bitter sweet victory

WARNING – MORE DEATAILED COMPLAINING AND WHINING AHEAD…

Last night was our worst ever in Piglet’s 13.5 months of life.  I imagine that is what cholic is like.  She slept fine from 7-11:30, then she was up until 1:30.  Nothing would soothe her – I could tell she hurt somewhere, but I didn’t know where…it could be a sore throat…it could be an irritated esophagus from all the throwing up over the past month…it could be gas…it could be the stomach pain side effects from the antibiotic…it could be hunger pains since she didn’t really eat dinner.  So we didn’t really know what to do.  She finally stopped crying after some crushed ice – not sure why that worked.  Then she finally settled down completely after eating a cracker.  She slept again from 1:30-3:15, then woke up screaming.  She wouldn’t settle down – very restless, so I put in bed with us, which worked for 15 minutes.  So we went to the living room to watch Scrubs – man, I wish we had cable.  Scrubs was the only non-infomercial on at 3:30 am.  She finally went to sleep again at 4:30, and slept restlessly until 6:15.  The only way to calm her down at this point was to go outside.  It was cold so we wrapped up in a blanket like a mommy-baby burrito, and walked down the street, back and forth in front of our house – I’m sure the few cars that passed us thought I was crazy.  The best sleep was the 3 hour nap in my arms from 7:00-10:00, then she woke up just fine and dandy – she sat straight up and said, “dada”.  I was exhausted and frustrated, but who can resist being melted by that.

I have spent the rest of the day battling with the insurance company.  Give me a bad week, and my patience is thin.  But not to worry, I used my short-tempered-power for good.  I took on the insurance company, and won.

I talked to eight different people trying to get Piglet’s prescription filled.  It was ridiculous the excuses they were trying to make.  First, they said that we needed the generic version of it, but the pharmacist said there was no generic because she was supposed to get the powered form.  You see, Singulair is expensive.  The insurance was trying everything they could to not pay for it.  Their second approach was to tell us that we should just pay for it since it would take so long to get approval – $300 – no, thanks, that’s what we have insurance for.  The third approach they tried was to tell us that aparently they call this a step-drug and there are other medicines that treat the same symptoms and are less expensive – I should try all of those first before coming to this medicine.  In order to override this, Piglet’s doctor would have had to call them, and give them specific reasons why she needed THIS drug.  Ridiculous.  Even if it wasn’t ridiculous, her doctor wasn’t in the office today, so he couldn’t have called until tomorrow anyway.

My favorite line throughout the conversation was the second to last lady telling me, “I don’t have the authority to override this policy, I’m not a medical professional.”  So I respond, “Well, our doctor IS a medical professional and he wrote the prescription for this particular medication, so that should be all you need to know.”  She again said that she couldn’t do anything about the policy, so I asked to be transfered to some who did have the authority…and Voila!  We have the prescription filled.  Not exactly, voila – I still had to negitioate, argue, and cry a little.

BUT in the midst of being transferred seven times, I looked up singulair online to see what other medicines we could substitute, when I found patient reviews on WebMD.  All but 2 reviews for the medicine given to children were horrible – mood swings, depression, not sleeping at night, irratible…not sure if it’s worth all that.  UGG!!  Not sure what to so.  I have a slight moral victory because I won my battle with the insurance company, but now I don’t know if we’ll even give it to her….we might just start with those other medications – I think Claritin will be next on our list.  But, shh, don’t tell the insurance company that.

And, a moment of bliss in the middle of the madness – as I was in the middle of typing this post, Piglet walked over to the stereo and turned it on.  When “At Last” came on, she started dancing (her idea of dancing is bobbing her head and trying to snap her fingers – poor thing has been wathcing her daddy do the “white boy dance” for far too long). Then she reached for me to pick her up to dance with her.  Then we danced to “At Last” three times as she slowly drifted off to sleep – so peacefully, not fighting (which is totally out of character)…but it was the sweetest moment and made the awfulness of the past week melt away.  She’s now sleeping peacefully in her crib – I should go do the same, in my bed, not the crib.

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2 Responses

  1. I can’t speak for how it works with a 1 year old, but I have been taking Singulair for almost 8 years and love it. It is a pain to get it approved, but once you do, just do the automatic refills through the Web and it is easy.

    I hope Piglet feels better soon and you get some sleep!

  2. still praying for you!

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