In honor of my beautiful daughter, Graciela AnnaMaria Arango, born still on December 31, 2010.

Summary of my loss:

The overall theme in my experience is that my voice was not heard. And because of that fact, and only because of that fact, my daughter is dead.

A little bit about me:

I like to go about things in life, both professionally and personally, in the most correct way possible. I am educated, ethical and understanding and will persevere over any challenge presented before me. I take pride on being well informed before I make decisions, exploring every circumstance of my choice. Overall, I really do live my life in trying to do what is best. I am passionate about science and medicine. I always have been, and possess a solid foundation in not only the biological and physical sciences, but in certain areas of medicine as well. I utilized that knowledge base throughout my entire pregnancy and whatever I didn’t know, I quickly learned. I am currently getting my Master's in Public Health and I hope to become a physician someday. I love animals and I like to support causes that promote animal awareness and safety.

My husband and I were very excited that our due date was in December for several reasons. One main reason is because of the holidays, and we were so happy that we would have our Christmas tree up, and family members would be around to see our baby, and then it would be time to celebrate New Year’s as well. But, also, the month of December has been a time of great personal tragedy for me as I have lost several close family members during that month over the past years, and it has always been a hard time for me. My birthday is also in December, and that day has also been one of immense sadness, because my grandfather past away in the early morning hours of December 30^th and I was very close with him. Graciela was to be our new beginning, and a way for me to put all of the tragedies that have occurred during that month, and look forward to celebrating a new baby, a new year and a new life.

Pregnancy:

Throughout my pregnancy my bloodwork tests came back normal, my blood pressure was very good, and there were no signs of pre-eclampsia, gestational diabetes, or any of the more common healthcare concerns for pregnant women. On paper, I probably appeared to be the “text-book” patient. However, it only took one look at me for anyone to realize that my pregnancy was anything but normal.

In the beginning of my second trimester I began to wake up around 3:00 am every night, and could not fall back asleep at all. This quickly turned into waking up at 1:00 am, and then waking up at midnight. And each time I woke up, I could not fall back asleep. I was wide-awake, actually. Finally, nighttime turned into an hour of sleep, maybe two hours if I was lucky. I would lay there wide-awake all night for hours, trying every psychological method to help me fall asleep. Nothing worked. The lack of sleep continued for the remainder of my pregnancy. I wasn’t able to nap during the day either. I did my best to stay away from stimulants. I mention this lack of sleep because it had a significant impact on both my emotional and physical well-being. I was always drained and exhausted, but couldn’t rest, and this only added to my anguish.

Also during my second trimester, I began to retain a lot of fluid. This was not your ordinary pregnancy-related edema. This was very different. Simultaneously, my joints began to hurt. At first, it was only my ankles and knees, but over time the joint pain began to include my wrists, elbows, and sometimes my shoulders. And I don’t mean a little dull ache; I mean excruciating, unbearable, needle-like pain. The joint pain and swelling quickly progressed, and often felt a burning sensation in my joints. In fact, the swelling was so bad and so severe, that every single one of my physicians said they had never seen anything like it before. I had severe pitting edema, and the skin covering my ankles, shins and knees was very, very tight and was hot to the touch. There came a point where getting dressed was unimaginably painful. Sliding my pants over my lower extremities, especially my knees, felt like I was putting on a pair of pants made entirely out of razor blades. Towards the end of the third trimester, I could barely walk. By this point I had to quit my job, and stayed home all day. I could barely move. Going to my doctor’s appointments was a big challenge. I couldn’t lift my legs to even put them in the car – my husband would have to pick up each leg and put them in. I could not get up out of a chair on my own. I would have to swing my arms around my husband’s neck, and he would lift me up. There were points I would have to use a wheelchair. When I did walk, it was so painful and I could only take about 4-inch steps. The medical staff at my OB/GYN office would even comment that it was painful for them to watch me walk. The remaining months of my pregnancy allowed for even more swelling of my joints, followed by more pain and continued lack of sleep. Again, every physician I saw had stated they never saw a patient present with such pathological swelling as I did.

Fast forward to the week of my due date, December 24, 2010. My physician had said that due to the severe edema, extreme pain and Lyme Disease diagnosis, that if I did not go into labor on my own, I would begin the induction process on December 27^th. As expected, nothing occurred on the 24^th, and on the 27^th, however, there was a snowstorm. I went into the hospital at around noon and was examined by a physician and a nurse practioner. I can clearly remember the hospital staff being very short and rude with me. I could not move on my own to be examined – I needed assistance. My husband stepped out to use the restroom and I told her that I couldn’t move my legs on my own. The nurse thought I was being difficult and uncooperative. I pleaded with the physician to go easy with me during the exam, because I had such pain throughout my entire body and I was visibly in tears. Let me state here that the exam hurt like hell, no prior exam hurt that bad, and I was yelling in pain and at this point I was crying. I expressed my concern that I didn’t think it should be that painful, and maybe there was something wrong. My concern was brushed off with some mumbled comment. There was no compassion, and since was the first time I was at the hospital, and my first time being pregnant, I was very nervous that my delivery was going to be one of great pain and grief from the hospital staff. I thought I was going to stay for the induction as scheduled but was sent home because the hospital was “too busy” to take me on that day. I went to see my physician on the 28^th and was informed that I could not go for the induction that day, either. It was re-scheduled yet again for the 29^th, my birthday.

I was informed that I would receive a phone call to go into the hospital at around 3:00 pm on the 29^th. I never received any phone call, and had a strong suspicion that I wouldn’t, due to the treatment I had received thus far from the hospital as no one seemed to be listening to anything I was saying. At around 5:15 pm I began bleeding significantly, and was experiencing what I thought might be contractions, but wasn’t sure because, as I described it to the medical staff, it was crampy and I recall a burning sensation in my abdomen. I called my doctor’s office and left a message with the answering service for a call back and briefly described my situation. The first one call I received was from a staff nurse, not a physician, telling me that the physician “says the blood is from your exam yesterday”. How would he know what the blood is from? I never described it to him and he has never personally examined me before. I was shocked with such a quick “diagnosis” of what the bleeding was from and felt as if I was being dismissed yet again. Being a high-risk patient one would think he would want more information. He made this assumption without me informing him of how much blood, how long it was occurring, or how I felt in general. I instructed the nurse that it was substantial and went into clear detail. I also told her I was not feeling good, and I I wanted to come in so I could be examined. She then told me she would have to tell the physician first. She called me back again a little while later. She said that if I truly “felt it was not from the exam on the previous day”, that I could come in. The tone of her voice on the phone left something to be desired. “Could” come in? Do I need permission? Why was there no concern? I had an induction order scheduled anyway – did they not know about that? Again, it brought me right back to the way I felt when I was treated on the 27^th at the hospital.

When I finally made it to the hospital, I was shaking violently, was nauseas, extremely nervous, and was crying. I felt grey and “clammy”, and I remember feeling like I did not want to fight anymore for people to listen to me. I remember almost vomiting upon arrival to the hospital and I was taken to Labor and Delivery floor again by a wheel chair. When I finally saw the doctor, I began to tell him a little bit about my health history. I began to tell him that I was diagnosed with Lyme Disease but was rudely interrupted by him stating curtly “I know all of that. I am aware of your situation.” I went on to say that I had an induction order scheduled for that night and that no one called me to come in. He then said that I was going to be sent home because the floor was “too busy”, and the nurse in the background was shaking her head left and right, signaling no, I could not stay. My husband begged and pleaded for me to stay, stating that I was not feeling well, I was high-risk, I couldn’t walk, I was bleeding, I had burning in my stomach, and had Lyme Disease. They kept shaking their heads and saying “no, we are too busy”, and I heard “she is not dilated enough.” Then the physician said to me, “I also do not see any of that blood that you are talking about.” I reassured him I was bleeding at home, and was bleeding when I got to the exam room. In fact, at that moment, I took the sheet that was covering my legs, cleaned myself in front him, and sure enough, there was blood on the sheet. I held up the stained sheet at that very moment and said to him, “No blood? What do you call that?” He did not respond. I was then rushed out of there saying that it looked like I was in early labor and if so, I would most likely be back by 3:00 am at the hospital anyway. He also said he would not start the induction because natural labor is best. I was forced to leave, with a feeling that something was not right.

You all know the feeling I am speaking of…like walking down a dark, deserted alleyway and you just know in your gut you should not be there…that was the feeling I had as I left. I knew that something felt wrong by leaving, but I was forced to go home. I was not given any option to stay after my begging and crying.

Before I left, the physician said for me to call the floor at 6:30 am the next day should I not go into labor before then, and gave me the name of the charge nurse of who I should ask for. I begged one more time to stay, but “no, we are too busy” was all I heard.

I went home, scared and nervous. Those crampy contractions stopped around 11 pm. I stayed up most of the night, falling asleep around 4:30 am. I can now recall that I felt no movement during those early morning hours of the 30^th.

I called at 6:30 am on the dot the very next morning and spoke with the nurse as instructed. She informed me that she was too busy and that her shift was ending in an hour, and that the next charge nurse would call me back. I told her that no one will call me back, that everyone keeps dismissing me and I was supposed to be induced on the 27^th. She reassured me that she would have the next charge nurse call me by 8:30 am. Well, no one called. In fact, I called back at 9:00 am and spoke with the new charge nurse. She told me that she didn’t even think I could come in today because they were too busy!

Let me express here that at this point I had enough of this treatment. My husband called my physician and explained what was going on. However, while he was on the phone I began to experience significant contractions, and was informed from the physician to time them for an hour and a half, and then to go to the hospital.

When I arrived to the hospital I was put in a wheel chair because I could not walk. I was brought upstairs and the oh-so-friendly nurses told me to change into a gown. Then an ultrasound tech came in, and using the Doppler, she could not find Graciela’s heart beat. I asked her to get a doctor, as after 30 seconds I seemed to have known that Graciela was gone. It wasn’t until about 8 minutes later she finally got the nurse, who after another 5 minutes finally got a team of doctors who then confirmed via ultra sound that my daughter was gone. I was requesting a physician to come in, and did not get one until about 15 minutes after I asked. Additionally, there was a point where I was left all alone in the room. My husband stepped out to speak with his parents in the waiting room, and then all of the sudden, people started to leave. I remember looking up, and realizing I was alone. I was screaming from the room for someone to be with me. I was alone with my dead baby. No one even thought to stay with me.

After making the decision to deliver naturally, I asked for pain medication. For whatever reason, it took over an hour to get me the pain medication from the time I asked to the time it was administered. The pain was unbearable and there was no reason for any delay.

I was sent home with a memory box of my daughter, and in that box a DVD of a few pictures of my daughter. When I found a little strength to view the photo’s of my daughter, you can imagine the shock I experienced when the images of a deceased baby came up on my computer screen – however, that was not my baby. The hospital sent me home with the wrong DVD, and I received pictures of the wrong baby.

I learned after the tragedy that my vital signs, as well as my daughter’s, apparently presented normal on the evening of the 29^th and that, on paper, everything seemed fine. However, it only took one look at me to see that I physically was not well: so edematous, in so much pain, bleeding, shaking and crying. That fact, in and of itself, should have been a red flag to the medical personnel that evening, but my pleas fell on deaf ears, and because of that fact, and that fact alone, my daughter is dead.

Some physicians have said that the death of my daughter may have been the result of a cord accident, some others have said that they have no clue as to why Graciela died, and that, and I quote, “we (doctors) use the term cord accident when we have no idea what happened”. Although, because the first autopsy proved to be done erroneously along with a wrong cause of death of my daughter, the second pathologist had to base his findings from the first results, and could make only assumptions at best. I have been told repeatedly by my own personal physicians that had I been allowed to stay that evening, and not sent home, that I would have a living daughter, and that if they were on staff, they would not have sent me home.

I had heard of these great stories of how Yale was one of the best places to deliver a baby, that the nurses on the Labor and Delivery floor were the best, so compassionate, and very experienced. Yet, I was being treated so differently and I couldn’t understand why. The staff was dismissive and short, and the way they treated me left me feeling I as if I was a second-class citizen, as if I didn’t know any better. I honestly could not believe it. In retrospect, I am so glad my husband was there with me at every instance so at least I had a “witness” as to how I was being treated, otherwise, I am quite confident my emotions may be summarized that perhaps I was too emotional and over-reacting being so close to delivery. I can tell you that I remember every detail that occurred, every name of doctor and nurse, and I remember what was being said to me and what my replies were. I even remember what other physicians, who were attending to other patients, were saying, and recall what their conditions were as well. I state all of this because I was completely coherent and competent of what was going on that fateful evening, and I was treated as if I was a simpleton.

Still, to this very moment in time, I cannot believe this has happened to me. I tried everything I could to tell the medical staff that evening that I was not feeling well, and begged to stay. Now, my daughter is dead. She was taken from me.

I have experienced a lot of guilt, sadness, anger, hurt, and depression, and I obviously will never be the same person again. It seems as if the medical staff that attended to me during that time have since gone on with their lives, as nothing ever happened. I never received a personal apology from any of them, yet I am the one who paid the ultimate price for their complacency.

The flashbacks and nightmares truly are the worst -- and no one else experiences them but me. Once again – the theme of being alone has again resurfaced.

My hope is that this information could be used as, at the very least, a learning experience to physicians, residents, nurses, and all medical staff, in that they way we are approaching patients, and medicine in general, needs to be re-examined and restructured accordingly. Health education needs immediate reform on the most basic levels of patient care and bedside manner. We are going about treating patients the wrong way – and it is costing lives. It is a sad fact, I believe, but if my husband was a doctor at Yale that night, or if my sister was a nurse there – I would never have been sent home, I would have received the appropriate care, and my daughter would be alive. I clearly did not have any connections…

I have never felt so alone in my life. And the death of my daughter, as the direct result of someone else’s actions, is a huge cross to bear.

A part of me died that day along with my daughter. And the rest of my life has permanently changed. I will never be the same again.

The few, brief times that I can seem to laugh are quickly taken away by the reality that my daughter is gone.

I miss my daughter very, very much.

The pain, truly, is undescribable.