Thursday, January 27, 2011

Mission Impossible: The Great Inhaler Chase

Once there was a family who had several kids and a mom with very infrequent and mostly mild asthma.

Because of the infrequency of the mild asthma attacks, keeping up-to-date inhalers on hand was always a bit of a challenge.  Usually the mother of this family was on the ball, and made sure that she had at least one that was full on hand, before the winter cold and flu season.  This year the family started the winter with one inhaler, partially gone; and two inhalers, nearly full.

But according to the actions of Murphy's Law,  when one of the children needed an inhaler, the only one able to be found was the nearly empty one.  After three days' use, that one was empty.  And so began the Great Inhaler Chase.

One day, after school
Elsie: Mom, we really need to find those other inhalers.  This one is empty.
theMom: Matt, where is yours?
Matt:  I don't know.  I thought Elsie had it.
theMom: It's probably under my heaps of junk.  Try to make it through the night and I'll call the clinic in the morning.  It shouldn't be a problem.

The next morning, after the pharmacy and clinic were opened for business
theMom:  Hello, Mr. Pharmacist.  Could you please check these names for me, to see whether I have any refills left on these prescriptions?
Mr. Pharmacist: What names please?
theMom: Mary, Matthew, Elsie.
Mr. Pharmacist:  No, Ma'am, I'm sorry you do not.

theMom:  Hello, Ms Clinic Receptionist.  Could you please have the good Doctor write up a prescription for new inhalers for myself and Matt and Elsie?
Ms Clinic Receptionist:  No, Ma'am.  I'm sorry, the good Doctor is not in today.  But you could call the pharmacy and have them fax us the previous prescriptions and we can fax them back a new prescription.  This takes 24 hours.
theMom:  I have a daughter who can't breath.  She is not a Japanese pearl diver, so she is not trained to hold her breath for 24 hours.
Ms Clinic Receptionist:  I can have our 2-hour nurse call you back.  Perhaps she could help you.  But in the future, please have your daughter plan her asthma attacks 24 hours in advance.
theMom:  Right.

Later that same day
Elsie:  Mom, I feel like I can go to school now.  My breathing is a little better.  I don't want to miss the whole day.
theMom:  Let's wait to see if the 2-hour nurse calls us back.

Still later that same day, the phone rings
theMom:  Oh, I bet this is the clinic now.   Hello.
Voice on the phone:  Hello, this is the Nice Office Lady at the School.  Your little Sophie is running a fever.  Can you please come get her.
theMom:  I will be there in half an hour.  Thank you.  Bye.
Nice Office Lady at the School:  See you in half and hour then.  Bye.

theMom:  Elsie, get ready to go.  Dad, I'm going to take Elsie to school in Oklee, then run over to Plummer to get Sophie, and then run down Fosston to get an inhaler for Elsie.
Dad:  Did they call back?
theMom:  No, but Elsie needs an inhaler for the night.  You know that's when it gets bad.  I will just fight with them until I can get her one.

theMom now drives 15 miles to Oklee, 11 miles to Plummer and then 30 miles into Fosston.  She arrives at the clinic.

Ms Clinic Receptionist:  Did you have an appointment, Ma'am?
theMom: No, I spoke to someone this morning about getting some inhaler prescriptions renewed.  She said she was going to pass my information on to the 2-hour nurse.
Ms Clinic Receptionist:  What in the world is a 2-hour nurse.  We don't have one of those.
theMom:  I'm only repeating what she said.
Ms Clinic Receptionist:  I'll see if I can find someone to help you.

Later that same hour
Nurse Twohour:  I printed up your records.  I checked all your records. We don't show that we've ever prescribed inhalers for you.  You'll have to go to the pharmacy and have them fax us the records.
Ms Clinic Receptionist: And next time remember to have your daughter plan her asthma attack to meet our 24 hour requirement.
theMom:  Sure, I'll get right on that.
Nurse Twohour:  I'll stand by the fax machine while all my other patients die, so that I can accommodate your unscheduled asthma attack.

The Mom is thankful that there is a pharmacy in Fosston.

A few minutes later
theMom: Hello.  I spoke to someone this morning about some expired prescriptions.  I just came from the clinic.  They said I needed to have you fax them the records.
Mr. Pharmacist:  Oh, yes, here they are.  I'll send them right over.
theMom:  Thank you.  I'm going to run a few errands and be back in 20 minutes.
Mr. Pharmacist:  If I have the reply by then, I'll have the prescription ready.
theMom:  Nurse Twohour said she'd let all her other patients die in order to await your fax.
Mr. Pharmacist:  I'm just sayin'.
Mom:  Right.

The mom runs a few errands and even resists the temptation to buy some very pretty fabric at the variety store.  It was really pretty, did I mention that?  She heads back to the pharmacy.

theMom:  Have you heard from Nurse Twohour?
Mr. Pharmacist:  Yes, I can't refill any of them.  You all will need to be seen by a physician.
theMom (barely not crying):  Couldn't they have told me that when I was there?  My daughter is in Oklee.  I'll never get back here before the clinic closes.
Mr. Pharmacist:  I'm sorry I can't help you Ma'am.
theMom:  I understand.  It is not your fault.

A few minutes later, back at the clinic.
theMom (through gritted teeth):  Hello, they told me at the pharmacy I need to make an appointment.  How late are you open today?
Ms Clinic Receptionist:  Oh, we don't make appointments here.  Please follow me through this door and I'll take you to Ms Appointment Lady.

After all is resolved, Elsie has a 6:30 appointment at the evening clinic.  Of course, by that time the handy-dandy pharmacy in Fosston will be closed. 

TheMom drives 20 miles back to Oklee, to pick Elsie up from school.  Elsie is not happy.  TheMom is not happy.  So at least they are both not happy together for the 15 miles back home.

After a quick supper, Elsie and theMom drive back down to Fosston (35 miles) to be seen by a Physician Assistant; and who is very nice, and sympathetic to our plight.  After that appointment Elsie and theMom drive the 35 miles back home so that theDad can jump in the car to drive the 30 miles to the Wal-Mart in Thief River Falls, because their pharmacy is still open.   He will then drive 30 miles back home so that Elsie who is not trained as a Japanese pearl driver can take her second breath of the day.  Her first was after the PA gave her a nebulizer treatment in Fosston because her bronchioles, or whatever they are called, were so tight the PA couldn't even tell what she was hearing.

All told 221 miles for an inhaler. 

Not to mention the appointment at the evening clinic, which is no doubt more costly than at the regular clinic; and the nebulizer treatment with the little vial of albuteral/saline solution that probably will cost, oh, I'm guessing, $50 extra dollars.  Or more. 

I'm not really frustrated anymore. 

Not really.



Joe Abrahamson said...

theDad: due to the new requirements in ObamaCare the pharmacist had to sell me a breathalyzer and chastized me

thePharm: "Everybody knows that it makes no sense that you send a kid to the emergency room for a treatable illness like asthma, they end up taking up a hospital bed, it costs, when, if you, they just gave, you gave them treatment early and they got some treatment, and a, a breathalyzer, or INHALATOR, not a breathalyzer."

Definition of INHALATOR
: a device providing a mixture of oxygen and carbon dioxide for breathing that is used especially in conjunction with artificial respiration [Merriam Webster]

Since Elsie is not trained as a Japanese Pearl Diver she might need one of those. But we were just trying to get the regular INHALER

noun \in-ˈhā-lər\
Definition of INHALER
1 : a device by means of which medicinal material is inhaled

thePharm: "Oh, yes, here it is. Has she been trained in how to use it? Remember that when the next phase of ObamaCare takes effect at the end of the month your daughter will have to give notice of her asthma attacks at least 24 hours in advance so that she can get treatment and not take up a hospital bed and need a breathalyzer or inhalator again."

[the above is fiction. Actually thePharm was very good and quick. I'm just projecting my frustrations with what is about to come upon our family. We've already lost under ObamaCare in a significant financial way because over the counter medications are no longer able to be purchased with our Health Savings Account. All of the OTC medicines are now taxed. And if HSA funds are used the tax is 20%.

BTW, the flu shot is OTC. So is Pseudoephedrine HCl. Oh, and Ibuprophin, and asprin, and acetaminophen, and benadryl, and dextromethorphan, and guaifenesin, and benzonatate. And, well, vitamins. Just about anything you could use for self-care and preventive care to keep from having to go to the emergency room is now taxed. You can no longer take them as non-taxibles on your income tax.

Thank you ObamaCare.

word verification: hypsines=plural: Hypsin, a Novel Thermostable Ribosome-Inactivating Protein with Antifungal and Antiproliferative Activities from Fruiting Bodies of the Edible Mushroom Hypsizigus marmoreus

Mom of FIVE said...

Oh, Mary! I feel for you. I do have albuterol and pulmicort here at my house for the nebulizer! You could have used that to get through the night! It would hav only taken the 5-6 mile drive here and home again. 11 miles sounds better than your tally. Next time, right?

theMom said...

Thanks, Alyssa, I did think of it. I also thought of mine in the cupboard. But I didn't know how the infant/toddler/big kid doses might compare or not. I figured I'd end up calling the pharmacist or Dr. on call anyway and they would yell at me for trying to use the wrong kids' meds...

Ah, well, it's done now...the good Doctor will be in tomorrow and review the records for the other two of us and if he shows his historical grace toward us, he'll just call those in. Oh, I suppose I mean "fax," these days.

But thanks. And I will call if it's ever an emergency.

A Stafford said...

Sorry for your run around. Sadly, that's where it's at now--and the fact that there are so many miles needed to get anywhere for you makes it so much worse.

It reminds me of when I had shingles and the local pharmacy wouldn't fill my scrips until they had been "accepted" into our insurance network which could take "several days". And yes, I was told I should have set that up before I needed meds. (As I'm in intense pain and close to tears because my shirt is touching my incredibly blistered side.) So, I purchased the one of 3 that cost less than $10, then had to send Shawn to Bemidji to get the anti-viral and Vioxx (the important meds) when he was through with his meeting that evening.

Where can you get training as a Japanese Pearl Diver in this area? That might be a useful skill for us asthmatics!

Jesse said...

Ah, the precious, painful and blessed cross. How the slivers sting. How we anticipate and revel in the joy of dying to live. How wonderful the love of God in Christ, exercised through His saints, for His saints, even as their sinful flesh gasps under the word-empowerd water of holy baptism.