update: the health insurance cirucus

"So I says to the guy..." Charlie has been approved by our insurance company for, get this, a single day of inpatient feeding therapy. One single day. After that, our appointed caseworker and the insurance company’s appointed caseworker will duke it out for approval of continued care in seven day increments.

Who comes up with this shit?

The minimum amount of time recommended for successful feeding therapy is four weeks. So if the insurance goons decide to pull the plug early, and his therapists see value in him continuing on, we have decided we will do what it takes to keep him there. Sell my car (we own it outright, finally), fund raise, sell blood, prostitute the cats, whatever it takes. The cats have not been informed of our plans. I figure it’s something we’ll introduce to them slowly. With cat treats. They’re pretty blind to reality when there are cat treats involved.

Things have started to feel particularly desperate this week with regard to Charlie’s feeding tube. He’s gotten very dextrous and it’s nothing for him to yank it out of his face – a trick he has started performing WHILE BEING FED. It’s also impeding his development. We can’t let him roll over at night, for fear of him getting it wrapped around his neck. We can’t tape it to his back to avoid him wrapping it around his neck because he rolls over on it and pops it open, leaving him soaking in his own stomach contents. THAT was a fun night. I didn’t cry, but I’m pretty sure that was because of the meds.

Plus, we’ve run out of the tubes provided by the hospital during his stay in June. And our insurance, NATURALLY, doesn’t cover home health, which would provide us with more. We have to buy them ourselves. At $20 a pop, and Charlie yanking them out six, seven times a week, well, he’s got some expensive habits, this one. Truly, it’s not even the money. It’s the stress of it all, hovering over us. Am I going to get to sleep for more than a couple hours before he pulls his tube out again and I have to intubate a screaming baby at 3AM?

Loves his Dr. Scott! On top of all of that, Charlie is fed by gravity, through a large syringe. If he decides he doesn’t want to be fed and starts crying, it forces the formula right back up the tube and out the syringe. He more often than not does NOT want to be fed. This place is like a circus. Thankfully, he’s become a fan of PBS’ Dinosaur Train and that buys me about ten minutes of tenuous bliss. And he’s wild about the show’s paleontologist, which is so funny to me. That’s Charlie, in fact, watching Dr. Scott. Grinning like a fool.

I just want a baby who eats. From his mouth. And enjoys it. He’s changed so much since getting that tube – always a little fussy, always on the verge of emptying his stomach onto my lap, one way or another. I want him to crawl and roll and sit and laugh and swallow. I don’t cry, but I want to. I feel it down there in my stomach, rolling and gurgling. I know it’s the antidepressants keeping it there, but sometimes, I think I might feel better if I just got it all out.

Thank you for all your prayers and well wishes. They mean so much. And thank you for the donations – I know I promised thank you notes last week. They’re coming, I swear! I couldn’t be more grateful to you all.

a dry update and a wet baby

Untitled A week ago, the biopsy results from Charlie’s endoscopy came back (normal) as did the labs they drew after the endoscopy was performed (not normal). The blood work revealed elevated levels of an enzyme (CPK) that indicate for muscle distress/deterioration, which along with another elevated enzyme from a previous test (Aldolase) are markers for things like muscular dystrophy. I felt like I’d been sat on by a rhino. Squished. Squished and nauseated. Although the gastroenterologist assured us there were muscular dystrophies that were nothing more than a nuisance, I wanted to be heavily medicated or drunk – it was too much to handle. With our neurology appointment more than ten days away, all we could do was wait.

Thankfully, there was a cancellation and we were able to see the neurologist this morning. Charlie’s fourth ‘ologist. The short of it is, he doesn’t think Charlie has muscular dystrophy, but he will reevaluate him in three months for any regression. The longer of it is, I had done some research on CPK and knew that elevated levels can be reported if it’s a particularly difficult draw. They had to try three times to get his blood that day. I could hear him screaming from the other side of the door. He still has little bruises on his hands, feet and arms. I mentioned this to the neurologist who confirmed my suspicion and said Charlie’s CPK levels should never have been checked after the endoscopy. Of course they show muscle distress – his muscles had just been cut on. He hasn’t explained away the earlier elevated Aldolase levels, but I’m doing my best to swallow that worry and wait for our next appointment. In three months.

Meanwhile, he did notice some weakness in Charlie’s shoulder tone – something I have been picking up on when trying to encourage him to sit. Feeding therapy will include physical therapy, so the neurologist seemed confident it would be addressed and remedied then. If all goes well, we should be starting therapy on August 18th.

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charlie and the ‘ologists

I posted a bit of an update in the comments:

Today he had an endoscopy, for which he had to be under anesthesia. Horrible. He has seen a cardiologist, an immunologist and allergist, a gastroenterologist. He’s had a swallow study, a brain scan, an EKG, a cardiac ultrasound and EVERYTHING checks out normal. We are on the waiting list for feeding therapy. It’s a four-week inpatient stay. I’m sort of falling apart.

Here’s a bit more on all that.

Another Day, Another 'ologistWe go to lots of doctors appointments. Sometimes three or four in a single week. And every doctor, every procedure – they’ve all lead to one dead end after another. Immunologist, Cardiologist, Gastroenterologist, Oh my.  Charlie’s endoscopy revealed that while he may have a bit of reflux, that’s not the source of his refusing to eat. His innards look lovely. His cardiac ultrasound revealed a beautiful ticker, ticking away just as it should. The gastroenterologist believes his problem to be wholly unconnected to his digestive system and is ready to release us. To a neurologist. For more tests.

The ‘ologists in general have been a parade of frustrating and sometimes infuriating interactions. One didn’t listen to my voicemail about a lab error because he’s “not a fan of parents looking stuff up on the internet.” No, I’m not kidding. Another helpfully suggested that perhaps “god and time” might heal my son.

God. And time. I looked around the room to be certain I was in a doctor’s office and not a chapel.

UntitledThrough all of this, I have tried to drag myself out of the fog of stress and worry to crack a few jokes and take comfort in the fact that our son is healthy and happy. He just eats through a tube in his nose. But one non-answer after another and I’m at a place where I want to scream, MY SON EATS THROUGH A TUBE IN HIS NOSE! And although inpatient feeding therapy sounds extreme, Charlie hasn’t eaten in nearly two months and we believe that this is the best way to undo old habits and form new ones – and hopefully, a positive association with eating.

Some days, I feel that all I am is my son’s disorder. Which, from talking to another mom of a kid with special needs, is a pretty common feeling. Some days you’re just drowning in it. The worry – over his long term well being, over your shorter term financial struggles, over your own inability to help your child with such a basic need. I feel so powerless. I can’t plan or make real decisions, only react to the ever changing demands of my tiny overlord. Whom I love so much.

I owe some of you some thank you’s for the kind donations – I cannot tell you how deeply I appreciate it. I swear I’ll get caught up on my mail this week. I think we have a break from ‘ologists until next Monday.

it’s a long story

Waiting for the Doctor The Nurse Who Put This Tube in Deserves to be Kicked in the Lady Parts

It’s a long story, how we got from here to here in the span of 24 hours. I’ll try to sum up.

Feeding Charlie has never been easy. And by the time he was 10 weeks old, we’d seen the doctor for it more than a half dozen times, been on two different acid reflux medications and three different formulas. By the time he was 12 weeks old, each feeding was taking upwards of two hours – and he hated every minute of it. Still, no one seemed in any real hurry to solve our problem. After all, he was gaining weight, meeting his development criteria. He was happy.

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I quit my job to care for him. No part time, no nothin’. We couldn’t afford the kind of caregiver that would spend two hours out of every three feeding our baby. We finally insisted on seeing a specialist, who ordered a swallow study – he was convinced Charlie didn’t have reflux, he just couldn’t swallow properly.

Within 12 hours of our visit, Charlie stopped eating altogether. The doctor on call at our pediatric gastroenterologist called the hospital emergency room and arranged for a bed. We packed up Charlie and headed to Medical City, knowing we’d come away from there with a feeding tube. The experience was, at times, nothing short of awful.

The One Worst Day of My Life First Father's Day Sarah Elephant, Charlie, Hospital

The nurse in the emergency room took an agonizing amount of time getting the tube in Charlie’s nose. I had to leave the room and go for a walk. When I returned, she was still at it. He cried for nearly four hours straight afterward. So did I. And knowing full well they were not going to let us leave the hospital the next day until I learned to put his tube in, I was miserable with anxiety. Turns out, I was a quick study and had the unpleasant task done in seconds. Seconds! After spending the Dork Lord’s first Father’s Day in the hospital, we were released.

The next day, we had the swallow study that the specialists were convinced would reveal our problem. It did not. Charlie swallows beautifully, and we were back to square one. This week, we have blood work (I’m dying inside at the thought) and a neuro-sonogram, which will rule out (hopefully) and problems with Charlie’s brain. In the meantime, our little non-eater is being fed through a tube… and his new magic, special formula runs a whopping $155 a week. Good thing I quit my job, huh?

Untitled And good thing he’s so darn cute. The cause and the cure for my stress.

two months

One day, I hope to be able to take the time to do each of these topics justice. But since I started this a month ago, and it remains unfinished, for now, I’ll try to sum up before Sir Poopsalot wakes up and, well, poops. I’ll try to provide updates throughout but, well, babies. They wake.

Baby Boy, Two Months Old Charlie is the most pleasant baby. He’s still a baby, so he’s a crazy ton of work, but lordy, did we hit the kiddo jackpot on this one. Once he starts sleeping through the night I’ll probably be even crazier about him (update: he sleeps through the night. It is magic. Better than magic. He also smiles and coos and is on the verge of out and out laughter), but even that’s hard to imagine. Also, he’s gorgeous. And has a very lovely, fuzzy head. I also hit the husband jackpot. The Dork Lord is a very, very good and very natural father. Listening to him give Charlie the play-by-play during a Mavericks game in his sing-song daddy voice gives me such amusement – and also this deep sense of happiness and peace.

Daddy on Duty

Postpartum depression was the darkest, scariest thing that has ever happened to me. I stopped sleeping, couldn’t eat, and sobbed endlessly over what I was convinced was abject failure at motherhood. I believed, most ardently, that my son deserved a better mother and that I had made a very grave mistake trying to be a mother. It hit with such force and suddenness, too – quite literally overnight. For a while, Prozac made it better, until Prozac made it lot, lot worse. Then it got really scary. Because then, in the span of one afternoon, I began to feel like I was dying. I was afraid I was dying, actually. And simultaneously, I was afraid I’d have to live. I never wanted to kill myself, but I didn’t want to be alive. I only believe that distinction is important because when answering the question, “Are you afraid you might harm yourself or the baby?” my immediate and honest answer was always “Of course not.” I’m glad I never got to the place where I had to stop to consider my answer more carefully. Update: I’ve now been to the hospital twice for a severe allergic reaction to Zoloft so now we’re giving Lexapro a shot. Here goes nothin’.

Trying and failing at breastfeeding was a miserable, miserable experience. Despite the help of an expensive lactation consultant and trying every which way known to man, Charlie would not latch. He could not – his palate was simply to high and his mouth too small and as the weight slipped off him, I continued to try and fail and blame myself. It wasn’t until I was in the throes of depression and my mother came to stay to care for Charlie that he really began to thrive – on a bottle. Update: at our two-month check up yesterday, Charlie had gone from 9th percentile in weight to 39th. I think we’re doing something right. Also, he’s in the 95th percentile for length, so his daddy is fostering some pretty high hopes that our son will be a baller. He’d better have inherited his father’s coordination, is all I have to say about that.

Bath time I love being a mother. When I was deep in postpartum depression, I was overwhelmed by feelings of remorse – that I’d made a terrible mistake having a baby. Not that Charlie was the mistake; his absolute innocence and perfection made me feel like a monster, unworthy of this new job. Getting help was the best thing I could have done for all of us. The Dork Lord said at the time that medication wouldn’t make me a good mother. It would let me see I already was. He wasn’t wrong.