Friday, July 13, 2007

Ketamine Blues

Well, we went yesterday to the dentist to get Vincent's cavity filled. A few weeks ago the dentist said, "it's just a small one, probably won't even need Novacane - it should only take a few minutes." How wrong he was. One look at the tooth yesterday and he exclaims, "ugh. That's gonna have to come out."

What's going to have to come out? The entire tooth? Yes, it had abscessed, and the tooth was dead or dying. Not to mention the raging infection below it. So we made an appointment at the oral surgeon for first thing this morning (what a way to start off Friday the 13th). What a little champion. The first part was the bite wing x-ray, which we've all had. You know, those hard little films they make you bite down on while holding perfectly still as the plastic cuts into your gums, under your tongue, wherever. Well, they put the "bite wing" in his mouth and told him to bite down. You could see the pain in his face as he bit and the edge cut into this mouth. His eyes started watering, but he sat perfectly still for the x-ray and didn't complain at all.

Then came the fun part. He got to the actual procedure chair, as images passed through my head of the recent case in Chicago where the little girl was OD'd by her dental surgeon and died. Blah.

He sat so still and good as they hooked him up to the blood pressure machine and the pulse oximeter. When the doctor came in, he explained what they were going to do and that I would have to leave. The team of nurses and other people in scrubs entered and I exited. About 30 minutes later, I was called into the recovery room.

There lay Vincent, wrapped in his Bob. He was mostly asleep, but opened his eyes when I talked to him. His little eyeballs darted back and forth in his head as the nurse told him to close his eyes again. After a few tears and a few "I wanna go homes" and a few episodes of vomiting, we were on our way. Ketamine was today's drug of choice. I know it has a tremendous street value, so it must be good. In fact, I know it to be used to tranquilize 1100 pound horses. The real kicker? The bill was an impressive $575 dollars for our little visit. I probably could've gotten the drug for a fraction of that cost in Gary. See what you get for being legitimate? Just kidding.

Yesterday the office called our insurance. It was always my understanding that they covered 90% of this type of procedure. But behold, apparently Anthem doesn't think a 4 year old needs general anesthesia to have an abscessed molar removed. They wanted the office to use Novacane. Now I don't know about you, but I guaran-damn-tee you that if that were me, we'd be breaking out the drugs. What insane person behind a desk at Anthem thinks it is sufficient to use Novacane on a 4 year old with this problem? Probably the same one I'd call every 6 months to insert Vincent into a straight jacket for the rest of his life to get him through the door at the dentist's office.

Obviously, I wouldn't subject him to this type of pain, even if it costed a million dollars... it's just the principal of it all that irks me. They can look at our history, a cleaning here and there, maybe every 6 months for me and Brian for the past 8 years of paying into the plan...I'd say I've MORE than covered the cost of the procedure in my premiums. The doctor's office is going to try to convince Anthem that the general was necessary in this case, but still with no guarantee that they will pay for it. Mark my word... if they don't, I'm going to make an issue of this to someone. Not that it would make a difference, but I'd feel better anyway.

At least it's done.

1 comment:

Amy said...

Poor guy!

You really should call Anthem and raise holy hell. See the movie Sicko. They're encouraged to, trained to deny claims. The claim-denyers make bonuses depending on how much they can deny. It's a horrible system, and I hate to think of the other 4 year olds with Anthem whose parents haven't been able to afford the anesthetic, and so they've had to do it under Novocaine. Ugh. Poor babies.

Anyway, fight fight fight. At least you can make someone's life a little miserable, and maybe if enough of us did that, they would change.

Love,
Amy