Thursday, March 27, 2008

An afront to connoisseur I'm sure

but I love White Zinfandel when I consume any food heavy in grease, cheese, or MSG. Basically, any cheap take-out is a perfect match.

We got delicious Chinese from Chien Garden tonight (cashew chicken and Szechaun chicken) and Buzzkill had to make a stop for a 2005 Beringer ($9.99 for 1.5L) at the local Buy 'N Low because we drank the bottle we had in the fridge of this sickly sweet vintage while my folks were in town. So good really cold with hot, spicy take-out. MMMMmmmmm.

Tuesday, March 18, 2008

Unusual baby toy? It would have been much more enjoyable to watch some of the Tivoed Jon & Kate Plus Eights I have saved up. Thanks to everyone that suggested I would like that show. Kate cracks me up - her sense of humor is so dry. And y'all, what up with Beth & Bob's zebra print carpet in the house hunting episode?

Since I referenced Tivo above, just wanted to mention that Punkinhead has her own Tivo remote now. Seriously.

For some reason she thinks our Tivo remote is amazing. It doesn't beep or flash or rattle but when we use it she demands we hand it over. I don't want her putting the germy thing in her mouth or more importantly, changing the channel.

We have an old Tivo remote that doesn't work so I took the batteries out of it and every time she throws a tantrum when Buzzkill and I use the real remote, I hand her the non-working one. Cries and howls cease immediately. Plus I can disinfect it like her other toys.

She insisted on taking it to the crib for her afternoon nap today. My daughter has a remote for a lovey.....if Buzzkill needed more proof she's his, I think we have it.

New Car Seat!

Punkinhead's Papaw & Gigi (HotMommy's parents) have generously offered to buy the needed new carseat for Punkinhead's birthday as we near the 12 month, 20 lbs limit on her current car seat. This will be her forward facing debut and HotMommy loves the pattern on it. And the pattern name is the same name that's on Punkinhead's birth certificate! How perfect is that? We were going to get the "Cowmooflage," but decided that anything with black on it would get too hot in Texas summer (thanks Kel).

At last

Punkinhead got her Synagis shot yesterday, but not without one last major obstacle. I'll start at where the saga left off though.

Buzzkill had read on The Consumerist that our insurance company had a department called Consumer Advocate that works outside the normal channels of approval and can work quickly too. He called the number and explained the entire situation, got a call back 10 minutes later that we'd been approved, and by Monday morning had a letter confirming all the details for our doctor. Yeah!

We faxed the letter to our doctor so we can get our appointment scheduled for Monday afternoon and here's where the last hurdle occurred. The only technician trained to give Synagis is ON VACATION for the week! They can't give her an injection until next Monday!!!!! I mean, the whole point of why we fought so hard was to get her shot in a specific time frame and if we wait until next week, I have to quarantine through March anyway.

HotMommy has a small breakdown and called Buzzkill, who in a wonderful, manly, take-charge manner (this manner is only welcome when I'm emotionally overwhelmed) says he's going to take care of everything and not to worry. He called the company that makes Synagis and found out which doctors they supply had the medicine on hand and then started making phone calls to see who could give her an appointment Monday afternoon.

Once he got Punkinhead's appointment (4 p.m. second to last of the day), he came home from work early, drove us over, and was there for emotional support during the appointment. HotMommy has one special hubby!

Thanks to all for supporting us during this crisis. I'm so glad it's over and Punkinhead is safe and protected.

Friday, March 14, 2008

News from the front

It appears the Synagis situation is going to go our way, but we won't have confirmation until Monday, so I don't want to go into the whole story yet.

Just keep up the prayers and positive focus for us 'cause it's working!

Liar, liar and not the funny Jim Carrey kind

The insurance company doctor that denied Punkinhead's March Synagis shot gave his reason for denial as "treatment not consistent with published medical evidence."

It's a TOTAL lie. Our state officially extended the RSV season here on March 8th because of..........VIROLOGY SUPPORTED HIGH LEVELS OF RSV!!!!!!!!! And the state published that info too.

All of Punkinhead's doctors say a March course of Synagis is needed and we even know that the health"care" company is approving shots for other babies all over the state so clearly they know it's needed. This is getting ridiculous.

Our last hope is that Buzzkill's company complaining that they paid for Punkinhead to be covered and that they're losing money with all the hours Buzzkill has to spend on the phone trying to get this fixed will get the insurance company to approve her shot.

HotMommy has been crying some hot tears of frustration today.

Wednesday, March 12, 2008

The goal is to make 12 boxes last all year.

But the best part was when I unpacked them and discovered we were given beautiful art along with our Girl Scouts cookies.

How did she know we were going to run out in excitment over our cookies?

I'll go all 15 rounds if that's what it takes.

The latest on the Syngais saga....

Apparently, I've misunderstood the cost of this shot. It's about $1,100 a DOSE not a shot and Punkinhead is now getting THREE doses based on her weight. If we pay out of pocket that's $3,300!!!!!!

So lets add up what the cost would have been if we'd had to pay for all her doses October-February. $11,000

We were referred to a group that is run by the Synagis makers that helps people get the medicines their doctors tell them they need when the insurance companies say no. This group can really help put pressure on the insurance company and has helped our doctors billing office realize that the insurance coordinator won't return their calls because if they stall long enough, it will be too late for her shot to be effective and they won't have to pay. They gave them advice on how to get around the local representative that's stone-walling. Buzzkill and I also got some helpful tips. We went to Buzzkill's benefits person at work and explained what's happening so she can put pressure on the insurance company. Buzzkill's employeer is the insurance company's "real client" and they're much more worried about the company's business than they are about our individual complaints.

We've also been told by this helpful group that despite what the insurance company's local rep has told the doctor, our insurance company is paying for Synagis injections for March ALL OVER the state because our RSV season is longer!

HotMommy is determined this health"care" company is going to pay what they're supposed to! (Rocky theme plays in the background of my mind)

Keep those positive thoughts and purposeful prayers coming. They're greatly appreciated......

You know what I hate?

High maintenance people.

Also, know what Saddam Hussein and the tv character Adrian Monk have in common?

A love of baby wipes.

This fact brought to you by the author of The Terrorist Watch, Ronald Kessler.

Tuesday, March 11, 2008

A whole other kind of Lost love story

So watching Brooke White on American Idol, I realized why she looks familiar to me. I think she is the love child of Kate and Juliet from Lost.

Monday, March 10, 2008

One tooth - ah, ah, ah. Two teeth - ah, ah, ah. Three, uh no, not yet. Sorry Count.

Yes, those are Buzzkill's fingers in her mouth and yes, he disinfected before and after. Someday I'll post the outtakes. There is nothing funnier than a grown man telling a baby she must NOT stick out her tongue.

Shot update

We're officially denied coverage for her March shot.

It looks like the CDC is saying for April no one needs a shot because this RSV season is ending early. Since we don't have to worry about coverage for an April shot, we're going to bite the bullet and pay for March.

We could quarantine on principle, but then I might go insane before the end of March, and really it's about what the Punkinhead needs more than anything.

She should get it tomorrow. Health"care" sucks. Pardon my language.

Tuesday, March 4, 2008

RSV stuff, this is long with no pictures

We got a call from Punkinhead's pulmonary specialist today that has us fairly concerned. As most of our friends and family know, Punkinhead was born about 9 weeks early and because of that has to get a monthly shot for RSV. We and all other families that have our same health"care" company and go to the same pulmonary specialist have been denied coverage for this shot for the month of March. The doctor's office tells us this happens from time to time and not to be worried because they negotiate the coverage back, but they've canceled her Thursday appointment and let me know that she has to have her next shot rescheduled no later than March 13 or we have to quarantine ourselves. The other option is to pay out of pocket and then negotiate for reimbursement from our stupid health"care" company. Yeah, right, we'd never see that money again.

A lot of you have asked questions about this RSV thing, so I thought I'd put something up to explain it for those interested. Don't feel obligated to read it, it's kinda boring medical stuff, but please everyone, just say a prayer that the awesome folks at her doctor's office can negotiate quickly and easily and we can get her next shot ASAP!

I’ve borrowed a lot of the information in this blog with gratitude from another blog mommy facing some of the same challenges.

For those of you unfamiliar with RSV (Respiratory Syncytial Virus) let me do my best to explain. Like the flu or common cold, RSV is a seasonal virus. It starts in October and continues through April. It's common and easily spread infecting nearly all children by the age of 2.

Most kids (born at full-term) develop moderate - severe cold like symptoms, but due to preemies fragile, less developed lungs and lower immune system they are at increased risk for developing severe RSV infection leading to severe lung infection (ie: pneumonia), life-threatening breathing problems, hospitalization, etc.
The common complicating risk factors include: Premature birth (35 wks or less),
Low Birth weight (less than 5.5 lbs), Heart disease, Lung Issues, Being Around Other Children, Family History of Asthma, Exposure to tobacco smoke, Multiple Births

Punkinhead had the first two risk factors, but luckily none of the others apply and we can control her exposure to other kids. A lot of people have a hard to getting their insurance to cover the treatment (a shot of Synagis once a month), but because Punkinhead was born before 32 gestational weeks weighing 2 lbs 14 oz, up till now we didn't have issues being approved for it.

Synagis is the only approved medicine to protect from the severity of RSV, which is the #1 cause of hospitalization in babies under one year. However, if we paid for the shots on our own it would cost us about $1000 dollars per month for a grand total of over $8,000! It so expensive because it is actually NOT a vaccine, it’s the an antibody injection. A vaccine is a small amount of a dead virus that your body reacts to by developing antibodies to it and then it is prepped to fight the live virus when you encounter it. There is not a working vaccine for RSV so Punkinhead is given a ready-to-fight antibody that requires a “booster” dose every month. The first dose was only one shot, but once she was over 15 lbs, it’s a LONG needle in each leg every time to give her the right dosage.

Our health"care" company's purpose in cancelling ALL our pulmonary specialist's patients for the month appears to be an attempt to rid themselves of a few patients. They cancel us all, make us beg for it back, make us worry about our kids, and then make some money by cancelling coverage for a couple of kids whose risk factor is on the borderline at the end of RSV season. It's sick and makes me want to move to Canada.