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Sleep Study, Broken Metatarsal and a Broken Medical System

Yesterday afternoon I was writing up a humorous blog post about our sleep study adventures. It was filled with funny antidotes about our trip, including: yet more bathroom breaks with Apollo, him yelling that he had to go poop and “my butt crack hurts” <—– not language I approve of, by the way. Stories about how I was going to avoid he mistakes Chuck made at Apollo’s last sleep study (he fell asleep in the van on the way there, so wasn’t tired at bedtime and Chuck forgot the melatonin and a movie for him to watch) and made my own mistakes instead (forgot an extension, so I had no way to tube feed Apollo) and driving off without my coffee from our Starbucks stop at 6:30 yesterday morning.

While I was writing that post, I got a call from the school to pick up Mordecai because he “twisted his ankle”. In reality, he broke his fifth metatarsal. I managed to get him an appointment at our doctors office (instead of rushing to the ER). And that was my mistake. Despite have a broken foot that need a boot-type cast and crutches, we didn’t get pre-authorization, so I was sent home to wait until the insurance company authorizes it. Sent home for the weekend, I might add, because it will take a few days and they may need to wait until Monday start the process. Now, keep in mind, if I would have taken him to the ER (and been using the resources designed for real emergencies AND costing the insurance company much more money) they would have taken care of it  then and there.

Because I know someone will ask, Mordecai has insurance through his Adoption Support. He’s had this insurance literally since he was born. It is supposed to cover all medical care and mental health services. Which is does, in theory, but I have been working since September to get him into to see a psychiatrist for some very serious issues we’ve been dealing with and FINALLY have an appointment for June 19. Nine months is a really long time when you’re dealing with mental health issues. He was all set to be evaluated at Seattle Children’s Hospital, but that was cancelled when Children’s lost many of their contracts with insurance companies after the recent changes to Obamacare (Affordable Care Act).

Add to this the fact that on the way to Apollo’s sleep study I fielded two calls from Children’s saying that insurance company (different from Mordecai’s) wouldn’t approve the sleep study, but to bring him in anyway, since he needs it done.

Needless to say, I was mentally and physically drained last night. I had to cancel a photo shoot I had scheduled, while I dealt with doctors, pharmacies and picked up pain meds for Mordecai. My sense of humor has been completely zapped as I fight to get proper medical care for my children. So instead, I leave you with this video Apollo and I made of his sleep study. Enjoy!

16 Comments

  1. Court

    Your video is so darn adorable! What a great way to funnel some stress. Wishing you and your family restful nights & insurance company cooperation. :]

  2. northofdelaware

    Just wanted to send sympathy. My wife (a family physician) also complains about how much time she has to spend with insurance companies getting them to provide care for some very sick patients she has. It’s hard and disheartening. The system is so broken and overburdened

    And I am so sorry that Mordecai has gone without the psychiatric treatment he needs. That has got to be grueling and heartbreaking as a parent. There is a lot of mental illness in my family (I have been waiting nearly 2 months to get into a perinatal psychiatrist) and it is its own kind of exhausted struggle. Mordecai is fortunate that his parents continue to persevere and get him the treatment he needs (it surprises me that all parents don’t…but many don’t.)

    • bakersdozenandapolloxiv

      Samantha- thanks for your comment. Yes, it is scary waiting so long for mental health services. At times I have wondered if it was going to take a huges, scary “incident” to get him the help he needs. I am praying his initial appointment next month qualifies him for the care he needs. I am very angry with the state of Washington right now. They offer “mental health services” sure…what they don’t tell you is you may not be able to access them for your child when he needs them. Most local mental health providers won’t take his insurance. The last doc I tried to get him in to see had a waiting list that was over a year long! And didn’t take his insurance. So if I wanted him to be evaluated, and was willing to cash-pay, he could be seen summer of 2015!

  3. Melpub

    I love the video! The music is great. Hey, you launched a video of Apollo XIV!
    About psychiatrists: is there any possibility of a hospital or an institute that would offer free services as part of a study–or free services of any kind? You’d want to meet the person providing the service, who will almost certainly be a student under supervision who is studying adopted children. But inexperience is not necessarily something to avoid: sometimes an inexperienced clinician has a fresh perspective, plus the energy to provide something worthwhile.

  4. Jessica

    I have talked to many doctors, surgeons, and nurses who are not pleased with the Obama Care. They say it is dealing care, causing to many patients in their office so they dont have the time necessary to spend with patients, and its allowing the insurance companies to pay less. Even worse is the thousands of people who lost their insurance.
    I am truly sorry and sadden to hear how the system has dropped the ball to take care of the children who need the help most.
    If I may ask, are you trying to get Mordecai in the see in to see a psychiatrist or a psychology? I ask because they are often mixed up. If so far you have tried psychiatrist, may I suggest a psychology for now? They may be able to offer some relief with talk therapy and assist you in getting him in to see a psychiatrist. I benefitted from seeing a psychologist. I have to admit I see the best psychiatrist in my area for what I deal with. I am told good psychiatrist are hard to find.
    Something to keep in mind that I had to learn the hard way… if a psychiatrist prescribes meds, please look up any meds his general physician may prescribe afterwards. GPs are often not fully aware of the side effects of mixing psychiatric meds.

  5. sarah

    I live in Wa state too, and adopted through the foster system. In fact, the law created to give adopted kids insurance, was created by my friends mom. Im really surprised to hear this with m. He should have an “open coupon ” with unlimited times for services and should be able to go almost to any doctor. (Except doctors that take CHIP ). I know I have had to tell the docs that it is an open coupon and it can be billed. I would call the state and make sure its open because it should be. 🙂 I am sorry to hear abot your struggles, and am praying for Apollo and now m. 🙂

    • Kara

      Sarah, Open coupons went away in WA except under very specific circumstances (when a child is already seeing multiple specialists that aren’t covered under the same plan and there is no way to switch without putting their life in danger) with the roll out of Obamacare in January.
      Even before that there was a very short list of providers who would accept it and long waiting lists.

      • bakersdozenandapolloxiv

        Kara- this is the first time in 11 years we’ve ever had an issue with his insurance card.

    • bakersdozenandapolloxiv

      Sarah- this is the first time it has ever been an issue and he’s 11. He’s had 4 surgeries and everything has always be covered 100%. The mental health stuff really sucks though, most providers here won’t take it. We are having to go through Catholic Community Services to even get the ball rolling.

  6. Suzan

    I cannot answer for the USA because I don’t live there. But I feel for you and your frustrations. It seems nothing is every simple and easy. The powers that be build expensive obstacle courses in an effort to “save money”. Hugs for you. I feel for the broken foot. I broke mine about eight weeks ago and it was four weeks before I could even obtain an X-ray. May be I should scream more.

  7. amulbunny

    I broke my 5th metatarsal and instead of the ER we drove to downtown LA (from the beach) to our 24 hour urgent care. They half casted it, gave me some RX for the pain and I had to get a referral from my PCP on Monday to see the podiatrist to get it taken care of. It happened on Saturday night and I didn’t see the podiatrist till Tuesday. It did heal on its own, which was good because the Thursday after I broke it I had shoulder surgery so I couldn’t use crutches. I was in a black boot for 10 weeks though.

    I have my own b&^%h about insurance. My adult daughter who is 25 is covered under my medical insurance through a government agency. She moved from CA to IL and our insurance doesn’t cover IL. So hopefully she can get insurance through her new employer and I won’t have to worry about it. She can however go to an ER and be treated.

  8. Penny

    Love the video! Sorry for the insurance problems. I lost my insurance last year, thanks Obama care. I hate that your kids are paying the price. We have a family member who needs mental health help but is going untreated and it’s not good. I hope you can get the help they need.

  9. Lara

    I am so sorry for your struggles with insurance. I am in American living in nz and have followed this blog since Apollo’s birth. If it’s any help we wait the same amount of time for surgery here. To see a specialist takes months…. My son had to wait 6 months for kidney surgery that left him peeing blood and unable to play. Thank goodness he is homeschooled or he would have missed months of school! So you aren’t alone xx

  10. Jess

    I keep spreadsheets for coverage and constantly badger my heath providers since Obamacare started. So frustrating! I caught them over charging twice! Big mistakes too. I am so angry about it all, especially since I pay through the nose for our family’s coverage!!

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