Saturday, November 18, 2006

He's not overweight, he's just undertall!

So Sarah took Sacha to the doctor this week as his persistent jaundice had not diminished in the 2 weeks the doctor had initially mentioned. When he got there, his doctor looked him over and was still a little bit concerned and so referred him on to one of the 2 local pediatricians in Timmins. We could get him in that night, so I was able to go as well.

It just so happens that not only is he one of 2 pediatricians in Timmins, he is also 1 of 3 Dutchmen in Timmins (myself and his son, the other pediatrician, included). (Not sure if that 3 is accurate or not, but pretty close.) Johannes Herbertus Verbeek graduated in 1969, so he is certainly no spring chicken. I had heard some funny stories about him, namely that he showed up to a continuing education seminar in rubber boots. I also heard he did not have the most stellar bedside manner. Typical Dutchman.

We got to his office, which is actually an old house used as a doctors office. Quite cool actually. I noticed that he had orange chairs in his waiting room, which I interpreted as his attempt to maintain a connection with his native land. As you may or may not know, orange is essentially the official color of the Netherlands, as the Royal Family is the House of Orange, descendant of William of Orange, liberator of the Dutch people way back when. Sarah thinks that I’m full of crap and that the chairs are just orange.

He certainly was an abrupt man, but seemed very competent. He was extremely thorough in his questioning and even more thorough in his physical examination of Sacha. Sacha thought he was playing with him and was smiling the whole time. He thought it was hilarious. Then came the event that would lead to a night full of grief and concern. Dr. Verbeek measured his length, weight, and…dun, dun, dun…head circumference. Apparently babies heads have a thick layer of fat around their skull impeding appropriate measuring of circumference and thus necessitating the creation of a measuring tape tourniquet to ensure accuracy. His head came in at a miniscule 14.75 inches.

When I got home I was interested in his percentile ranking, as apparently physicians in Timmins do not share such information. He is short (10th percentile). No surprise there. He is light (25th). Bit of a surprise there. However, he is 75th in weight for length. Therefore, he is either overweight for his length, or underlong for his weight.

Then came the real shocker. He was off the charts for head circumference. He was so far below the lower limit, I could barely determine what to classify him as. This would normally be an indicator of developmental delay, but he is clearly not suffering from that. So I panicked for about an hour. How could my child’s head be so small when they do not even make hats large enough to fit mine? Furthermore, how could he be developmentally delayed when there is no other indication as such? Maybe he is a little person, but only in his head.

Then I asked Sarah, “How big was his head when he was measured 3 weeks ago?” She said it was 15.25 inches. Well, now I was really concerned because apparently his head was not only small, it was actually shrinking. I knew we kept it warm in our house, but not that warm. I always make sure to lay him flat to dry.

Finally Sarah ended my angst when she brought out the measuring tape and determined that he was in fact a respectable 15.5 inches. All that worry for nothing.

Some day I will find all the growth charts in the world and burn them. Or at least we could make them password protected and only allow access to parents on their second child.

Friday, October 20, 2006

Typical day in a pharmacy

This is the e-mail that I received awhile ago that made me wet my pants. (If you have chronic problems with that, there is a pill you can take.)

Why your pharmacist hates you so much…

For over a year and a half now, the first thing anyone visiting my little blog garden has seen under the headline at the top of the page is the promise that the question of “why does my prescription take so damn long to fill” will be answered. Tonight I looked over this blogs archives and realized it was a promise not kept. While many topics have been covered here, and you have been provided with ample evidence of how drugstore workday life does indeed warp the mind, the question of why it took 2 hours for you to get 20 Vicodin has remained unanswered. I can’t help but to think there may be someone out there who has been logging on every day for the last 18 months hoping in vain for this mystery to be solved. Should such a person exist, I offer my humble apologies. To everyone else, I offer the following prescription scenario: You come to the counter. I am on the phone with a drunk dude who wants the phone number to the grocery store next door. After I instruct him on the virtues of 411, you tell me your doctor was to phone in your prescription to me. Your doctor hasn’t, and you’re unwilling to wait until he does. Being in a generous mood, I call your doctor’s office and am put on hold for 5 minutes, then informed that your prescription was phoned into my competitor on the other side of town. Phoning the competitor, I am immediately put on hold for 5 minutes before speaking to a clerk, who puts me back on hold to wait for the pharmacist. Your prescription is then transferred to me, and now I have to get the 2 phone calls that have been put on hold while this was being done. Now I return to the counter to ask if we’ve filled prescriptions for you before. For some reason, you think that “for you” means “for your cousin” and you answer my question with a “yes”, whereupon I go to the computer and see you are not on file. The phone rings. You have left to do something very important, such as browse through the monster truck magazines, and do not hear the three PA announcements requesting that you return to the pharmacy. You return eventually, expecting to pick up the finished prescription… …the phone rings… …only to find out that I need to ask your address, phone number, date of birth, if you have any allergies and insurance coverage. You tell me you’re allergic to codeine. Since the prescription is for Vicodin I ask you what exactly codeine did to you when you took it. You say it made your stomach hurt and I roll my eyes and write down “no known allergies” You tell me… …the phone rings… …you have insurance and spend the next 5 minutes looking for your card. You give up and expect me to be able to file your claim anyway. I call my competitor and am immediately put on hold. Upon reaching a human, I ask them what insurance they have on file for you. I get the information and file your claim, which is rejected because you changed jobs 6 months ago. An asshole barges his way to the counter to ask where the bread is… …the phone rings… …I inform you that the insurance the other pharmacy has on file for you isn’t working. You produce a card in under 10 seconds that you seemed to be unable to find before. What you were really doing was hoping your old insurance would still work because it had a lower copay. Your new card prominently displays the logo of Nebraska Blue Cross, and although Nebraska Blue Cross does in fact handle millions of prescription claims every day, for the group you belong to, the claim should go to a company called Caremark, whose log is nowhere on the card… …the phone rings… …A lady comes to the counter wanting to know why the cherry flavored antacid works better than the lemon cream flavored antacid. What probably happened is that she had a milder case of heartburn when she took the cherry flavored brand, as they both use the exact same ingredient in the same strength. She will not be satisfied though until I confirm her belief that the cherry flavored brand is the superior product. I file your claim with Caremark, who rejects it because you had a 30 day supply of Vidodin filled 15 days ago at another pharmacy. You swear to me on your mother’s… …the phone rings… …life that you did not have a Vicodin prescription filled recently. I call Caremark and am immediately placed on hold. The most beautiful woman on the planet walks by and notices not a thing. She has never talked to a pharmacist and never will. Upon reaching a human at Caremark, I am informed that the Vicodin prescription was indeed filled at another of my competitors. When I tell you this, you say you got hydrocodone there, not Vicodin. Another little part of me dies… …the phone rings… …It turns out that a few days after your doctor wrote your last prescription, he told you to take it more frequently, meaning that what Caremark thought was a 30-day supply is indeed a 15-day supply with the new instructions. I call your doctor’s office to confirm this and am immediately placed on hold. My laser printer has a paper jam. It’s time for my tech to go to lunch. Caremark issues the override and your claim goes through. Your insurance saves you 85 cents off the regular price of the prescription… …the phone rings… …At the cash register you sign… …the phone rings… …the acknowledgement that you received a copy of my HIPPA policy and that I offered the required OBRA counselling for new prescriptions. You remark that you’re glad that your last pharmacist told you you shouldn’t take over the counter Tylenol along with the Vicodin, and that the acetaminophen you’re taking instead seems to be working pretty well. I break the news to you that Tylenol is simply a brand name for acetaminophen and you don’t believe me. You fumble around for 2 minutes looking for your checkbook and spend another 2 minutes making out a check for four dollars and sixty seven cents. You ask why the tablets look different that those you got at the other pharmacy. I explain that they are from a different manufacturer. Tomorrow you’ll be back to tell me they don’t work as well. Now imagine this wasn’t you at all, but the person who dropped off their prescription three people ahead of you, and you’ll start to have an idea why your prescription takes so damn long to fill.