Rant, Vent, Health Care my arse....

[miraclesrule]

So, it''s been a helluva week for my DD and her new month old. We discovered that the baby has an umbilical cord hernia. The thing keeps popping out and causing bleeding so the Peditrician asks her to come in today. The night before last my DD was up all night with a throbbing index finger because she was chewing on a hang nail. The following day, she woke up and it was swollen and filled with pus.

She is only 4 weeks post partum and breastfeeding so she cant'' take antibiotics. She gets the baby all geared up, shleps up her four flights of stairs and get to the doctors office yesterday for her finger. I tell her to demand a MSRA culture as she has a newborn and it was too freaky for her finger to swell like that overnight. The doctor told her she would have to go to the hospital ER if she wanted a culture.

She goes to the ER which is full of hacking, dirty, sick people so the hospital staff gives my daughter a surgical mask and she covers the baby and calls DH to come get the baby away from all the sick people. She ends up having to have the finger lanced, cultured and drained. The inserted a wick and wanted to see her back today.

So, the baby''s appt was this morning with the Peditrician. DD gets baby ready, schleps up her three flights of stairs, can''t find parking and has to walk several blocks to the Peditricians office with the baby carrier and the office staff tells my daughter that her insurance won''t authorize the visit. They say that the insurance company states that since my daughter had the baby on 9/23/09 she is covered for one month under the Mom and then extended under that same coverage until the 1st day or the following month, which is Nov. 1. Would have been nice to know that before my daughter went through hell to get there. She is still recovering from a 4th degree tear of the perineum. Anyway, my daughter gets on the phone with the insurance company rep and tells her that the baby needs to be seen. They tell my DD that she can take the baby to an Urgent Care and it will be covered, or take the baby to and ER or my daughter''s doctor and they will cover it. Which is stupid, because it will cost more. So my daughter just leaves with an appt for Monday.

Then she has to go back to see the ER doc for the follow up on her finger since she can''t take antibiotics. I tell her to call the ER and confirm that the same doctor is working today and what her shift time is so my daughter doesn''t miss her and can minimize the time she has to sit in the ER and get exposed to H1N1 since she has a newborn. The ER clerk responds with major attitude and tells my daughter that she is not going to give my daughter the doctor''s schedule and that many doctors don''t work every day and that she shouldn''t expect to be seen by the same doctor. My daughter was so exhausted that she didn''t have the fight in her to confront the cranky clerk who didn''t need to give her an education on the workings of an ER. The same doctor either was or wasn''t there and she should have answered my daughter. Needless to say, my daughter refused to go get her finger checked. I just want to whip a can of whoopass on everyone involved right now. But I sit here praying that they will both be okay.

I hate our system. Where is our humanity and common sense and pride in our jobs?

 

[swimmer]

Really sorry to read about her ordeal. Your poor baby and her poor baby!

 

[robbie3982]

Sorry she''s having such a rough time! She really needs to get that finger looked at though! Same thing happened to DH''s finger for no apparent reason a few weeks before I had DS. He had cellulitis and without treatment it can actually be pretty serious. His uncle was in the hospital last summer with it and they were talking about having to amputate his leg if they couldn''t get the infection under control (they finally did).

 

[kama_s]

Most antibiotics pass the breast membranes in very very minute amounts and can be safely taken during breasteeding. Call a Teratology Information Service in your area if you want information on an exact antibiotic.

Hope your DD and the baby get well soon

 

[iluvcarats]

Can she get a new Pedi that accepts her plan?

They should have known beforehand that the ins. co. wouldn't cover her visit.

Sorry about her ordeal. Sounds like she had a very difficult birth

 

[february2003bride]

Miracles- I am SO sorry to hear what an ordeal your DD has gone through! I do want to tell you that certain antibiotics ARE safe while breastfeeding!! Erythromycin, Zithromax (a form of erythromycin), and forms of Penicillin are safe. Only small amounts go into the mothers breastmilk, if any at all. It''s much better for the mother to take one of the medicines and the baby get minute amounts in the breastmilk than the mother to get seriously ill from not taking a much needed medicine. She can speak to her ObGYN or a lactation consultant for further reassurance.

 

[drk]

Sounds like a crummy week.
Most of the time they won''t do anything about an umbilical hernia unless bowel is getting stuck in there and can''t be reduced. Not worth the risk of surgery for a small infant. Not sure what they''ll suggest if it''s bleeding where the cord was.
Ditto what the others said about getting on antibiotics. Many are safe when breastfeeding, and if the cultures came back showing something that''s not covered by one of those meds, she''d be better off pumping and dumping and take a brief course of whatever is recommended rather than running the risk of getting some nasty spreading infection or even sepsis from the finger. Getting really sick won''t help her milk supply at all.
Around here, I think if someone showed up at the ER for a nasty finger infection, they''d be given a clinic appointment (whether for surgery or family medicine or plastics) to follow up on things. No way would they want a patient to show up at the ER for a follow-up. I know they would definitely not tell you when a certain doctor would be working, nor would you be likely to see the same one (they could be working minors one day, majors the next). Best you could hope for would be to tell the triage nurse you were there for follow-up, so they could pull your old chart and ensure that the doctors had everything they need at their fingertips when the see you. Of course, for something minor here, you''d be waiting a good few hours to be seen anyhow. The system in Canada might be less efficient though.
Hope they''re both feeling better soon.

 

[icekid]

Date: 10/29/2009 12:11:49 PM
Author: drk

Around here, I think if someone showed up at the ER for a nasty finger infection, they''d be given a clinic appointment (whether for surgery or family medicine or plastics) to follow up on things. No way would they want a patient to show up at the ER for a follow-up. I know they would definitely not tell you when a certain doctor would be working, nor would you be likely to see the same one (they could be working minors one day, majors the next). Best you could hope for would be to tell the triage nurse you were there for follow-up, so they could pull your old chart and ensure that the doctors had everything they need at their fingertips when the see you. Of course, for something minor here, you''d be waiting a good few hours to be seen anyhow. The system in Canada might be less efficient though.

This is also true of the US. The clerk was probably a PIA because ER physicians are not in primary care and they generally do not perform follow-up.

Sorry about the problems, Miracles. No system is perfect! Hope your two girls are feeling better asap.

 

[packrat]

Good lord what an ordeal! I was on antibiotics when I was nursing the kids, so ditto what the others said about that.

Seems like a bunch of needless rigamarole for an infected finger. Also seems like an odd way of seeing patients-directing them to the ER and doing follow ups there. Especially one with a newborn. Um, duh? Our hospital has 2 separate Dr''s offices inside..the hospital clinic has 5 providers and our office has 3. The ER just sends them to either their clinic or ours, during business hours, and if they need a culture, the hospital lab does it, and they wait there or at the providers office. I''m guessing your daughter is in a big city?

What a pain in the butt for her..I hope her finger heals quickly.

If the baby is covered until the 1st of November, how come the visit wouldn''t be covered?

 

[miraclesrule]

Thanks everyone for putting up with my rant.

I deal with health care professionals all day...I am an insurance risk manager, so it comes with the territory. My daughter is not. I am aggressive, she is more passive.

I guess that is what pissed me off the most. Knowing that it could have been prevented.

The baby is covered for 30 days after the birth under the mother''s name and not their own name, however, if the 30th day is mid-month, the child is covered the first day of the following month. My daughter could have taken baby in to Urgent Care or to the ER, but we knew that umbilical hernia was NOT an emergency.

It''s the lack of communication that peeves me the most. My daughter had to get her baby and herself dressed, walk up four flights of stairs, get in the car, drive to the Pedi''s office, no parking, park a mile away, cart the baby all the way...just to find out that she would have to wait until Monday. Totally unnecessary. It''s the information, communication age people!!!! Anticipate needs!!

Anyway, her finger feels fine now. Good to know. She never did go back to the ER for the infection. She was spent. She knew that if it continued to get worse and not better she would go back and get some safe antibiotic. I just tend to go into orbit over things that could be prevented with adequate communication. It is one of my pet peeves. I always freak out over it. I''ll live.

 

[iluvcarats]

Glad everything is OK and she is feeling better.
Sometimes the Mama bear in all of us just has to come out.
It doesn''t matter how old your baby is, sometimes it feels like the umbilical cord was never cut.

 

[miraclesrule]

iluvcarats....

SO TRUE!!! I don''t think that umbilical cord was ever cut. I trip over it everyday.

 

[MustangGal]

Yeah, babies have to be added to the insurance plan within 30 days of the birth, your daughter''s company should have told her about that before the birth, sucks about the office not saying anything until she made it all teh way down there! And antibiotics can be safe, I was on giant doses of ammoxicilian the week after delivering due to developing a blood infection. The pedi told me it wasn''t a problem to keep breastfeeding.

 

[Bliss]

I'm so glad your daughter is feeling better - dust to her and your dear GD!
Mama bears can totally growl when their cubs aren't getting the care they deserve! Way to go, Mama Bear!

Glad it got sorted out and DD's finger is better.

 

[soocool]

Hope your DD is doing better!

Insurance rules do suck. For my routine mammogram I have to wait 365 + 1day or insurance won''t cover it. Luckily I was reading something at our insurance website and saw that and my appointment was the following day ( 2days short of the rule). I changed the appointment in time.

Also, it doesn''t matter if your insurance company changes, they communicate with each other. For example, I had a restoration done on a tooth 6 years ago and unfortunately have to have another one done on the same tooth. DH changed jobs a few years ago and even though the original restoration was perfomed while under one insurance plan, the new insurance company made sure that it has been at least 5 years. And I even switched dentists since then. I think that is ridiculous.