Tuesday, July 26, 2011

On Hold

(written almost entirely while on hold with Team Heath)

I have hung the diapers, stepping on the sweet smelling pineapple weed (Matricaria discoidea) at my feet.  Ivory is napping on my bed and I just gently deposited Sylvan on his sisters bed. I sighed and picked up the phone.


I am sitting here, tethered to my phone, being transferred from one person to another. Somewhere along the way I have gotten dropped and am back to the first step in the process, I was just transferred back to the Team Health billing center. I have been on hold so long that the battery on my phone is noticeably warm. This has become a weekly ritual.


It all started on March 23rd, 2011 when Sylvan was 7 weeks old. We were visiting family in Oklahoma and he developed this horrible mucus in the back of his throat. He would choke after nursing and instead of spitting up milk, he would spit of masses of sticky slime. I had him sleeping propped up, terrified to fall asleep myself... It just seemed to be getting worse.
So, I called Montana Healthy Kids, which is our state's Medicaid program to find a physican/hospital that was enrolled in their program. I so desperately wanted to do it right. Take the right steps. Be a responsible mom. The Stillwater Medical Center was enrolled. I called trying to figure out where at the hospital to take him. It appeared the emergency room was our only option.
So I threw the kids in the car and drove two hours, slamming on my breaks at least once to pull over and check on my choking tiny baby boy in the back seat. I arrived at the hospital, hungry and shaking to wait and wait for a doctor

But instead of finding solace, I found a doctor who didn't listen to a word I was saying. “He isn't coughing”, I kept repeating, over and over, “he is choking on mucus, but there is no coughing.” He proceeded to prescribe an inhaler for the cough, “but he is NOT coughing”, I say again. He gets up and tells me that someone from radiology would be right over to take an x-ray and leaves. WHAT?!? When the lady from radiology arrives, I try to tell her that I don't want my baby x-rayed. She brushes me off. She says it is very little radiation, makes Ivory leave the room, puts a little lead apron over Sylvan's tiny genitalia, snaps a picture and is off.
I sit there feeling so low. Was that my attempt at standing up for my son? It is mid afternoon, Ivory and I have not had lunch, she has a stomach bug and is being a super trooper. I feel helpless, abandoned.
After a while, the Dr. comes back, hands me a prescription, I don't know what for, and disappears again. Our visit is over.

I go to fill the prescription. I go through the drive- through. I bring it home, open it. It is a $50 inhaler. An inhaler for a 7 week old. I stare at it dumb founded. What the fuck am I supposed to do with that? I read the fine print. This medication has been tested once on kids aged 7, all other trials were done on children older than 11 and I am supposed to give this to my 7 week old baby? For bronchial spasms??? I drive back to the pharmacy. Do you want the nebulizer to go with the inhaler? No, I want to know why this is prescribed to my 7 week old? Well, they tell me, “Doctors can prescribe what ever they want. We however can not take back medications once they have left our counter. That is against FDA regulations.” But, I think to myself, a doctor can prescribe any medication they want to whomever they want?

I sit crying in the parking lot. Sylvan sleeping in the back seat. Still choking on mucus and no better off for having sought help from the medical establishment.

Angry. Who do I turn to? Do I write my senator? Do I suggest that rather than emergency rooms walk in clinics should be enrolled in out of state medicaid programs? Because I can tell you for sure that this visit was a waste of tax payer moneys, and that I feel children could be better served (in a non-trauma situation) by a setting other than an emergency room.

The best advice I got was from my yoga teacher who came by to meet Sylvan. “Give him a teaspoon of water with a few drops of apple cider vinegar”, she advise. “It will cut the mucus.” I do that. I have no idea why, but it works. For the next few weeks, when the mucus came back that is exactly what I did, and eventually the problem subsided.

The emergency room visit still haunts me.

And after having returned to Missoula, I opened my mailbox to find a bill. A bill for two hundred and twenty five dollars. The doctors bill from the emergency room visit that I liked to forget. From the doctor who did not listen to me, who was of no service to me, and after having made sure that his medical facility was “in our system”. I called the hospital only to have them tell me that this is not one of their account numbers... and I explain. I get transferred, and transferred again. I talk to a friendly lady who tells me the bill should now be taken care of, and to call Team Health again tomorrow to make sure the balance has been removed.

But it wasn't removed. 

Phone call after phone call. Nice voices. Rude voices. Telling me it is resolved. But then it isn't. I finally get transferred to the main office. They will look over my file and call me back. But I have yet to hear from them. I call them again and again. Then I get a bill from a collections agency for something that was supposedly resolved months ago. I call again. Wait they tell me. The main office will call you back.

The lady I talked to today has no idea what I was talking about. She was rude. I called the hospital again. And then Team Health again. This time I reach Nicole. I've talked to her before. She reads the same notes on her computer that the rude woman read half an hour ago... but instead of talking to me like I am an idiot she laughs: "I will email the collections agency and tell them to quit bothering you. I will call the main office again and file you in the displaced claims. We lost you somewhere. They will call you back in a few days."

There is no resolution yet... but at least a little peace of mind.  For the moment.  Until I start this all over again.

I wipe away my tears of frustration as Ivory walks out of my room. I steady my voice. “Lets go for a walk” I say. “I really need a cup of coffee.”


Up date:   So after 4.5 months of phone calls and learning three days ago that our ER physician was an independent contractor and therefore not subject to the hospitals usual policy of having their physicians accept the same insurance policies as the institution...  I finally received a phone call back from Team Health.  They have agreed to settle with me reducing our bill from $225 to $57.50.  I'll take it.  Hopefully this is it.
Done. 

Monday, July 18, 2011

Home

The day after Adam defended his master's thesis, we loaded up a rental truck and he drove from Stillwater, Oklahoma to Missoula, Montana. A month later I crammed our tiny car full of all the things we managed to forget to pack into the truck, put my daughter into her car seat and made the trip north to join him.
I took the Orange street exit, and I will admit it, promptly got lost. So rather than being absolutely ecstatic, I was more than a little grumpy when I finally managed to fine the MUD site where we would be living for the next year. I was even more grumpy when I walked into our new home, only to see how literal my husband had taken my request to not move in completely with out me.... everything, and I really mean almost everything was still in boxes or laying on top of boxes.
So, I unpacked, sorted, moved furniture and slowly put my life back in order and started to explore this new place we lived in.

In August Ivory and I will have lived in Missoula for two years. So many things have happened: my husband got a new job, we moved to our 2nd Missoula home and our family grew a little larger. Ivory (Sylvan) and I have had a chance to explore.... and these are a few of the things that make Missoula wonderful:
  1. the Missoula Public Library – The Missoula Public Library is definitely number one on my list. Shortly after we moved here I walked to the public library and signed us up for a library card. Before I knew anyone else in town, Ivory and I strolled down town to attend Tiny Tales on Tuesdays, Thursdays and, yes, Fridays. It was a great way to meet other moms, get ourselves out of the house and it is absolutely free. There have been days on which I have wrapped Ivory in layers of blankets, stuck her on a sled and pulled her to the library, pregnant belly and all, because the snow on our neighborhood walkways was to high to push the stroller through. We no longer go as frequently and have switched from Tiny Tales to Story Time that is Fridays at 10:30. Sometimes, we just go to check out books. Sylvan, Ivory and I cuddle up on the sofa in the kids area, read a few books, and then bring them home by the dozens. Alphabet books, counting books, gardening books..... truck books... and every now and then I even check out a book for myself.
  2. The Children's Museum – The Missoula Children's Museum is a fantastic destination. Ivory's grandmother's have purchased a family membership for us for the last two years and we make good use of it. We pack a lunch, walk to the museum, explore for a few hours and make it back home for nap time. I have to admit, that after having gone at least once a week for months, it has gotten a little monotonous for me, but Ivory still loves it as much (if not more) as the first time we went. So now, I invite a friend to come along.

  3. A Carousel for Missoula – Missoula has a carousel!!! Does that need any further explanation?


  4. Missoula City Parks – I know that I have by no means been to all of the city parks. I have no idea how many there are, but here are my favorites so far:
    1. Lowell School – It has a giant playground and water features...
    2. Greenough Park – This place is perfect for a dip in the river, a wooded walk and the occasional edible mushroom find.


    3. McClay Flats (I'm not sure if this is actually a city park, but it is still on my personal list of favorites.) – The Flats have a nice flat walking trail, so if perchance there is a whiny toddler in tow, it is perfect for pushing a stroller.
    4. Currents – While we very rarely go to Currents it is wonderful to have an indoor water park as an option, especially in the winter.
  1. Hot Springs – Grab some snacks, a few towels, fuel up the car and head out of town. Forget the bathing suits, they are more trouble than they are worth. We love going to soak in either the Jerry Johnson or Wier hot springs. The drive is breathtaking, the hike just long enough and the water... well hot. On the way there, take a moment to stop at the DeVoto Grove. On the way home, we like to stop at the Locsa Lodge for a beer, coffee or hot chocolate.... maybe even dinner.


  1. Orchard Gardens – On her second birthday, Ivory and I spent the morning just like many other mornings that summer. We were volunteering at Orchard Gardens, except that day, she got to try out the hoe so had received as a gift (along with a rake and shovel, but I told her she could only bring one). We have been volunteering there through Garden City Harvest's Volunteers for Veggies program. I love watching Ivory munch on carrots that have just been pulled from the ground and cucumbers that have just been picked from the vine. I want her to know and appreciate where her food comes from. I feel guilty that we have not been able to make it out very often this summer... our car has been acting up a bit, and I have no good way to transport two kiddos out there.


  2. Taco Del Sol – Of all the things we have tried, restaurants are not usually on our list. They require expendable cash which we usually do not have, but we always make a little room in our budget for Taco Del Sol. Before, I moved here I had never dared to try a fish taco. But now, I order a fish taco with hot sauce and jalopenos for myself and a bean and cheese burrito for Ivory. She loves them and will eat the ENTIRE thing if I give her enough time.
  3. Big Dipper – locally made, fantastically fabulous, absolutely delicious ice cream. What more can I possibly say??
  4. the markets – Missoula has two farmer's markets and a people's market on Saturdays. The streets are teeming with people and the air carries the sounds of street musicians. There are also Sunday and Tuesday and Thursday markets all though we usually don't make it to those, it is nice to know that they are an option.
  5. Good Food Store – I haven't gotten tired of going grocery shopping yet. I used to dread going shopping, when my only option was Walmart, now it is a chore I usually look forward to. I can buy almost anything I want in bulk, buy organic, buy products from local businesses and the cheese selection is, well, delicious.
  6. Inner Harmony Yoga – After all the wonderful adventures I have with my kids and my husband I need a moment to myself to breath. I found Inner Harmony Yoga through my number one stop on the list, the public library. I met Brian, the owner of IHY, with his daughter at Tiny Tales.   

There are so may other places that make Missoula unique. I haven't even mentioned Home ReSource. It was walking through the aisles at Home ReSource, that I somewhat reluctantly admitted to Adam that this store sealed the deal: We could make Missoula home.

Our house is quiet. Ivory finally fell asleep after crying because it got to dark to read her new library books. Sylvan is tucked way in his co-sleeper and Adam is sprawled out on our bed taking up just enough room so that he will wake when I finally crawl into bed next to him. This is home.


Monday, July 11, 2011

Chocolate Beet Cake


For Ivory's first birthday I made her carrot cake and lemon zucchini cake cup cakes with cream cheese icing. She tried one bite, and decided she would not have any. Instead she shoved handfuls of watermelon into her mouth, dripping and sticky, but immensely happy.


On her second birthday, we had carrot cake with cream cheese icing. It was much better received this time. 

 
By her third birthday I had discovered a wonderfully rich and moist chocolate beet cake. She proudly told everyone who would bend down to listen: “I had a vegetable cake for my birthday!”, which was followed by confused looks in my direction... and my subsequent interpretation of Ivory's statement.
I came across the recipe while perusing the pages of a tiny little cook book that was given to my husband as he commenced his year as a VISTA at Missoula Urban Demonstration Project (MUD). The cook book is the 2006 edition of Eat Local, Feel Noble! compiled by Lauren Caldwell as a part of the University of Montana Farm to College Program (I have no idea if there were any additional editions).
Not everyone shares my enthusiasm for beets, especially in my household. My husband usually wrinkles his nose when a new beet dish graces our dinner table (although he usually reluctantly admits that the dish really “wasn't that bad”, which I think is his way of maintaining the illusion that he dislikes beets), and Ivory, well the best part of the beet for her is that it turns her teeth and tongue bright red.
While this might be cheating a bit when it comes to including beets in your menu, it is a wonderfully sneaky way to add a vegetable that might otherwise not be well received. There have been no complaints from either my husband or daughter in regard to this cake, so, here is the recipe:

Chocolate Beet Cake

By: Ari LeVaux
Total Cooking Time: 1 hour
Preheat oven: 350°

Ingredients:
2 cups Flour
1tsp Baking Soda
1tsp Baking Powder
½ tsp salt
½ cup cocoa powder
1 tsp vanilla
1c brown sugar
¾ cup half and half
1 cup mayo
2 cups shredded beets

Preperation:
  • peel two large beets, grate, measure two cups and boil for ten minutes in 1 cup water until tender and drain
  • while the beets are cooking, combine ingredients in the order listed. Mix the dry ingredients before adding the wet ingredients.
  • Bake in a greased 9”x13” pan for ½ hour (or until a knife comes out clean).

I like this cake with cream cheese icing, but it simply serving it with sweetened whipped cream (add a little vanilla) is also a wonderful option.

Next year, Ivory's fourth birthday, I think I will have to try the Lemon Zucchini cake again. After that, I am all out of vegetable cake ideas.  

Friday, July 8, 2011

Drifting

We were supposed to be drifting in a canoe on a lake, but instead Ivory is drifting in and out of sleep on the sofa. I cancel all of our play dates, and resign myself to a quite day at home. I pick up the yard (where does all this clutter come from?) drifting in and out of the bedroom the living room and the yard to check on the sleeping children. It is a drifting kind of day.


The flat pod peas Ivory planted weeks ago are ready to be harvested.


































But picking them can wait for her, and I leave them hanging, translucent in the morning sun. “Stir-fried with thin slices of beef”, I think to myself.

Between naps, we read chapters of Lucy and the Green Man by Linda Newbery. We read about the passing of seasons, summer waning, winter arriving. That seems so far away. Summer and sunshine seem to have just now entered our lives. We read about Lucy's grandpa passing away and my voice cracks a little and I wish I had known my grandpa as well as Lucy knew hers. Ivory doesn't notice. She just cuddles closer: “I want you Mama”.

It is a cuddling kind of day.
We drift from the sofa, her bed, my bed.
We draw pictures to send to grandparents.
And just when she seems to feel a little better, the sun hides the wind picks up and raindrops fall from the sky. What better thing is there to do on a rainy day than bake a cake? “Lets bake a cake”, I say.

















So we measure, pour and stir: Peanut butter cake made with whole wheat flour. I put the pan in the oven and we cuddle. I try making a new icing - Chocolate Fudge. Ivory wants the cake to have a picture of a mouse on it... so, it gets a picture of a mouse on it. When my husband comes home, we are back on the sofa... “I got a raise”, he says. “Great”, I say grinning, “we made a cake to celebrate”.

















In graduate school I had an adviser tell me: “You can lose the battle, but still win the war”, and while I don't mean to label motherhood or family life as a combat situation, it is some of the best advice I have ever received. The days on which I remember this advice go smoother and are more stress free for me and my kids. Sometimes the best laid plans just disappear, and that is okay - just drift.







Friday, July 1, 2011

I've Got This

“I've got this”, is the thought, or the more the feeling I relish in as I wake up, change a diaper, nurse my son back to sleep and slip out of bed. My husband is already in the kitchen making breakfast and his lunch after having taken out the dogs. We dance around each other, resembling chaos more than a waltz, and before my whole wheat pancakes are done he is gone. Sylvan has joined me in the kitchen, and we clean up while we wait for Ivory to join us.
What to do today?
On a beautiful sunny day like this?

I briefly consider an outing.. walk along the river, visit the library, but no. I think we will just stay home. Throw open the doors and windows and relish the day.

Ivory walks out of her room in a foul mood. Already crying about how she wants to keep on her shirt, and how Daddy told her she could.... Oh, no. Not to today. “How about you go to back to bed and we start over”, I say, trying to come up with some solution so that I can cling onto that 'I've got this' feeling. To my amazement, she turns around and disappears. I finish dishes and climb into her bed with her.
“I want to eat dinner (she calls every meal dinner) in this shirt” she says “ and then I will put on a different one”.
 Relief.
We make it through breakfast, the getting dressed, the hair brushing and without any battles of wills.
I start a bread dough.


































Ivory waters the garden.


She kneads the dough.

I have the overly ambitious idea to start dinner.
My own take on Moussaka - Eggplant, celery, onions, last years garden tomatoes, ground beef spiced with fresh parsley, oregano and cinnamon all covered with a rich Béchamel sauce and cheese.

Just when I am stirring the melted butter, flour and boiling milk together my 'I've got this' feeling ebbs, practically disappears. Ivory is crying. She wants picked up. Sylvan is crying: has a clean diaper – not hungry - probably just wants picked up. And I can't. I can't pick anyone up...

I finish, slide the casserole dish into the oven, and frantically slice some cheese, some carrots, an apple and grab a handful of strawberries. This counts as lunch right? I throw everything into a container, grab a blanket, the baby and Ivory. We need a quick change of scenery. We walk to the closest park and everything is alright.

The timer on my phone goes off, we head home, pull the Moussaka out of the oven, slide in the risen bread loaves and both children go down for a nap in time for the loaves to be pulled back out.




I am left with the gigantic pile of dishes.
I've got this.

Today, for some reason is a good day. A wonderful day, really. And I have to pause a moment to contemplate the duality of emotions that I often experience. How different one day can feel than the next, even though they are all pretty much the same. I know by five, I will most likely be dragging, in desperate need of a cup of coffee (and it is a wonderful thing that for once, dinner is already done), and by bedtime I most likely will dread the task of brushing someone else's teeth.

Or not.
Maybe this feeling can last all day.
And if it doesn't, I am insanely grateful, that I can go to bed, and start a new day.