Thursday, March 19, 2009

Another Day, Another Doctor's Visit

Today we met with the plastic surgeon to discuss the possibility of upcoming procedures. At first, the doctor thought Aleks was five for some reason. So he said we didn't need to do anything. Then he found out he is actually six-and-a-half and decided that he is indeed ready for a palatal extender. Turns out Aleks has a rather wide arch already, so that may mean he won't need to have it very long (I hope). We do have to wait for the two teeth that the pediatric dentist recommended having out to come out and to heal before the palatal extender can be placed, however. So it's on to coordinating the ear tubes and the tooth extraction. Which proved to be more problematic than I'd expected it to be.

So the hospital (if you can call such a massive medical corporation a mere hospital) doesn't take our insurance. Our otolaryngologist (ENT) who works at the hospital takes our insurance for some reason, but other doctors there and the hospital itself do not. I'm not certain how this all works out. We can see all the specialists at the cleft clinic and some of them can do Aleks' surgeries, but we can't just walk in and pick whoever to do necessary work for us. And oddly I went to this hospital for my occupational therapy after I had my hand accident, so I have no idea what their deal is.

At any rate, we cannot just get a dentist to pull the teeth. Our pediatric dentist can't do it as he no longer works in an OR. It also turns out that you can't coordinate an out-of-hospital/system provider with an in-system provider, so I can't use an outside pediatric dentist to work with our inside ENT. The plastic surgeon told me to talk to his receptionist and have her call upstairs to the dentists to find someone to see us today.

The appointment lady tried to schedule us for the end of the month upon these instructions. I corrected her and she said she didn't think there was a pediatric dentist up there at all. I told her I just needed someone to coordinate the surgery with to pull the teeth. Nothing too complicated, but I didn't want Aleks to have to go under general anesthesia twice for two separate but very simple out-patient procedures when we could just do them at once. She saw my point and suggested I go upstairs and ask them myself. All the while, Aleks was drawing pictures for everyone he met.

We went upstairs to talk to the dental people. They were pretty confused too. This system is so ridiculous. This is why health care needs to be well-coordinated and, more importantly, free for everyone. Aleks gave them free art, they should be able to get us in and out and know what the heck they're doing. So eventually we were able to discover one single dude who could help us and who would consult with us on Monday. We also learned that it will take about a month to get our insurance to approve this out-of-network provider & procedure. Which is fine as the time is not an issue, but is annoying nonetheless.

Then I realized that the plastic surgeon has our x-ray of Aleks' teeth that I had to drive 25 minutes to pick up and now the dentist we're seeing on Monday will need a copy too. I called this afternoon to try to see if they can just let him borrow it for the time being, or even give it up and settle for post-operative x-rays, should those become necessary. I haven't received a reply yet, which makes me nervous. I'll need to get that ready immediately or else run downstairs from the dentist and steal it from the plastic surgeon myself on Monday.

So it's another appointment with another specialist before we can definitely arrange a date and time for this surgery. All of which will add to our file of medical records. Whenever we find ourselves moving, I'll have to request my own copies of all his surgical records and clinic visits to add to this file from his first two years of life:
It doesn't seem that bad, all things considered. That's some cleft/craniofacial reports which are usually just a page or two long plus the surgical records from his first four surgeries. This upcoming surgery will be his sixth.

Generally, my approach to all of this is practical, and that's been true even with the back-and-forth of appointments lately. The last week or so, however, has found us facing greater stressors than usual with the loss of my cousin in an accident in Iraq and the sudden death of a colleague of my husband's. Additionally, we don't have a move for a sweet job lined up for the fall, so our economic position has been tenuous and our future remains uncertain. Our emotional life has been put through the wringer. We've kept our heads about us in a larger sense for quite some time, but today and yesterday I have been feeling wholly overwhelmed. There are no words for it, really. I'm just totally and completely in the thick of it.


Jennylou's Projects said...

I can't imagine keeping all that coordinated. I hope you get everything all squared away soon. I file claims for my mil and sometimes we get prior authorizations in two weeks (which just about makes us fall over and faint) upwards of six months. It's crazy how much more difficult they system makes it for people.

becks said...

we're sending you guys lots of good vibes.

Chrissy Johnson said...

I am banging my head against the wall for you, Anna. I'm doing it up here in Alaska for our own reasons, so I'll throw in a few bangs for you guys, too. xoxo

Julie said...

My heart goes out to you:( Wow! Lots to deal with. I can't imagine the stress.

I agree with the state of our health care system in this country. I always hope nothing extreme happens with us, as we have no health insurance. We're still paying off Damek's dental bill from last summer that was over $1,000. We definitely need to start putting some money away for a possible emergency. Maybe after we refinance our house.