Doctors galore

For years we have suspected that Ian might have sleep apnea. When I asked his pediatrician about this years ago, I was told that we should just wait and see if he would naturally outgrow it. When I mentioned it at his physical in January, we were given a referral for a pulmonologist at Geisinger. Ian had a video appointment on April 3, which resulted in a sleep study being scheduled for August 19. Because we don't have insurance, they sent us an estimate of the cost. With a "cash" discount, the price was still $6K. I called Healthcare Bluebook, and they told me that Ian could have a sleep study at Hershey Medical for $1,500, and because it was the "fair price," we wouldn't have to pay the usual $400 co-pay. We saw the pulmonologist at Hershey Medical on April 30. It was worth driving 3 hours round trip to save our family $400 plus save the Samaritan system $4,500. An in-person visit was much better than a video appointment. He was able to see that one side of Ian's nose is completely blocked. Ian has said for years that he hasn't been able to breathe out of his right nostril. He's been a mouth breather since he was a toddler. The doctor said that he's too young to fix the deviated septum, but that the turbinate hypertrophy can be addressed. He submitted two prescriptions to address that issue and said Ian also needs to see an ENT in light of the size of his tonsils plus the blockage in his nose. Unfortunately, he sent them to a Walmart in Lewistown rather than Lewisburg, so I wasn't able to pick them up on Tuesday. I'm planning to pick them up tomorrow. I called Healthcare Bluebook to find out which ENT within a couple of hours radius of our home would do a tonsillectomy and/or open up his nasal passageway at a fair price. They are working on that. The good news is that if we go with one of their recommendations, we won't have to pay for the surgery, and our $400 co-pay will be waived. Normally you pay a bill, and then submit it for reimbursement if it exceeds $400. That will still be the case for pre-op testing and consultations, but not for the surgery itself which is nice as that can easily be $5,000 or more. We've been with Samaritan for 2.5 years and only submitted one bill for reimbursement so far. 

We are planning to stick with Hershey Medical for the pulmonology, but we're hoping to see a local pediatric cardiologist, and we have no idea yet where we'll go for the ENT. Ian saw MANY doctors during the first three years of his life due to his urological condition and eosinophilic esophagitis (GI, allergist, psychologist, urologist, ENT, and cardiologist). However, for the last almost 11.5 years, he's pretty much only gone to the doctor once a year for a physical. I feel badly that I never mentioned his frequent nosebleeds or his complaint about not being able to breathe through his one nostril the last several years, but I'm also wondering if I need to find a different PCP for him if he has had a heart murmur and they never detected it, and they also must never have looked into his nose because the doctor said it's 100% blocked. My sister, Yvonne, has an innocent heart murmur. Hoping if Ian has a heart murmur, his is also innocent, and I'm praying that the ENT will give us wise counsel as far as whether or not surgery is needed so that he can breathe better. I used to drive him to Philadelphia, Hershey, etc. for appointments in the first three years of his life. It seems like that will be the case again now for at least the next seven months as we already have two appointments scheduled in Hershey in October and November with the pulmonologist. Ian doesn't remember any of his urological surgeries or endoscopies. If he has another surgery this year, obviously he'll remember this one. 

At the doctor's office on Tuesday, they measured his height as a little over 5 foot 4 inches. He grew two inches since January! He's a tiny fraction of an inch shorter than Nadia. Her days of being taller than him are definitely numbered. Unfortunately, with his clothes and shoes on he only weighed 90 pounds, which puts him at the 2nd percentile for BMI. He lost weight over the last few months. I've asked him to try to gain at least five pounds. Oliver has been gaining weight like a champ the last couple of months as I told him he needed to weigh at least 80 pounds when we go ziplining in Alaska in August. I think it's going to be harder for Ian to gain five pounds, but hopefully he can get his BMI to at least 5%. As one who is often wanting to lose a few pounds, I can't relate to having a problem gaining weight. 

On March 22 the health insurance company told the investigator that they would reimburse us. We haven't received anything yet. Hopefully they haven't changed their minds. I found a cheaper place for a mammogram in Bloomsburg. I haven't had one in 17 months. They only reimburse the cost of a mammogram if a problem is detected, so I'm hoping never to be reimbursed for a mammogram. Oliver had quite a few doctor appointments and hospitalizations for the first six years of his life, but for the last almost six years, he's also mostly only gone for his annual physical. Nadia has been very healthy for almost sixteen years. Hopefully after we address the sleep apnea and other issues recently uncovered with Ian, we can again have a stretch without many doctor appointments.