Tuesday, June 29, 2010

My Insurance Nightmare

I'm living an insurance nightmare. When the girls were born, both Robin and I had insurance through our respective employers. Because I was planning to take a leave of absence from my job (and hence lose my benefits), we were going to add the girls to Robin's policy. That decision has started us on a path that feels like a dog chasing its tail. I haven't seen all of the bills yet, but I'm sure you're wondering how much it costs to have intensive pre-natal care, be hospitalized for 11 days, give birth via c-section, stay in the hospital for 4 more days AND have 3 girls in the NICU for 59, 63 and 70 days. Based upon what I have seen, I'm estimating the final cost to be approximately $1,750,000.

When babies are born, they are automatically "covered" under the mother's insurance policy for the first 30 days. They do not need to be "added" to the plan, but if they are not added then coverage ends after that 30 day period. Simple enough, and I was fully aware of this fact. However, I thought we could just deny that coverage and add them to Robin's policy. As soon as I could, I gave all of the providers Robin's insurance information. Only one provider followed through and billed Robin's insurance. I wish they would not have done that.....

After much run around, I have discovered that there is this little known (or at least not known to me and my first job out of law school was in-house counsel for an health insurance company) law called the "birthday rule." Insurance companies live for denying coverage. This fact I know first hand from my first job. In order to keep them from arguing about which one is primary when both a mother and a father have coverage, they apply the birthday rule which states that whichever parent's birthday comes first in the calendar year is the primary insurance. Well, that's me. So, now we know that the girls must be covered by my insurance, as primary, for the first 30 days and Robin's insurance is secondary. After the 30 day period, Robin's insurance is primary.

This is all fine and dandy, BUT because we didn't "add" the girls to my policy they are added as BG (baby girl). So, now my insurance company is getting three bills for the same service for BG (probably somewhere on the bill it says BG1 or 2 or 3). They think they are being billed in triplicate, and they deny two of the claims. I continue to call and explain the situation to them, but they can't include the girls' names unless we "add" them. FINALLY, someone who is trying to collect money (the doctor), gets their insurance rep to add the girls' names, which fixed that problem on that end.

Next problem - when we added the girls to Robin's plan, I put down that they did not have any other coverage because I was not aware of the "birthday rule." They paid approximately $250,000 in claims (from the aforementioned NICU doctor) as primary, when they should have been secondary. Ugh. Now Robin's insurance is all pissed off. They are holding all claims as "pending" until they can get information from my insurance company about coverage dates. I received a 2 inch thick packet of "overpayment letters" regarding these claims. I have sent them the prior coverage information twice now, but it is still being held. Meanwhile, providers are getting angry and sending me bills. Ugh, ugh, ugh.....

I think I'm really close to solving this nightmare of a problem, but seriously, do they think I have all the time in the world to spend on the phone arguing with customer service reps who refuse to transfer me to someone who can actually help me?

Currently, all of our unpaid claims are being held by Robin's insurance company in the "large claims" department. I'm trying my hardest to get them released, but seriously...what a nightmare.....

Wish me luck.

First Bite

On Monday June 28th, I gave the girls carrots for the first time. They all made ugly faces at the new taste. Katherine did the best with actually eating them. On Tuesday, both Katherine and Margaret actually ate some of the carrots. Isabella likes to spit hers out. Next week we'll try a new vegetable. Here are some pictures from their first bite:

Katherine:



Margaret:



Isabella:



And - this one of Isabella says it all:

Saturday, June 26, 2010

Handedness

I'm left handed and Robin is right handed. Having grown up in Asia, Robin thinks that everyone should be right handed. I agree that we live in a world that is mostly geared toward right handed people - school desks, scissors, etc. Maybe it doesn't bother me so much because I'm fairly ambidextrous. I pretty much only use my left hand for writing, talking on the phone (good thing I didn't get the iPhone 4G) and spreading butter with a knife. Everything else I do with my right hand - bowling, shooting pool, using scissors, cutting with a knife, etc. As an aside - it's difficult to cut butter with your right hand and then spread it with your left because the butter is always on the wrong side of the knife.

Anyway - Robin thinks our girls need to be right handed to make life easier. I think it's something we're born with, but we can be taught to use the other hand. I just want to let the girls be who they are and not try to influence it.

I have recently noticed that both Katherine and Margaret chew on their right hands when they're hungry. Isabella doesn't chew on her fist very often, but when she does it's her left one. Therefore, I predict that Katherine and Margaret will be right handed and Isabella will be left handed. I have no idea if these events are related. Only time will tell (so long as Robin doesn't intervene), but I have officially made my prediction.

Friday, June 25, 2010

To minivan, or not to minivan

For me, the answer is simple: not to minivan. Why am I posing this question? Because we're going to need a new car. For those of you that know us well, you know we are car people. We've had more cars in the last 12 years than most people have in a lifetime. Here's a list of the cars we've had since we've been married, which is only 6 of the 12 aforementioned years:

1. 1996 4Runner (grey)
2. 2000 Kia Sephia
3. 2004 WRX
4. 2005 BMW 325xi
5. 2005 Scion tC
6. 2002 Audi A6 Avant (my current ride)
7. 1996 4Runner (red)
8. 1985 Supra (black)
9. 1985 Supra (silver) (Robin’s current ride)
10. 2008 Outback 2.5xt

I'm not sure I could even come up with an accurate list that includes the previous six years, but some of the highlights include a Mitsubishi Eclipse, Toyota Corolla, Jeep Cherokee and a Honda Accord.

In 2008, we owned 5 cars at one time (numbers 6-10 on the above list). I asked my insurance agent about a fleet discount, and, just in case you're wondering, you need 10 cars to qualify. So, how is it that we are now in a situation where we do not have two cars that meet our needs? Robin insists on keeping his Supra, which doesn't bother me except that it's so impractical. He can't drive it when it's snowing, AND it most certainly cannot fit three car seats. We had to sell the Outback because it couldn't fit three car seats.

Last night my Audi started acting up. We're pretty sure we know what the problem is, but now the dilemma arises. How do we get the Audi to the dealership (it's a recall issue - otherwise we wouldn't take it to a dealership) and get Robin to work? Luckily, the dealership has a shuttle that can take Robin to and from work, but when we need to take it in to our trusted Audi repair shop that is only open from 8-5 (not working people friendly) how do we do it? More importantly, if the Audi needs to be in the shop for a few days, we cannot take the girls anywhere. Thus, we need a back-up car that can take Robin to work in the winter and that can fit three car seats.

Now, back to the original dilemma - I vote for a Honda Pilot. I hate minivans. I really don't see how they are any more practical than an SUV with a 3rd row of seats. You have to put at least 2 of the kids in the back of the van anyway, and that leaves little room for storage or carrying big items - oh say a triple stroller. Plus, you have to get into the van to get them in the back. My back already hurts, I don't need that. Lastly, minivans are not AWD. Our alley and driveway pretty much necessitate AWD in the winter. The thought of getting stuck somewhere with three babies in the car is very unappealing (I mean somewhere other than the alley).

Anyway - we're in the market for a good used something or other. For anyone out there actually reading this - any suggestions? Here are the criteria: leather seats (much easier to clean with kids), 3rd row of seats, AWD, enough room in the back for a triple stroller.

Tuesday, June 22, 2010

A Day of Firsts

Today marks the day of a few important firsts in the girls' lives. First, they are now scooting around their cribs. As I noted in my last post, Katherine did at least a 180 and Isabella did at least at 90 degree turn.

At 9:30 this morning, I went in to check on the girls before I warmed their bottles. What did I find? Margaret full on sucking her thumb. Ugh! I don't want any thumb suckers. She is the only one who really relies on her pacifier at night. On the plus side though, it already appears that she has an overbite, so I am already prepared for her to need braces. Yes, I know they are only 4 months old, and I'm already thinking about orthodontia.



This is not a first, but it does fit in with the "planning ahead theme." My girls are 4 months old, and I have already put them on a wait list for kindergarten at Cherry Creek Academy, a charter school. Here's my reasoning. First, we currently live in a terrible school district. Secondly, it's a difficult charter school to get into. Lastly, we don't live in the Cherry Creek school district, so we're on the bottom of the list for people they admit. I've heard it can take up to 3 years to get into this particular school even if you do live in the district. As I was filling out the forms, I thought about the movie Baby Boom with Diane Keaton. Here is the excerpt from the movie:

Mother 1: How about a week from Wednesday for Jr. Symphony?

Mother2: No, no, no Cole has drama on Wednesday.

Mother 1: Ben has to play the French Horn on Monday, Gymboree on Tuesday, Computer Readiness on Thursday. What about Friday? After violin, but before his shrink.

Mother 2: Perfect.

Mother 3: (Comes to the park with her son and meets up with mothers 2&3) Cosby go play in the sandbox.

Mother 2: What is wrong with you? You look awful.

Mother 3: We heard from Dalton, Cosby didn’t get in.

Mother 1 & 2: (in unison) Oh no!

Mother 3: I’m so upset, if she doesn’t get into the right preschool, she’s not going to get into the right kindergarten, if she doesn’t get into the right kindergarten, I can forget about a good prep school and any hope of an Ivy League College.

Mother 1: Honey, that is devastating.

Mother 3: I just don’t understand it. Her resume was perfect, her references were impeccable. Dennis is going to kill me.

J.C.: Excuse me, I heard you talking about preschools, and I was wondering, what age do they actually start? I forget.

Mother 1: It depends, 2 ½ or 3.

J. C.: All the good schools, are they hard to get into?

Mother 2: Ha, ha, ha, are you kidding. I had Alexis registered at the Preschool for the Performing Arts, since birth.

Mother 1: (Patting her pregnant stomach) He’s already on the waiting list for Dalton.

J.C.: So if you are not on the waiting list or something by now.

Mother 2: You can forget it honey.

Ben (Child of mother number 1) Mom

Mother 1: Hi honey.

Ben: Does the sky look like St Bay of Mercy?

Mother 1: Gee it does, oh Ben that is a terrific observation. Go play honey.

J.C: They teach Susanne in preschool.

Mother 1: No, Ben is a graduate of the center.

Mother 2: Oh, that’s an idea for you.

J.C.: The center? What’s that?

Mother 1: It’s a week long intensive training program that literally teaches you how to multiply your child’s intelligence. When we first went there, Ben could barely speak. By the time we left, he was residing the Raven.

Mother 2: What kind of classes do you have your daughter in now?

J.C.: Oh, none.

Mother 2: Not even a Mommy and me.

J.C.: No

Mother 1: Gymboree.

J.C.: No

Mother 2: Not reading readiness?

J.C.: Nothing, the child can’t even hold a cup.

Mother 2: The other babies are way ahead of her.

Mother 3: And I thought I had problems.



I can't believe I remembered this from a 1987 movie. I was only 9! I guess the idea of getting my kids into a good school was ingrained in me. Anyway....I digress.

Back to firsts - this morning I gave the girls rice cereal from a spoon for the first time. I started giving them rice cereal in their bottles several weeks ago, so the taste is not new. The spoon thing though, that's an entirely different story. Let's just say it didn't go so well. They didn't get it, but I didn't expect them to. It's all about practice says the pediatrician. So, practice we shall do! For some silly reason, I decided to give the rice cereal a try. Big mistake - I'll leave it at that.





Schedule, Schedule, Schedule

When you have triplets, sanity equals schedule. The babies were on a strict schedule in the NICU. Every three hours they had their temperature taken, diaper changed and they were fed. When we brought Margaret home, it was *easy* to maintain the three hour schedule. When Isabella joined her at home, I thought I was going to lose my mind. Three hours isn't much time when it takes almost 1 full hour to get two babies to eat. By the time you're done feeding two, it's only two more hours until you have to start all over again. The pediatrician suggested that I wait until all three come home to move them to a four hour schedule, but I just couldn't wait. I immediately switched Margaret and Isabella to a four hour schedule. Luckily, they adjusted very well. When Katherine came home, she seamlessly joined her sisters on the four hour schedule. Now, after having them home for two months, I can complete the feedings in about 45 minutes to 1 hour, and they are still on the four hour schedule (except they sleep 8 hours at night).

I assume many people wonder what my days are like. Well, wait no longer - big drum roll - here it is:

Between 12am-12:30am (yes, I mean midnight) - go to bed

5:30am - Robin gets up to feed and change the girls.

between 8:30-9:30am, I get up. See, I'm very well rested! *I'm up early today because we're getting a new roof.

10am - feed, change diapers and change the girls clothes. I hate changing their clothes, so they generally just wear a onesie and a sleeper all the time. New outfits every 24 hours. Do I hear my name being called in the mother of the year nominations?!?! :-)

11am to 2pm - Do general housework and watch TV. Every couple days, I give the girls a bath at 11:30am, which takes 1 hour.

2pm - feed and change the girls

3pm - 6pm - Do general housework, have tummy time, watch TV.

6pm - Feed and change the girls

7pm - Cook dinner

10pm - Feed and change the girls. This feeding usually goes faster than the others because I add rice cereal to their bottles. I've been doing this since they were 11 weeks old, and they've been sleeping through the night since they were 12 weeks old. I brought the idea up to my pediatrician, and he encouraged it.

10:30pm-12am - Lots of computer time

Generally between feedings, the girls sleep. So, for now, I'm able to get a lot done (and stay caught up on all of my TV shows - hmmmm - can you tell that I enjoy watching TV?!?!). The witching hours are between 8pm - 10pm. All three girls usually scream and scream. I'm not sure if it's colic or just that it's so much hotter in the house at night (we do have a swamp cooler).

I plan to start on solid (ok, pureed) foods later this week or next week. First I will try rice cereal on a spoon. I'm excited to make my own baby food. Hopefully I'll have the time and energy to do it. As the girls begin to be awake more and move around more (Robin found Isabella rotated 90 degrees and Katherine rotated 180 degrees in their cribs this morning - and for all we know Margaret had done a full 360), I'll be much busier.

Monday, June 21, 2010

Life in the NICU

Immediately after the girls were born, they were whisked off to the NICU (neonatal intensive care unit). I was sent to the recovery room and then moved to the family care unit. I desperately wanted to see my girls, but I couldn't get up to go see them (spinal block). Robin followed the girls to the NICU and was able to get some great pictures and videos for me to see. He also recorded my entire c-section, which I watched while in the recovery room. That night, Robin spent several hours in the NICU holding Isabella. I was so upset and jealous, but I kept telling myself that it was important for the girls to have skin-to-skin contact. Robin didn't come back to my room until around midnight. The next morning I was finally able to get up and go see my girls.

Katherine:





Margaret:



Isabella:




My first trip to the NICU was overwhelming. Swedish Hospital has private NICU rooms, which is so nice. They even have a special room designed just for triplets (and they have two twin rooms). So, all of my girls were in one room that had two couches and cabinet with a safe just for our stuff. At this point we were only allowed to hold each girl for 30-45 minutes per day. I think I held Katherine first, but honestly, I can't remember (see...I should have been blogging all along!). Because I was carrying triplets, I knew that they would be in the NICU for some period of time. So, the whole NICU experience for me was not traumatic because I expected it, but seeing my girls in the isolets for the first time with three nurses all introducing themselves at the same time was overwhelming...not to mention I had just had major surgery! For at least the first week, each girl had their own nurse.

The girls were remarkably healthy for their gestational age. I felt lucky that my girls were in the NICU because they were born early, not because they had major health problems. Katherine was put on a CPAP (continuous positive airway pressure machine) for 4 days. By day 16, she was completely off oxygen. Margaret was also on the CPAP for 4 days, then a high flow nasal cannula for 10 days and lastly a low flow nasal cannula. When Margaret was discharged, so was still on a very small amount of oxygen until the beginning of May. Isabella was put on a ventilator for the first 18 hours. She was then on the CPAP for 4 days, and by day 22 she was completely off oxygen.

It was hard going to the hospital every day. I could only hold each girl for up to 1 hour each day. I had to balance my time holding them with Robin's time to hold them. I was at the hospital twice a day.

We got to know our nurses really well. There were some that we liked better than others. Most of our "primary" nurses were young, and we bonded with them. We even set one of the nurses up on a date with one of Robin's co-workers.

Margaret was the first to go home. She was the smallest at birth, and she was "Baby C" in utero who caused the premature birth. I nicknamed her "Mighty Margaret." She went home on April 15th (59 days), her two month birthday. She was still two weeks shy of her due date. On April 19th (63 days), Isabella came home. Katherine was having issues eating, so she stayed longer. At first it was quite overwhelming to have two babies at home. I know the doctors could sense that, and I think they kept Katherine a few days longer than necessary just to let me adjust. Katherine was discharged on April 26th (70 days), exactly 10 weeks old and one day shy of her official due date. The funny this is, Katherine is now the fastest eater.

In the end, I'm so thankful for the NICU experinece. I learned how so much from the nurses. I would have been so overwhelmed had I just taken them straight home from the hospital. Robin and I had the opportunity to learn so much about parenting babies before we took them home. It made for such a smooth transition. We do not argue or question one another about caring for the girls because we were already on the same page before they came home. I think every parent (not child) could benefit from some time in the NICU.

Saturday, June 19, 2010

My Pregnancy

I should have started blogging a long time ago. I feel as though I have missed out on capturing certain moments in my girls' lives. So, I will start here with a summary of my pregnancy.

September 2009 - I first found out I was pregnant on September 3, 2009 after taking 3 home pregnancy tests (I had to be sure!). I scheduled my first appointment with my OB/GYN for September 8th. I assumed the appointment would be more in depth, but instead they only did ANOTHER pregnancy test. She scheduled an ultrasound for September 22nd. Normally I would not be able to get an ultrasound so early in the pregnancy, but she said she would code it as "viability" so insurance would pay for it. So, there we are on September 22nd getting our first ultrasound. The tech says to me, "Were you using fertility drugs?" It didn't even occur to me why she would ask such a question, so I just said, "No." She quickly responded with, "Well, you're pregnant with triplets." Boom - just like that. I felt like I had been hit by a MAC truck. The first image that came into my head was a very large stroller. (As an aside, you have to understand that I hate strollers, and I think they should be banned from the mall. Now, here I come with the largest stroller ever. One word - Karma) I immediately burst into tears, and Robin burst out laughing. And, just like that the ultrasound was over. We were taken to a different room where a doctor came in to "answer any questions we might have." We were told that this is a high risk pregnancy, and they would not be able to see me. I was referred to Dr. Heyborne, a perinatologist, at Swedish hospital. The next couple of days were a blur. I was overwhelmed with emotions and concerns.



I first saw Dr. Heyborne on September 29th. One of my first questions for Dr. Heyborne was whether I would be able to go on the cruise that we had already booked for November. He responded with, "Did you buy travel insurance?" Of course, we hadn't. We booked the cruise in June 2009. We knew we were trying to get pregnant, but we didn't foresee triplets. Every visit I always asked if I would be able to go on the cruise.




October 2009 - I had another ultrasound on October 14th.



I continued to be seen by Dr. Heyborne every two weeks.

November 2009 - Time to cruise! During my 17th and 18th weeks of pregnancy, Robin and I took what promises to be our last great big vacation for several years. We cruised for 10 nights. We left Miami and stopped in Labadee, Haiti; Cartagena, Colombia; Colon, Panama; Puerto Limon, Costa Rica and Grand Cayman. It was amazing. Looking back, I'm surprised that Dr. Heyborne let me go. I can now see how many complications could have arisen. Luckily - none did.



January 2010 - I had my first of three (how fitting!) baby showers on January 2nd. It was thrown by my co-workers. On January 16th, I had a baby shower with my family. Then, on January 30th I had a baby shower with all of my close friends.








February 2010 - I decided to start my maternity leave effective February 1st. I was starting to get very tired and needed some time to finish the nursery while I still could! On February 2nd, I started to leak fluid. I called the doctor, and went in for an ultrasound on February 3rd. My cervix was still very long, but it appeared that one of the amniotic sacs may have ruptured. It was hard to tell, so they told me to come back the next day. On February 4th, I went back for another ultrasound, and I didn't leave the hospital until February 19th. I was admitted on the 4th because it appeared that Baby C's sac had broken. Aside from the great food (I'm serious!), life in the hospital was horrible. I had to be monitored three times a day for one hour each time. Now, that may not seem so bad, but it takes a long time to find three heartbeats. And, it's hard to sit still with an aching back for that long. On Valentine's Day, I started to bleed pretty heavily. The nurse didn't really listen to me, which in the end made me happy because I did not want Valentine's babies. On Monday February 15th, Dr. Heyborne delivered my three little girls at 29 weeks, 6 days. Katherine Dorothy - 2lbs 11oz, Margaret Elizabeth - 2lbs 9oz and Isabella Josephine - 3lbs 1oz. Their official due date wasn't until April 27th.

This picture was taken February 14th at 29 weeks, 5 days. I had no idea it would be my last "belly" picture and that my girls would arrive the next day.



The birth announcement: