Blog

Gulp!

Everyone is at camp today and everyone was excited to be there.  Mr. C is doing camp at his school — in the big boy preschool 3 class with no nap!  Miss N is at gymnastics camp.  And Mr. N was very excited to go back to YMCA camp.

Mom took Mr. C for me, so it was just the two drop-offs for me.  Total from home, 2 drop-offs, to work was 50 minutes.   Which means that with Mr. C it’ll be over an hour, which is what I expected.  Miss N has to be picked up by 5:30, so we’ve got to time this so I’m in the office by 8:30.  It makes it a particularly long day for her and Mr. C, but I will get some nice one-on-one time with Mr. N in the car.

I introduced the kids to Ghostbusters today:

It was a hit, though I believe the kids think I pulled a fast one on them, telling them it was a “funny” show.

Its been a long, long, long 3 weeks — let me tell you.  For this last one, Mr. N and I got some nasty virus that made a nice breeding ground for some bacteria in each of us.  We both started Zithromax on Wednesday and are 300% better now, though we each still have a cough.  Fingers crossed that its back to work and school tomorrow — I’ve got this looming project I have to make progress on.  It was supposed to happen last week.  I had this beautiful week with *no* appointments that is just gone, now.

The kids all seemed very big today.

Mr. C was playing computer games this weekend.  I’m not sure when he became able to actually manipulate a mouse, but it happened.  This week he starts transitioning to pre-school 3.  Which is the class before KINDERGARTEN!  He draws these people with heads, arms, and legs — no bodies, but definitely identifiable as human.  And these intricate maps.

Ms. N is huge.  She attended a party for a party for a friend from her old school and she just towered over everyone there.  She’s moved to taking gymnastics class on Thursday evenings and its a much smaller class than the Saturday morning craziness.  Her teacher pushes her a little bit and its good.  She’s good.

And Mr. N, well, let’s not go there.  He is going to be 10(!!!!!) in July.

The magnitude of this is not clear until you know the history of the past month.

Two and a half weeks ago Mr. N got a major headache late one Wednesday evening.  It happened after his school’s “field day”.  It was a beautiful day, but hot.  I chalked it up to too much sun and sent him to bed with some Tylenol.  He woke up in the middle of the night and started throwing up.  He still had the headache and proceeded to throw up every 1/2 hour or so.  I emailed work come morning and said I’d work from home and took Mr. N in to the doctor’s at 11 to see if they could get him something to calm his tummy.  Well, the pediatric nurse practitioner got on the phone with the neurosurgery NP and they colluded.  They sent us down to CHOP, where they were “expecting us” at the ER.  He didn’t have a fever you see, so everyone was worried about a shunt malfunction.  They took it very seriously.  Mr. N had an x-ray series and a CT scan and they hooked him up to an IV and monitors.  The whole time, he is still thowing up and complaining of a headache.  The nuerosurgery resident was pretty sure, based upon the x-ray and CT scan that the shunt was fine.  The ER doc was still worried, though.  Apparently you can conclude that there is a problem from the x-ray and CT scan, but you can’t completely rule out a problem.  Mr. N’s blood pressure was high and his heart rate was slow, which can indicate intercranial pressure.  It can also indicate pain, though.  As Mr. N was still not keeping anything down, I let the ER doc and Mom convince me to keep him overnight.  The ER doc, especially, was worried, as she had apparently followed the advice of neurosurgery and sent shunt kids home in the past only to have them return.  The hospital took it seriously and we spent the night in the PICU.  Mr. N slept through the night after they dosed him with a narcotic.  Now, he hadn’t eaten for over 24 hours.  He woke up better in the morning, but the headache quickly came back into play, as did the nausea.  Neurosurgery came down and the resident, in his odd, neurosurgery resident way, still said it wasn’t the shunt.  So, neurosurgery sent down neurology.  We met with the neurology resident several times and then, at the end of the day, the big neurology doc.  The end diagnosis was a migraine and they sent us home with steroids for the migraine and zofran for his tummy.  We did get to come home on Friday and Mr. N went right to bed.  He was better on Saturday and mostly back to normal by Sunday.

It took him a bit to get back to 100%.  Then, on Friday night, the poor baby woke up in the middle of the night with a headache, vommitting and a temperature.  He vomitted again in the morning and felt all around crappy.  Coming on the heels of the whole shunt/migraine situation, we were both a bit tense about it all.  My head started spinning.  Could it have been the shunt the week before and now its gotten worse?  But, what about the fever?  Could it be a shunt infection?  Mom helped calm me relax with the reality that it was probably just that tummy virus that the pediatrician said was going around.  I gave him a bit of that zofran and when it didn’t come back up, gave him some motrin about half an hour later.  And it all stayed down.  His temp came down all day and he ate lunch and then a big dinner just fine and we had a normal Sunday.  We did have to cancel the sitter and miss Mr. C’s Munchkin Sports Jam and two birthday parties on Saturday.  Mr. N did school just fine.

I noticed he looked a little peaked this morning and he was coughing.  And he was warm when I kissed him.  Now, Mr. C had felt warm to me to earlier when I picked him up under his arms, but not when I kissed his forehead - so  iwas inclined to say I was a little cool.  I handed Mr. N the thermometer and had him take his temp.  It was 99.2.  Now, I must confess, I looked at him putting it in his mouth and thought, that’s not in far enough, but I didn’t follow up on it.  I did give him some motrin, because he said his head hurt a little bit — I wasn’t thinking of masking a fever, just getting in front of a migraine.  I didn’t explicitly think, I have so much to do — Mr. C’s well-check was today, Miss N’s end of year show was this morning, and the day was planned such that I’d drop Mr. C off at school and get to work a little before noon and then was in meetings from noon until 4:30.  I’d been out Monday morning, to take the kids to the dentist for their cleanings, I’d missed the two days before Memorial Day Weekend and have this huge project looming.  I didn’t lay that all against Mr. N’s peakedness, but it was chatter in the back of my head.

At any rate, the Mommy guilt kicked in at the end of the day and I skipped out of work early to go get everyone.  Mr. N was still looking peaked and when I took his temp when we got home it was floating up at 102.6

Bad Momma.

However, no nausea and no headache and the Tylenol well controled it and brought it down to 99.9 by bed time.  He does have a cough, so its clearly a different bug than last week’s tummy bug and I haven’t been able to figure out a way to lay the cough on the shunt, spina bifida, or scoliosis.

I really don’t want Mr. C to have to miss another Munchkin Sports Jam, so if the motrin continues to hold Mr. N’s temp down and he’s not miserable, I’m probably going to bring him with us out to Mr. C’s activity. Nothing else
The one up shot, if you can call it that, is that everyone was in bed by 7:40 tonight.

The poor kiddo.

Its supposed to be sunny and warm tomorrow and Sunday.  Hopefully some time in the sun and fresh air (not running around, but sitting out there) will chase some of this out of his system and the system of all the other petri dishes in the elementary school.

The kids and I are taking Steven and Jon to a baseball game down the road.  They came with us 2 years ago around this time and Jon just sent me a photo of the last trip.  They look so young!!!  Mr. C had only been home for about 2 weeks and I talked Steven and Jon into coming both for their company and because I wasn’t sure I could manage 3 kids at a baseball game on my own.

Its been a long week, but more on that later.  For now, we are all looking forward to this evening’s outting!

… its expensive and full of waste.

No news there, right?

At Mr. C’s last visit to the adoption clinic, the OT used Mr. N to show Mr. C how to do a tracking exam (follow the light type of thing).  She commented to me that Mr. N seemed to have some tracking issues.  I didn’t do anything about it for awhile, but it felt to me like Mr. N’s reading skills were not improving as much as the should be (he’s probably low-to-mid grade level right now).  It felt to me like his eyes would get caught up in the words.  I chatted with his ESL teacher and she paid some extra attention and agreed with me.  So, I schlepped us all down to Cherry Hill to visit the doc recommended by the adoption clinic.  After a battery of tests, that doc diagnosed Mr. N with pretty significant tracking and teaming problems — meaning he has a hard time moving his eyes across the page from side to side and a hard time getting his eyes to move together.  The doc kindly suggested another doctor much closer to us that could provide vision therapy (its kind of like speech or physical therapy, only for the eyes).  I gave that doc a call this week and of course, he’s got to do his own set of exams.  The thorough write-up of the first doc isn’t sufficient.  Sigh.  Supposedly this new doc is in network, so insurance should cover just over 1/2 the cost of the exam and probably all the vision therapy sessions, outside of the copay.  None-the-less, does it make sense, from a system point of view, that we have to do the exams *over* again.  (BTW — I had this experience at Shriners when I brought Mr. N in for a second opinion way back when.  They wouldn’t work with the x-rays from CHOP down the road — no, no, had to run their own).  There is no incentive for the doctor to not run the exams again.  What the hell am I going to do, say no?

Speaking of no incentive, I came home today from a bill from CHOP and an EOB from insurance.  The bill from CHOP is the same one I’ve discussed with both CHOP and the insurance company in the past.  Its a tiny bill, relatively speaking.  Its from the same day where 5 or 6 other charges were paid by insurance just fine.  Then, this one, they decided Mr. N wasn’t covered at the time.  Apparently a digit was wrong on the insurance number or something.  You’d think, though, that either the insurance company or CHOP would have noticed that a series of other charges from the same day and the same place and the same kids went through and were paid.   So, I called the insurance company and after some negotiations … I had to do the, “I want to talk to your supervisor.  Now.” thing … they admitted that Mr. N was covered and they’d send it over to some other department to straighten out and then resubmit the claim.  I called CHOP to tell them the insurance company was working on it and CHOP wanted to know if I knew when it would be resolved.  Sure, I’m in that much know.  Of course, I got an EOB a couple of weeks ago, showing that the insurance company had denied the claim again.  When I called the insurance company, again, they said that it had gone through and been approved properly since that last EOB.  Check hadn’t been cut yet, but it would be.  So, today I got the bill from CHOP — guess they haven’t gotten that check yet.  There is no incentive for them to work it out.  All they have to do is best effort, whatever that turns out to be, and then bill the patient.

Along with that bill from CHOP, I came home to an EOB and check from the insurance company for $139.  You might think that’s a good thing, except its an out-of-network claim for over $2000.  Its the !@#$!%# neural monitoring.  There is no one in-network to do it in the area, CHOP has to go out of network for it.  Now, I don’t think I’m going to be stuck with the bill, but I am going to be stuck with the time it takes to work it out.  This “company” — which seems to be a couple of very specialized docs and an inusance manager — and the insurance company have this problem each and every time.  I’m guessing it wasn’t coded properly, as the insurance company has paid the majority of this bill in the past.  You would think that either the neural monitoring folks or the insurance company would have figured it out by now.  This is the 3rd time Mr. N has had this surgery.  Don’t any of these people look in the records to try and see how it was resolved last time?  Of course not, they have no incentive to do so.  They’ll just bill me.

And I’m one of the lucky ones.  I have great insurance and I know how to navigate the system to resolve these things.