Sunday, August 7, 2011

Hello again - Birds leave the nest

Well, the summer has been flying by. As a mom to older children, my birds have been leaving the nest so things have been a bit hectic and that, with other issues, has pre-empted my posting for a long time.

You never know how kids are going to react to new things. Whether driving across the country to a new job and place to live, or moving into an apartment, it's new and unusual and takes time to adjust. How fast kids DO adjust reflects, I think, how much independence they have been given growing up.

I watch in amazement as mothers with small children refuse to allow them any freedom. I have friends who still pick out full outfits for their school age children. Other friends, with high school age children, drive them everywhere and try to plan their futures for them (one co-worker is currently "helping" her child find a college. The requirements include close enough for mom to drive out there and bring home child for the weekend EVERY weekend!)

I don't get it. I encouraged my children to be independent. Yes, they got injured at times. Yes, they experienced bad things. Yes, they suffered from homesickness while away at camp, fights with friends, and deaths of classmates. But they have grown up into independent adults. I know if anything were to happen to their father and/or me, they would be able to cope in today's world. I don't know if some of their friends or some of these other children will be able to.

Sunday, May 15, 2011

Sex and Immunizations...HUH?

I read a lot about immunizations. As the mother of two (now mostly grown) children, I didn't really give them much thought back in the day. As a nurse, I was well aware that immunizations had risks. My children's doctors, back in the day, always made sure I was aware of that immunizations they were given, risks, and side effects. Outside of some after-shot crankiness and fevers, my children had no issues with any of their immunizations.

Hepatitis B was not a recommended vaccine when my children were born. I knew it was out there, and, at the time, it was given only to those infants at risk (mothers with positive tests, persons from areas where Hep B is common as exposure could be an issue). As a nurse, I knew it was not just "sexually transmitted", and the issue of a "biter" in daycare was as important as blood or body fluid transmission. But, it wasn't offered, so they did not get it then. I DID see a young child with Hep B in the hospital where I worked. But it wasn't common so at that time I put it out of my mind.

When it was recommended, I did make sure they got the Heb B doses. And yes, to be honest, I delayed (only a few years; it was not recommended until they were nearly school age for those who did not get it at birth) until they were middle-school age so they would be protected during the highest at-risk years sexually. (At that time, it was felt the immunization was only effective for 10 years, so I wanted to give them that 10 years when they would need it most.) Later reviews have shown that once someone has developed antibodies from the vaccine, they may be protected for life.

Gardasil. The vaccine that protects against that other sexually transmitted disease HPV. Only sexually promiscuous girls would get HPV, right? Wrong. One of the problems with HPV is that your system can clear it, or you get it, or, in rare cases, it becomes dormant. I had a patient who, after 30 years of monogamous marriage (on her part, per her report and on his part per HIS report), developed an HPV infection. Both firmly denied extramarital activity. Upon probing, the husband recalled that many years prior to marriage, he'd had 'warts' on his penis that went away and never came back. Guess where the wife got HPV from? Loving husband. Their marriage survived, but she had several issues with abnormal pap smears leading to additional treatment. If you asked her, she would have gotten the HPV vaccine in a second.

In the back of my head I always see the young teenage girl who was brought to the gyn clinic I worked at. Her mother was concerned because her daughter always cried when urinating. When I went in to examine her, I was horrified...I could not see anything because this girl was one huge mass of warts from pelvic bone to anus. If you touched them, they bled. Every time she uninated, the warm urine over the bleeding warts hurt her immensely. We called in the physician to manage this case. The upshot was many, many weeks of care to burn off the warts and be able to see this girl's urethra and vagina. This girl had had sex once. If you had asked her, she certainly would have preferred a vaccine over the care she required.

When the vaccine became available, I asked my children if they wanted to get it. I got the literature from the doctor's office, verified with my insurance as to whether or not it was covered, and let them make the decision. Both opted for the vaccine, and got the series of 3 with nothing more serious as a side effect than a brief dizzy spell (younger hates shots and needles and hyperventilates).

So, yes. I am pro "STD" vaccines. I am pro all vaccines, because the risks of the disease outweigh the risks of the vaccine. As a child who got a vaccine that is no longer given - smallpox scars in the US designate a certain demographic. I have one, my brother has one. Our younger sister does not have one because, lucky girl, she was born after it was eradicated in the US. My children did not have to have it because they were born after it was eradicated world-wide. Maybe, in the future, my grandchildren or great-grandchildren will not need vaccines against other diseases that have only human vectors, like measles. Wouldn't that be wonderful?

Sunday, May 8, 2011

Still Here

Just a note to say that I am still around. I have several posts in mind but have been very busy in real life so haven't posted any of them. I promise that one should be coming. I may get it done tonight (Moms get to do whatever they want on Mother's Day, right?).

Saturday, March 26, 2011

Breast is Best or when Bottle is Better...

First of all, let me say that I am a huge fan of breastfeeding. If a woman wants to breastfeed, she should have all the support and encouragement she needs and wants. I breastfed my children for as long as possible. Neither child made it to the magic "first year" nursing. One quit at 9 months (she would take a bottle, but much preferred being an adult and using a cup), the other, who decided that nursing was the cause of her ear pain (not the raging ear infection she had, with NO symptoms), quit at 6 months. (I tried for 3 days to get her to nurse...latch her on in her sleep, nope. She would awaken and scream, even after the ear infection was gone.)

Breast milk, of course, is meant to be fed to babies. Studies have shown that breastmilk changes as a baby grows, and that the breastmilk made by a mother who delivers prematurely is different from that made by a term mother. And as the baby grows, breastmilk changes to support the baby's needs.

Although women are "born" to breastfeed - we almost all have the right equipment (breasts, nipples, milk ducts), some women don't. Genetics plays a part in an ability to breast feed and throughout history, women who have been unable to nurse have found substitutes. Milk nurses, bottles, a friendly lactating cow, goat, whatever...all through history you will find women who couldn't breastfeed due to physical issues. And that is not counting the women who can't nurse due to starvation, illness or injury.

So, what about women who CAN breastfeed but don't? Are they failing their children? Are their children any different than breastfed children?

A patient of mine, long ago, told us at her very first prenatal visit that she did not want to breastfeed. In our practice, we remained non-judgmental, as we did with all our clients. All clients were given information about breastfeeding benefits. This client steadfastly refused to even look at the literature. Late in her pregnancy she confided that she had been sexually abused as a young girl, and having her breasts touched by anyone made her physically ill. She would not even allow her husband to see or touch her breasts. For this woman, bottlefeeding was definitely better for her and her baby. As we told her, better a happy bottle-feeding mother/baby pair, then a baby who senses with every breastfed meal that his/her mother hates what is happening.

Other women, without the problems of this woman, also choose to bottle feed. The reasons are many - convenience, family pressure, need to work in an environment where continuing nursing is not possible. Unfortunately, these women are often condemned by the "all natural, all the time" mothers.

So, what is your attitude? What have you experienced? And how can we promote breast is best and not neglect those women for whom bottle IS better?

Saturday, March 5, 2011

I had a (mother) who read to me...

Well, sorry for the break but I've not been quite my usual self so blogging got put by the wayside until I had some energy.

I've been thinking about baby gifts, because I have friends who are expecting. Usually I give them copies of books. "Good Night Moon" and "The Runaway Bunny" are most common, but if I know they have those books, any books that catch my eye. I almost always give copies of the cardboard types, so the babies may enjoy the books and mom and dad don't have to worry about torn pages.

I have to admit, I am a bookworm of the first order. My husband has often threatened to leave me if I bring home ONE more book (he hasn't left yet, BTW...). But I do have books and books and books. So do my children. I fully believe that kids have the right to own books, their own books - that they choose, read, mutilate, whatever.

From baby-time on, either my husband or I read nightly to our children. Early on, the books were the traditional - "Pat the Bunny", "Good Night Moon", "The Runaway Bunny". We had bought several of the cardboard-type books at one of the big superstores and the children both loved being read those books and being allowed to "read" them whenever they wanted.

Our eldest caused quite a fuss one night. I was at work and she was demanding that her father read 'hush book' to her. Unfortunately, he hadn't a clue what she meant. He finally called me at work, and I told him that she wanted "Good Night Moon" - her version of the title was due to the fact that I always emphasized the word hush when reading the sentence "...the quiet old lady whispering hush..."

Later on, we wandered into other books. We read Beatrix Potter (and had some beautiful VHS tapes of the books; unfortunately who has VHS any more? We still have the tapes). We read Dr Seuss. I don't know when my children learned to read but I know that it was well before school age. We also belonged, for a while, to one of those "Children's Book of the Month" Clubs and got some very charming books that way. Unfortunately, the children grew but the age of the club's reading material didn't, so eventually we dropped the club.

Books were never forbidden to the children. If they wanted to read them, they could. If they got bored or disliked the book, they put them back. The only requirement was that they handled it with care.

Reading material was never censored, either. Babysitter's Club books (all types), Goosebumps, American Girl, Alcott, Tamara Pierce, Caroline Cooney, Nora Roberts, J.D. Robb, Tolkien, J.K Rowling...whatever they wanted to read, they could. I found new authors from them and they learned new authors from me. We discussed books and events. Fiction, nonfiction, graphic books (there was a period when it seemed we owned every manga book on earth), they were all allowed.

So...reading material. What do you read to your kids? What do you allow them to read? Do you have trouble with getting your kids to read? Do they like to read or hate it?

Monday, February 21, 2011

Epidurals - the Good, the Bad, and the Ugly

Reading the book review by Dr Harriet Hall on SBM regarding pain relief in childbirth made me stop and think. Like breastfeeding, epidurals seem to be a tender point. So, let's talk about them.

First, let me say that I am one of those women who didn't have an epidural, has never had an epidural. Why? Because I have a phobia. I am totally, irrationally afraid of needles going into my spine. Even when suggested for non-childbirth related procedures, I panic too much. As I said, totally irrational.

Let me preface this by saying most anesthesiologists are fantastic. It can't be easy to put an epidural in. I admire their ability to perform their job, even when they are "trying to hit a moving target".

The Good: a good epidural is one that has been discussed in advance and agreed upon (as either a definite choice or a possible choice) by the patient and her care giver. She is aware that an epidural provides pain relief but she will probably still feel touch, pressure and temperature changes. (Personally, I would like to know more about the 'walking epidural' that supposedly women get in some European countries. It sounds like a win-win situation - pain relief without immobility). These women may or may not have problems with the epidural - spinal headaches being the most common - but they are happy with their choice.

The Bad: a bad epidural is one where the patient has irrational expectations. I have seen women be very distressed that they feel anything at all. They may be totally numb to pain, but since they feel pressure and touch, they often feel betrayed because they were "promised that they would not feel anything." In this category also falls the epidurals that "don't quite work". Some women do not get pain relief, others get pain relief in all areas but one (a window, we call it). I always felt very bad for those women; it seemed that having only one area feeling pain made the pain much worse. These women feel very betrayed and are unhappy with their choice.

The Ugly: my category for a physician-ordered epidural when the patient does not wish to have one. The one instance that stands out in my mind: a woman came in to the hospital in labor, dilated 9 cm. She was coping and did not wish any pain relief. When her physician was informed of her admission, he ordered an epidural (All of his patients ended up with epidurals). The patient did not want the epidural and, due to her very advanced stage of labor, the nurses called the OB resident who delivered the woman shortly thereafter. The attending was irate when he arrived and found the patient had not had the epidural. He tried to write up the nurses for "disobeying his order". Only the intervention of the anesthesiologist on call, who stated that he would not have given the epidural anyway, saved the nurses. These epidurals were rare.

However, before I left OB nursing, I found more and more commonly that patients were being told "they would get an epidural as soon as they came in." Some women were very happy with this. Others, who had plans for natural, unmedicated childbirth until they learned late in their pregnancy that their OB really didn't support this, were quite unhappy. So, here were the good and the ugly.

I always felt epidurals had their place. I strongly believe that not every woman needs one, but that they should always be an option. Personally, I would like epidural to be the last option for pain management instead of the first, but that's the midwife in me speaking. I never talked a woman out of an epidural. On a few occasions, I did talk women into having an epidural. Rare occasions and generally extenuating circumstances.
(In one place I worked, there was a very toxic childbirth instructor who preached that pain medications lead to mental retardation and epidurals caused fetal death. Her students were very hard to care for if they were unable to cope with labor contractions using the childbirth techniques. We tried to steer women away from classes with her; there were other instructors who taught the same method without the hyperbole whom we recommended. Many of those instructors were 'on-call' for us if we got toxic-teacher's students in who really needed pain relief. They would give the student permission to get the pain relief - TT also convinced her students that they needed permission from the instructor for it!)

Rather a rambling post. So, epidurals. Good, bad or Ugly? What has been your experience?

Sunday, February 20, 2011

Name Change

Well, as you can see, I changed the blog name. I haven't changed the address so I hope this doesn't mess up anyone's bookmarks. One nice thing about the name change is that I was able to make it more inclusive - parents instead of mommy. Let me know if you have problems with accessing the blog.

I have another post in the works and hope to get it up either later today or tomorrow.

Monday, February 7, 2011

Health Insurance and you: Part II

My apologies for this delayed post. Due to Mother Nature's rain/snow/slush/sleet/freeze life has been interesting. AND...I had to call 2 branches of my own insurance company today. to make friends with your insurance company. First, as I said before, know what your coverage is and what it allows, as much as possible. Not only does it answer many of your questions, but it gives you a starting point if you do need to call the company.

By the way, in case you are wondering: if the company says your call may be monitored, rest assured that they are taping all calls; sometimes senior employees are also "listening in" to calls to make sure employees are doing and saying what they should be doing and saying. It's just a nice way to saying that you are being taped. Taped calls are also randomly audited, to check on employee accuracy and politeness.

(Star Wars Death Star Music)

(Pauses the music)
[This assumes this is your first time calling about an issue.]
Before calling, get prepared. Have a working pen/pencil at hand, paper, your insurance card, any paperwork you have that you have questions about. Plan to be on hold, so have a book/game, whatever to occupy your mind. Make someone else take care of the children's needs as much as possible during this time. And find out what hours the Customer Service reps are in (I like to call on get the available hours information pretty fast that way). Generally, the best times to call are first thing in the morning, both weekdays, and, if they have Saturday hours, on Saturday.

Additional note: re: holding and menus: I hate them too.

Hold times can't be helped sometimes. Most places try to keep them under 5 minutes. However, sometimes the fates conspire against you. One time, we had hold times under 1 minute. Then...we had a fire drill. Our phones shut down automatically to incoming calls (we have to say goodbye to whomever we are speaking to and hang up). All calls on hold were routed to our sister office. So, instead of 90 people answering phones, we were down to 30 people answering phones for over an hour. Hold times were dramatically increased, as you can imagine. If the hold time gets too long for you, hang up and try again later - or actually, earlier (see above).

Menus. I hate them. Press 1, say 5, give me your firstborn. If it is something that can be done through the menu faster (I need new cards), I will use the menu. But if I need to talk to a human to get something fixed (like my claims issues this morning), I'll skip the menu by saying "Operator". Generally the menu will then default to a human although you may have to hold to get one.

(Music restarts)

Call the Customer Service number on your insurance card. Be prepared to give your insurance number information, and other information they may need to identify you (my company always asks me to confirm my address and birth date, sometimes adding home phone number or work number). Then, be polite, calm, and specific about why you are calling:
I don't understand why you denied my claim.
This EOB is asking about other insurance and I have/don't have some/any.
My doctor wants me to have (an X-ray, CT scan, surgery) done and said I need to call about getting approval.

Make sure you write down the name of the person you are speaking with, and the time and date. Make notes as to their answer to your questions. While they are supposed to document all telephone calls, some are more diligent as to how much they write than others are. If you don't understand their instructions or information, ask them to repeat it another way. Make sure to get a call reference number for your notes.

If the call resolves your problem/issue/question, great. You are done. You remained polite, and they remained polite.

Now, what if, some weeks later, something goes wrong. Your claim is still denied, you had the surgery but it's not being paid for, you are being billed for services you don't believe you should have to pay for.

You need to call again. Remain as polite as possible. I well know how frustrating it can be (it took me 10 calls to get an ER bill paid correctly once...). Please don't scream, swear or threaten the employees. Some companies will allow an employee to hang up on a customer if they become abusive, others require the employee to call a senior manager. ALL states/companies take threats seriously these days so don't use physical threats of harm. Continue to note down to whom you speak along with the time and date. If, after another call, things are not corrected, request to speak to a supervisor/senior Call Representative. Again, note down date and time and stay polite.

(A company had a very frustrated woman once state that she would come over and bomb the company to kingdom come. The employee panicked, claimed that there was a bomb threat, and the whole building was evacuated. The police arrived at the woman's house and she spent some time in the police station until things were straightened out.)

If things are still not corrected, it's time for a certified letter. Send copies to your HR people and to the company. Spell out the time and date of all your calls, and to whom you spoke. Note in full the problem and state how you would like the problem to be resolved. Most problems are solved by this point.

Especially note if there are discrepancies in information - I spoke to Susie on X date at Y time, and also John on Z date at A time, before my surgery, who told me I could have my breast enlargement surgery covered by insurance so I had it done, but now my claims are being denied since you don't cover cosmetic surgery. If I had known it was considered cosmetic I would not have had it done. (Yes, this was an actual call. Due to the member being given erroneous information, which she had documented, as did Susie and John, the insurance paid for the cosmetic surgery even though it was not covered under the member's contract. Yes, Susie and John lost their jobs since they hadn't checked the contract information before giving their answers and their job description requires them doing so - John actually just used Susie's answer and never bothered checking!).

Also note if you are given 2 different answers, for the same reason as above. Sometimes people don't check for correct information and this is one way to get things paid for that may not be covered under your contract. However, if you get identical answers and know that's what your contract says, please don't badger for a different answer. That's unfair to the insurance employees AND to your co-workers who play by the rules.

Let's now say, for some reason, that you aren't getting the issue resolved. You/your child REALLY needs this surgery/drug/treatment/wheelchair and you aren't getting it. You know your policy should allow it (one of the worst issues a company has is when a member insists on getting something that their policy doesn't allow. Insurance companies don't want an unhappy member who might sue or go to the media, but they also have a legal contract with your employer so what can they do? The answer to this varies). The time has come for your first level of appeal.

First appeals are reviews of contested denials of service, generally internally, by a board of various people. Boards usually consist of medical directors (doctors who work for the insurance company), lawyers from the legal department, staff from the Patient care areas, and sometimes "members of the public" who are not employees. The issues are reviewed and may be approved at this level (yes we will allow this even though the contract denies it under X circumstances) or they may be denied yet again. Sometimes information is sent out to a separate review board at this level for their opinion. Other times, this occurs at the second level of appeal.

The Second level of appeals. Here's where things get messier. Some member contracts allow 1 additional level of appeal, some allow 2. Some require going to arbitration. There may be costs to you for these levels. Sometimes they are worth it to a member. Other times, they are not.

Generally, a member's last choice is to involve the regulatory commission that controls all insurance work in the state. Others will try to involve the media (letters to the paper, TV, internet). Depending on the issue, again, the member may win or lose. It can take months to years to get through all the levels of appeals. It is very individual, and only you can know for sure what is right for you and your family.

Try to work with your insurance company. You will both be happier.

(And yes, I did get my insurance issues worked out. Yes, it is frustrating, but we all make mistakes. Files don't get updated properly sometimes so you have to call and make sure they do so. Sometimes, it takes multiple calls - one of my coworkers had multiple claims denied for her husband and son because the computer system kept dropping their PCP. She had letters showing she called and the system had been updated, but it happened for nearly 2 years until a system update was put in. It seems the old system had problems with people with the same names in 1 family - John Smith and John Smith junior were seen as the same person, even with 2 VERY different birth dates, and the system couldn't figure out how to assign the PCP so it just didn't. Finally got that fixed.)

(Music fades away...)

Saturday, February 5, 2011

Name Change Request

So, I got a request to change the name of the blog because it is too similar to another blog's name. I am not unwilling to do so, but would like to have your thoughts as to a new name. Since I do want to include fathers, should I just try a name like "Parents are minions"? I think it might entail a link change, too, so am not going to do anything until I hear from you all.

Haven't forgotten about the insurance post. This has been a busy week, but with Mother Nature conspiring to keep me in the house today, I should get it up this weekend!

Saturday, January 29, 2011

Health Insurance and you: Part I

Health insurance. Love it or hate it, you have to admit it's a lot cheaper than getting sick without it. So, how do you get the most out of your health insurance? I will give you some hints. However, this subject will require you to do your homework.

First: like all good teachers, homework gets assigned first. Find out from your employer (if you don't already know) exactly what type of insurance you have and what it covers. Ask for a handbook, if you don't have one, and read it. You may have to go to your Human Resources department for the information. If they don't have a hard copy, ask if they have soft copy. If they don't, ask them to get one for you. READ IT. It will answer many questions you may have. (And you would be amazed at the number of people who have never looked at the information and are then VERY upset that something isn't covered).

A little secret that employers don't tell you: when they contract for health insurance, it's rather like the old Chinese menu joke: you pick from column A and column B and with 6 you get egg roll.

Health Insurance (HI) is like that. Basically, a HI company will give your employer anything it wants to offer to its employees, for a price. However, as usual, the federal and state governments have something to say about it, too. Depending on factors discussed below, there are minimum requirements that the HI company HAS to offer and your employer has to pick (AKA Column A). Then comes the fun part: what pieces can they CHOOSE to pick (AKA Column B)? This can vary depending on several factors: how many employees are there? What does the state require a company of your size to offer? Does your company want to be a "self-funded" group, if allowed by the state, or "fully-insured"?

What's the difference?

Self-funded groups basically work on a "pay as you go" method. They pay the insurance company varying amounts depending on the cost of the claims received that month (along with a processing fee). So, the amount will vary from month to month as to what your employer pays (not what you pay, if you contribute).

Fully-Insured groups pay a set fee every month. It does not matter what was paid out in claims- $0 or $1,000,000 - the company pays the same amount every month. This can be easier for the company to figure cost-wise, but it has some problems.

One reason is this: in many states, self-funded accounts are often allowed to "opt-out" of benefits that the state requires fully-insured groups to offer to their members. This drives up the costs for fully-insured groups (and is often a reason given for groups to change from fully-insured to self-funded; it's a cost containment measure). For example, certain benefits regarding the treatment of children with autism are mandated by my state. Self-funded accounts can decide not to follow the mandate and offer more or less (or none) of the services the mandate requires.

Next, we have the products issue: does your employer want to have only one type of insurance? What kind - managed care (like an HMO, POS plan, etc) or a traditional plan? Do they want to offer several kinds of plans? Do they have to/want to cover spouses, children, domestic partners? All of these things may be options or may be required by your state.

What's the difference between managed care and traditional ?

With managed care, most plans require you select a Primary Care Physician (PCP) who can be a pediatrician (for children), a family practice doctor (all ages the MD wishes to care for), or an internist/internal medicine doctor (typically an adults-only practice). This doctor acts as a general "gatekeeper" who sees you and decides if you need specialty care or not, and refers you to a specialist if you do. Generally, you need to stay "in-network" (IN) for all of your care for the best benefits. Most HMO plans do not allow a member to go "out-of-network" (OON) for care unless there is no IN specialty provider within a certain range of transportation. POS members may go OON but will have to pay more if they do so.

With most "traditional" type plans you can see any physician you choose, no matter what specialty, without a referral from your "regular" doctor (if you have one). If you belong to a PPO or standard traditional plan, you get better benefits if you see an IN provider but no referrals are needed.

IN providers: what are they? Basically, they are physicians (individual or groups) who have signed a contract with your HI provider for set fees. As a patient, you generally pay less if you see an IN provider. You often only have a "co-pay" amount for an IN provider, and, if the insurance company pays less than the provider charges (a common situation), the provider cannot "balance-bill" you for the difference.

OON providers: Obviously, doctors who are not contracted with your HI provider. They are not held to the fees an IN provider has agreed to, and they often can "balance-bill" you - which means after they receive the payment from your insurance company, they may bill you for the remainder of the amount they charged for your care.

Example: Jan has a "copay" of $10 if she goes to see an IN provider for care. When Jan goes to see Dr A, her IN provider, she pays $10 no matter what Dr A charges. However, Jan has been unhappy with Dr A lately; she feels he isn't helping her. She decides to visit Dr B, whom her BFF absolutely loves (and who belongs to BFF's insurance plan). Unfortunately, Dr B is not a participating (PAR) provider with Jan's insurance. Jan's policy states that when she sees a non-participating (NON-PAR) doctor, her insurance will pay 80% of "reasonable and customary" (R&C) charges and she will be responsible for the remaining 20% of R&C, and the difference between the charges and what is paid by insurance (balance-billing). Jan sees Dr B, who charges $300 for the visit. Jan's HI has decided (based on several components, one of which is 'What does Medicare pay for this?") that the R&C for the visit type Dr B billed is $100. HI pays $80, and Jan is responsible for the remaining $20 of the R&C fee, AND the additional $200 if Dr B decides to balance bill her.

Well, enough for tonight. Do your homework and enjoy the next part:

Part II: How to make friends at your Health Insurance Company

Wednesday, January 26, 2011

Quick Picks

I'll have more to post later but the snow calls for a shovel so it probably won't be tonight.

Sane Mom mentioned in the comments the post by Lisa Belkin "Seeing All Men as Predators". I read that when it came out because Lenore Skenazy mentioned it in her blog "Free Range Kids" (listed on the side bar). She has a lot of good information (and a book) about raising your kids in today's society without fear. My kids were pretty free-range. They walked to/from school, rode bikes to friends, went to the park and played. And they weren't kidnapped, molested, or harmed in any way (well, scratch that. My eldest has scars from falling off her bike 2 blocks from home and walking home, knee bleeding profusely, crying. But she made it home, with the bike, and in the house before I knew anything had happened).

I just got a list of items that per the Health Insurance Act, should be covered by insurance. Unfortunately, I left it in the office. Sorry! I'll review it later.

Speaking of insurance, I would be happy to write a post on how to make friends and influence the people at your health insurance provider if people would like to read it. (Yes, I DO work for the dark side of the force, why do you ask?)

Last on the agenda: a discussion about breast is best or bottle is better. I have my reasons for wording it that way, which I will explain in the post.

Comments and post suggestions are welcome. And if you have something you want to post for feedback, let me know and I'll happily add you as a contributor.

Edit: I turned off the sign in feature so those who want to post comments don't have to sign in. Capcha will remain off for now because I really don't like capchas, but if the spam gets back one or the other will be set up. I'll ask for opinions before I do that though.

Sunday, January 23, 2011

Gee, what do I say?

It occurred to me that people might wonder what they can say here, so I thought I'd give some life examples that they can start with.

Back in the day, pediatricians recommended you give tylenol to your baby 30-45 minutes prior to your vaccination appointment. Now, I've heard they don't do that. True? What has your pediatrician told you?

My child vomiting, for me, was the worst thing to deal with. I would generally retch in harmony with them, as I cleaned up their bodies, hair, faces, beds... It was always the odor, not the sound or appearance of the vomit. However, like all parents, I coped and tried to make them feel better. One "tried and true" treatment has been handed down in our family for 60+ years and we still use it.
Whenever a child vomits, the clock starts, and they may have nothing by mouth for 4 hours. Once that 4 hours is up (and the child is awake), the child may have 1/4 teaspoon of FLAT ginger ale or coke. If they keep that down, it may be repeated in 15 minutes. Repeat for an hour; if no further vomiting then the amount may be slowly increased to 1/2 teaspoon, after another hour 1 teaspoon, after another hour, sips. However, if the child vomits again, the clock resets for the 4 hours of nothing by mouth

This is not carried on for more than 24 hours; if the child (or adult) can't keep anything down for 24 hours, the doctor really needs to see them. It's effective for those 24 hour bugs with intermittant vomiting. If vomiting is continuous, or combined with constant diarrhea, then dehydration is a much greater concern and the doctor needs to be involved much earlier.

Nowadays, I suppose parents could try substituting fluids with electrolytes available. But we just always found coke or ginger ale more effective (provided it was real coke/ginger ale). My parents still keep coke syrup, which they can get from their local pharmacy, on hand for vomiting.

What family treatments do you use?

Welcome to Mommy Minions

Welcome, and I'm going to start out with an apology. I would like this to be a place where ALL parents, not just mommies, can openly ask questions about parenting, immunizations, whatever. However, I messed up creating the template so that's what the name is for now! And why minions? Tell any parent they are not at a child's beck and call (at least, when really needed).

Parents are welcome to post anything. I will ask that comments be respectful. I'm not against obscene language, necessarily, but don't want this to degenerate into a name-calling sight. While you may believe (and state) that you think someone's ideas are wrong or stupid, you may NOT call that person wrong or stupid.

As we grow, I hope to add links. I will be honest and admit that my HTML skills are very minimal, but we'll see what I can do!