. However am still waiting for her letter describing what was the outcome of the meeting of the grievance committee

Meeting with the patient advocate\Modifying medical records

2008-10-10T11:54:00.000-07:00

I had a meeting with the patient advocate of the Edward Hospital. She was very nice and understanding about the whole issue and she said that my letter has been forwarded to the Vice President of Risk management

I know maybe nothing will come out of it as she said that Hospital employ doctors as independent contractors and hence cannot do anything about it. She asked me to write to Department of professional regulation about it.

She spent almost an hour talking with me about everything and it was really nice. I also asked her about the process for getting my medical records modified. Though my records have lots of false information by Dr Bajaj, there is one that I particularly need taken care of

On Day 3, It was 36 hours after the CT Scan. Dr Bajaj had asked me not to breastfeed but Dr Quejada said it was ok to breastfeed. It is recommended to wait 24 hours after scan to start feeding but we had decided to wait 48 hours.

Before the baby came, I had gotten out of bed and lost a lot of blood. I was placed on strict bedrest catherised again. And I was given an antibiotic which was incompatible with the heparin drip. So I had to have a fresh IV in second arm. That IV failed 5 times because my blood was too thin. With IVs in both arm, when my baby was bought to me, I asked Bharat to hold him
Dr Bajaj has written in my records "Patient refuses to hold and nurse the baby". I hope Arnav doesnt think I am a bad mom. I was missing my baby away in the nursery all the time, yearning for him. How can I refuse to hold the baby

Talk About It

2008-10-10T09:24:00.000-07:00

How many people often tell you that forget about the issue. The problem is sometimes we just dont want to forget about it. We want to talk with our loved ones and friends about how this still hurts and terrifies us

Getting over it does not means not talking about it. That makes us feel that they feel that this issue is not important. It makes me feel that no one cares about what I went through. Hence this blog. It lets me talk to myself about how I feel about all this

More to come

2008-10-10T08:26:00.000-07:00

Based on the google analytics reports sending traffic to my site and at my own frustration on the lack of information available on the net, my next few posts will cover
1. Coumadin and Breastfeeding
2. Procedure for getting your medical records
3. Procedure for modifying your medical records
4. Quality of care complaint procedure against your physician and hospital
5. Pregnancy on Coumadin

Please send me any more topics you would like see covered on this blog

The good doctors

2008-10-07T07:38:00.000-07:00

While I was unfortunate to have a very bad experience with my gynecologist, I would be failing in my duties if I dont thank some of the very nice doctors who saved my life

1. Dr Leonard Sherman
He is the radiologist who read my second CT scan and had the guts to go against his colleague and tell them that there is no DVT or PE. He is the one who saved me from getting the IVC Filter. He is my god, no words can ever fail to express my gratitude and thanks to him

I don't know if I'll ever be lucky enough to meet you but I thank you each and every day of my life

2. Dr Todd Singer

The Interventional Radiologist who did the surgery for draining fluid from my abdomen. Since I was on heparin, I couldn't be given spinal anaesthesia. He offered me general but I was worried that they would proceed with IVC Filter while I am asleep

He was so calm and talking to me during the procedure , telling me about the baby he and his wife had 5 months back. Even when I was shouting uncontrollably he told me very nicely "Don't worry, things will be fine. I have seen your records. You don't need a filter"

Dr Singer, you don't know how much your kind attitude mattered to a lonely frightened girl.

Unhappy with your maternity care

2008-10-06T12:17:00.000-07:00

Then complaint. Make your voice heard so that others may not be subjected to the same torture you were subjected to.

http://cfmidwifery.org/Resources/item.aspx?ID=1

Many times we choose to keep quite and ignore because We are afraid of letting the world know that we have been treated so badly. I was afraid will people still think me as the bright and smart girl when I could not take care of my own well being, when I couldn’t take right decision about my own child. I felt guilty that I couldn’t judge people correctly

I felt ashamed, guilty, failure. I was afraid of what people will think. I was scared arguing and asking Vimi Bajaj for my records because I was scared of going to any doctor. I believed that my doctor had my best interests in mind but this was not the case.

But there is nothing wrong and ashamed of in putting in words what you are feeling. Save someone the heart break. Let the world know that when Vimi Bajaj could do this to a healthy smart educated girl, she can do this to anyone. Complain and ensure that your voice is heard. Spread the word, be brave and this is the pathway to healing emotionally and physically

Refuse To Be a Womb Pod: What doctors have to say for themselves#links#links#links#links

2008-10-03T13:02:00.000-07:00

I came across this interesting story on Refuse to be a womb bad. Enlightening indeed
Refuse To Be a Womb Pod: What doctors have to say for themselves#links#links#links#links

Writing is Therapeutic

2008-10-01T12:34:00.000-07:00

Nothing to me has been more therapeutic than putting in writing what I feel about the whole incident. Puting in words that I feel betrayed and hurt about all this. Many times we keep quiet aout how we feel by another person's wrongdoing.

Then again we are giving chance to such individuals to hurt people again and again. Like it was told to me by the heamatologist "We do it always, a person has to say suspicion and we start the treatment". And by the time person sees his or her medical records it is too late for him or her to do anything. At the end of three months when he sees suspicion the window has gone out to verify whether clots existed in first place.

Why choose a doctor wisely?

2008-10-01T12:25:00.000-07:00

After my hospital ordeal, for first two weeks I was shocked. Then I started looking into new doctors and was shocked when all doctors denied to look at my c section wound.

I had a gaping 5 inch x 1 inch x 1 inch wound that dripped enough to soak half a dozen pads per day. Because of liability issues all doctors refused to touch it till Dr Vimi Bajaj gives me my records or request in writing

Since Dr Bajaj refused to give me my records, I was left with no choice but to depend on her for my wound care. So better be safe than sorry. Choose doctors judiciously because once the case is spoiled, you would have a hard time finding someone who would even touch you till the first one is healed

Happy Birthday Sweetheart

2008-10-01T12:19:00.000-07:00

Today is my darling husband's birthday. I am such blessed to have a wonderful. loving , caring husband and not only this he is very handsome and also is in a great job. What more can a girl ask for.

All through my hospital ordeal he has been a pillar of strength. He leaves for work at 5.40 in the morning to avoid traffic. For 16 weeks, he would get up at 4.00, clean and pack my wound, then go to work, then come back at 5.00 clean my wound again, play with the baby while I get some rest

Many time people asked him, doesnt he gets disgusted and he would reply, "Oh!, Its nothing", No one could have done what he did.

And he puts up with my cribbings and cries, give me endurance that things will be all right

Happy Birthday sweetheart and Thank you for everything you mean to me

Response from Hospital

2008-09-29T12:42:00.000-07:00

I got a mail from the Patient Advocate that my medical records will again be reviewed on October 8. Though I doubt anything will come out of it

A couple people have asked me to talk with attorney. I dont know about that process and frankly I am afraid. I am new to US and had heard nothing but good about the medical system here, so when this happenned I was shocked. That and the expenses and the time

Working full time at a high demand job, doing masters part time, taking care of baby leaves little time if any

Healthy Moms matter too

2008-09-26T12:29:00.000-07:00

How many times have I heard that phrase, "No matter what happenned, you have a healthy baby". Isnt thats all that is important. Yes that is important and yes that is the most important part but that does not means that healthy moms are not important.

I love my baby and I would do it all again for him but I detest the fact that I have a huge abdominal scar, i am still anemic, I am unable to lift him and the car seat together still and I still get nightmares about the IVC Filter

I am never going to trust a doctor again

2008-09-19T12:49:00.001-07:00

I love Arnav, I am grateful I am alive and so is my baby, I have a wonderful husband but I have no faith, no trust left. Dr. Bajaj was the fisrt doctor I met in US. Before I got pregnant I had not visited any doctor in US. So when I looked up Edward service and contacted the doctors, she had the first available appointment. When i saw her first, I thought she looked a lot like my mother looked when she was young. No one had heard about her, she was not any of my friends doctor but I liked her and she was close to work

For 14 weeks she told me lies, bad mouthed the radiologist with me. I thought fluid levels were a fluke but now I realize how shallow she was. I am never going to trust a doctor again

Its been 8 months

2008-09-19T12:49:00.000-07:00

And I still feel sad and depressed. Not one night has passed when I dont get dreams of being strapped in bed with foley between my legs. Dr Bajaj pressing hard on my stomach to stop the bleeding and telling me time and again not to have another kid. Bharat was standing and crying and since you are the dying person, so you are supposed to be brave and not even cry.

She asked me not to move my legs. I worked till the day I delivered and laid absolutely still for 4 days to avoid bleeding.

2008-09-16T11:19:00.000-07:00

It has been 8 days and havent got any response back from patient advocate or the doctors. Am planning to file a complain with JCHO next

My Response to the Hospital

2008-08-08T08:06:00.001-07:00

To,
Tish Eller, LSW
Patient Advocate
Edward Hospital, Naperville

Dear Ms Eller

Thank you for your letter. As you suggested in your letter, before bringing the matter to your attention I had indeed talked with my doctors and these were the responses I received:-
1. At the hospital, I was told by doctors that the radiologist has read the report wrong and reported three clots when there were none.

2. Dr Bajaj: Because mine had been such an uneventful and uncomplicated pregnancy, I had never gotten to test the medical acumen of doctor. Prenatal visits were all so routine and I believed that because I was visiting her regularly she would have discovered if something was wrong. At the question of low amniotic fluid levels going undetected unless the day I delivered she told me that “babies in my family always died”. My mothers are six sisters and one of them did had three neonatal deaths because she had an incompetent cervix and her 28-32 weekers did not survived 15 years back in India. She also has two healthy babies after then
All during my 14 weekly visits with her for wound care, the issue of false PE came up invariably and we both bad mouthed the radiologist together and it was she who suggested that I write a letter to Patient Advocate and Head of radiology describing what I had to go through and my complaint with radiologist. However she never told me the name of radiologist. Also my requests were records were denied for a long period of time. I wanted my records for any future pregnancy. During one of my last visits when wound was almost healed, I finally gave a written request for records. She again refused but I insisted I want to. She then opened my dressing to look at wound and then said she can’t dress it back. The single member in her staff will give me a gauge and I can cover it with my underwear. The wound was not fully healed with raw skin at that point. Mine is a bikini cut incision and she was well aware I cant dress it back myself.
I did talk to her on phone once after picking up records. When I asked her that radiologist is saying suspicion and limited motion exam, she said that the in CT reports clots are always reported as suspected and when there are no clots the report reads low probability. When I said that second reports says “no pulmonary embolism” and does not says “low probability” she refused to discuss it further and said that I should talk to radiology if I have any concerns. This behavior not only raises concern about the medical acumen but also about the ethical behavior of the doctor as instead of coming out clean the blame is put on one doctor whom the patient has never met and is unlikely to meet. I was also told by her “That what can you do about it”
3. Radiology: Naperville radiologists says that radiologists talk to doctors directly and rarely with patients
4. Dr Quezada: She says that starting Coumadin was decision taken by cardiology and OB and her job was just to check whether I had some genetic clotting disorder. She says that the decision to start or reverse thinners was to be taken by doctor who operated and couldn’t have been her.
I was also told that I was lucky I bleeded and insisted on CTA and thus second was done. They give long term anticoagulants to patients and if that fails they put in IVC Filters. I am also told that even if there is respiratory motion or an artifact as was in my case, they start the anticoagulation for a year without verifying if medication is truly needed. I am concerned that while Edward is treating many patients who actually need anticoagulation, many others are enduring years of medication without verifying even if it’s needed.
I shudder to think what would have happened had I not bleeded fatally. I would be taking Coumadin even today and getting INR testing weekly , bleeding on slight episodes, having thousands in medical bills and if I get pregnant later, I would have been injecting myself heparin all because I was breathing fast on a Friday Night
And had my husband not refused surgery, I would have been on these blood thinners for life and the havoc this would have played would have had coming me to hospital again and again as long as I lived.
If CTA is equivocal, MRI, VQ Scan, Venus Doppler, d-dimer could be done. I am sure doctors running the billion dollar cancer center and heart hospitals have tests to verify whether the medication is needed. The entire emphasis is on administering treatment not diagnosing whether that treatment is warranted.
5. Dr Davis \ Dr Clark: I haven’t talked with cardiology as I am too exhausted to do so now.
I have also been asked by my doctors not to make a noise about this episode because I did not die.
The point here is that a 27 year old girl with a picture perfect pregnancy and absolutely no health problems is diagnosed with DVT and Pulmonary Embolism, given blood thinners that were contraindicated with her recent surgery, allowed to bleed for 4 days before any action is taken and is later told that there was No DVT or no PE. And while she did not die, she walked around dripping bloody fluid from her abdomen for months, had severe weakness, anxiety and suffering. And during all this, it was her husband who was packing and cleaning her wound twice daily and it was while they both were trying to take care of their newborn baby.
And if the girl did died (which was entirely possible had the lab not come to draw blood since there was no telemetry), doctors could put the cause of death as Pulmonary Embolism and adverse effect of anticoagulants in therapeutic use. Whether that therapeutic use is warranted no one bothers to check. There wouldn’t have been a repeat CTA done on a dead body. Long term anticoagulation should be clinically correlated and undertaken with definitive diagnosis.
Respiration is being reported as PEs and filing defects as DVTs. Patients are being incorrectly told they have blood clots and they are dying. It is a crime to let patients being forced into unnecessary medication by not allowing them to make informed decision. Patients are not allowed to see reports and they have to make decision based on what is being is told to them by doctors. It’s a crime giving false information to patients about there condition. Radiologist is reporting them as suspicions and others are doing no clinical correlation and treating them.
While the physicians are not employee of your hospital, they do have privileges to practice at Edward and I would like to talk with the committee who grants these privileges to doctors or the Chief Executive of Edward or to the peer review\grievance committee. This is a serious concern and requires attention. My Admitting doctor made serious mistakes with my care and treatment and it needs to be warranted that this does not happen again

I am copying this letter to the doctors who treated me and if they would like to explain to me:
1. Why was I lied about my condition. ? Whenever I asked about where and how big the clots were, the answer was elusive as In there own words
a. “You have two blood clots in your lungs and one in your thigh. You could have died but I called the cardiologist and you are safe”
b. “You are going to get into cardiac arrest.”
c. “Be grateful that we caught you else you would have your son with you now, but not 25 years later when he becomes a doctor”.

2. Why was I not made aware of the bleeding effects of Coumadin.
3. There were 3 episodes of bleeding
i. On morning of 01\13, patient was placed on bed rest again with Foley.
ii. On morning of 01\15, entire wound was opened up with wound separation and indurations was noted
iii. On night of 01\15 there was wound drainage and patient was running a fever with increased indurations
b. Why was no affirmative action taken after three bleeding episodes? It was clear that keeping patient on strict bed rest, oral iron and intravenous antibiotics were not working/
c. Why was wound not checked regularly after bleeding and fever on 01\15 night? Why wasn’t a CTA ordered on 15th night. Even a couple of hours would have a made a great difference in my recovery

4. Why was I discontinued from telemetry in spite of very high Heart Rate especially as tachycardia was the only indication of the presumed PE?

The most important thing is that patients need to made aware of the correct facts about there condition. And had mistakes been made, an apology and making me aware of facts was enough rather than lying and putting blames on a doctor whom the patient had not met and was not likely to meet. This even raises ethical concern about the behavior. I did not wanted to bring these issues up unless really necessary and was sticking to plain simple facts about what happened. I am sure all the doctors would attest to the fact that whatever I am saying is true.

Thank you

Copy to:

1. Dr Vimi Bajaj
My ob\GYN
2. Dr Maria Quejada
My heamatologist. I think she actually allowed me to brestfeed when Dr Bajaj wanted to give me injections to dry out milk because of coumadin
3. Dr Ann Davis
The cardiologist who I saw first day and last day
4. Dr Stanley Clark
The cardiologist who treated me. But didnt see me after it was determined that PE does not exist
5. Dr Leonard Sherman
My god, the radiologist who determined no PE\DVT exists
6. Dr Paul Goldberg
The radiologist who said I had PE\DVT
7. Dr Giradot
Head of Radiology
8. Dr David McElligot
Pulmonary MD who was called on Day 7 instead of day 2
9. Dr Todd Singer
A very kind and compassionate doctor. Did second surgery to drain fluid from my abdomen

Response from the Hospital

2008-08-08T08:01:00.000-07:00

This is the response I received from the hospital

1. It was determined that my complain is mainly with the physicians who treated me. Doctors while an important part of the healthcare team are independent contractors and not employee of the hospital. So the grievence committee cannot do anything about it

2. That being said grievance committee did forward my case to peer review committee. The recommendation of peer review committee is confidential and cannot be shared

3. I should talk to my doctors about the care I received because they are the best persons to answer the question

4. Lastly, if there are any issues that are not to my satisfaction, I can contact them back or there are other institutions available as well

Incident Report sent to Patient Advocate

2008-08-08T08:00:00.000-07:00

I was visiting Dr Vimi Bajaj regularly for my prenatal care and follow-up and ever so more regularly during my last 8 weeks of pregnancy. At none of the appointments she failed to diagnose that I had low amniotic fluid. Not one NST was performed during my entire pregnancy well being aware of the family history of neonatal deaths nor was the fundal height measured or recorded correctly. This was after I was assured that post 32 weeks we would be doing weekly NSTs. My concerns about baby movements being slow and irregular were dismissed as being said that baby has outgrown space to grow. On a routine appointment at 38 weeks after being dismissed from her office saying that there is no dilation and baby won’t be born for 5 days. However I returned back and on my insistence an NST and Ultrasound was performed which showed that baby was measuring 2 weeks small and fluid levels were 4. This was not detected or monitored during any of my prenatal visits. And I had to undergo an emergency c section the same day because baby was more than stressed at this point. The baby who was measuring exactly on target at 30 weeks was measuring two weeks small for his gestational age. Had my gynecologist had been able to determine my fluid and baby’s growth restrictions by measuring fundal heights correctly; I wouldn’t have been robbed out of the experience of delivering even with laboring. I was very fortunate that I insisted on NST because else the baby might not have able to make it.

Due to being anxious, tired and dehydrated based on my very negative birth experience and possibly as a reaction to anesthesia, I developed tachycardia .The next day, Dr Bajaj orders a cardiac consult for tachycardia. TSH, ECG, EKG were all normal so a CTA was ordered to rule out PE. I refused CTA telling that I am fine. However I was forced to get the CT Scan by the doctors. The CTA was severely degraded by respiratory motion and inconclusive in its findings. At that point, based on equivocal report and in absence of any symptoms, heparin was started being fully aware that the patient has just had a recent abdominal surgery.. In the CCU, my HR stabilized during the night. Dr. Bajaj arrives next morning and instead of ordering definitive diagnostic tests, took the decision to start me on Coumadin and anticoagulation for a year and 5 days on heparin moving me to the heart hospital. Dr Bajaj also asks me not to breastfeed and says she will give me injections tomorrow to dry out my breast milk. This was after that fact that I denied all symptoms and insisted I was feeling fine. I was also not told that CTA was inconclusive and I was not allowed to see the report in the hospital and all requests for confirmation CTA were denied for 5 days. I was also not made aware of the possibility of bleeding on anticoagulants.

On Post Op Day 3, there was significant bleeding from the incision site and wound was opened with 4 staples. There was copious amount of serum and blood drainage (almost to soak fifteen to twenty ABD Pads and bed sheet completely) However still no definitive studies were carried and anticoagulation was continued. Also Dr Bajaj tells me that I should never have any more kids because of the severe PE I had. On Post-Op day 5 the entire wound opened up, again large amount of serum and bloody fluid was extracted from the abdomen. Again fifteen – twenty ABD pads and the entire bed sheets were soaked with blood. And anemia kept on getting worst in spite of oral Iron medication thrice a day. WBC count keeps on rising daily in spite of intravenous antibiotics for past 5 days. The wound which was superficial is now almost a centimeter deep. Still heparin and Coumadin are continued in spite of recurrent bleeding and repeated absence of any symptoms (chest pain, shortness of breath, leg pain, swelling etc ). I am also discontinued from telemetry saying that my tachycardia is due to anxiety and anemia. At that point I again requested them that since I am having no symptoms and I am bleeding and telemetry is being discontinued saying tachycardia is due to anemia and anxiety (And since tachycardia was only indication of cardiac consult) why don’t we order another CTA and see where we are at clots. But they dismiss me. On day 5 nights, I start running a fever due to loss of blood and weakness. However still heparin is continued. On Post op day 6 finally wound erupts and massive hemorrhage occurs. There was enormous oozing through gauze despite significant amount of pressure. I was on vitals every 4 hours and when nurse came to check vitals she saw me covered with clotted blood and gradually diminishing blood pressure. Since I was not on monitor even my falling vital signs were not detected. At that point five days late Doctor Bajaj finally orders a second CT scan, VQ Scan, and Venus Doppler study all of which rule out DVT and PE. At the end of 6 days finally she refers me to pulmonary doctor who rules out PE and DVT. On Day 6, Dr Bajaj tells me that we need to do a CTA to drain fluid from the abdomen and also because first was inconclusive so let’s now order a CT scan again and see if clots actually exist. It was determined that there was no PE or DVT and there was no evidence of PE or DVT ever, I was never required to be on anticoagulants.

Had Heparin been started as a preventive dose, Coumadin and anticoagulation for a year should have been decided only after a definite diagnosis was made. Coumadin was started on 01\12 very well being aware that patient feels fine, CTA is inconclusive and recent abdominal surgery. Bleeding on 01\13 did not force them to take any necessary action till 01\16.Even on 01\15 when incision was draining serous material and patient developed a fever of 101.1 , heparin was continued. Pulmonary consultation, repeat CTA, Venus Doppler, VQ Scan should have been carried out much earlier instead of on 01\16. The patient had started bleeding on 01\13. In light of the inconclusive reports, repeat CTA or VQ should have been carried out before jumping on decisions for IVC Filter or Coumadin.

All during the course, I was kept in bed with a Foley catherator and asked to lie absolutely still without moving my legs. Once it was determined that no PE or DVT exists, I was to be transferred to the OB floor on morning of Jan 17. The baby was discharged on Jan 17 mornings and it would have been easier for us to keep the baby on OB floor. However she does not visits me till late in the afternoon on Jan 17. At around 3.30 p.m. She arrives, removes the Foley and asks me to go home without checking if I am able to ambulate or urinate. I was only allowed to get out of bed once during these 7 days to bedside. When I expressed my hesitation and discomfort on ambulation, she leaves me in the heart hospital room and we had to make the baby sleep in the hospital bed with us because there was no bassinet available on the floor. I was discharged with continuous bleeding and indurations from the incision site and only hours after I was allowed to ambulate after 7 days in bed. She does not even visit me on the day of discharge (Jan 18). After that I had to visit her continuously for 14 weeks for wound care and treatment. Wound drained purulent thick bloody serous material for 6 weeks enough to soak 8 ABD pads per day and there was a big clot over the right hand corner of the corner of the wound. After 6 weeks the drainage changed to yellowish and continued for another 6 weeks. The wound was 13 cm long and an inch deep. I faced great difficulties in walking and urinating during weeks after discharge. Even today there is a 0.5 cm gap from where the incision closes to the point where it meets the rest of the skin.

There was no home health care barring once a week and my husband had to dress and pack the wound twice daily for 14 weeks apart from taking care of my infant son. He had to suffer severe strain because of this. Also because of mother baby separation and anemia during the first week of his life, my baby lost on a lot of precious breast milk. Entire trauma all caused loss of bonding and breast milk for my baby.

All during the hospital stay my baby was kept away from me in the hospital nursery and allowed only 2-3 hours per day for the first week of his life. Moreover he was discharged a day earlier and we had to make him sleep with us in the heart hospital room before I was allowed to go home. Any planning for baby no 2 definitely needs to wait a great amount of time due to the ongoing physical and emotional trauma

Her carelessness is evident from the numerous mistakes in the hospital discharge summary:-
1. The wound has been mentioned to open superficially in the hospital records. The patient wound was 13 cms long and at its peak 2.4 cms deep and has taken 14 weeks to close. The patient had to undergo severe mental and physical trauma during this period.
2. The PT\INR was not therapeutic on Coumadin during the hospital stay
3. Coumadin was started on Post Operative day 2 i.e. January 12, 2006 and not Day 4 as mentioned in the records on being ok by Dr Bajaj.
4. Hypercoagulable workup was ordered due to clots and not due to lipids.
5. Heparin was discontinued only for an hour on Jan 16 due to super therapeutic levels and was to be restarted after an hour.
All during the hospitalization, I ask Dr Bajaj that I feel fine and I have no symptoms. I want to know how big the clots are. But all I am told by her is that I should be grateful to her for saving my life. I feel no symptoms and I would have never known about her PE and died had she not been proactive in saving her life. How lucky for me that she treated me although there were no symptoms. A girl like me who is generally logical, confident and smart is exploited in most vulnerable way. My coherent confident self turned nervous, anxious and scared as I was told that I am unable to feel symptoms of what is going wrong with my body.

Complaint process

2008-08-08T07:58:00.000-07:00

I filed a complaint with the Patient Advocate at the Hospital. She was very supportive on the phone and asked me to send the letter. This is what I sent her

Dear Ms Eller,

Pls refer to our telephonic conversation. I am attaching my story as talked with you. I chose to deliver at Edward because of the excellent reputation I had heard about the hospital. Infact i chose my doctor based on edwards referral program. So I was naturally stunned when this happened to me. I believe that when this can happen to an educated, logical girl like me , there are many more who are subjected to unnecessary pain and trauma.

At the request of the Food and Drug Administration (FDA), Bristol-Myers Squibb has strengthened its US label for warfarin (Coumadin) to include a black-box warning about the risk for major or fatal bleeding. It says that bleeding is more likely to occur during the starting period. Among others, the risk factors for bleeding include trauma, anemia and concomitant drugs

Warfarin label also reads that warfarin is contraindicated with recent traumatic surgery resulting in large open surfaces. Potential adverse reactions to COUMADIN may include: Fatal or nonfatal hemorrhage from any tissue or organ. This is a consequence of the anticoagulant effect. Therefore, the possibility of hemorrhage should be considered in evaluating the condition of any anticoagulated patient with complaints which do not indicate an obvious diagnosis. (Source: http://www.fda.gov/medwatch/safety/2006/coumadin_PI_april2006.pdf)

And yet I was given Coumadin following recent abdominal surgery (C section), in absence of any symptoms and inconclusive CT scan reports. And these were continued for next 5 days in spite of my repeated denial of all symptoms (Pls see hematologist initial report saying that patient says she feels fine ) bleeding from surgical site, drainage from c section incision, increasing anemia in spite of thrice a day oral iron, increasing WBC count on antibiotics, fever and complete wound separation. After 5 days, clarification CTA and other required tests like VQ Scan and Ultrasound of lower extremities were ordered to conclusively rule out PE and DVT. It was determined I had no PE\DVT and I was not required to be on anticoagulation ever. I had several thousands in medical bills, severe anemia, weakness and anxiety and a 13 cm long and 2.5 cm deep abdominal wound for 14 weeks.

The FDA Med watch announcement also notes that warfarin prescriptions will also be issued with a new patient medication guide warning about potentially serious bleeding with the drug. FDA regulations state that such medication guides are to be provided with each prescription that is dispensed for products that the FDA determines pose a serious and significant public health concern. I was also not made aware of the possibility of bleeding on Coumadin.

This incident happened under the treatment of Dr Vimi Bajaj following my C section on January 10, 2008. I was hospitalized from Jan 10 - Jan 18, first in the OB ward and then at the Heart Hospital. I strongly urge you, to take necessary action against the doctor so that no more patients like me are subjected to unnecessary trauma, pain and suffering. Such doctors should not be allowed to practice especially at big hospitals like Edward. At the very least they should be asked to undergo special continuing education classes before they are allowed to practice at Edward.

The other doctors involved in my care were Dr Ann Davis and Dr Stanley Clark from the cardiology department and Dr Maria Quejada from the Hematology department.
Thank you

Attached:
My incidence of what happened Before, during and after my delivery

Happenning too often in Chicago Area

2008-08-04T13:16:00.000-07:00

Today while browsing one of the forums, I came across another person who had suffered anticoagulation for a long time when he had no evidence of PE\DVT,
http://dailystrength.org/c/Pulmonary_Embolism/forum/2233214-unbelievable

My Story so far

2008-08-04T13:15:00.001-07:00

A 27 Year old girl with a picture perfect pregnancy and absolutely no health problems goes to her doctor who tells that she won’t be having her baby for next 5 days and dismisses all her concerns. She however refused to leave and demanded that an Ultrasound be performed which showed results that necessitated an emergency c section. She feels stressed by the loss of birth experience. From the time of admission to hospital she has a high heart rate due to anxiety because she was found to have dangerously low amniotic fluid which was never detected and she feels stressed. Following her delivery, she demands that she wants to sleep and rest but a barrage of medical intervention follows her. All the while the girl insists she does not wants any test and she just wants to sleep and rest. She is forced to undergo a CT scan apart from multitude blood and other tests. his poor girl does not knows that she is suppose to hold her breath during the CT scan and thus becomes the start of trauma, pain and suffering that she is to endure for a long time to come

It’s a Friday night and her breathing causes the CT to be degraded. The easiest option was to treat her based on a degraded CT film and start on some dangerous medications called “Blood thinners” because no one wants to be bothered especially doctors on a weekend night. She stabilizes her heart rate during night because all she needed was sleep but how can doctors tell that they did something wrong. She again says she feels fine but no one listens, and keeps on giving her blood thinners.
These blood thinners can cause fatal hemorrhages especially after recent surgery and anemia. Manufactures of these medicine are well aware of this and ask doctors to use prudence and caution in there use. She starts bleeding, starts accumulating abdominal fluid. She is told she is dying without blood thinners and the barrage continues. The baby is not allowed in mother’s room and she is asked to lie absolutely still in bed with Foley between her legs. A multitude of doctors and nurses parade in and out the room checking her bikini cut incision several times a day. She has to undergo pelvic exams thrice a day checking for vaginal bleeding. She develops anemia in spite of oral iron and WBC count continues to rise with antibiotics. All during the time she keeps on draining serum and bloody fluid from abdomen. She keeps on insisting that she is having no symptoms (no chest pain, no shortness of breath, no leg swelling, no leg pain). No symptoms other than tachycardia and the doctors themselves told her that tachycardia was due to anxiety and anemia and discontinued her from telemetry but continued giving hers blood thinners. Her heart shows normal function on ECG and EKG. She is left to bleed for 4 days because doctors are too proud to accept that they did something wrong. Finally the poor girls body gives up. She bleeds uncontrollably and is almost collapsing when she is found by a young nurse. She is then being prepared for an IVC surgery that will require her to be on these blood thinners for life. Before IVC filter surgery she needs another procedure to drain fluid from her stomach.

Fortunately for her, her husband insists that before doing surgery they be shown the CT report. Finally the doctors realize that the patients are aware of something wrong and agree to do clarification CTA and the other required tests like the Ultrasound of legs and VQ Scan and agree that blood thinners were not needed as there were never any clots. She was not required to be on blood thinners ever. The poor girl at this point has a 13 cm long and an inch deep abdominal wound. She walks around draining bloody fluid from her stomach for next 8 weeks. It took 6 more weeks after that for wound to close leaving a permanent depression and disfigurement. She has more than $90,000 in medical bills. And had the surgery possibly Coumadin for life that would not have allowed her to have any more kids and she would have medical bills this large for the rest of her life.

So the cost of breathing fast on a Friday night is $90,000 in medical bills, severe anemia, weakness and anxiety, 14 weeks of open abdominal wound that was to be packed and dressed by her husband. This girl is me Prachi and this is my story a part of health fraud going on at Edward Hospital in Naperville. Patients are being subjected to long term anticoagulants without doing all necessary procedures as an anticoagulated patient earns at least $100,000 in revenue for the heart hospital and the doctors in a year. They often have 5 days stay in hospital and lots of blood tests for CBC, PTT, INR testing. Numerous doctor visits and the havoc this drug plays on the body keeps them coming to the hospital again and again. Anti coagulants or blood thinners are dangerous medications that require careful monitoring and use. While they do save lives, they have a lot of adverse effects too. The manufactures of these blood thinners called Coumadin are well aware of this and they carry black box warning about bleeding urging doctor to use caution and judgment in there use.
At the request of the Food and Drug Administration (FDA), Bristol-Myers Squibb has strengthened its US label for warfarin (Coumadin) to include a black-box warning about the risk for major or fatal bleeding. It says that bleeding is more likely to occur during the starting period. Among others, the risk factors for bleeding include trauma, anemia and concomitant drugs

Warfarin label also reads that warfarin is contraindicated with recent traumatic surgery resulting in large open surfaces. Potential adverse reactions to COUMADIN may include: Fatal or nonfatal hemorrhage from any tissue or organ. This is a consequence of the anticoagulant effect. Therefore, the possibility of hemorrhage should be considered in evaluating the condition of any anticoagulated patient with complaints which do not indicate an obvious diagnosis. (Source: http://www.fda.gov/medwatch/safety/2006/coumadin_PI_april2006.pdf)

There were 3 episodes of bleeding
1. On morning of 01\13, patient was placed on bedrest again with foley after wound was opened and drained.
2. On morning of 01\15, entire wound was opened up with wound separation and indurations was noted
3. On night of 01\15 there was wound drainage and patient was running a fever with increased indurations
Why was no affirmative action taken after three bleeding episodes?
4. Why was wound not checked regularly after bleeding and fever on 01\15 night.
5. Why was I discontinued from telemetry in spite of very high Heart Rate

The FDA Med watch announcement also notes that Coumadin prescriptions will also be issued with a new patient medication guide warning about potentially serious bleeding with the drug. FDA regulations state that such medication guides are to be provided with each prescription that is dispensed for products that the FDA determines pose a serious and significant public health concern. I was also not made aware of the possibility of bleeding on Coumadin.

When an educated young couple like us can be manipulated into the scenario of dangerous medications, I shudder to think what happens to the general public. So many people never even care to check there records later to Verify the medication was ever needed. They all endure years of medication and have thousands and thousands in medical bills.
Let us consider what would it have cost Edward had
1. Carried all definitive studies
The heparin was started as a preventive dose but the patient had all stable vital signs normal ECG and EKG and repeatedly denied all symptoms. A second radiologist could have been asked to review reports since it was just suspicion or VQ Scan, Leg ultrasound and if need be a repeat CTA carried out. Edward would have earned only on the diagnostic tests and possibly even all diagnostic tests were not needed.
2. Started on anti coagulation
Person would have had hospital stay of minimum 5 days, and she would be on Coumadin for a year. She would have had several visits during the course of the year with Edward doctors, weekly blood draws, possible couple transfusions and definitely repeat CTAs throughout the year. They knew the patient desired more kids and they could again give her blood thinners throughout her subsequent pregnancies again adding to profit.

Yes there was a very high risk of bleeding because of recent surgery, trauma and anemia but this weighed no where near the profit Edward would generate. Even if patient starts bleeding they would put up IVC Filter. A surgery which would cost thousands. If IVC Filter becomes permanent, person would have to take Coumadin for rest of life and Edward would have revenue for next several years. Even if IVC Filter is temporary, there would have been one more surgery to take out the filter and that would again generate revenue. Plus there was always the anti coagulation for the year which maybe they can now extend to two.
And if the patient did die, Edward could put the cause of death as Pulmonary Embolism and adverse effect of anticoagulants in therapeutic use. Whether that therapeutic use is warranted no one bothers to check. One person made a wrong diagnosis and all others follow. How that medicine could impact the person profoundly no one cares. No one would have bothered to perform repeat CTA on a dead body

A group of three doctors (cardiologist, hematologist and her OB\GYN) visit the patient in turn. To each the patient asks that she feels fine and she has no symptoms. She wants to know how big the clots are. But all she is told by all three that she should be grateful to doctors for saving her life. She feels no symptoms and she would have never known about her PE and died had the doctors not been proactive in saving her life. How lucky for her that her doctors have treated her although there were no symptoms. A girl who is generally logical, confident and smart is exploited in most vulnerable way. Her coherent confident self turns nervous, anxious and scared as she is told that she is unable to feel symptoms of what is going wrong with her body.
Few people hemorrhage fatally and the rest are given several blood transfusions again adding to profit line of Edward. While PE can be a potentially life threatening situation, anti coagulation has its risks as well and can be as life threatening as a PE. Decision to place a patient on long term anticoagulation should be only taken after a definitive diagnosis is evident. I would have thousands more in medical bills for INR testing; any future pregnancy would require prophylactics and again would have cost thousands. An anticoagulated patient is at great risk for bleeding and stroke during day to day activities. A person may simply be denied life insurance because he or she has been on Coumadin.

The number of dispensed outpatient prescriptions for warfarin had increased 45%, from 21 million in 1998 to nearly 31 million in 2004, and that warfarin was among the top 10 drugs with the largest number of serious-adverse-event reports submitted to the FDA during the 1990 and 2000 decades. From US death certificates, they showed that anticoagulants ranked first in 2003 and 2004 in the number of total mentions of deaths for drugs causing “adverse effects in therapeutic use.” In addition, data from hospital emergency departments for 1999 through 2003 indicated that warfarin was associated with about 29 000 visits for bleeding complications per year, and it was among the drugs with the most visits. And yet warfarin is continued uninterrupted at Edward Heart Hospital because of the revenue it generates. All patients require several blood transfusions, INR testing and medical visits all of which are adding to the profit line of Edward. Long term anticoagulation should be clinically correlated and undertaken with definitive diagnosis. The emphasis should be on correct diagnosis and not treatment. The emphasis need not to be on covering other doctors and earning revenue, but on the welfare of the patients.

Where was the baby

2008-08-01T13:34:00.001-07:00

There was no home health care barring once a week and my husband had to dress and pack the wound twice daily for 14 weeks apart from taking care of my infant son. He had to suffer severe strain because of this. Also because of mother baby separation and anemia during the first week of his life, my baby lost on a lot of precious breast milk. Entire trauma all caused loss of bonding and breast milk for my baby.

All during the hospital stay my baby was kept away from me in the hospital nursery and allowed only 2-3 hours per day for the first week of his life. Moreover he was discharged a day earlier and we had to make him sleep with us in the heart hospital room before I was allowed to go home. Any planning for baby no 2 definitely needs to wait a great amount of time due to the ongoing physical and emotional trauma

Jan 17

2008-08-01T13:33:00.000-07:00

All during the course, I was kept in bed with a Foley catherator and asked to lie absolutely still without moving my legs. Once it was determined that no PE or DVT exists, I was to be transferred to the OB floor on morning of Jan 17. The baby was discharged on Jan 17 mornings and it would have been easier for us to keep the baby on OB floor. However she does not visits me till late in the afternoon on Jan 17. At around 3.30 p.m. She arrives, removes the Foley and asks me to go home without checking if I am able to ambulate or urinate. I was only allowed to get out of bed once during these 7 days to bedside. When I expressed my hesitation and discomfort on ambulation, she leaves me in the heart hospital room and we had to make the baby sleep in the hospital bed with us because there was no bassinet available on the floor. I was discharged with continuous bleeding and indurations from the incision site and only hours after I was allowed to ambulate after 7 days in bed. She does not even visit me on the day of discharge (Jan 18). After that I had to visit her continuously for 14 weeks for wound care and treatment. Wound drained purulent thick bloody serous material for 6 weeks enough to soak 8 ABD pads per day and there was a big clot over the right hand corner of the corner of the wound. After 6 weeks the drainage changed to yellowish and continued for another 6 weeks. The wound was 13 cm long and an inch deep. I faced great difficulties in walking and urinating during weeks after discharge. Even today there is a 0.5 cm gap from where the incision closes to the point where it meets the rest of the skin.

What is coumadin

2008-08-01T13:32:00.000-07:00

Coumadin is a widely prescribed blood thinner. At the request of the Food and Drug Administration (FDA), Bristol-Myers Squibb has strengthened its US label for warfarin (Coumadin) to include a black-box warning about the risk for major or fatal bleeding. It says that bleeding is more likely to occur during the starting period. Among others, the risk factors for bleeding include trauma, anemia and concomitant drugs

Coumadin label also reads that Coumadin is contraindicated with recent traumatic surgery resulting in large open surfaces. Potential adverse reactions to COUMADIN may include: Fatal or nonfatal hemorrhage from any tissue or organ. This is a consequence of the anticoagulant effect. Therefore, the possibility of hemorrhage should be considered in evaluating the condition of any anticoagulated patient with complaints which do not indicate an obvious diagnosis. (Source: http://www.fda.gov/medwatch/safety/2006/coumadin_PI_april2006.pdf)

And yet I was given Coumadin following recent abdominal surgery (C section), in absence of any symptoms and inconclusive CT scan reports. And these were continued for next 5 days in spite of my repeated denial of all symptoms, bleeding from surgical site, drainage from c section incision, increasing anemia in spite of thrice a day oral iron, increasing WBC count on antibiotics, fever and complete wound separation.

The FDA Med watch announcement also notes that Coumadin prescriptions will also be issued with a new patient medication guide warning about potentially serious bleeding with the drug. FDA regulations state that such medication guides are to be provided with each prescription that is dispensed for products that the FDA determines pose a serious and significant public health concern. I was also not made aware of the possibility of bleeding on Coumadin.

The next 5 days

2008-08-01T13:31:00.001-07:00

The CTA was severely degraded by respiratory motion and inconclusive in its findings. At that point, based on equivocal report and in absence of any symptoms, heparin was started being fully aware that the patient has just had a recent abdominal surgery.. In the CCU, my HR stabilized during the night. Dr. Bajaj arrives next morning and instead of ordering definitive diagnostic tests, took the decision to start me on Coumadin and anticoagulation for a year and 5 days on heparin moving me to the heart hospital. Dr Bajaj also asks me not to breastfeed and says she will give me injections tomorrow to dry out my breast milk. This was after that fact that I denied all symptoms and insisted I was feeling fine. I was also not told that CTA was inconclusive and I was not allowed to see the report in the hospital and all requests for confirmation CTA were denied for 5 days. I was also not made aware of the possibility of bleeding on anticoagulants.

On Post Op Day 3, there was significant bleeding from the incision site and wound was opened with 4 staples. There was copious amount of serum and blood drainage (almost to soak fifteen to twenty ABD Pads and bed sheet completely) However still no definitive studies were carried and anticoagulation was continued. Also Dr Bajaj tells me that I should never have any more kids because of the severe PE I had. On Post-Op day 5 the entire wound opened up, again large amount of serum and bloody fluid was extracted from the abdomen. Again fifteen – twenty ABD pads and the entire bed sheets were soaked with blood. And anemia kept on getting worst in spite of oral Iron medication thrice a day. WBC count keeps on rising daily in spite of intravenous antibiotics for past 5 days. The wound which was superficial is now almost a centimeter deep. Still heparin and Coumadin are continued in spite of recurrent bleeding and repeated absence of any symptoms (chest pain, shortness of breath, leg pain, swelling etc ). I am also discontinued from telemetry saying that my tachycardia is due to anxiety and anemia. At that point I again requested them that since I am having no symptoms and I am bleeding and telemetry is being discontinued saying tachycardia is due to anemia and anxiety (And since tachycardia was only indication of cardiac consult) why don’t we order another CTA and see where we are at clots. But they dismiss me. On day 5 nights, I start running a fever due to loss of blood and weakness. However still heparin is continued. On Post op day 6 finally wound erupts and massive hemorrhage occurs. There was enormous oozing through gauze despite significant amount of pressure. I was on vitals every 4 hours and when nurse came to check vitals she saw me covered with clotted blood and gradually diminishing blood pressure. Since I was not on monitor even my falling vital signs were not detected. At that point five days late Doctor Bajaj finally orders a second CT scan, VQ Scan, and Venus Doppler study all of which rule out DVT and PE. At the end of 6 days finally she refers me to pulmonary doctor who rules out PE and DVT. On Day 6, Dr Bajaj tells me that we need to do a CTA to drain fluid from the abdomen and also because first was inconclusive so let’s now order a CT scan again and see if clots actually exist. It was determined that there was no PE or DVT and there was no evidence of PE or DVT ever, I was never required to be on anticoagulants.

The First CT Scan

2008-08-01T12:37:00.000-07:00

I am asked to get a CT scan. So I am given a thick needle to inject in contrast. In the CT scan department they ask me to sign a form and pump and dump my breastmilk. I refused and said I wanted to go. My husband is called and told that Prachi will go into cardiac arrest. Finally he agrees

This poor girl does not knows that she is suppose to hold her breath during the CT scan and thus becomes the start of trauma, pain and suffering that she is to endure for a long time to come

The next day

2008-08-01T12:35:00.001-07:00

12 hours later, I still havent slept a bit. I am still shocked that what was a normal pregnancy had a serious complication. Nurses ask me how long I had known about my low fluid. When i said only for 2 hours, they all look surprised.

Because of loss of birth experience and dehydration, my heart rate continues to ran high. Dr Bajaj arrives at 12.00 and says I need to talk with cardiologist. I refused but she said I have to

So I have a barrage of medical interventions, everything is normal. Viles of blood are drawn and I am fine, just more and more tired. I had been awake for more than 36 hours at that point.

Emergency C Section

2008-08-01T12:32:00.000-07:00

So we go to L and D. My heart rate is in 100-110. I am so pissed with the doctor. Because mine had been such an uneventful pregnancy, I had never gotten to test the medical acument of doctor. They were all so routine and I believed that because I was visiting her regularly she would have discovered if something was wrong. Neither of us had lunch. They admit me and put in cervidil to ripen my cervix. Say they will start pitocin in the morning after 12 hours of cervidil. I call up my neighbor to go in from the garage door and get my bag and Cord blood kit.

Within the next hour baby's heart rate dips again. RN calls my OB. She tells me that OB has said we wont start pitocin and do a c section in the morning if cervix doesnt ripen but she doesnt comes to see me

They give me oxygen and ask me to sleep. 45 minutes later, several people rush to my room. Arnav's heartrate is in 60's. Dr Bajaj is called again and we had to do an Emergency C section

Me who wanted to go completely natural had to have a C section without even laboring. Me and my husband thank my stars that we didnt listen to doctor and left. I even shudder to think what would have happenned.

The D Day

2008-08-01T12:30:00.002-07:00

It was snowing. So me and Bharat decided to work from home. It was a 11 a.m. appointment and I was going to drive myself but because Bharat was home he came with me. Bharat was on phone with his coworker and I drove. We had shirts that needed to be dropped for laundry in the back seat. On the way we debated where to have lunch

Dr Bajaj did an internal. She told me I am still closed. She did some other tests, told me I am not leaking any fluid and she doesnt thinks baby is coming for next 5 days atleast. She also told me baby's head is in position. Asked me to dress and leave

I dressed came out but then I asked her can we do some monitoring. I think something is wrong, mother's instinct. She told me I am still nervous. So I go down, have coffee, and then she puts on monitor for 15 minutes. This turns for one hour. She then comes in and tells me go to Labor and Delivery. There have been two periods of heartdip.

We reach L & D. There we get a message we need to go and see perinatologist for an Ultrasound. The US was the quickest. She said she is going to induce me right away. Baby is only 5 pounds 10 oz and has dipped from 46% to 10% for his gestational age.

My pregnancy

2008-08-01T12:30:00.001-07:00

My pregnancy was the most beautiful time of my life. I had an extremely uncomplicated pregnancy, not a single instance of morning sickness. I did not miss a single day at work.

During my 7th month, my friends at work threw me a beautiful baby shower. Then my friends threw me another one later at home. Bharat's work also had a baby shower for him. So we had lots of cute gifts and we were all ready and excited. My weight gain was perfect, I glowed, had luxurious hair, and basically looked and felt lovely. I had not felt better in my life.

My prenatal visits were routine, hear the baby's heartbeat, check weight and be back.I had an Ultrasound on week 30 at which baby was measuring 3lbs 3oz and everything looked great

I planned on going all natural, so kept on eating good, exercising and had decided against the use of epidural

During my last month of pregnancy my coworkers and friends started commenting that I dont look pregnant. I believed them because apart from my jeans, I was still fitting in my all clothes, my gowns, sweaters etc. I asked my Ob about it. She told me everything is fine, baby's heartbeat is good and I am measuring correctly. Turns out she was wrong. My amniotic fluid was reducing for some unknown reason.

Choosing providers

2008-07-28T08:49:00.000-07:00

Choosing care providers:

First thing I did was deciding on the hospital. I chose Edward Hospital in Naperville because
1. Its closest hospital to my home: Around 8 miles
2. Its 3 miles from work and I planned to work right till the end

Then I started looking for providers. I looked up edwards Ob\doc
1. I wanted a female doctor
2. Preferably wanted an Indian doctor
3. Easy commute to office

So I selected the only female Indian doctor who spoke Hindi,turns out that was my biggest mistake.

Another factor was I could get an appointment in a week's time where as all other providers had a long waiting time, often 3 weeks

Getting Pregnant

2008-07-28T06:41:00.001-07:00

After 2 years of marriage, and with both me and Bharat well settled in our careers, And having bought our lovely home, we decided it was time to populate one of the empty bedrooms with a baby. And ofcourse, both set of parents wanted to meet their first grandkid too.

I conceived during our annual visit to India in the very first month we tried. It was just perfect. After I came back, I did not think much about my periods being late. I thought it was due to change of weather from India, trip exhaustion etc. I mean we had just started trying and these things do take time. Then on May 27, we were invited to a friend's baby shower in the afternoon. The same evening we went for a memorial day get together and I met my colleague's very pregnant wife. So I came home and tested. And Voila, I was pregnant

Who am I

2008-07-28T06:20:00.000-07:00

I am a 28 year old Software Engineer living in southern suburbs of Chicago with my consultant husband. We are basically from India and migrated to US about 4 years back when my husband's then employer decided to transfer him to the US office.

We had and still have a picture perfect life with a strong marriage, excellent career and lots of friends , health and sunshine. And this was suppose to get better with the new addition of our son due Jan 2008. He was born via an emergency C section on Jan 10, 2008 falling which I suffered serious injuries due to some medications that were administered to me.

Though me and my son are both doing ok now, there were times when both of us narrowly escaped death. The entire journey has strengthened my believe in god. This is a blog to let my friends know how important and prudent it is to select good prenatal care even for low risk normal pregnancies. All my injuries were avoidable have I had a good Ob . I delivered at Edward Hospital in Naperville under the treatment of Dr Vimi Bajaj