Life, and Money

Ah, the money problems have hit. Not the every day ones, the "oh crud, we now have big bills and have to find money to pay them." The default of course, has always been to grab a credit card, which is just moving the debt but preferable to collections. And that's probably what we'll end up doing. I'm grateful that we have good, long standing credit and have that option, although I deplore having to go further in debt.

First we did our taxes. We owe this year, thanks to the "resourse rebate" given us by the State of Alaska. Hubby's in a bit of shock, as he's never owed taxes. I put some away for it, but we've had to dip in and we're a little short. Basically, April 15 we'll send them everything we can. In the mean time, I'm trying various ways to report our and the kids' incomes to see if I can reduce it at all.

Next, I finally got to the dentist. After 16 years I'm pleased to report that all I have are dirty teeth (need to have root planings, which is scraping the heck out of the area below the gums), two small cavities, and a 25 year old crown which needs replacing but isn't critical yet. The dentist said I'm blessed with good teeth. Cost: Roughly $800 after insurance, but the crown can be deferred a year if needed. They're getting everything pre-approved, I should hear what we can do in about a month.

Finally, we got the pre-insurance bill for my new glasses. This one has me stunned. Total bill, with the exam, $998. My heart stopped, I swear. A thousand dollars for GLASSES? The big kicker is they charge you for the regular lenses AND the "progressive" ones. Next time I might have to see if the bifocals with lines are cheaper. If my insurance pays up what it claims my out of pocket will be around $550. I paid $175 at the visit, which I'm betting is the difference between the insurance's "full" coverage of the exam and what they'll really pay (they always use that "normal and reasonable cost" excuse, don't they).

This is why we don't usualy do regular health maintenance. We don't have a couple grand lying around to cover what's left after insurance (when we're lucky enough to have insurance). But what are you supposed to do? It's your health and well-being. I probably could have postponed the dentist, if I wanted major tooth issues later, but I can't see my hands in front of my face without glasses.

So we're squeezing the budget even harder in an attempt to wring every last penny out of it. Not that there's much to wring out, but we're trying. Memory upgrade for the laptop? Gone. The rice cooker I've been covetting? Gone. Mid-winter car washes? Gone. New jeans? Nope, patch the old ones. You start hitting the nickels and dimes when there's nothing big to cut, and you hope it adds up.

We're not scrimping on the kids' birthdays, which are March 3rd and 11th. We don't do huge parties anyway, but there will be cake and balloons and presents. I'm at a loss for Junior, but Kiddo wants the two Ninja Turtles he's missing, and I found those online at a not bas price (right before Christmas they compeltely disappeared in town).

And there's one other expense we won't be scrimping on: Hubby's decided it's time to go back to school. His original plan was to use his GI Bill to go to college, but instead he had a kid and had to be responsible, and through the course of life and time the GI Bill has expired. He's tired of not getting jobs he can most certainly do because he doesn't have a piece of paper. There's an AAS at UAF that will hook him up with the aforementioned paper and the various certifications he needs, so he's decided to do it part time (unless we can find a miracle of financial aid. We're hoping). We ran down his various transcripts and he submitted his application yesterday; tomorrow there's a carrer fair sponsored by TVC, the community college that covers his degree, and he'll talk to more folks. I'm all for it, even though I know it will hurt money wise. In the long run it can only be good for us.

I saw a documentary last week on the poor in Appalachia. Can you imagine feeding a family of 12 on $500 of food stamps a month? Of having your kids eat just one meal a day when school isn't in session? Of being toothless by 30 because of poor nutrition? Of not being able to get a job because you're too far away from the nearest job and have no car?

It really makes you wake up and count your blessings. We have a home, we're all reasonably healthy, and there's food on the table, even if it's starting to get a little uninteresting. We have jobs, computers, internet, and transportation. We'll just have to handle a little more debt.

Grin

In the last two days Kiddo's been to the dentist and eye doctor. I'm terribly pleased that he has no cavities and does not need glasses. Also, when he was very little his eyes tended to drift inward - not cross eyed, but not totally straight - and while they still do that just a little, it's much improved.

While we were at the optometrist I also had them adjust my glasses - again - and change the nose pads to smaller ones. I think we might be getting close to these being comfortable. They just aren't to "forget you're wearing them" yet.

Hubby went to the dentist for a cleaning/follow-up too, and his mouth is much happier that it was when all that started. All that work we paid for last year is paying off, looks like he'll have his own teeth a long, long time.

The kids still have Denali Kid Care (and I'll say it again, Denali Kid Care is the only good thing about being broke), but for once we have decent insurance and we were sure to buy the Vision and Dental. I still haven't seen a bill for my glasses, and I'm afraid to ask since my best estimates say $500 out of pocket. But our dental has a $50 deductible, $2000 maximum, and covers your regular exams 100%, so I've really no excuse any more. Grandpa even volunteered to babysit.

So while Kiddo was in I made an appointment. I'm embarrassed to say I haven't seen a dentist since my last husband needed his wisdom teeth out, and that was before 1996. At the time it'd been probably eight years since I'd been in, and the hygienist told me that if that's all I had after eight years, I probably only needed to come in once a year, not twice.

Of course, that was at least 13 years ago. I have no pain or sensitivity anywhere, so here's hoping all I need is a couple of descalings (the intense cleanings they have to do for folks like me).

Random Kid Stuff

The kids love The Upside Down Show. It was a one-season kids show produced in Australia in conjunction with the Childrens' Television Network. I wish there were lots more of them, it's just da' bomb!

Here's a clip of some random Upside Down Show nuttiness. The Happy Fly Ditty sees a lot of action around here:

It's Official - I'm Old

Those who know me know I'm no spring chicken. I did the college and career thing before I had kids (most of my age peers have kids out of college by now). But I don't feel over the hill. "Not young" (which is fine, not sure I'd be young again if you paid me), but surely that proverbial hill isn't even in sight yet, is it?

Well, it wasn't until I went to the eye doctor. I broke my glasses, and since I can't wear my contacts 24/7 I really needed to replace them. It's been 3 years or so, I was due anyway.

I need bifocals. The condition is called presbyopia, which literally means old person eyes. It generally begins to manifest between 40 and 50 as your eyes lose some of their flexibility. I turned 41 last year. It's like "Hey, you're over 40 now, here's your bifocals!" Yay.

My eyes are cruddy to start with. I'm horribly nearsighted and have astigmatism in both eyes. Eventually I want the laser eye surgery - not to necessarily get to 20/20, but to reduce some of the maintenance expense. I really have no clear field of focus at all. Which should have been a clue, because used to be that I could see close up, from about 10 inches away. Now I can't.

The doctor said I could probably go another year without bifocals (I'm actually getting "progressives", which use the same principle as bifocals but slightly different technology and no lines), but that is was easier to acclimate to them if you started early. So, in a bit of shock, I ordered them.

My new glasses cost almost $700. Seven. Hundred. Dollars. My eyes have always been expensive, but this is ridiculous. Insurance will cover $200 of that. The "progressive" lenses alone are $225, and I get that high-density plastic 'cause otherwise I have Coke-bottle lenses that are so heavy they give me migraines. I broke the frame of my old glasses and they're unrepairable, so I need new frames. I get that scratch-resistant coating, that's another $100. My only indulgence was Transitions lenses, because clip-on sunglasses are a pain and I spend a lot of time outside in the summer.

If I had gotten cheapo "whatever" frames and not gotten the Transitions coating I only would have saved about $150. Ow ow ow.

But it's not like I can go without them. So in two weeks the bifocals will come in and I'll order some Geritol and call the Scooter Store. And learn to read and drive and shoot all over again.

The High Cost of Health Care

Kiddo, Baby and I are all sick. There's a nasty cold going around, which of course we caught, and we just haven't been getting better. Baby had a Well-Baby checkup this last week, during which the pediatrician discovered an ear infection. I talked to her about my and Kiddo's symptoms, and she very sternly recommended that we both see a doctor. We did: Kiddo has a sinus infection (I fear he inherited his Mom and Nana's sinuses, poor kid), and I have a sinus infection and bronchitis.

We're part of that much-talked-about uninsured demographic. Hubby's new job pays just enough that the kids don't quality for Denali Kid Care any more, and we can't afford even the mediocre insurance offered by Hubby's work ($12,000 a year!). My prescriptions cost over $200 for two weeks of treatment, and we haven't seen the doctors' bills yet.

There's a lot of discussion on why health care is so expensive, and it's usually blamed on insurance providers and drug manufacturers. Here in the Land of the Sue I can kind of understand why physician's malpractice insurance is so high, and I don't pretend to understand the prescription drug trade (my Nasonex prescription was $95!!!). But in the early 90's I worked at our local Operating Room as a database monkey and there was something I saw that I've never seen addressed, and it just appalls me: the sheer amount of waste that happens in the medical industry.

You can probably blame HIV, or rather the whole bloodborne pathogen problem. You see, almost everything used in the medical industry is disposable. Apparently there is such concern about the spread of infection and/or pathogens that almost nothing is reused, no matter how efficient sterilization techniques are. No glass syringes; no washing and reusing sterile field drapes. I'm torn between what may be a medical necessity (theoretically the CDC has a hand in this) and the huge quantity of perfectly good stuff I saw thrown away.

For example: if you have an appendectomy the physician will have provided the facility with a pick sheet of items she prefers for the procedure. Medical supply companies are aware that there's darn near a standard set of items used in such a procedure, so they sell an "Appendectomy Pack" that contains those items, pre-sterilized and ready to go. However, if your physician is extremely efficient (or your case really simple and routine), much of the contents of that pack may be unused.

And they are thrown away, deemed unusable, because they have been opened and are no longer considered sterile. Even if they were opened in a sterile O.R. environment by a nurse who prepared everything according to sterile procedure. They're garbage.

If you get stitches the needles are pre-packaged with a fixed length of thread; surgical staples are a pre-loaded staple gun which is disposed of along with any unused staples; surgical drapes (those blue paper things we all despise when handed one to cover our bare fannies) are garbage even if they sat there and were never unfolded. Not only are the items deemed unusable, but there's a huge amount of packaging involved too.

There is some recycling going on. I know that partially used surgical staplers are often saved for veterinary clinics (apparently our sterilization technology is good enough for animals but not for us); many hospitals save unopened but "not sterile" drapes, needles and other items for donation to third-world countries where relief efforts are happening. Which is all good and fine, waste not want not and charity starts at home, but the patient pays for all that whether it is used or not.

Meanwhile, anything else used during the course of your stay is charged to you too. Hospitals and other medical facilities have high-tech, complex inventory systems to make sure that not a single thing slips through the crack. Those cheap plastic water pitchers? Disposable, and you're charged. The digital oral thermometer? Yep. Your water glass? You betcha. This is why your nurses encourage you to take everything home. If they have to open another pre-packed sterile kit for your procedure you're charged. If they accidentally open the wrong suture? Yep, you're charged. Even the little black cone on the end of the ottoscope (that's the thingie with the light they peer onto your ears and nose with) is disposable.

It angers me, not just because of the cost but it's horribly wasteful. I've never seen this issue addressed, and it should be. Just like turning off lights when not in use adds up, a little efficiency and a re-examination of the use of sterilization could save tons of money.

It's the Flu

Wouldn't you know it, Kiddo started pre-school this week and brings home the flu. At least, I think it's the flu. We all had a touch of it earlier this year, I was hoping we were done with it.

I'm the kind that hates to panic and call the doctor for every little thing, so I looked up the Flu on Babycenter.com, which has a medical advisory board to look over their medical articles. Basically the flu is a virus that induces fever, body aches, and lack of appetite, often combined with a dry cough and upper respiratory distress. (Interestingly enough, the "stomach flu" isn't technically the flu.) The rule of thumb is that if the fever came first, it's probably the flu; if the cough, runny nose, and sniffles came first, it's probably a cold.

Treating the flu hasn't changed in forever:

The best treatment for the flu is bed rest, plenty of fluids, and as much nutritious food as your child can handle. Try offering frozen fruit bars to encourage him to get extra liquids — along with soup or broth, which may ease his congestion as well.

For muscle aches and fever, give your child a pain reliever such as children's acetaminophen or ibuprofen. (Never give a child aspirin unless your doctor has recommended it, especially if he has a viral infection. It can trigger Reye's syndrome, a rare but life-threatening condition.)

Okay, simple enough, and we all just suffer through it together. I have Tylenol and Pedialyte and lots of clear juice and water. I was more interested in when to panic. They have different lists for babies and pre-schoolers (age 2-4), so here you go:

Call your doctor for your preschooler:

• If your child has a fever over 103 degrees F (39.4 degrees C) or any fever that lasts longer than three days
  
• If your child develops a cough that persists for more than a week
• At the first sign of the flu if your child is HIV-positive or has a chronic illness (such as cancer, sickle-cell anemia, diabetes, or heart, lung, or kidney disease)
  
• At the first sign of the flu if your child has rheumatoid arthritis or Kawasaki disease, both of which are treated with long-term aspirin therapy. (In such cases, the benefits of aspirin outweigh the tiny risk of Reye's syndrome.)
• If your child has an earache
• If your child is wheezing or seems to be working harder than usual to breathe
• If he becomes sick again soon after bouncing back from the flu, or if he has a high fever for more than three or four days. (He may have a secondary infection that needs to be treated.)
• If your child shows any signs of dehydration

Call your doctor for your baby:

• If your baby is 2 months or younger and has a temperature of 100.4 degrees F (38 degrees C) or higher. A baby this young needs to be checked for serious infection or disease. For a baby older than 2 months, ask your doctor what her guidelines are for phoning. She may suggest you call if your baby is between 3 and 6 months old and his temperature reaches 101 degrees F (38.3 degrees C) or higher, or if your baby is over 6 months and his fever reaches 103 degrees F (39.4 degrees C) or higher.
  
• If your baby develops a cough that persists for more than a week
  
• At the first sign of the flu if your child is HIV-positive or has a chronic illness (such as cancer, sickle-cell anemia, diabetes, or heart, lung, or kidney disease)
  
• At the first sign of the flu if your baby has rheumatoid arthritis or Kawasaki disease, both of which are treated with long-term aspirin therapy. (In such cases, the benefits of aspirin outweigh the tiny risk of Reye's syndrome.)
  
• If your baby seems to have an earache (he may pull on his ear and fuss)
  
• If your child is wheezing or seems to be working harder than usual to breathe
  
• If he becomes sick again soon after bouncing back from the flu, or if he has a high fever for more than three or four days. (He may have a secondary infection that needs to be treated.)
  
• If your baby shows any signs of dehydration.
  

Disclaimer: I'm not a medical professional of any kind, this is just stuff I've learned. Don't take my word for it, when in doubt call your doctor.

I Hab a Code id By Dose

Ack, I got it. The Creeping Crud. A Bug. Whatever Is Going Around This Time.

A heckuva juicy head cold.

There's no real cure for the common cold yet. Common anti-virals have no effect, although there a drug in testing, called Pleconaril, that shows some promise. The medical profession lists over the counter medications as optional, since the virus runs its course in seven to ten days. I've had sinus problems my whole life, so I've got lots of strategies for fighting the symptoms. Unfortunately, I'm also a nursing mom, which rules out most over the counter medications and herbal remedies. I'm left with hot and cold compresses, steam, tea, and Tylenol. The problem is that Hubby is working 12-14 hour days right now, so I'm essentially on my own with Kiddo and Baby. Hard to stand under a hot steamy shower for any length of time with the kids.

(Backside-covering anti-liability statement: I'm not a doctor. I'm not a nurse. My medical training stops at first aid and CPR, and I let my CPR certification lapse. Please consult a medical professional.)

The problem with taking drugs while pregnant is that many of them cross the placental barrier, and affect the development of the fetus. The problem with taking drugs while nursing is that darn near everything ends up in your breast milk in some concentration, and your nursing child is in a major development phase.

Sudafed (Pseudoephedrine), my good-ol' fallback, was on the "approved for pregnant and nursing women" list for a long, long time, but has recently been getting re-evaluated and has been moved to the "we think it's okay but just in case" list. Joy.

Antihistamines have long been allowed for pregnant women as a sleep aid, but the newer ones like Allegra and Claritin are too new to be recommended. You could take them, but they haven't been adaquately studied yet. If that doesn't make you nervous, read about the Thalidomide babies.

Homeopathic remedies! Of course! They're all natural, they couldn't possibly hurt my baby, right? Wrong-o. Remember that many modern drugs were developed from nature, and whether that pill started out in a greenhouse or a laboratory, they still contain chemicals to do the work. Homeopathic remedies can actually be more dangerous as there are no established guidelines for standardization of chemical concentrations and dosages.

Here's a hidden risk you probably never would have thought of. Have you seen those plug-in vaporizers? They have a pad saturated with menthol-type oils which are heated and released when the unit is plugged into an outlet. Neat concept. But you can't use them if you're pregnant; as a matter of fact, the SudaCare brand specifically says not to use during pregnancy. Why? Eucalyptus oil is extremely toxic if ingested.

So much for homoeopathy.

I can't even take the Wonder Drug, aspirin. It's contraindicated in children with the flu or chicken pox, and I don't know that this cold isn't the flu, not for sure. It could result in a disease called Reye's Syndrome.

Tylenol! Good old Tylenol, no side effects and good for everything right? Yep, that looks safe. Unfortunately it does nothing for my major symptoms, which are all in my face.

Someone's bound to bring up Vitamin C and its effect on the common cold. I personally believe that vitamins only work as a preventative, not a cure (in other words, I should have been taking it a week ago). But just for you, I found an interesting information sheet on Vitamin C.

*sigh* *coff* *sniffle* *coff coff*

If you're pregnant or may get pregnant, I recommend this article on OTC medications and pregnancy from the American Acadamy of Family Physicians. If you're a nursing mother I found a nice (if dry) information sheet from the University of California San Diego on common drugs in nursing mothers.

Me, I'm going to make more chamomile tea (I can't find any warnings anywhere about chamomile!) and talk Kiddo into watching a movie with me.