"Good day, eh? Welcome to the Great White North. I'm Bob and this is my wife Dina. "
"Good day, eh? "
"And today's topic is, like, why insurance companies suck and how you always, like, get totally *hosed*! "
"Yeah - like they should like, take off, eh? "
"Beauty, eh? "
OK. Insurance companies, in a word, suck. They have stopped paying for Ethan's formula (which was doctor prescribed and cannot be bought retail - this particular formula is only available via prescription) and made some noises that they may request back payment for all the formula back to August.
The frustrating thing is that I've called the insurance company twice and Dina has called them twice and between the 4 phone calls, we've gotten 3 different replies/answers.
We spoke to Children's about this and the doctors are fairly upset about this and they are working to correct this with the insurance company. What sounds particularly suspicious to them is that the insurance company was covering everything up to about about January and then they've stopped covering for the formula (and possibly the pump - but we can't even get a straight answer about that from the insurance company). Because of the way they bill, the issue wasn't actually brought to our attention until about 1-2 weeks ago.
The doctors are putting together all the documentation and are making phone calls to the insurance company to rectify this. The insurance company apparently does not even have a correct diagnosis in their records for Ethan. The last time Dina called them, they asked (to confirm) if he had a cleft palate as the issue. So something is clearly wrong or people are not communicating over there. With Children's working with us on this issue, I hope to have it cleared up within the week.
But then again - it's an insurance company so you never know. They'll do anything to scam you out of more money.
- bob
Tuesday, April 27, 2010
Marathon Appointment Day
We were at Children's from 9 to 4 today. It's been a long time since we've had such a long day there. They combined the hearing screen, regular Cranial Facial visit, and pre op all into one visit.
The hearing screen indicated that Ethan has minimal hearing deficiency - but they attribute that to him still having fluid in his ears (both) due to his ear infection that he had a few weeks ago. They said it was not uncommon for fluid to remain in the ears even up to 6-8 weeks after the infection for infants and it can affect the results of the hearing screen. The doctor recommended another hearing screen in about 6 months. The hearing loss was not significant and due to the circumstances, the doctors were not concerned at all. The doctor also indicated that since hearing screens are $300 a pop - if you do too many of them, the insurance company will simply not pay for them anymore. So she recommends waiting 6 months for the next one rather than another at 2 months and another a few months after that.
The issue of PT tubes being inserted to help drain fluid from the ears was discussed. The doctor said that they will not even consider talking about that until Ethan has established a pattern of significant ear infections (like at least 3 in 12 months) and/or continually showing fluid in the ears (i.e. in 6 months - if he still has fluid in the ears, and then again 3-6 months again after that). It came up because it was indicated to us that children with CFM often have chronic problems with ear infections and fluid build up in the ears and the tubes help alleviate the issue. But in Ethan's case, it is way to early to tell and they will just watch and monitor him over the next 12 months.
Otherwise, the appointments were routine. Cranial Facial is very pleased with his progress and how he looks. They will want to see him next at post op. Pre op was uneventful. The doctor discussed the procedures with us. There will be a little scarring where the procedures will be done: one by each ear where the tags will be excised and one at the corner of the mouth where the macrostomia repair will take place. The doctor said that he would spend that night in the hospital and most likely go home the next day. Surgery is still on for June 3. Total time in surgery is slated to be about 2 hours.
One thing that the doctor mentioned is that for 2 weeks following the procedure, they will most likely want Ethan's arms to be be somewhat restrained so that he can't accidentally pull on/pull out the stitches. Since Ethan *really* likes to put things in his mouth, this will eliminate that ability. So it will be a very long and probably miserable 2 weeks for all of us. He will still be able to grab and play with toys - he just won't be able to put his hands to his mouth.
- bob
The hearing screen indicated that Ethan has minimal hearing deficiency - but they attribute that to him still having fluid in his ears (both) due to his ear infection that he had a few weeks ago. They said it was not uncommon for fluid to remain in the ears even up to 6-8 weeks after the infection for infants and it can affect the results of the hearing screen. The doctor recommended another hearing screen in about 6 months. The hearing loss was not significant and due to the circumstances, the doctors were not concerned at all. The doctor also indicated that since hearing screens are $300 a pop - if you do too many of them, the insurance company will simply not pay for them anymore. So she recommends waiting 6 months for the next one rather than another at 2 months and another a few months after that.
The issue of PT tubes being inserted to help drain fluid from the ears was discussed. The doctor said that they will not even consider talking about that until Ethan has established a pattern of significant ear infections (like at least 3 in 12 months) and/or continually showing fluid in the ears (i.e. in 6 months - if he still has fluid in the ears, and then again 3-6 months again after that). It came up because it was indicated to us that children with CFM often have chronic problems with ear infections and fluid build up in the ears and the tubes help alleviate the issue. But in Ethan's case, it is way to early to tell and they will just watch and monitor him over the next 12 months.
Otherwise, the appointments were routine. Cranial Facial is very pleased with his progress and how he looks. They will want to see him next at post op. Pre op was uneventful. The doctor discussed the procedures with us. There will be a little scarring where the procedures will be done: one by each ear where the tags will be excised and one at the corner of the mouth where the macrostomia repair will take place. The doctor said that he would spend that night in the hospital and most likely go home the next day. Surgery is still on for June 3. Total time in surgery is slated to be about 2 hours.
One thing that the doctor mentioned is that for 2 weeks following the procedure, they will most likely want Ethan's arms to be be somewhat restrained so that he can't accidentally pull on/pull out the stitches. Since Ethan *really* likes to put things in his mouth, this will eliminate that ability. So it will be a very long and probably miserable 2 weeks for all of us. He will still be able to grab and play with toys - he just won't be able to put his hands to his mouth.
- bob
Saturday, April 24, 2010
And It Continues Plus First Dentist Visit
Jonathan ended last week and started off this week with a fever. For four days he had a fever of over 103 degrees F. He was lethargic and slept a lot. I took him to the doctor who thought that he had a bad cold and to wait a couple more days to see how things go. The next day Jonathan's fever broke and he was almost acting normal except for developing a nasty cough. We tried to keep Ethan away from Jonathan, but low and behold a week later, both Ethan and Bob have developed a cough. Ethan's is pretty nasty, but not as frequent while Bob's is starting to increase.
We also took Ethan to the dentist for the first time. Dr. Rama wanted to see Ethan when he got his first tooth, which happened back in mid-February, but she wanted to see him on a procedure/surgery day so she could have more time to spend with him. It was nice to be able to have some time to talk to her about Ethan. Because there were very few people in her office that day, we were still able to bring him in even though he was sick. We got some encouraging news too. Dr. Rama doesn't think that Ethan's jaw is as short as we originally thought. When she was feeling around, she said she could feel bone all the way around; a good sign. Usually if there is a short jaw, there is a dip, which she didn't feel. She also can feel teeth coming. She also talked to us about his upper frenulum and the one under his tongue. She agrees with Suzy, Ethan's PT that there is some extra tissue on the underside of Ethan's tongue that may be causing some restrictions. We will definately mention this to Dr. Cunningham and Dr. Sie when we see them on Monday for Ethan's behavioral hearing screen, regular Craniofacial check up, and pre-ops.
We also took Ethan to the dentist for the first time. Dr. Rama wanted to see Ethan when he got his first tooth, which happened back in mid-February, but she wanted to see him on a procedure/surgery day so she could have more time to spend with him. It was nice to be able to have some time to talk to her about Ethan. Because there were very few people in her office that day, we were still able to bring him in even though he was sick. We got some encouraging news too. Dr. Rama doesn't think that Ethan's jaw is as short as we originally thought. When she was feeling around, she said she could feel bone all the way around; a good sign. Usually if there is a short jaw, there is a dip, which she didn't feel. She also can feel teeth coming. She also talked to us about his upper frenulum and the one under his tongue. She agrees with Suzy, Ethan's PT that there is some extra tissue on the underside of Ethan's tongue that may be causing some restrictions. We will definately mention this to Dr. Cunningham and Dr. Sie when we see them on Monday for Ethan's behavioral hearing screen, regular Craniofacial check up, and pre-ops.
Saturday, April 17, 2010
Will It Ever End?
Jonathan has developed a fever. After a couple of healthy weeks for the family, now we have illness back in the house. This time, Jonathan seems to have flu-like symptoms whereas before Bob, Jonathan, and Ethan all had colds. I hope he doesn't have the flu; we are all vaccinated against seasonal flu and H1N1, even Ethan who just got his second round of H1N1 a couple of weeks ago. Even though it was late in the season, the doctors felt that he should be vaccinated after he turned 6 months (the minimum age) since he will be in and out of the doctors office and be in the hospital in a couple of months. Luckily, Children's Hospital still had some Thimerosol free vaccine left (yes I know that Thimerosol has been proven to not cause Autism, but I'm a little paranoid mommy). It was also stated that H1N1 made an appearance last April, so better to be safe than sorry I guess.
Anyways, Jonathan developed a cough late on Thursday night and then Friday was more coughing, but he was acting normal most of the day. My dad even came over and spent time with the boys, which Jonathan really liked of course. Grandpa also put Ethan to sleep for a while. Late afternoon, Jonathan fell asleep and slept for a while. When he woke up, he just wasn't quite himself. He was a little lethargic and just wanted to be held. Then he fell asleep again for a while. He also felt very hot. I tried to take his temperature when he woke up and he screamed, squirmed, and I ended up with a reading of over 103 degrees, which I'm pretty sure wasn't accurate, but he got a dose of Tylenol anyways. He few minutes later he perked up a bit, but has since woken up several times crying. I sure hope Ethan does not catch it, though I don't want it and I'm sure Bob doesn't want it either. I also hope that this does not last long.
-Dina
Anyways, Jonathan developed a cough late on Thursday night and then Friday was more coughing, but he was acting normal most of the day. My dad even came over and spent time with the boys, which Jonathan really liked of course. Grandpa also put Ethan to sleep for a while. Late afternoon, Jonathan fell asleep and slept for a while. When he woke up, he just wasn't quite himself. He was a little lethargic and just wanted to be held. Then he fell asleep again for a while. He also felt very hot. I tried to take his temperature when he woke up and he screamed, squirmed, and I ended up with a reading of over 103 degrees, which I'm pretty sure wasn't accurate, but he got a dose of Tylenol anyways. He few minutes later he perked up a bit, but has since woken up several times crying. I sure hope Ethan does not catch it, though I don't want it and I'm sure Bob doesn't want it either. I also hope that this does not last long.
-Dina
Thursday, April 8, 2010
Trainspotting
I took the day off work yesterday and we all went to the Northwest Railway Museum down in Snoqualmie. We figured Jonathan would love it, and we were correct!
While Jonathan really seemed to thoroughly enjoy looking at the trains and walking the tracks, I'm pretty sure the hit of the day was the gift shop. I (naively) assumed it would be a shop with lots of generic train stuff and some Thomas stuff. It was, in fact, a Thomas store with some generic train stuff.
They had Thomas trains (of various sizes), shirts, books, CDs, DVDs, - you name it - they had it. Jonathan was beside himself: he didn't know where to start.
And of course, when you bring a toddler into a store sporting his favorite toys, you can't leave without buying something. Or some things. Among other things, we bought tickets to A Day Out With Thomas later this summer. The saleslady working the desk informed us that on that day, there will be *lots* more Thomas merchandise on hand - much more than than they normally carry. >sigh< Much money will probably be spent on that day...
- b
While Jonathan really seemed to thoroughly enjoy looking at the trains and walking the tracks, I'm pretty sure the hit of the day was the gift shop. I (naively) assumed it would be a shop with lots of generic train stuff and some Thomas stuff. It was, in fact, a Thomas store with some generic train stuff.
They had Thomas trains (of various sizes), shirts, books, CDs, DVDs, - you name it - they had it. Jonathan was beside himself: he didn't know where to start.
And of course, when you bring a toddler into a store sporting his favorite toys, you can't leave without buying something. Or some things. Among other things, we bought tickets to A Day Out With Thomas later this summer. The saleslady working the desk informed us that on that day, there will be *lots* more Thomas merchandise on hand - much more than than they normally carry. >sigh< Much money will probably be spent on that day...
- b
Olympics Redux
OK, so chronologically, this post is way out of whack.
During the final weekend of the Paralympics, we decided to go back up to Vancouver to see (or see again) a few things before all the Olympic sites/sights closed down for good. So this would have been the weekend of 3/20/10.
One of the things that we wanted to see was the Olympic medals. This is apparently the first time that they have been available to the public to view/touch/see in person.
We arrived at the place (Vancouver public library - downtown) at around 10:30/11AM. When we got there, the last person in the line was standing by a sign that unfortunately proclaimed that from that point, the line was 6 hours long. Yes. SIX HOURS. One of us (the names have been withheld to protect the guilty) stated emphatically that this was ridiculous and we would have to be certifiably nuts to actually wait 6 hours to view some medals that neither of us had won anyway. The other party involved emphatically stated that they really wanted to do this. The reluctant party relented but made it clear: if we get in this line, we were committed - no waiting for 2-3 hours and then bailing.
So yes, we waited six hours.
Yes, we are crazy.
And apparently, this is what everyone else who *wasn't* in the line thought. When you get to the end of the line, you are actually in the foyer of the library. As the final minutes of your quest tick by, various library patrons would pass by and ask 1) what is the line for? and 2) how long is the line up? When you answer question 1, you get a look of interest: "hmm, maybe I should get in the line too". When you answer question 2, you get a look of, "you're a nut. "
But yes, we did actually see the medals.
Now, for the record, the insisting party thought it was totally worth it, while the relenting party thought that, while it was pretty cool, it was not "six hours" worth of cool.
When you (finally) get to see the medals, they give you one glove (that you get to keep - so that glove/souvenir represents six hours of your life) and you may only touch the medals with the gloved hand. Before you actually go into the display area (that is thoroughly curtained off so no outsiders can peek in) they explain the rules to you: take as many pictures as you like and take pictures of anything you like - but no pictures of you pretending to have actually won the medal: no thumbs up or #1 signs or victory signs or wearing the medal, nor may you kiss, lick, or bite the medals (seriously - they said that). And you (and your group - you are herded into the display area in a group of 20) get 15 minutes.
The medals are actually quite heavy. Much heavier than one would think just by looking at them. Also, they really mean it when they say no two are alike. Apparently, if you could put all the medals that were made all together (and assuming you put them together correctly) they would form a piece of aboriginal art.
Also, while they give you all these rules about the pictures, they actually encourage everyone to take their pictures with the medals. Go figure.
Now, one might wonder how this six hour David-Blaine-feat-of-endurance was accomplished with young children present. And like any good illusion, there is a trick involved. Here, the trick is to not have them present - or at least not the older one that gets bored easily. Jonathan stayed with my parents for the day and we took Ethan who was not opposed to standing around for six hours (did I mention it was a *six* hour wait?!) and was surprisingly really good - he didn't complain about anything all day (unlike the reluctant party).
The Vancouver Art Gallery was free for the duration of the Olympics/Paralympics. However, the line literally stretched around the block. And after waiting six hours for the medals, the person that was originally opposed to to lining up for the medals was quite emphatic that we were *not* lining up for this too. The other person (wisely) did not argue the point.
By this time, (the last days of the Paralympics, that is, not six hours later) the Olympic Superstore downtown was well picked over. You no longer had to line up to get in or get in only through one entrance off the street. But by the same token, unless you are a very large person (height or girth), there is nothing you can buy that you would want to wear. Unless you like/can tolerate polyester.
- b
During the final weekend of the Paralympics, we decided to go back up to Vancouver to see (or see again) a few things before all the Olympic sites/sights closed down for good. So this would have been the weekend of 3/20/10.
One of the things that we wanted to see was the Olympic medals. This is apparently the first time that they have been available to the public to view/touch/see in person.
We arrived at the place (Vancouver public library - downtown) at around 10:30/11AM. When we got there, the last person in the line was standing by a sign that unfortunately proclaimed that from that point, the line was 6 hours long. Yes. SIX HOURS. One of us (the names have been withheld to protect the guilty) stated emphatically that this was ridiculous and we would have to be certifiably nuts to actually wait 6 hours to view some medals that neither of us had won anyway. The other party involved emphatically stated that they really wanted to do this. The reluctant party relented but made it clear: if we get in this line, we were committed - no waiting for 2-3 hours and then bailing.
So yes, we waited six hours.
Yes, we are crazy.
And apparently, this is what everyone else who *wasn't* in the line thought. When you get to the end of the line, you are actually in the foyer of the library. As the final minutes of your quest tick by, various library patrons would pass by and ask 1) what is the line for? and 2) how long is the line up? When you answer question 1, you get a look of interest: "hmm, maybe I should get in the line too". When you answer question 2, you get a look of, "you're a nut. "
But yes, we did actually see the medals.
Now, for the record, the insisting party thought it was totally worth it, while the relenting party thought that, while it was pretty cool, it was not "six hours" worth of cool.
When you (finally) get to see the medals, they give you one glove (that you get to keep - so that glove/souvenir represents six hours of your life) and you may only touch the medals with the gloved hand. Before you actually go into the display area (that is thoroughly curtained off so no outsiders can peek in) they explain the rules to you: take as many pictures as you like and take pictures of anything you like - but no pictures of you pretending to have actually won the medal: no thumbs up or #1 signs or victory signs or wearing the medal, nor may you kiss, lick, or bite the medals (seriously - they said that). And you (and your group - you are herded into the display area in a group of 20) get 15 minutes.
The medals are actually quite heavy. Much heavier than one would think just by looking at them. Also, they really mean it when they say no two are alike. Apparently, if you could put all the medals that were made all together (and assuming you put them together correctly) they would form a piece of aboriginal art.
Also, while they give you all these rules about the pictures, they actually encourage everyone to take their pictures with the medals. Go figure.
Now, one might wonder how this six hour David-Blaine-feat-of-endurance was accomplished with young children present. And like any good illusion, there is a trick involved. Here, the trick is to not have them present - or at least not the older one that gets bored easily. Jonathan stayed with my parents for the day and we took Ethan who was not opposed to standing around for six hours (did I mention it was a *six* hour wait?!) and was surprisingly really good - he didn't complain about anything all day (unlike the reluctant party).
The Vancouver Art Gallery was free for the duration of the Olympics/Paralympics. However, the line literally stretched around the block. And after waiting six hours for the medals, the person that was originally opposed to to lining up for the medals was quite emphatic that we were *not* lining up for this too. The other person (wisely) did not argue the point.
By this time, (the last days of the Paralympics, that is, not six hours later) the Olympic Superstore downtown was well picked over. You no longer had to line up to get in or get in only through one entrance off the street. But by the same token, unless you are a very large person (height or girth), there is nothing you can buy that you would want to wear. Unless you like/can tolerate polyester.
- b
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