Insurance and Red Tape

Well, we still are waiting to hear the date of Jake's surgery. We should find out this week or next, but we're hoping this week. Once we get the date, it will be easier to wrap our minds around what's coming next. Another dilemma is keeping our minds off the surgery for now. Several weeks ago we along with our doctor's office were told by Pharmacare, a pharmaceutical company, that Jake was approved for Synagis, the vaccine for RSV. Last week once we found out that surgery was in Jake's near future, I called to find out when the medicine would be delivered to us. Since RSV is a virus that settles in the lungs, it is even more vital that Jake avoid it with surgery coming. On Thursday, the rep. I talked to said we were not approved and that they were still waiting to hear from our Insurance company for approval. I was quite confused since I had been assured several times we were approved. After 5 hours on the phone with Pharamcare and our insurance company, we discovered the woman who had been telling us we were approved was new and didn't read Jake's chart correctly. Apparently our application was collecting dust on someone's desk but was not being processed. Ty, being the assertive person he is, called Pharmacare's corporate office and somehow got through to the Vice President. The vice president called me back within 30 minutes with many apologies. Pharamacare has promised to deal directly with United for us and to try to hurry our application through. Dr. Grenier wrote a letter for us explaining that Jake's condition is worsening. We're waiting for her office to fax it to Pharamacare who should then forward it to the United...Our prayer is that the process will be expedited and that Jake will get the Synagis!

Meanwhile, you would never know Jake has the heart defect by just looking at him. He is crawling everywhere and this weekend started pulling up in his crib. He has two teeth and is full of smiles to light up the room! He does tire easily and after a few hours of crawling, he's ready for a nap. Today we got him his flu shot and he didn't shed a tear--he's one tough little boy! I did notice at the doctor's that he has lost 3 ounces over the past 3 weeks. That makes me feel better that we are going ahead with the surgery. Once he has the surgery he should grow normally and start to catch up. In the meantime, Destin gave me some OT tips for weight gain like adding formula or olive oil to his baby food for extra calories.

This post is long enough and probably a little on the dry side. It was therapeutic for me to write though. We continue to appreciate the prayers of everyone. Yesterday at church I was so encouraged by all the people that told me they were praying for Jake. I know many of our family members have their churches all over the country praying too. God is a BIG god and I know he's watching over Jake!