Author name: Sandra Tayler

Medication is Complicated

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It was a routine trip to the pharmacy. I had seven prescriptions to pick up. That right there says something. Somehow a seven prescription pharmacy trip has become “routine.” Three of them had been called in over the phone. Four required me to hand signed pieces of paper to the pharmacy staff. I understand the reasoning behind requiring paper with signatures, yet the need for it adds layers of complication to my life. Any time the prescription needs a refill, I have to call the doctor’s office and either physically go get a piece of paper or plan ahead to allow time for them to mail the paper to me. Add in the fact that the insurance companies keep track of when they last filled the prescription and they won’t fill early, so there is a window of only a few days during which I’m allowed to refill a prescription before we run out. I always try to hit the early end of this window because sometimes the pharmacy doesn’t have the pills on hand and they have to be ordered in. Tracking all of this has become routine. I’d done the math, calculated the windows of time, and taken myself down to the pharmacy to pick things up.

Then the pharmacy register rang up at $500 instead of the $35 I was expecting.

When I picked a healthcare plan last November, I paid close attention to the prescription copays. I picked a plan with $5 copays for their Tier 1 medicines. Tier 2 costs $35 and Tier 3 is $175. It is a system designed to encourage people to switch to the Tier 1 medicines. I don’t really know all the reasons that medicines get assigned to various Tiers. We had some stress in January because my kids had to be switched to a different form of their medicine because capsules were Tier 3, but caplets were Tier 1. Then we had to get special permission for Howard to be on the same medicine because anyone over the age of 18 needs a doctor’s approval, but under that age the insurance company doesn’t require preauthorization. So we jumped through hoops, and settled everyone onto their medicines. And all was well for a couple of months. I was relieved each time I picked up a prescription and it cost only $5. We’d paid much more than that in years past and it had been a financial burden on our family.

“That price can’t be right.” I said.
“You can call your insurance company” the pharmacist said. So I stepped over to a bench and called the customer support number on the back of my insurance card. It was a long phone call with multiple waits on hold while I watched my frozen groceries in my cart slowly thawing.

The systems around health insurance are arcane and complicated. I have to make far too many phone calls because automated systems aren’t as automated as they should be. Yet any time I’ve talked to an actual person on the phone, both for my insurance company and for the government healthcare marketplace, they have been very kind and helpful. The pharmacists are helpful. I end up with this sense that we’re all tangled up together in some weird bureaucracy where the key focus is not on best treatment, but on appeasing the computer system so that treatment can be extracted.

The customer support lady looked up the pharmacy order and found that I’d been billed at a Tier 3 rate. She looked up the medicines and they were all listed as Tier 1. Then she looked at another place and they were listed at Tier 3. Ultimately she had to put in a support ticket to…somebody… to figure out which Tier is accurate. There might have been a change in the formulary listing for these medicines or maybe it was just a mistake. She says she’ll call me back once she hears back. I have her name and number, because I fully expect that in a day or two I’ll have to call her because she hasn’t yet called me.

In the meantime my kids are taking medicine once per day and we’re running out of pills. It may be that the insurance company has changed these meds to Tier 3, which would mean that I have to research and figure out which medicines are comparable and are Tier 1. Then I have to call their doctor and discuss a med change with him, discussing the options and what possible consequences there might be from switching medicines. Then I would either have to drive to Salt Lake City (2 hours round trip) or wait two days for the prescriptions to be mailed to me. After which I then have to make another trip to the pharmacy (40 minutes round trip).

Just today my “routine” trip to the pharmacy cost me 2 hours and significant emotional distress. And I still don’t know how much more time it is going to cost.

So when people accuse parents of putting kids on meds for the parents’ convenience, excuse me if I laugh out loud in derision. There is nothing convenient about this. I would dearly love to be able to skip it all. I wish that willpower, diet, and exercise had worked for us. That would have been lovely. I track and manage all of this medical mess only because I can see that the medicines make a positive difference in the lives of my family. As an ancillary effect, my life is better too, for which I’m grateful. But better is not the same as easy and it definitely isn’t the same as convenient. The minute my family members don’t need medicine anymore I will ditch the stress and expense. I think that some of them will reach that. I suspect that others will need medicine for most of their lives. For this week, I’ll be tracking remaining medicine, waiting for phone calls, and making phone calls. Again.

UPDATE: The insurance company called me back the next day. It was a glitch in their system. The pharmacy re-ran the prescriptions and they came up at the correct $5 rate.

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The End of the Day

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I’m at the end of a day where I can look around my house and see that it is more organized than it was when the day began. The same is true for my email and my task list. I like being at the end of that sort of day. I particularly like it when we also took the entire family out to go see Avengers: Age of Ultron. We frequently have trouble finding an activity that appeals to everyone, but this movie fit the bill. Everyone had a good time and we all came home happy. All that remains is to remind the kids that we still have school in the morning. None of us wants to remember that. We’re all very ready to have summer. This feeling is amplified by having Kiki home from college. Four weeks left. We should be able to make it through.

For now, I need to go to bed so that tomorrow can be another day where things are more organized at the end of it.

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April Photo a Day Part 5

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I had fun doing the photo a day list during April. I only missed one day. I won’t be continuing to post photos to twitter every day, but I will be posting them sometimes when there is a thing in the world that I think is pretty or interesting.

A Favorite Place (reading with a kitty)
A Favorite Place

Flower
Flower

Landscape
Landscape

And these last two are from May.
Moon
Moon

Yellow Ladybug
Yellow ladybug
I walked past this ladybug a little bit later and realized that I’d caught it just after it emerged from metamorphosis. It was sitting there letting it’s wings dry. When I cam by again it was more orange and spots had begun to develop. So I guess new ladybugs are like Polaroid pictures. It takes a while for the colors to settle into what they’re actually going to be.

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Ten Miles is a Long Walk

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I was anxious before the hike began. The entire church group planned to walk ten miles in preparation for the Pioneer Trek we’ll be taking in July. The trail was a fairly flat bike path, but ten miles is still a long way to walk for people who aren’t used to walking very much. I worried that one or more of my children would, at some point, sit down on the trail and declare they couldn’t go any further. I worried that there would be blisters and pain. I worried that if one of the kids had to be rescued part way by a vehicle, then that kid would refuse to go on Trek at all. But we needed to know what ten miles of walking would do to us, because if we did need to be rescued, perhaps the trek was inadvisable.

We were all good until mile eight. That was when Howard’s legs began aching in new and interesting ways. It was also when Link slowed down and began to limp. By the end he was hobbling along and wincing, but he continued. He did not stop. He did not give up. And we made it to the end.

The remainder of the day was spent sitting on cushy pieces of furniture and wincing any time we had to move. Yet I can tell that all we suffer from is some sore muscles. We’ll be better fairly quickly. There were a few small blisters, but we can attend to those. We all did ten miles with very little advance training. If we do more walking in the two months between now and the trek, we’ll be fine.

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Counting

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We’ve gotten to the time of year where I’m counting down days. Less than one day until I fetch Kiki from college. Two days until we have a family excursion in preparation for Pioneer Trek. Five days until my son is supposed to have a big history fair project ready for presentations. Eighteen days until the Kickstarter closes and we switch into creation mode. Nineteen days until the new carpet is installed. Four weeks until school is over for the year and we switch into summer mode, which will also include school, because Link needs to make up credits. There are other things to count toward, but these are the ones that I keep counting even when I try not to. I don’t really want to count these things. I want to be content in the days as they come to me, but getting closer to these landmarks feels like progress.

The good news is that I’m beginning to be able to put my house back in order. The room shifting is mostly accomplished. Now I just need to sort through the displaced items and find them new homes. Or get rid of them. I like getting rid of things. It means I won’t have to clean them up or store them ever again. Having Kiki at home will help with this.

In the meantime I’ll just keep putting on foot in front of the other. If I keep doing that, then eventually I’ll end up somewhere else. I could do with a “somewhere else” that has more routine and fewer mental health issues to manage. Last week I counted the hours I spent on mental health stuff. Fifteen hours. That’s a part time job that I’d love to be able to ditch because everyone was doing better. The good news is that we’ve finished jumping through hoops and having application meetings. Going forward we’ll just be having the appointments which are actually supposed to help instead of the ones which determine what sorts of help we qualify for. I have lots of thoughts on all of this, but I’ve had trouble sorting them into anything coherent. Hopefully that will come back as I put more things in order around here.

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Memories of a Room

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The end goal for the construction we endured a week ago was to create a room large enough for my two boys to share. They’ve been sharing a room for twelve years, ever since Patch was born, and it worked reasonably well when they had a bunk bed. But a few years ago they felt done with bunk beds. The result was a room that had an aisle for walking, two beds and two dressers. There really wasn’t any space for playing or hanging out. It was where they slept and where they stored their stuff. And they kept getting bigger until we had the largest person in our house and the rapidly growing one crammed together in the smallest bedroom. So I wiggled the finances around and we finished the basement room which used to be my shipping room. When we learned that the carpet would not arrive until mid-May, the boys decided to move into the new room and live with a concrete floor for a few weeks. We moved the essentials and boxed the rest in order to minimize the amount of stuff we’ll have to move back out for carpet install. By noon the furniture was in and the boys were already enjoying their new space.

A strange thing happened as the upstairs room began to empty out, I traveled back in time. The last time I saw the room so empty was when it held a crib and a mattress on the floor for my two little boys. I stood among the boxes and read the history writ on the walls. There were the circles Link drew on the wall and ceiling when he had the top bunk and planned out orbits for his glow-in-the-dark solar system. Next to them was the shadow of a Blues Clues wall sticker, beloved for years and then removed when it became embarrassing. The spot where Link decided to keep score in a game by writing it on the wall. A hundred pin holes because the boy’s default mechanism for hanging things was to steal push pins from my corkboard. My flow of memory was only enhanced by the fact that we dug into the very back corners of their closet. It was an archeological dig back to Link’s much younger years. I had him sort things he wanted to keep into boxes and the rest we discarded or gave away.

I kept it together until Link left his jar of eraser buddies for me to get rid of. I held it up and said “what about these.” He shook his head and said “nah.” I held the little jar in my hand. It had been so important to him eight years ago. I wrote a blog post about the games he played with them during homework time. That was half his lifetime ago and he has become someone else. I sat in the room after Link had gone downstairs. I looked around the room where my little boy used to live. I held one of his treasures in my hands and a wave of sadness rolled over me. I grieve sometimes for the children that are gone. They transformed and became new people. I like who they are. I certainly don’t want them to stop. But sometimes, like today, I cry for a while. And I keep the eraser buddies, even though I know that is a little bit silly.

The new room is so much better for the boys. They have space to be teenagers together. They’ve made plans to acquire a small couch and a monitor so that they can play video games with friends in their room. Link walked with me through IKEA and I could see him thinking about an adult living space. He’s getting excited about chairs they way he used to get excited about toys. Time marches onward. We change and we change our spaces to match our new selves. Next week Kiki will come home and move into the room that was vacated by the boys. She will hang things on the walls and turn that room into something it has never been before. In the near future, probably after Kiki has vacated to return to college, the room will get a new coat of paint and a new carpet. The room my little boy grew up in will transform, just as he did.

(Eraser buddies post: https://www.onecobble.com/2007/10/18/eraser-buddies/

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My Week in Progress

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I’m having the kind of week where I spend all of my hours on important things, but all the work is broken into small portions of time by all of the other work. And none of it is finished, so I know that next week and the week after will be the same way. I feel like I’m failing at all of it, even though I have logical evidence that I am not.

So here are the things that make up my week:

Parenting:
My 17 year old had an emotionally rough week, (depression stinks) which means I had extra time spent trying to help him, extra consultations with professionals, ongoing appointments to set up support structures which are supposed to help, but thus far have only created extra burden in testing and appointments.

My 12 year old has a history fair project. It is big. I have to make sure he does all the research and then we will have to do all the preparation and construction. This big project is not his only homework. I know some of it is being missed because he is not good at tracking and I am distracted.

The Kickstarter:
We’re really excited that it has hit several stretch goals. Hopefully it will hit many more. For the duration of its run Howard and I are answering questions, corresponding with backers, and preparing new things for people to see. We’re also reaching out and trying to spread the word. All of this spills over into all of the brain space that we need to be using for other things, because the other things do not stop.

Design work:
Right now much of this is in support of the Kickstarter. But it is separate work from what it takes to actually manage the Kickstarter itself. The fast turn around necessary to have things to show to backers is hard on my brain.

Shipping and customer support:
I can’t allow the urgency of the Kickstarter make me neglect the good people who need help or who have ordered things through our store. They’re they people who keep the lights on around here. I have to set aside time for them.

Accounting:
There are bills to pay and reports to file. If I don’t keep on top of the numbers then my anxiety goes up and we make mistakes in our planning. The outcome of the Kickstarter is a giant question mark in my accounting plans for the rest of the year. I’m trying to ignore the question mark and just pay the bills.

Remodeling:
We haven’t had any construction this week, but we still have piles of things sitting in working and living spaces. This negatively impacts my ability to think clearly and makes me house grouchy. Word is that the carpet won’t be ready to install until mid-May. I can’t wait that long to clear away the piles, so Saturday is going to be a shifting things day.

Staying sane:
I’ve been operating under strain for quite some time. In the past few weeks I’ve been taking deliberate steps to strengthen myself. This involves getting together with friends who are in the same emotional place, attending a support group, reading scriptures, reading in general, and taking time off. This is all important. It is the only way I can continue to carry all the things. But it takes time in an already time-stressed week.

Add to all that the regular things such as laundry, random phone calls from people who only want a minute of my time, and the fact that my kids have decided that digging holes is the new cool thing, which means I have dirt everywhere. (They track it in, then their sweeping is inadequate.) I want to do all the things well. Instead I’m managing to do the most important ones adequately. I’m fairly certain that somewhere up ahead is a week that is less busy. I’ll enjoy that when I get there. For right now, I need to get back to work.

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April Photo a Day Part 3

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This is the third week of my photo a day project.

Sign
Sign
(We had some remodeling done. I recommend these people if you’re local. They were pleasant, worked quickly, and did good work.)

Texture
Texture

Underneath
Underneath

Wrinkled
Wrinkled
(Yes that is my eye. I need to get some new author photos taken so that people can see the wrinkles I’ve earned.)

Blue
Blue

Tiny
Tiny

Tiny 2
Tiny also
(I did two photos for tiny because I liked both of these. What you see are lady bug larvae in the process of metamorphosis. For some reason this particular curb is the popular place for ladybugs this year.)

Fun
Fun
(That’s Gleek on her way to church. I didn’t notice until she was far ahead of me that she’d brought her parasol. It made me smile. She is such her own person and decides for herself what is cool and not.)

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Working for Pay

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It was a lecture I’d given before. It felt like I was always giving it to no effect, but any time my kids began pouting because they didn’t have money to buy what they wanted, the lecture just falls right out of my mouth. I can’t help it, because it is infuriating that I spend weeks trying and trying to get my kids to do work. I offer them money. I offer them more money than the job is actually worth because I really want someone else to do it, because I can’t to all of the things by myself. I practically beg “Please take this money and make this dumb task go away.” They always decide not to. They don’t want anything right that minute, so they would rather play. Or maybe they do want something, but they don’t want THAT job. Or they want one job that will give them all of they money they need instead of seeing that multiple small jobs can add up to a lot of money. So they decide not to work. And then a few weeks or months later they come and be sad at me because life is not fair and they never get anything they want. Then they get the lecture about the value of work and why small jobs are worthwhile with a side order of the importance of planning ahead.

So Gleek was sad about not having a mermaid tail. She’d spent her birthday money on other things and been happy at the time, but today the lack of funds to buy a tail was tearful. And the lecture fell out of my mouth and landed on her. It made her sad/mad. But then something happened which has not happened before. She slammed out of the house and mowed the front lawn. Lawn mowing is one of the standard paid work jobs that I’m having to beg kids to do. As she mowed, she did math in her head. She asked questions about whether she could also take over mowing sections of the back yard. I told her about other work that I’d be delighted to have her do.

Only time will tell if she actually sticks to her plan of earning money week after week. I really hope she does. I could use the willing help. I would also be relieved if I could see my kids recognizing that they have to work for the things they want.

Addendum: I should note that my college age daughter, Kiki, does understand that work is necessary. It is the three live-at-home kids who have yet to grasp the concept.

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