Keziah recently told me she doesn't like the photo of her I have on the wall, and asked me to take a new one. So, while I borrowed Leslie's lens again (I won't rant, I won't rant, I won't rant...not yet) for Clark's newborn shoot, I decided to grab a couple of photos of Keziah. Seriously, I know she's mine, but is she beautiful, or what? I was so happy with the shots I got, and she was pleased too.
I realized when I posted the update of Jubilee yesterday, I never mentioned why she was having surgery. Jubilee had a chronic runny nose as a baby and toddler. Every day for years, her nose was draining. We hoped she would out grow it (Adalia also had a runny nose for her first three or four years, but it eventually went away). When Jubilee turned six, and began reading, I suddenly realized how many words she cannot pronounce. She speaks like she has a bad cold (plug your nose and talk...that's what Jubilee sounds like). I then remembered my mom talking about how my brother Neale always talked like that...until he got his tonsils and adenoids out.
I took Jubilee to our family doctor, who first wanted to rule out allergies. After two weeks of nasal spray and no improvement, we headed to the Ear, Nose, Throat doctor. The x-rays he ordered showed that Jubilee had almost no air passing through her nose (along with the other symptoms, Jubilee breathes strictly through her mouth and snores every night). Thankfully her tonsils were fine, and didn't need to be removed.
Yesterday after the surgery, the ENT said her adenoids were "huge". Which was a relief. You'd hate to go through that only to find out they were "kinda big" or "moderate sized". And just to be clear, her adenoids were not enlarged (i.e. swollen or enflamed) just large.
So yesterday after the surgery we headed straight for the pharmacy to pick up her prescriptions (pain meds and a nasal spray). I made sure they had the prescription (it was called in) then loaded my cart with popsicles, yoghurt and ice cream for Jubilee (they go through the throat for adenoid surgery, so a sore throat is a normal part of recovery). When I headed over to see if the prescription was ready, I was told the woman was on the phone with the insurance company...they were refusing to cover the prescription because the amount of pain medicine the doctor prescribed was "more than the plan allowed".
Pharmacist: "If you want to wait, we'll resend the request and you can pick the prescription up later, or if you need it now, you can pay for it and if they decided to cover it, they'll reimburse you".
Me: "My daughter just had surgery and is out in our jeep crying...I can't wait until later to pick up her prescription".
And so I paid and left (and by the time I got back out to the jeep, she was actually smiling...and happily awaiting her next popsicle...but she was crying when I went in).
Now, we pay $1,000 a month for this insurance coverage and have to fight them for almost every claim we make. From doctor's visits to prescriptions, they always have some reason why they "don't cover" whatever it is we need.
My children's dentist prescribed a special toothpaste for my cavity-prone children (who's teeth we brush and floss every night) and the the insurance company wouldn't cover that because it was like two milliliters more than they "allowed". I heard the pharmacist on the phone that time. She said, "That's the size the toothpaste comes in...what do you want me to do? Squeeze some of it out?"
*sigh*
Once again, I am so thankful to live in a country where medical care is an option. A country where it is safe to take my child to the doctor. A country where I can choose my own doctor...however, I refuse to be thankful for an insurance company who makes me fight every single bill and who has "policies" I can't argue with about how big a tube of toothpaste is or how many doses of pain medication the doctor is "allowed" to prescribe. It seems to me, the doctor, who just operated on my daughter, knows more about her medical needs that the insurance company's book of policies.
Jubilee is now up and around for the day and feeling pretty good! It looks like she is in for a smooth recovery.
I'm a reader who stumbled on your blog -- I'm not sure where, but anyway.
I had my adenoids out when I was 11--it made such a difference! I'm glad that Jubilee had a chance to get them out now. I hope that her recovery goes smoothly. eat those popsicles!
Posted by: Jenna | July 03, 2009 at 08:32 AM
I'm glad Jubilee is feeling okay and recovering well!
I feel your pain with the insurance companies making medical decisions. My dad has been in chronic pain for several years now due to sciatic nerve problems. He's had a number of procedures done that have not helped long-term, and his doctors believe that is because there has been too much delay in many of the procedures, rendering them less effective or ineffective. The insurance company is constantly denying certain procedures, or requiring months to pass in between procedures. We pray constantly that he will not be in pain like this for the rest of his life!
Posted by: Joceline | July 03, 2009 at 08:41 AM
I'm thankful that Jubilee is doing well!
About the insurance...I feel your pain, too. My dad is a doctor--an old-time country doctor--and the insurance companies drive him NUTS with all their regulations. As much as we patients fight them, the doctors do it even more as they try to treat their patients in the way that is best for the patient! Crazy.
Have you ever considered ditching your insurance and joining one of the Christian need-sharing ministries that is around? We've been a part of Samaritan Ministries for a few years and LOVE it. Traditional insurance was hugely expensive for us since my husband is self-employed, and Samaritan Ministries is cheaper and much less frustrating--much more satisfactory for us all the way around.
Anyway, I'm not trying to do a commercial for them...just was curious if you had ever looked into something like that.
Posted by: Davene | July 03, 2009 at 08:49 AM
My son had his adenoids out as well and it made such a difference for him! He has tubes in his ears as well and the day after tubes and adenoid removal, he learned to read and swim!
The ins is a hard battle. My husb is in mil so that is good ins but what a pain to get referrals for my sons ENT needs! The doctor and the Ins FIGHT me on this every single time he needs one, then I get to the ENT and he says, I am so glad you came in, he is having problem A or B with the tubes, needs new ones, need to come out etc. I like Davenes suggestion!
Posted by: Jo Abair | July 03, 2009 at 10:02 AM
Great pic Keziah! You are beautiful!
We pray Jubilee continues to heal and feel better, I am sure the popsicles are helping her recovery alot. :)
Your US health care sure is a down side to living in the states. Reminds me to be so thankful and grateful for our health care. I can't believe you pay $1000!!!!! a mo. and have to fight over every little perscription etc. You know there is a big house for sale just down the road from us. :) kidding. Love you all, Aunty xo
Posted by: Cool Canadian aka TARA | July 03, 2009 at 10:15 AM
The picture is beautiful!!
I'll have to have my son's adenoids checked, he has a hard time with certain sounds when he talks.
Posted by: Teresa | July 03, 2009 at 03:49 PM
I just had a minor op and was a bit grumpy about the hospital stay - now I am feeling very grateful and thankful for living in country with nationalized health care! Yay NHS - must not take it for granted. Hope they pay up and Jubilee is all better soon.
I love your blog btw - it brightens my day on a regular basis and your photos are amazing!
Posted by: Verity | July 03, 2009 at 03:51 PM
Oh that comment the chemist made about squeezing some out of the tube of toothpaste is priceless!! The pics of Jubilee and Chuck were so heart warming. It's beautiful to see such love.
Posted by: Lou | July 03, 2009 at 07:13 PM
No, it's not just because she's your daughter that you think she's beautiful, I think she is too. I'm glad you guys got some photos she's happy with. :)
Posted by: Holly | July 03, 2009 at 11:31 PM
We've been amazed at our insurance too. My son is going to Haiti and needed malaria pills. The insurance would not pay for the 7 pills he needed (about $35) but would pay for a prescription of 30 pills ($100 plus).. He now can donate malaria pills to the orphanage he is ministering at. We too battle with every claim. My husband is also in business for himself so we are very aware of all the costs. Thanks for blogging. I love keeping up with your family.
Posted by: Sue Jeffery | July 05, 2009 at 11:02 AM
Wow! I have such a pretty friend! :)
Posted by: Kaisha | July 05, 2009 at 12:42 PM
I hope she will be fine.
-Kaylee
Posted by: ENT doctor | July 22, 2009 at 07:34 PM