Tuesday, October 30, 2007


So last week was a kick. Or something.

G got the last of his sealants done on his permanent molars, K got the impressions done for her spacer. There was something extra scheduled every single day. On Wednesday Q had an ENT follow-up. At the follow-up visit for his broken ear drum, the pediatrician saw a bit of gunk stuck onto the membrane itself. She hesitated to give him the all clear without knowing what was going on behind the glob, but didn't want to disturb it for fear that she might be dislodging new tissue and causing further damage. Irrigating an ear drum without knowing whether or not it's intact isn't such a good idea either.

So after piano lessons, we had potluck lunch with friends at their place, then took off for the appointment. We arrived at the ENT office to see Dr. C, handed over our already filled out paperwork. After waiting for awhile, we headed back to the exam room. The sweet nurse took notes on Q's history (abridged version), and went to get Dr. C. Shortly, Dr. C enters with his laptop, takes a seat, glances at the top sheet and says, "Oh. Excuse me just a moment will you?" He gets up, goes out, doesn't come back. His nurse comes back, apologizing all over herself, followed closely by the receptionist, also apologizing. It would seem that Dr. C doesn't contract with the state sponsored insurance and so won't be seeing Q.

I almost cried. Most of the time I can take this kind of stuff in stride, but good grief. From 11:30am to 6pm that day was spent entirely on getting us to that appointment and home again. It's only a half hour drive, but we had piano lessons in the morning, then all the other miscellany.

I hesitate to use that word: discrimination. I feel for the professionals whom, in order to provide care through state agencies, must agree to take a significant hit when billing. How can people expect that to continue? No wonder Dr. C doesn't want to take that insurance (it's basically Medicaid). I mean, he has at least as many hoops to jump through for them as for any other insurance, but gets back about 1/3-1/2 (in most cases) compensation as he would for "regular" insurance. On the other hand, how on earth are we to expect parity in care? This is a caste system, people. Those who can afford it will get it, those who can't will just have to enjoy a different kind of socialized medicine. Don't kid yourself. It's here. (And here are some more thoughts on the subject.) The whole experience was just demoralizing. I've never encountered anything like that before.

In all the tripping over themselves to apologize (I felt terrible for them by the time they were done), we got Q immediately rescheduled for Friday with Dr. C's colleague. By the way, I bet the colleague's wife and family just love him. He couldn't see Q that day because he had to leave for a kid's game right now, so sorry, but any other time..... On one hand I wanted to holler at somebody, he would have been handy, on the other, well--what a man. What a man. What a very good man.

The colleague saw him Friday afternoon as the kids occupied themselves with schoolwork and toys in the waiting room. (Oh yes, they did. Under penalty of no punkin carving if they happen not to complete the goals for the week. Amazing what fervor we can show over the top of an otherwise friendless math book.) This ENT was super, funny, nice, thorough, knowledgeable, asked if with my grasp of terms had I gone to med school. I grinned, but chuckled in my head. I guess in all that quizzing of a certain someone, some things must've stuck. Of course, then there was my cadaver lab.....

So on with the story, then.

Today G and E had their second opinions for orthodontia. (Thanks for sharing your experiences, by the way.) This guy's treatment runs $6880, and it would last approximately 23-26 months. I'm not the only one noticing that this isn't better, right? Holy cow. E will revisit this in a year or two, when all her permanent teeth are in--nothing too urgent there. G, on the other hand, is another story altogether. This office also believes his mouth needs rather more immediate attention. I've no idea what to do about this.

I talked at length with Q's OT Monday morning. She told me that it's incredibly difficult to get feeding chairs paid for, so I should go ahead and get whatever I can that's commercially available and make it last as long as possible, because Q is gonna be one big guy. Thus, we want to wait as long as possible before heading down the road of circus tricks required to obtain a feeding chair of appropriate size. She also noted that if we're very lucky, perhaps he won't need it after about 45 pounds. (What? Woohoo!) I've dithered a bit, but think I may go with this. We had a much earlier version of the same brand for the older four, but it didn't tilt. Can you believe it made it through FOUR kids? My only objection: by the third, whatever non-stick-ability it originally had was fast disappearing. Getting that thing clean was quite a task. It was white. (Yes, I picked it out for my first child. Doh.) I never did figure out how to get the straps off, so I soaked them in bowls of warm, dish-soapy water. It worked okay for getting the goo out, but after four little "sweet potato piggies" had their way with them, the white straps turned kinda orange. Glech.

We also talked about how to get Q some mats and other stuff for home use. I asked the lovely OT if she'd ever heard of ABR. She hadn't. But she gave me an emphatic lecture on making sure that in being curious about these things, I don't set aside my other kids or sacrifice everything in the name of some supposedly miraculous cure. She's known families who spend every vacation and all their money on getting little guy or girl "better" and end up broke, exhausted, and disillusioned, only to see any progress evaporate if their efforts slow.

Well, that's not me. I admit to the guilt part. I admit to being curious about other therapies and "things to do" (because I do so love having Something To Do). But tossing everything for one kid? I can't do it. Hey, I even have guilt over that. I mean, shouldn't I be jolly well able to just work myself to death if it means keeping any of my punkins at their peaks? No, no and no. I have a hard time even identifying with people who spend lots of time chastising themselves for whatever they must have done to "cause" their little one's issues. Not that I don't ever think about it, but I can't spend much time there. It is what it is. It is. It's nobody's fault. It just is. And there's nothing to do but keep on keepin' on. Whether it's therapies or hugs and kisses, all the stuff that needs doing just needs doing. No arguing. Just doing.

Well, I got rather far afield from the starting point. It's those pesky rabbit trails. Or my squirrel brain. I'll probably hit post and then remember everything else I wanted to say. (grins)



doc said...

About the orthodontia - I don't know if its the money worrying you, probably is, many orthodontists (most) accept payments through plans with this company, they have programs that charge no interest. No, there's no catch.


C said...

Thanks, ma'am. I'll check that out. Blessings to you.


strider said...

I am so sorry about your medical discrimination. I was on state medical aid years ago and had many, many frustrating experiences, at least one of which caused me to break down in tears at a clinic. All we can do is keep plugging away with God's help to stay sweet and ladylike through it all. ((()))