I called the ins. company this afternoon. I just couldn't get the odd reasons for not calling in neb meds for David out of my head.
They were very nice and said they agreed with my preventative approach and (furthermore) based on David's history alone they would approve a separate nebulizer AND the meds. (To be completely honest, the woman on the line seemed quite surprised we didn't have these things on hand already after reviewing his history.) The person was knowledgeable about the medications, treatment options, preventative care and equipment (refreshing) and told me to get a second opinion if the pedi wouldn't write the order.
It might be our secondary policy that's the issue - in which case I would decline using it - but sometimes I can't do that...it's complicated because we pay for a secondary policy under the Medicaid system for them...and just explaining how we came to that is complicated - even when talking to the Medicaid people never mind office staff and doctors...I have a call in with the pedi explaining what I discussed with the ins. rep so I'll see what comes of it. Nothing simple I'm sure. (sigh).
Lizzie's appointment went well. Her bloodwork and physical exam came out ok - no burning red flags anyhow. She has lost just over 6 pounds. Her vertebrae and hip bones are showing, but her coat still looks beautiful. She's behaving generally well but for her ravenous appetite and not putting on weight despite being given extra food - almost as if she's not absorbing what she's eating. I am working a bit more with her diet and we'll go back in a week for a weight check. If she continues to loose, our next step is to take some xrays...
Ready to put this day to bed - Mary Louise already "unadjusted" her glasses by playing rough with David and smashing them against her face. So, please ignore my little crooked eyed kiddos for a couple of years (uh -because I'm pretty sure this trend won't end anytime soon).