Friday, October 28, 2011

On Shaky Ground

As we wait to hear from our pediatric nephrologist, I got some upsetting news. My husband’s company is dropping our HMO. This comes as quite a shock and has left us pretty disappointed. I honestly felt like I could throw up when I heard the news. If you’ve been following my blog for a while, you may recall that we’ve had a tough time finding the best doctors for our son’s case. We’ve gone through numerous therapists and several psychiatrist to find those that have the best experience and skills. It may not be perfect, but I can honestly say that we finally felt comfortable with our team and trusted the care our son was receiving.

Now we have until the end of the year to find a new team within a new HMO. Considering the critical time with our son’s kidney concerns, this couldn’t have happened at a worst time. Fortunately, our pediatric nephrologist feels comfortable referring us to somebody on the outside and feels confident that he can perform the biopsy before the change, if that’s his final decision. As for our mental health team, I’ve got some work to do.

It’s ironic that once you feel that things are finally on solid ground, there’s another crack in the dirt.


  1. mama bear ,i know you are trying really hard to get you little boy stable ,i know because i have been throught a lot more than you describe your sons behaviour in this blog ,i believe in every single word you say ,but trust me if your son is showing this simptons most around the house or to people he really knows ,so try to go without meds as long you have him under your roof ,you will need quite a lot of help but in the end of the day you will teach him how to control his emotions ,he needs exposure to a lot of things ,and dont make a big deal just about any fears he might have ,teach him how to face life in a different way you and the family will need therapy to learn how to deal with his emotions ,but trust me he will be fine .

  2. I really, really hate this for you! We have been in those exact shoes - and I know what you mean when you say you looked diligently for the team you have now. I was devastated when our doc left the practice to become a consultant to behavioral hospitals. However, it really did work out to our advantage. We landed with a new doc who had been an adult psych for 20 years and had just completed getting his child/ado certification and then opened a private practice. We were his first patients! He's a neuropsychiatrist and his approach is totally different. So much so that he changed up the meds on all 3 boys and I have to say, all three are in the best place they've ever been. Had the timing been any different, I would have never landed with the new doc - I'm grateful! I hope your change will work out as well for you. Try not to panic yet! I'll ask God to make this work for you. Fingers crossed!

  3. I'm sorry, Mama Bear. I'm sure you have thought of this, but perhaps your team can recommend colleagues that they know are good with Juvenile Bipolar Disorder and accept the new HMO.
    I know you have your work cut out for you - I am about to embark on the same journey since we can never get emergency appointments and have to wait a month between med changes when one doesn't work, unnecessarily prolonging my child's symptoms and hurting both of us.
    Keep us posted and I'll keep you in my thoughts.


  4. Calm Fury- Yes, I’m hoping to get some referrals from our current team and also from some other resources I have. I am shocked to hear the med changes take a month for you, that must be terribly difficult.

    Boxturtle-I’m glad to hear things are working out for you. I too am holding onto some hope that in the end this will all be a blessing. Sometimes that is how these things work out.

    Anonymous- I understand waiting as long as we can until we medicate and for us, I believe we did. Our son’s suicidal thoughts we not something that could continue and more than anything, our son wanted his suffering to end. The therapy we used had limited power in his life, it wasn't until we had medication on board that he could even apply what he was learning in therapy. I hope for most families this is not the case, it would be great if kids could grow up without the help of meds, but for our son it wasn't possible.

  5. I have had my fair share of battles with finding new doctors when I had to switch insurance. I ended up seeing some quack for a while who put me on 8 different meds in a matter of 2 Anonymous does have a point that we must be very careful because not all doctors have a clue....I am sure you know what I mean.

    These are scary times though when you are unsure of the upcoming months but have have faith that things will all work out. I mean they have to right?

    But also you can look online to compare drug costs so long as you have a valid script. I do not envy your situation.

  6. I am so sorry you're having to go through this. I know how important it is to find the right mix of doctors. Would there be any way your current docs would do a Single Case Agreement with the new HMO? We've done that in the past when in a similar situation.

  7. Accidental Expert- Hmm.. what's a Single Case agreement?

  8. Single Case Agreement:If services your son needs are not covered through your new network then an out of service network can be contracted to do the needed services within a predetermined set time.

    To put it is a contract created between your insurance company and an out of network doctor on your sons behalf because the doctors within their network are not treating him satisfactorily or because you already have an established medical team. (I used to work at a doctors office).

    So don't lose heart. Also many doctors will see clients at a discounted rate but that is on a person to person basis and usually done for those with no insurance.

  9. That really sucks, Mama Bear. The Single Case Agreement In the Pink and Accidental Expert mentioned sound worth exploring. I'll be thinking of you and really hope things work out! I know you'll keep us posted...