Sunday, April 23, 2017

This Month's Disaster.....

We all know that Larry has a....delicate gut.  Our experience with last years' 4th of July fireworks aftermath (Sure Fire Paint Remover...) was just one example:  It took two weeks to get his tummy settled.  He can't eat people food, and we have to be careful not to switch up his dog food either.  And he's REALLY not the guy you want on a long road trip. So when he stopped eating for a day early last week, we didn't really think too much of it.

The second day, he ate some.  And then he didn't.  And then a little, and then...not.  And then came the poops.  We came home to a house that smelled like a cross between dog doodoo and death. We spent some time trying to imagine WHAT he could have gotten into and came up with nothing. He's either in the house or on a leash all the time.  The second day of this horror, he hit a bathmat.  I rinsed this out in the toilet and realized that I was seeing a LOT of blood.

Needless to say this was on a Friday evening.  Our vet has no weekend hours.  Over Friday night to Saturday he began throwing up as well, and by Saturday morning it was clear that he wouldn't make it to Monday without some professional help.

What is it with kids and dogs?  Do they all absolutely know for SURE when the doc's/vet's office closes??

There's a lovely animal walk-in not far from here.  When Simon had a tummy bug a couple of years ago they fixed him up, but they made it clear then that he was at the outer edges of what they could do on site there.  Larry was clearly a few steps over that line, so I called the Vet Hospital emergency line and they invited us on over, after informing us that there was a minimum $150 fee for weekend emergencies.

(I checked the place out online before going. Our other option would have been Cornell Vet center, an hour away, and they also ask for you to pay up front.  The reviews were either "They did a great job," or "They were great but expensive," or "What kind of bastards won't even care for your dog if you can't pay??" Personally, I understand your pain if your pet is suffering and you can't afford a vet, but dissing someone because you expect them to work for free seems unreasonable to me.)

The initial evaluation was reassuring, but the differential diagnosis somewhat alarming, as I expected.  The tests to rule out the ugly stuff was what set us back the most.  IV fluids, antiemetics, antibiotics were given and he looked like a new man when we walked out the door.  He's a bit tired today still but eating and walking, and no more of the runs.  We have a couple weeks of special diet, medications and probiotics for him. We will see our (much more affordable) regular vet in a couple of weeks for follow up.

Hemorrhagic gastroenteritis.

It usually hits little dogs, and tends to be related more to stress than infection. Untreated, it can be fatal in a matter of days. They asked about stressors, and I really couldn't think of anything in particular.

But as I was walking this morning I pictured Easter from HIS point of view:  Five extremely excited children ramming through the house at high speed screaming about baskets and eggs and CANDY and baskets and EGGS and eight or ten extra adults crammed into his space talking and laughing and eating and maybe some goodies being dropped on the floor for doggie cleanup and.....

Who knows.  He's a good boy.  He's had Thanksgiving and Christmas under his belt already, with the same people and chaos, more or less.  This might have just been one too many.  We might have to make sure he's upstairs and quiet for the next family gathering.

At our house we joke about the $1000-disaster-of-the-month.  This will do for April.

DeeDee

Sunday, April 16, 2017

Odd Things....

Easter Sunday is always wonderful. Crazy busy, but wonderful. Today was blue-sky sunny and 75.  Eggs were hidden outdoors, so the one we inevitably didn't find didn't matter. Dinner was perfected by that one daughter who stepped up and said, "What can I bring?" and doubled down with three choices on the veggies. Dinner is early on Easter, so there is plenty of time to sit, relax, and let the mind wander.

It's been an odd couple of weeks.

Babygirl's recent doctors visits were not bad. Her labs were drawn a week ahead, and she happened to be ill, so we had to redo them because they were a bit off, but the repeats were fine.  Her Botox injections finally appear to be paying off, and she's had more headache-free time than she has in a very, very long time.
Meanwhile, our insurance insists that the last Botox injections were experimental therapy and won't pay for them.  They DID pay for the ones before that, and the ones before THAT, and so on.  In fact, they covered the first two sets without argument and I've had to fight for each one since.  W. T. H.

My thumb has been healing slowly with no recurrence of infection.  My wrist and my shoulder, oddly, still bother me, because I tweaked them all over the place trying not to use my thumb.

I am dealing with a patient in my office who believes he was bitten by a pit viper while visiting Daytona Beach.  Given the nature of his story, I'm guessing that I might be exploring my first involuntary commitment if his leg isn't getting better.

My washer died Thursday. I discovered it when I went to move Thursday's was to the dryer and put in Friday's load.  There was some kind of error code flashing, so I just opted to try to restart it.  It pumped out all the water and then just kept pumping. And pumping. And pumping.  Since this was clearly not helpful, I pulled the plug and waited for the 'door locked' light to fade out.  The door remained locked.  I plugged it back in, hoping it had forgotten whatever it was on about, but NO, the endless pumping resumed.  I unplugged it for several hours.  Rinse. Repeat.  It's stuck on trying to empty when it's already empty, and permanently locked.  This would be less of a problem if nearly every bra I own wasn't in there, sopping wet, and, I imagine, getting fairly nasty.  I'd go shopping for more, but it's Easter Sunday and, ewww, Walmart bras?  Besides....

I found a killer mother-of-the-bride dress yesterday.  Bella is getting married in the fall, and although she didn't stay with us as long as her sister JuJuBee did, she asked me to be Mom for the wedding.  (In other news:  I saw a picture of myself from this morning and I didn't look.....bad.  Sometimes I forget how much weight I've lost.)  So although the dress was reasonably priced, hosting Easter dinner, putting together Easter baskets, and buying a fabulous dress doesn't leave a budget for new lingerie, especially if I need a new washer.  Hopefully our repair guy will be able to liberate them tomorrow and I can used Curlygirl's washer to finish washing them.

We are considering a fence for the yard.  Capone is just that crazy. And the grandkids are just to little to trust with the doors.

It's our second Easter without Mom.  Maybe SHE took the missing egg. It was always her before.

DeeDee


Tuesday, April 4, 2017

Fiscal Year 2016....

I am, as always, behind on paperwork.  Our tax lady doesn't even bother scheduling us until April, and as always I put everything off until I have no choice.  It's a genuine pain in the hiney to do our taxes. Sorting the medical crap alone can take HOURS.  But....it's done.

Historically, our worst year was transplant year, 2012, with a total of $19,157 in out-of-pocket medical expenses (and 14,701 miles traveled for medical purposes!), and our best since then was 2014 with $5,500 out of pocket and 2015 with only 2,261 miles of travel.

2016 had some interesting challenges.

Our insurance has changed the way things are reimbursed and we didn't figure this out until bills started rolling in after Babygirl's February blood tests.  Our home hospital and her new neurology center are "Level One" providers. Our deductible for the family using these providers is $4400/year.  The hospital where Hubby gets his pain management, and Children's Hospital of Philadelphia (where Babygirl gets all of her transplant-related care) are Level Two providers.  Our family deductible there is $8800/year.  Hubby's pain management sends tests to a Level Three lab, which is not covered AT ALL.

Babygirl's first set of blood tests at CHOP in February came to just over $10,000.  We ended up owing about $3500 for those visits (I negotiated $1500 of her neurology visit down to $200, just settled: The insurance said her treatment was "experimental" even though they had paid for the SAME treatment three months earlier) but the rest was lab costs, and I had to set up a payment plan.  I learned that if I had had the labs drawn at home, it would have cost half as much, so all further labs were done here to decrease our portion of the costs.  Hubby's Level Three lab cost is still under appeal.

So.

Pharmacy costs:  $3,415.90.  That includes two $300 co-payments for Botox.

Medical copayments and deductibles: $7,302.

Mileage: 3,040 (worth $.19/mile for tax purposes, $577.60)

Tolls and parking: $157.27

Grand total out-of-pocket:  $11,834.77.

$985.40/month.

Add an additional pre-tax $215 for our part of health/dental/vision that comes out of my paycheck, sight unseen.

We'll do a bit better this year.  All Babygirl's labs will be drawn locally.  We're considering whether switching Hubby to our hospital's pain management program is reasonable. Babygirl has been taken off of some medications, and there are no copayments for Botox at her new neurologist's. But this is the second year in a row our costs have come up, and with the loss of Hubby's income last year the hit was especially onerous.

DeeDee

Meeting a Donor's Mom....

During my recent hospital stay, the discharge planner asked the usual questions:  Are you safe at home?  Do you have any trouble getting and taking your medications?  Do you have any mobility issues inside your house?  But there were two rather interesting questions.

"If you needed a caretaker, who would that be?"

Well.  When my headaches were kicking my butt, hubby stepped up and did the muscle work: Shopping, cleaning, parenting, whatever I couldn't manage at any given moment.  He's in no shape for that right now.  My response?  "That just can't happen."  She looked a little nonplussed, but I suspected it wasn't the first time she'd heard something similar.  Then:

"Do you have any concerns about how you'll pay for this hospital stay?"

I actually laughed out loud.  She went somewhere beyond nonplussed.

"I have a child who had a kidney transplant five years ago.  Medical expenses are $1000/month line item in our budget. I'm just taking the hit for team this year and meeting our deductible."

Her eyebrows hit her hairline.  So we chatted about the realities of the expenses of it all.  And then we chatted about her reality:  Three years ago, her twenty year old son died and became an organ donor.  She'd not met an organ recipient, although she had letters from some of her son's.  I asked if she had written them, and she said, "I haven't gotten to that place yet."  We talked about Jorge, and his parents, and Babygirl, and suffering.

"I have to look at it this way:  I got to be his mom for 20 years, and it was the most amazing thing that ever happened to me."

I feel the same about each and every one of my kids.  They are, collectively and individually, the best part of my life and heart.  I've never had to say good-bye to any of them, and I hope I never, ever have to.  But if I do, I hope I do it with the grace and courage this woman has.

DeeDee

Friday, March 24, 2017

MRI-asana......

Yesterday morning gave an update on the thumb injury.  It didn't quite carry it far enough, apparently.

Each workday since the injury, I've had the same nurse unwind the ACE wrap, pull of the gauze and really LOOK at the boo-boo with me.  Monday - okay, not bad - and a whale of a lot better than the massive Sunday morning swelling that I had before my dose of Godzillamycin.

Tuesday, same.

Wednesday?  That drainage looks a little....yellow.  And what do you think? Is it more red? No?

Thursday I start work late.  So after I did yesterday's post, I got the bandage off.  Hmmm... That's DEFINITELY more red. And more swelling.  And doesn't this area feel a little mushy to you?  So, naturally, since I had a million patients scheduled, I kept working and went to the walk-in after work. (To give me credit, I did call my doc.  He was off work. HIS little girl was home with influenza and a fever.)

The walk in doc heard the story and basically said, "So what do you want ME to do about it?" and sent me to the ER.  The ER called in the troops and had me admitted.  So I've been on IV antibiotics for over 24 hours, and the thumb is looking better. Orthopedics have me in a bigger brace. Infectious disease ordered an MRI and won't let me go home without a second look tomorrow.

MRI with AND without contrast.  Thirty minutes of lying on my back with my broken thumb jacked up in an awkward position while IV fluids continue to fill my bladder.  Yoga practice to the rescue!  I was the longest, noisiest shivasana EVER, but I actually fell asleep for a couple of minutes.

Sigh.

I tell my kids all of the time that intelligent people are NEVER bored.  It's true. But sometimes we ARE at a loss for things to do. I should have grabbed my Sudoku book.

DeeDee

Thursday, March 23, 2017

Thumbs....

It's been 5 days since I put a drill through my thumb.

For those of you who didn't hear the details.....

I was working with the mission team at about 9:30 AM Saturday, making Christmas ornaments out of wood to sell as a fundraiser.  As I was drilling through one piece, the 3 mm drill bit snapped.  I had quite a bit of downward pressure on the drill, so when it bucked sideways, it went into my left thumb.  Since there wasn't much left of the bit, I avoided impaling myself to the table, but you can see; looking at the side opposite the entry wound, just how close I came to having an EXIT wound.

There was a 3 mm entry wound and a good bit of bleeding.  My tetanus shot was up-to-date, so I had a teammate bandage it up, mopped up the bloody floor and continued working.  It was just my left hand, after all.  I changed the bandage about 5 times over the course of the day as the wound continued to bleed (a good thing for a deep puncture - you want it to wash itself out, really).  At our 11 PM bedtime, I took the bandage off for a final cleaning and fresh dressing and realized it was throbbing a bit.  And....there were some red streaks headed up past my wrist into the forearm.

Well.  That's not good.

So I did what any sensible person would do. I went online and checked out the ER wait time.  It was a little over 2 hours.

I did the math.  Two hour wait, 4 hour treatment time.  Added up that equalled no sleep, and I'm on call tomorrow.  Yeah, nope.

I took three Advil and went to bed.

When I got up in the morning it didn't look any worse (nor any better, truth be told) so I checked the ER times again. Twenty minutes?  Hallelujah!  I preregistered and was assigned and arrival time in 45 minutes, time enough to eat breakfast (NEVER go to a hospital on an empty stomach, never ever ever) and pack my gear.  I arrived ahead of schedule.

X-rays showed that there were no drill fragments in the thumb, BUT!  I had managed to knock some bone fragments off the edge of the joint with the drill bit.  I done broke it.  It really didn't feel that bad, honest!

The ER doc had an out-loud mental discussion about what antibiotic to use given my list of allergies and recent bout of C. diff, and opted to give me a dose of IV Godzillamycin while I was there to jump-start the treatment.  He also scolded me for waiting.  I'm not thinking that what amounted to a 5 hour delay in starting that antibiotic really mattered a lot, but time will tell I suppose.

I was back at church before the service was over.  Early Sunday morning IS the time to be in the ER.

So.  It really doesn't hurt much.

But you can't button your jeans with only one thumb.

You can't hold a dog food can and fork out the food with only one thumb.

You can't cut meat like an adult with only one thumb.

You can't open ziplock bags with only one thumb.

And for absolutely sure you CANNOT remove a 4-hook bra at the end of a long day with only one thumb.

DeeDee

Tuesday, March 14, 2017

A Homey Blizzard...

I grew up south of Buffalo.  OMG BUFFALO! People say! SO much SNOW!!

Well, the honest truth about the city of Buffalo is that it is generally sunny, fairly windy, and not too snowy. (Think about it.  If it got 10 feet of snow at a time ALL the time, would it make the news when it did?  I mean, who ever reports on a snowstorm in Syracuse?? In 'Cuse, a snowstorm is just SSDD, right? In Buffalo, it's an Event.) In fact, if you listen to weather reports in the area, you generally hear things like, "In the city we expect 2 - 4 inches of snow overnight. But in squall areas south of the city we can expect up to 18 inches."

"Squall areas."  "The Snow Belt south of the toll booths."  "South of Rich Stadium."

Call it what you will.  It was my Dad's driveway.

It wasn't at all unusual for us to get 6, 8, 10 inches and go to school in the morning with the snow still coming down. We used to speculate the the superintendant of schools had a bright sun and blue sky painted on the inside of his window shades.  When the snowfall got above a foot, there was one area where the buses just couldn't get to, so those few kids down in the valley simply didn't make it to school.  It had to approach nearly 18 inches in one snowfall to make them close the schools. Snow commonly started in October. We were frequently ice skating on ponds at the end of November.

Our town was Prepared. They started running plows when the first flakes flew.  Our town had SIDEWALK PLOWS.  Seriously. Sidewalk plows.  I miss those babies. Especially today.

We've had 30 inches of snow since midnight.  They cancelled school preemptively.  I've shoveled the sidewalk three times and my FitBit says I've done 15,000 steps even though the dogs only got walked a mile. I've helped dig out about 8 cars.

I'm sitting here with hot tea, getting ready to assemble some goulash and put a pumpkin custard in the oven. I'm supremely grateful for a large number of things:

Central heat.
A gas stove.
Neighbors who help you dig your car out (and who get excited when they get paid in organic Farmer's Market beer).
Neighbors who can't dig themselves out, and the strength in my own arms to help.
Fleece blankets.
Warm socks.
Snuggly dogs.
Well-stocked cupboards.
Candles.
Childhood memories.
Memories of my children's childhoods.

No matter what our day-to-day struggles, having that odd event that makes us completely switch up our lives and schedules can trigger gratitude and reset our hearts back to a quieter, more elemental time.  Snow.  The smell, the beauty, the challenge.

DeeDee