Insurance companies suck

Baby is now about two months old and doing well. But these first two months have been an adventure.

Baby was breastfed for the first few weeks, but she lost nearly a pound and she had blood in her stool so her pediatrician recommended stopping the breastfeeding and put her on a hypoallergenic formula at about $25 per 16 oz. can. She gained some weight but she was still in terrible pain with each feeding so after a few weeks her pediatric gastroenterologist changed her formula to Neocate which costs $135 for a case of four 14 oz. cans. Right now we are using a can of Neocate every two and a half days.

We tried to get our insurance company to help with the cost of the formula. I called the insurance company and they told me that infant formula is not covered. I called Health Advocate the next day and they talked to the insurance company and again they told me that infant formula is not covered unless the baby has one of four conditions that they are required by state law to pay for formula--she does not have one of the four--and they told me to have her primary care physician (PCP) put through a pre-authorization request for the formula. The PCP's nurse called me back the next day and told me that they got a fax from the insurance company saying that infant formula is not covered. I called my wife's employer's benefits office who called the insurance company and got the same response.

Next, I called my state representative. His office took the information and contacted the state insurance department and they got back to me and said that there is nothing they could do to help. The representative's office suggested calling the manufacturer to see if they have an assistance program and if all else fails to call the county assistance office to apply for Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). We called the manufacturer and they had no program. So I called the county assistance office and they said that I should apply for Medical Assistance for Baby and then if she gets that she will automatically qualify for WIC based on medical need even though we don't qualify financially. So I filled out the application online and dropped off a stack of documents. They called me back a few days later and said that Baby qualified for Medicaid and that we should call the WIC office to set up an appointment. A few days later Baby got her gold card in the mail and we have an appointment with WIC in a few weeks.

I think it is a crime that insurance companies get away with this crap. We pay about $1,000 a month for health insurance and they won't cover something that my baby needs to to survive. I was hoping that they would at least cover some of the cost since the Neocate costs two or three times the cost of regular formula. Baby has multiple food allergies (including cow's milk and soy) and that was causing colitis and keeping her from gaining weight. She also has Gastro Esophageal Reflux and she was in terrible pain during and after eating. Shortly after she started on Neocate she gained weight and the colitis went away.

Insurance companies in the United States cover only healthy people. Old people, poor people, and people with health problems have to get health insurance from the government. If it were up to me I would like to see everyone in the US covered by a national health plan and do away with private, for-profit health plans. Right now these for-profit plans collect thousands of dollars in premiums for people who are basically healthy and then when they incur healthcare expenses the insurance company does everything in its power to deny coverage.

So now I have to swallow my pride and take my daughter in to the WIC office so she can get her monthly supply of formula. But she is now thriving and we won't have to go into debt to feed her.

Birth Story II

Baby number two came on Wednesday. This time was so much easier than the last one. It is still scary and the most exciting thing I have ever witnessed.

This time we went in around 9:00 am with regular contractions. The doctor examined Mom and she was dilated to 3 cm. So doctor told her to go for a walk and to come back in about two hours and they would check her again.

At about 1pm we went back. Her contractions were getting stronger and now she was dilated to 4cm. The doctor said with her Russian accent, "I think we'll have a birthday party before midnight."

They took us to a room and we got settled in. The nurses were in and out for the next few hours monitoring the fetal heart rate and contractions. And everything was going smoothly.

A little after 6pm the nurse came in and said that she was going to have the doctor examine Mom again and see how she was progressing. By this time the shift was changing and a new doctor came in. He didn't introduce himself he just said that he was going to check her and then he said that she was still about the same and sent the nurse for something. She handed it to him and as he is inserting this thing he said that he was going to break her water and get things moving. Then he told the nurse to get some Pitosin and he left.

Now Mom was in tears. This whole pregnancy had been very good until this point. She had seen the same two midwives for all her regular exams. Now, on the day that she goes into labor there is no midwife on call. So not only is she stuck with a doctor that she has never seen before, but he is also a jerk.

I got the nurse and told her that Mom was very upset about that doctor and asked if there was any way to get a midwife, since that was the plan from the beginning. She said that she understood and she would see what she could do to help.

A few minutes later she came in and said that she could not get one of the midwives to come in and Mom was sobbing by this point. I asked if there was any way that the Russian doctor could do it because she was very nice and took the time to explain things and listen. The nurse went to check. Within seconds the Russian doctor and another female doctor, Dr. B, came in. The Russian explained that her shift was ending in a few minutes but Dr. B would be there and she could do the delivery so that we did not have to see Dr. Jerk again.

Dr. B introduced herself and said that she had trained with the midwives and would do everything possible to have the same type of delivery as we would have with a midwife. Then the Russian said that she would be only a few minutes away and would come in assist as long as the attending allowed her to come in. But, after checking with him she came back and said the she was not allowed and she assured us that Dr. B was very good and that she would do a great job.

At about 8:30 pm, Dr B. came in and examined Mom. She was completely dilated and +1. "It's time to have a baby," she told us. She predicted that that baby would come in 10 to 15 minutes.

Mom started pushing and by the second push I could see the baby's hair. Thirty minutes into pushing Dr. B said that the baby will come with one or two more pushes. They brought in the pediatrics team and the attending physician and she pushed one more time and out came baby's head. Dr. B suctioned the mouth and Baby screamed. One more push and we had a baby girl--a beautiful pink, screaming baby girl. Dr. B cut the cord and handed her to the pediatrics team. They checked her out and she was fine.

This was not as scary as Baby One's birth. He was blue when he came out and it took a while for him to cry, but he is now a very healthy two year old.

Baby Two and Mom get to come home tomorrow.

Update

OK, so I wasn't really in jail. I just needed some reality.

So here's what's been going on:

I have a happy, healthy 2 1/2 year old who keeps me busy and entertained. We are doing Kindermusik right now. I'm not a big fan. I've done several of these music classes for babies and toddlers and this is my least favorite one. It could be because it is sponsored by a church and they throw in a few Jesus songs. It could also be that there are about twice as many kids in the class than there should be.

Oh, and we are expecting baby number two in a few weeks!

What else? Well, I am still running my own business. It is going pretty well. The best thing is that I can pretty much work as much or as little as I want.

We joined an organic community supported agriculture (CSA) farm. It is great! I highly recommend it if you can find one in your area. We get a big box of fresh organic vegetables every week. It is fun to see what's in the box and then trying to put together a menu for the week based on the box.

That's all I have time for right now. More later.

Baby update

Well, Baby turned one year old a few weeks ago. Things have been crazy and I haven't had the time or the energy to post much. Anyhow, we had a little party for him and he had his first taste of cake and ice cream.

We are just overwhelmed with toys now. Between the gifts for his birthday and xmas...ugh. We were tempted to stop at Goodwill and unload half of his xmas presents on the way home from visiting grandparents and aunts and uncles on xmas.

Baby woke up with two new teeth on Christmas morning, so he now has eight teeth. I also noticed a big purple-blue spot on his lower gums right where his 12-month molar will come in. The poor kid had to be in pain but he was as pleasant as he always is. The next day he had a cough and some congestion. After he finished his breakfast he had a coughing fit and gagged himself until he vomited. Yuck.

He has been signing lots of new words and repeating words when I read to him. I took him to the shoe store a few weeks ago and as he was trying on shoes he was signing "more". I thought that he was hungry because sometimes he uses "more" when he wants to eat. Then we got home and I told him I was taking his shoes off and he did it again. I finally realized that he was trying to sign "shoes" which is very similar to "more". I was kind of surprised that he remembered the sign for shoes because it is not one that we used a lot.

Today he was sitting on the floor looking through his "Ten Little Rabbits" book and he turned the page and there was a picture something like this and he looked up at me and put his hand in front of his mouth and said "hushhhh". That is what we do when we read "Goodnight Moon" and we get to the old lady whispering hush. And she looks like the rabbits in the book he was looking at. Sometimes I am amazed watching his little brain work.

We go for his twelve month check up and shots in a few days.

Baby's first Halloween

My sister invited us to bring the baby to the annual Halloween party at her church. So we quickly put together a costume for him. We dressed him in a red sleeper and put a red turtleneck over it. We glued a piece of white fabric over his tummy. Now he just needed something for his head. I ran into the Family Dollar store and found a red knit hat for $1 and a $1 red plastic crazy straw cup that was shaped sort of like a heart with a hole in the middle. I put the lid of the cup inside the hat and screwed the cup on the outside. Put the hat on his head and he was Po. And he looked pretty good for a $2 costume. In fact he won the prize for the cutest. The prize: coupons for Burger King french fries and a small Coke. I guess those coupons will go in the scrapbook. I know that people feed that crap to kids but I can't imagine encouraging it.

My mother and father were there too. Just as we were getting ready to leave my mother said she would hold the baby while I put on my coat. She had him for maybe ten seconds and I turned around to get him and she is wiping white icing from his mouth. He is ten months old and she is feeding him icing, and after she asked me earlier if he could have some and said no. So I took him back from her and said, " Nanny has lost her baby privileges." Grandparents!

Anyhow, we had fun. We felt like we were crashing the party since we do not go there, but it is the family church. I went there as a kid and my parents and sister and various cousins attend, so it is sort of like a family gathering.

We will have another family gathering today at the hospital. My father is getting his knee replaced today. He is probably in surgery right now. He is not in the best health and I'm a bit worried about him having any surgery but he could hardly walk on his knee. I hope this helps him.

Baby update

It doesn't seem possible but Baby will be a year old in a few weeks. This year has gone by so fast.

He has one more physical therapy appointment for his CMT. There has been a great improvement. When we started PT he had about 50% range of motion on one side of his neck and now it is almost 100%. We do stretching exercises three times a day with him. I wish that I would have pushed the doctor to send us to PT earlier. He waited three months after I first asked about it, so now Baby's head is flat in one spot.

We are still signing. He uses several signs--more, milk, eat, book, shoes, hat, all gone. And he understands more but does not make them. He has even started to put some signs together like more milk or more eat. He says a few words--dada, mama, bye-bye, bubble, pap pap.

He is also walking pretty well for an eleven month old. He hasn't quite mastered the stopping part. He usually just keeps going until I stop him or he falls over. I have lost about five pounds in the last month or so. I think it is from chasing him and carrying him up and down the stairs about five or six times a day.

He is still a really good sleeper. He almost always takes two naps during the day and the sleeps from about 8:30 until 7am. We are afraid that if we have another baby we won't be able to handle it because he has been so good and relatively easy to take care of.

Baby Update

It was an exciting day here, Baby took his first steps. I didn't think that it would be exciting, but it was. I have been encouraging him to walk for a few weeks but he usually will just stand there for a second and then dive towards me. Today he stood there and then took about three steps before he toppled over. So this is first-time parent excitement at its best.

He is 9 months and three weeks now. He has five teeth and he's working on number six. That probably explains his relative crankiness lately. And he has decided that instead of an afternoon nap he prefers to jump up and down in his crib until his legs give out.

Life, death and baseball

The baby is two months old now and today was shot day. He was very happy through the whole appointment. Then the doctor left and sent the nurse in. The baby was on the exam table smiling at the nurse as she readied the syringes. She gave him the first shot and it took a second to register but then he screamed. By the third shot he was bright red and screaming and shaking. Within a minute he was calm again and he even smiled and cooed on the way home. We'll see how the next few days go.

I can't complain, he is a very content baby. He is now sleeping through the night (9:30pm until 6:30am) so I've been getting some rest lately. He has to have an operation in a couple weeks so I'm a bit worried about that. I know that doctors are doing these operations on kids every day but it is a little scary to think of him going under the knife.

My sister-in-law who has a week old baby and a two year old had a stroke and is in intensive care. They were not sure if she was going to make it but she seems to have stabilized and is now showing signs of improvement. I kept thinking of her kids. How terrible it would be to grow up without a mother.

We also had sort of a family reunion. Not under the best circumstances but it was nice to see everyone. My father's brother died so my aunts and uncles and some cousins were all in town for the funeral. I had not seen my one cousin since she spent the summer with us in 1976. My uncle from New Jersey was there, I hadn't seen him since I ran into him on campus during my junior year of college.

It was nice to hear some of the same old stories from a different perspective. My dad always tells us the story about how he was so poor growing up that the family dog hung himself. Well, my uncle told the same story. He said that they kept the dog on a long rope attached to the clothesline and one day the dog got into a tree and the rope got wrapped around a branch and then it jumped to its death.

Then there were the baseball stories. My uncle who died was a very good ball player for the local team in the 1940s and 50s. In fact, three of the four brothers played baseball and my grandfather was a local celebrity in the 1920s and 30s because of his baseball talents. My dad was the only brother who did not play organized baseball. He was sick for most of his childhood so he did not play but he always loved the game. My grandfather and my uncle were both catchers and my brother played catcher on the high school team.

My playing days ended after Little League. I could hit but my eyesight was already at 20/800 by then and there were no plastic or lightweight lenses back then. After Little League my playing was limited to games with the neighborhood kids. One game I was pitching and I caught a line drive in the sternum from about 40 feet. I had purple stitch marks on my chest for a week.

Anyhow, that's what has been going on in my life. Political ranting will resume with my next post.

Quote of the Day

"That kid is soooo bleeping cute!"
-- Aunt Katie

Birth story

Birth is the most exciting thing and scariest thing I have ever witnessed. It was a long labor. She planned on doing it without any kind of pain relief but after suffering through back labor and going without much sleep for over two days she changed her mind. I am so glad that she did. The midwife suggested an epidural so we talked to the anesthesiologist and agreed to do it. Within minutes she was asleep and she slept through contractions for a few hours.

About twelve hours after we arrived she was able to start pushing. She pushed on almost every contraction for 3 1/2 hours. I could see the baby's hair but he just wouldn't come out. The midwife brought the doctor in and they said that they wanted to use a vacuum to help get the baby out. We asked about the risks and after they explained them we tried a few more pushes and then agreed to the vacuum.

So the pediatrics team showed up and manned the baby warmer, the doctor and the midwife put on gowns and eye protection and we were ready to have a baby. I was right there as the doctor pulled the head out. Then an arm and another arm and the rest of the baby. As soon as it was out they put two clips on the cord and cut between them. They took the baby's limp blue body right to the warmer where they suctioned his nose and mouth and rubbed him and gave him oxygen. He took a breath and and then let out a scream. His face and torso turned purple then pink. His arms and legs remained a bit purple for a while.

By this point my knees were getting weak and my head was spinning. I thought for sure that there was something wrong with him. I went over to get a closer look him and he was beautiful. My eyes filled with tears. I went back over to his mother and held her hand. She asked if he was okay and I told her that he was beautiful.

We spent the next two and a half days there. The baby is extremely pleasant. He is being followed for a few minor (we hope) health concerns but he is great. It seems like we've always had him.