Here, let me try and explain...
When you get Medicaid you don't just get "Medicaid" you have to select a Medicaid 'PLAN.' Now I was given a few booklets about these plans with lists of doctors to choose a Primary Care Physician (PCP) and little other information about the plans. I believe there were three. So when I called to select a PCP at the start of all this I wanted to use an OB since that was what I thought I'd be seeing the most of, but first I had to select a plan. I was rapidly explained the differences between these 'plans' and selected one called Parkland Health First because it seemed like it had the closest doctors, and I couldn't tell much difference. Now I know what I selected was an HMO, which is I suppose why all the jumping through hoops to see another type of doc outside my PCP. What happened last Thursday, as far as I understand, was that the doc that I made my appointment with was a PCP not a 'specialist' and therefore wouldn’t have even been able to see me with a referral, though they’d told me on the phone when I made the original appointment they could. See the PCPs can be Family Practice, Pediatrician, Internist or some other types. But NOT an OB. As a woman, I get to select an OB AND a PCP. But more on that in a sec. The doc from last Thursday couldn't see me because they weren't my PCP and Medicaid told me if I needed to see a specialist from a referral from my PCP that those were located in the BACK of my booklet. OF COURSE they are! I found the list of Internal Medicine Specialists and was quite displeased to see that it was no more than a list of names. Names with no numbers or addresses! Using my Google skills, I found some addresses and narrowed down the list of docs actually taking new patients to a handful that were not on the other side of downtown Dallas. I had to then call the Medicaid people, who btw were so busy they had to keep taking my number to call me back, so I could get these doctors phone numbers and then call the doc’s office for an appointment.
Still with me?
Then I call my OB, my PCP’s, office to give the lady that had been trying to help me, the doc’s name and phone number. She would then call Medicaid to request a referral for me. Then Medicaid approves it, and then my PCP’s office faxes it the doc, and then I get to go see my internist. No problem. I started at the top of the list of phone numbers. Fortunately, I thought, most of the doctors, minus 2, were all located at the same hospital. I thought that would make it real easy! The first office I called said that doc couldn’t see me because he was a gastro intestinal specialist and I’d need to see a pulmonary specialist. Well, I of course had none of this information so I’m calling blind on all of these. She was nice enough to patch me through to the main office so I could inquire about the other docs on my list or whether any of theirs met these requirements. The lovely young lady I spoke with kindly informed me with great assurance, because they had just had a meeting about it that morning, that I could not see ANY of the docs in their facility unless I was referred to them by my PCP and my she (this very modern woman kept referring to my doc as a ‘she’ which I thought was funny) was located in the hospital with which this facility is affiliated. Which of course HE isn’t. And in addition to that, their doc could only see me one time. So there goes most of my list of possibilities. Time to call on the last two, I suppose, and hope for the best! The second to the last phone call I made was met with that lovely recording that let me know I had reached number that was no longer in service. For shits and giggles I tried a different area code since we are drowning in them here in north Dallas, but got the same reply. So on to my last choice of doc that was within reasonable driving distance. Not only was the place I called not a doctor’s office or a hospital but an association of doctors of some kind, BUT the doctor I was calling about was no longer associated with them. Would you agree that Medicaid may need to update their info?
Are you still hanging on? Hold on tight!
I called back Medicaid and talked to yet another different but very friendly and helpful person. She was nice enough to explain to me after I broke down for her the situation I was in and the calls and trouble I was going through, that I didn’t need to be doing any of this really. All I had to do was go back to the front of the book and pick an Internal Medicine PCP, make an appointment with them, call Medicaid back and change that person to be my PCP. What about my OB I wondered. That’s when she told me that because I am a woman, I get both a PCP and an OB. My OB does not need to be my PCP. You see, as a woman, I am blessed to have many other complications to deal with than just one simple doctor can provide. Medicaid supplies an OB for one annual woman exam and all pregnancy and birthing related issues. When I started this gig I didn’t expect to be seeing anyone else, so I wanted my PCP to be my OB. But now that I know the situation, that seems to be a bad way to go. My new options are, find a new PCP that is an internist and tell my OB I don’t need the referral. Or I could even go through my over-priced own insurance that will double btw once we have the baby, and hope they cover a visit even though I am pregnant. I think I’ll try the twisty Curly-Q route that is Medicaid first. I tried calling the lady that’s been helping me in my OB’s office to let her know the situation first and where it stands but she left me on hold so long I had to hang up and go to class. I will start again tomorrow and let you know next week what happens.
Phwew, did you get all that?
Also, next week is out next OB appointment. I don’t know whether this one will have another U/S or not. I think I am only allowed 2 during the whole pregnancy on my HMO plan, and we’ve already had one, so I want to be sure the next one is during a time that we can for sure see the sex. That is of course if the little bugger cooperates and shows us its privates! I’ll only be at the beginning of my 18th week and if doc says it may not be clear till after 20 weeks, I’d rather wait. I have read on some of my pregnancy forums that girls are finding out as early as 17 weeks, but most of these ladies can also afford to get the super expensive private 3D U/S’s done. We can’t do that, and I don’t want to risk missing our only chance on our last sonogram! I do plan to drink some sugary juice and eat a few chocolates before the appointment just in case we can do it. I want to make sure the little one is awake and jumping, not sleeping and shy. Let’s see those privates baby! My big fear now is that it won’t show us what its packing, and we won’t be able to find out at all. But that would be a blessing in a way. The pressure would be off to find out the sex since we’d no there was no way, and it would sure make the phone calls much more fun after the big birthday! Either way, I’ll be happy; I am getting a little tired of playing the “that means it’s a boy – that means it’s a girl” game. Although I’ve done enough reading about wives tales at this point, I could almost write a book. In case you’re wondering where we stand, it’s about half and half! I even took a quiz online of old wives tales and got 52% girl and 48% boy. But some of the questions I am still a little early on to tell the answers to. Maybe I should take it again before the next appointment. I’ll let you know next week how all that goes.
Andy is my rock as usual. When I had the breakdown after the doctor’s appointment fiasco last week, I had been so excited to finally see someone about my allergies! He was the greatest comfort. Even just now tonight. Believe it or not, this is my second writing of this entry. I made the mistake of not writing in Word first and thinking I could just write it directly into the blog entry system. When I went to spell check, I lost everything expect the first two paragraphs. As you can see this is quite a bit of typing. And I had the pics all in and everything ready to go too! Well, Andy kept me from throwing the keyboard out the window and held me and even went and got me some apple juice from downstairs to calm me down! Then he talked me into retyping it all, and I’m glad he did!
We’re really just trying to focus on relaxing right now. There is a lot to get done and I know it will all get done, but once September hits, there will be little relaxing time left for quite a few years to come. We want to make the most of it and each other while we can!
School is finally almost over! It’s been a rough semester as the baby has slowly but surely stolen my brain. I have such a hard time thinking of words when I am talking and my memory is shot! Makes learning microbiology a bit tough for sure! I did take a test in nutrition this week and got the highest score I’ve gotten all semester. They’re all open book open notes, but they’re really long and still difficult tests. I’m hoping that this good grade will give me enough points for the semester to be exempt from the last test. I’m not sure yet, but even if it’s not, I’ve done well enough all semester that the pressure is off to do too well on the last test. Which will be good since I have about 4 tests in micro to take in these last 3 weeks of class. And that I can’t afford to take it easy with any of them. We had a test this week too, and I am pretty sure I passed, which is all most of us in the class can hope for. I could still finish with an A but I’ll be satisfied with a B because there is some extra credit and a couple more big projects to turn in. Keep your fingers crossed that I make it through this. It’ll mean once I start back in another district in a year, I won’t have to retake this class! I swear, if I was tested over the first 17 weeks of pregnancy and foods for pregnancy and stuff like that, I’d totally ace it since that seems to be what I am spending the majority of my time studying!
Here we have the biggest and the smallest of the bunch posing together. Big Tyler and Thunder, who got named for his booming voice. He thinks he can talk like we do, and he yells at Andy sometimes when they talk. It's so cute! He's such his daddy's boy that we have to feed him next to Andy's computer chair or he won't eat. Lately he's been snuggling up to me more than ever in the last 7 years I've known him, I wonder if that means it's a girl...? Tyler wouldn't look at the camera for this one, he was showing off his profile.
Here's the daddy-to-be cuddling with his Thunder in Thunder's favorite cuddle spot. I often find him sprwled out under daddy's hand with one paw stretched out. He tries to sleep with him at night like this but it's harder because me and Tyler are there too so he waits at my feet where there's more room and waits for Andy to wake up. I always say no kids will be sleeping in our bed because there's no room left, Tyler likes to sleep right netween us!
16 week belly. This is last weeks. I don't feel like I am getting much bigger. I am ready for it! I am ready for strangers to touch my belly and to feel this little one do some kicking! I think I felt it move the other night but I'm not sure. I haven't felt the same thing since. It was a different kind of movement than gassy-ness, and believe me, I know what that feels like for sure!
The three little piggies in a row! Beggars waiting right outside the door while we eat hoping to be invited in for some treats. The funny thing is, they don't eat people food, they just want to have their faces in whatever we're eating! From left to right we have the baby, my girlie Sammi, Big Tyler, and Raven, the loudest of the bunch. Raven almost never shuts up. He'll talk just when he's getting up to go downstairs. And forget about it if he can see the bottom of his food bowl, no one's ears get a break!That's all I got for now. Hope you made it this far! Please feel free to comment, but remember our families read this so be good. ;)
