Our Wonderful Military Medical System and an Update on Kyle's Health!

I will be the first to say that all of my children have received good medical care through the military treatment facilities (MTFs) we’ve been stationed with.  Great, even.  Actually, with Zack and Kyle, I only have the experience with the RAF Lakenheath Hospital, but through Laura’s growing up years and six assignments all over the globe, I have been pretty happy as a parent with the quality of care.  Speaking as a patient, that goes for me, too.  Mostly. 

I am, however, less than happy with the medical admin side of things, and my experience here at the RAF Lakenheath Hospital, trying to navigate the military healthcare system with two post-institutional, internationally adopted children…well, to say this has been a negative experience is a huge understatement.  Huge. 

But first, the good news – after a little “squeaky wheeling”, this mommy got her newly home China boy seen by a pediatrician less than 72 hours after enrolling him in DEERS.  I don’t have the energy to explain DEERS – short answer is, it’s insurance/benefits stuff.  After getting him “eligible” to make medical appointments, I called the appointment line to get him set up with his initial appointments.  Kyle needs lots of medical care, but according to the Air Force, he needs to be seen by dental and pediatrics so they can evaluate him on his fitness for something called “command sponsorship”.  Again…something I don’t have the energy to explain in this blog post.  The truly curious can Google it.  It is a Pain. In. The. Hiney.  Anyhoo…I was told by the nice clerk on the appointment line that Kyle could not have a peds appointment and that she’d have to pass our case to the nurses in peds and they’d have 72 hours to get back to me.  Yes…I know…they don’t know me very well. 

Apparently Blogger will only let me upload one picture per post and this is going to be it...I'm sure I am doing something wrong, but until I get my IT guy to look...you will have to be content with this one little shot of my "virtual twins" in the top bunk.  This harmony did not last long, BTW.

 

I explained our particulars and asked that she put a note in the phone consult asking that the call back to me be expedited.  She agreed to do this but warned me that I shouldn’t hope or expect that I’d be called any sooner than 72 hours.  So.  In my infinite patience, I waited a full 24 before visiting the peds clinic in person…really, I just wanted to give myself the warm fuzzy that the peds nurses did indeed have our consult (no…I didn’t trust the appointment line), and if they did, I had planned to apply a little friendly pressure. 

As it turned out, the nurse did indeed have our consult.  I again tried to explain our particulars to him, but he was more interested in talking at me than listening to me.  In the time it took him to explain why he could not triage us, he could have triaged us.  Whatever.  The end state of the conversation was that he hoped to be able to call us to schedule an appointment by the next day and that this appointment wouldn’t likely happen for 2-3 weeks. 

Yes, I pushed.  I pushed nicely and in a professional manner, but I pushed.  I told him that as a medical professional, that he could hopefully recognize that a child who has been in a Chinese orphanage for 3 years might not be in the best medical shape.  I pointed to my 3.5 year old child who was flitting around the waiting room in his cute, 12 month old overalls and voiced my concerns about his overall health and nutrition and stated that I didn’t think it would be in this child’s best interest to wait that long.  I got the “he’s in a good home now, everything will be fine.  This will all work out”.  I have been a nervous, first-time parent.  I am not one now. Did not particularly like being spoken to as if I were one.  I tried the “if I’d have pushed this kid out upstairs in L&D, no one would make him wait that long to receive medical attention”…and yes, thank you…I did voice it much more tactfully than that.  I didn’t use the word “pushing him out” but I might have said “adoption discrimination”.  I left a little pissed off and close to tears, honestly, with an invitation to complain via a website on a little card I was given.  The nurse told me "I'm sure you really don't want to call it a complaint, but if you should so choose..."  I told him that I called things as they were and that "just between us girls" (okay, I didn't really say that) there would be some complaining going on. 

We did get a call when we got home and we were offered an appointment about 2 weeks out.  I took the appointment and told the nice nurse that I was willing to accept any type of short notice appointment, should they have a cancellation.  He warned me that this was probably not possible but I was insistent that I wanted to be called if there was anything that came up on the schedule sooner.  He promised to try.  I was not feelin’ him. 

At the suggestion of someone who shall remain anonymous, I committed the cardinal sin of emailing our pediatrician directly.  Although Zack hasn’t needed a whole lot of medical care in the year he’s been home with us, I was confident that our pediatrician would know who we were and understand our situation, at least a little.  We had an appointment with one of his colleagues the following afternoon.  Part of my wants to gloat…but really…I am just so grateful we were seen. 

This. Doctor. Is. Amazing.  We love our pediatrician, Dr. Sayers.  We do.  But Dr. Kiel had actually had some experience caring for internationally adopted kids and she actually had some reference material she was working off of about what care the post-institutional child needed.  She was nice, and super thorough, and allowed me to talk and actually listened.  She did not try to talk over us while we were explaining something or ask a question.  Our 30 minute appointment pushed the two hour mark and she never showed any signs of impatience or the nonverbal "how can I get rid of this family?"  Not one time. 

The nurse was a nice guy.  He really was.  He is probably a good nurse, too.  Let's all give him the benefit of the doubt.  But my encounter with him wasn’t positive.  He kept telling me how busy the peds clinic is and how undermanned they are.  Hmmm…doing more with less?  Sounds familiar.  I would NEVER give this line to one of our clients.  I walked away from our encounter thinking that perhaps I should have apologized for daring to present a new child for care the week that school starts.  Almost.  I mean…really?  Our child is in line behind school physicals and requests for inhaler refills?  Really?  Should we really have planned our adoption trip around school starting?  We traveled as soon as we were able.  Perhaps Kyle should have sat another couple of weeks in the Zhifu Children's Welfare Institute being practically starved to death to make it more convineient to be seen in peds.  Give. Me. A. Break.

I have a little bit of moxie.  I don’t give up easily and when it comes to my children, I’m willing to fight for what I think is in their best interest.  I could not be less interested in training at the clinic, hospital manning or surge in requests for appointments because of school starting.  As a manager of people and resources in a client-based organization…yes, I get all of these things.  But I’d never stoop to expecting our clients to accept my managerial challenges as a basis for getting less than the best service we can give.  RAF Lakenheath Hospital admin – try the approach of “yes, if” versus the “off the cuff no”.  Asking me as a parent of a child in need of medical assistance to cut the peds clinic some slack because it’s a busy week?  Foul. 

So.  Our awesome “temporary pediatrician” asked if we could “give her the weekend” to draft up a plan for Kyle’s care.  “uh…yes?”  I seriously wanted to hug her.  She did not seem the huggy type so I didn’t.  She mentioned referrals to civilian GI/urology, to early intervention, to a developmental pediatrician, to a nutritionist, and to immunology (because her tech’s benign suggestion that Kyle just be “revaccinated because it’s too hard to read his Chinese shot record” made me get that crazy look where you think my head might spin around.  Yeah…you know the one.  She wanted the weekend to research what labs she needed to order.  You mean…I didn’t have to present her with a list of what I wanted my child screened for?  This is unreal?!?!

So…we have a few medical appointments in our future.  Our little guy is most certainly going to need some surgery and some extra TLC and monitoring to make sure he catches up nutritionally and developmentally.  But we’ve got a few medical professionals in our corner who seem committed to helping Kyle get to where he needs to be.  Honestly…if I could have looked ahead and seen a snapshot of my life at this moment last January when we accepted Kyle’s referral…I don’t think I would be inclined to say yes.  I would have said “no…I think that is more than we can handle.”

But…we accepted Kyle’s referral based on the information we got.  And really, with adding any child to your family, however you do it, isn’t it a chance?  A leap of faith?  Acceptance of the unknown?  I really believe that Kyle is where he is supposed to be.  I really believe the hand of God was active in placing him with our family.  Were his medical issues a surprise?  Oh heck yeah.  Can we manage?  Yes.  We can.  But the “omigosh this isn’t what we signed up for” is still alive and kicking.

I do have to say…I love this little guy.  He is one tough nut and he’s such a sweet and loving little soul.  And so it is another day...and we are managing.  One. Day. At. A. Time. 

Cheers, people.  We are hanging in there. Pray for us.  Send us happy thoughts.  Throw some fairy dust our way or dance naked/chant around the fire.  Whatever is your thing.   Cheers, people.