Monthly Archives: July 2014

New Medication or How to Argue with Insurance

I was so excited when we finally found a pediatric psychiatrist to manage Mikey’s medication. We initially had an appointment at a very large clinic, but it was taking me 10+ minutes to reach a human being when I had questions leading up to the appointment…plus I felt nervous about the fact that we had to schedule over a month out and there wasn’t a single other opening for another month!

A friend recommended a few names and we got Mikey in with a wonderful woman in Greenfield. We had such a great visit with her–I like her because Mikey likes her. She asked just the right questions to get him yabbering. Plus she helped him build Lego staircases.

She really listened to me discuss the side effects I was noticing to the second medication we’ve been trying and she observed some of the anxious behaviors that concerned me. We decided to try a new medication that’s liquid and banana-flavored. Though I wish she’d have asked me first before hyping up the banana flavoring to Mikey, who detests bananas. I quickly interrupted her and yelled, “Candy! She means the medicine tastes LIKE CANDY!”

This new doctor has very high hopes that the new medication will be a good fit, but it’s a relatively new product. Which meant, literally, 9 days of paperwork and phone calls trying to seek insurance coverage for it. What a mess!

First I had to take it to the pharmacy, who didn’t have it and had to order it. Then, according to the rules of this game, they had to try to order it, but first prove it was rejected by our insurance. Then, back to the psychiatrist for paperwork and authorization to get it approved by our insurance. (It costs over $200 per month without insurance. Yikes!) Then, approval from the insurance company had to be sent to the pharmacist, who had to type things into her computer for a VERY LONG TIME before telling me it would take until Tuesday (4 business days) to get the medication into the pharmacy.

Our psychiatrist explained that I’m not usually meant to be the go-between in this process, that the pharmacist is supposed to deal with her…but it’s better if I’m involved, because I’m persistent and follow through. Without my nagging, this stuff tends to sit around on desks somewhere for who knows how long.

THEN, after all that, Mikey is on such a low dose of the medication to start that the pharmacist had to properly mix and dilute it, or whatever it is that they do. I actually was standing around watching this part, which was pretty interesting and involved some beakers and swirling and a little eyepiece thingy like jewelers wear.

This new, banana-flavored medicine is still in the stimulant family, but is reported to have fewer negative side effects (in our case, anxiety all the time and increased aggression as the medication wears off…rebound effect, I think it’s called). We’ll try this small dose for 2 weeks and then regroup.

Thankfully, our pediatrician agreed after the second medication that it is indeed useful to seek an opinion from a specialist. We signed some papers so they can communicate with one another and hopefully, we’ll find a tool that helps Mikey be his best self.



This week, Mikey went to a camp at the Museum of Natural History, although I think maybe it was really at the art museum? Anyway, the theme was Castles, Knights, and Dragons. I assumed he would feel most drawn to learning about dragons. As with many things involving Mikey, I predicted wrong.

Mikey has discovered dungeons.

Boy, did he like learning about dungeons. He then spent the entire week first sketching and then building a model dungeon (while all the other students were working on castles with turrets to put their princesses in, etc.). Each day, his camp teacher would update me on the progress of his dungeon. I learned that he was drawing bad guys and good guys, differentiating between them via facial expressions.

On the last day of camp, the kiddos did an art show, displaying their model castles. Mikey proudly walked me through the details of his creation: he had a rat tunnel, where rats enter the dungeon and eat the prisoners’ food. There was a staircase, where people walked to the top of the dungeon and got shoved through a hole. They then fell down into orange construction paper flames before a worker closed the roof to the dungeon, trapping them inside.

There’s also an outer wall in case the prisoners escaped the main cell of the dungeon. It’s all very detailed! And he did all the work himself, from the cutting to the folding to the masking-taping.

I’m so proud of him, if a wee bit disturbed by his fascination with such a morbid concept.

It’s really a creative piece of work and he’s so proud of it. He had meant to take some Playmobil guys to entrap, but forgot them, so he made people out of pipe cleaners. I think that’s even better!

I wonder how he can spend a whole week devoted to working on one such project, with such gusto and pride, and have such a fabulous experience at camp, but has so many behavior challenges and struggles to stay on task at school. What is it about camp that’s working so well? I’d love to figure out the answer.