Thursday, October 22, 2009

Why We Need Healthcare Reform

Or

Why Asthma Sucks, Part 78

The boy has asthma; the baby does not. This does put them both in the catgory recommended to receive the flu vaccine every year.

The boy also has food allergies, including an allergy to eggs. The boy had his first flu shot in December of 2002, before his allergy was diagnosed. He had no reaction to the shot.

The following spring his allergies were diagnosed. His records don’t list him being vaccinated when he was one or two. One of those years I was expecting the baby, and would have received one also, but there was a shortage that year. I was not hauling my hugely pregnant self and a toddler into town to wait in the county health department line with a bunch of elderly people for hours.

Bellevue pediatrics gave him his flu vaccines again in October of 2005, 2006, 2007, and 2008. He never once had a reaction to any of these vaccines.

The child has had severe asthma flares since he entered kindergarten. Every cold that came along his first year in school landed him in the ER.

And now it’s fall 2009, the year of the swine flu. A highly contagious, new strain of the flu for which there is no herd immunity. Which is hospitalizing children and young adults at rates much higher than the elderly and ill, opposite the seasonal flu.

We schedule the flu shots. The nurse practitioner refuses to administer the vaccine. Wants his allergist to sign off on the flu shot. We contact the allergist’s office. It’s been eight months since he’s seen that doctor. Eight months ago that doctor wanted to challenge his egg allergy, which we chose not to do at that time as we had just challenged his milk allergy and were introducing dairy to his diet.

The allergist’s office wants us either to challenge the egg allergy, or get enough of the flu vaccine from Bellevue pediatrics to use as an egg challenge. Here comes the epic logic fail: how in the hell were the flu vaccines he received in 2002, 2005, 2006, 2007, and 2008 not challenges to his egg allergy but an extra dose of the vaccine this year will be?

In summary, we now have two medical practices more concerned about being sued over a possible allergic reaction than the possibility of a school-aged child with compromised lung function catching swine flu.

And guess what, while the two medical practices are busy trying to push their responsibilities off on each other, the child catches swine flu. Well, technically we don’t know that as the pediatrician discouraged us from having his strain typed, but she did say the swine flu IS the only flu they are seeing.

Child also has an ear infection, so we leave the doc’s office with prescriptions for amoxicillin and Tamiflu. But not the child-friendly, liquid dose of Tamiflu. The pharmacies are all out of that. His weight puts him between the two dosages of capsules Tamiflu is available in. This means he takes two pills twice a day for five days, twenty pills in all.

Except UPMC Healthcare considers ten pills to be a prescription of the 30 mg dosage of Tamiflu. Therefore, the pharmacy that does have Tamiflu (and we called them all) has to give us two and a half days worth for our forty dollar copay. And then two days later I get to take a highly contagious child out to a store to pay another forty dollars for the other half of his medicine. So screw you, UPMC.

And while I’m at it, screw you for uglying up our skyline.

And we are fortunate to have health insurance. We’re fortunate that we can come up with the two copays. Because that Tamiflu is the only thing that has kept our kid out of the ER. We’re fortunate we have jobs where we can manage to get some time off and juggle our schedules.

The baby was vaccinated for both seasonal and swine flu. Which we didn't get to quickly enough, as he woke up today with the same flu symptoms his brother has. Their dad works in a small office. Worst case scenario for him should he get sick is he stays out of the office longer and works from home more.

I work retail. We’re going into the holiday season, our most crucial time of the year, in a recession year. My company gives us PTO (paid time off) days. We can use these as sick days, vacation days, kid emergencies, whatever, but we cannot schedule them after November tenth. We can only carry one over into January of next year. So, the actuality becomes all of us full time employees use or lose our paid sick time by the first week of November. I’m out of sick days. If I catch the swine flu, I will be taking massive doses of ibuprofen and DayQuil and heading to work.