Becky's Journal

As many of you know, my son Andrew (13) suffers from anxiety and depression as a result of past trauma (PTSD). Over the years, he has been on various medications for this and for related conditions (such as trouble sleeping). His depression manifests in various ways, and being a teenager has made him even worse in some ways.

Right now he's on a combination of medications -- Effexor for depression and Clonidine for impulse control and to help him sleep. The Clonidine has had the excellent side effect of helping him with some other physical problems he has been dealing with.

Last week I noticed that Andrew was running low on his Effexor. I called the refill request in to the pharmacy. I expected that it would be ready in a day or two... Not right away because the doctor needed to approve the refill request.

A couple of days went by, and Andrew ran out of Effexor. I knew that we had to get more ASAP because he crashes hard when he suddenly goes off of this med. I mean, the depression and anxiety are probably 10x worse than how he was even before he was on meds. We can maybe limp by a day or two but it gets bad after that.

Come Sunday Andrew was out of sorts. He moped around the house, didn't talk to me much. He didn't respond to me when I told him it was lunchtime. At dinnertime he came storming downstairs demanding food. He was angry about not getting lunch. He started screaming at me and pounding on the walls. I sent him upstairs to cool down and he stood in his room and pounded on things up there, crying and screaming. Eventually he came out of his room and downstairs and announced that he was going to go into traffic and kill himself.

I followed him out the door to make sure he didn't do that. I took the phone with me and called the pharmacy to find out what the holdup was. I was told that the pharmacy had been in contact with the insurance company (actually Medi-Cal, state insurance that we have because we are low income and my job does not provide health benefits). The insurance company was requiring prior authorization. But I was welcome to come get meds from the pharmacy, one day's worth for $19. Great.

While I was on the phone, Andrew ran into the street (luckily we don't live on a busy street) and then back again and tried to attack me. I decided he needed to go to the hospital.

I took Andrew to the county emergency psychiatric unit, which is luckily just a few miles away. He was admitted in right away after I did a little bit of paperwork. They assessed him and kept him overnight. He had his meds and came home the next day feeling a lot better, and much more safe at home.

I went down and paid $19 for a day's worth of pills (that's two Effexor XR 75mg capsules!) for today and called the pharmacy today to ask what was up.

You know what they said? The real reason for the delay was that Medi-Cal had decided that Andrew should be on one 150mg capsule instead of two 75mg capsules. This was their reason for delaying the prescription. For which they will have to pay for his overnight hospital stay. I was so angry. Of course Andrew can swallow a slightly bigger capsule. That would have been preferable to, say, him becoming suicidal. But to me it just seems like a stalling tactic. Maybe if we didn't bother with it, we'd go away and they wouldn't have to pay for his medication?

I looked up the medication. I thought... Maybe the bureaucrats down at Medi-Cal were trying to save the taxpayers money. (I had my doubts about this, since when we switched to Medi-Cal they actually insisted we switch from the less expensive generic to the outrageously expensive brand name! What the heck??) So I found out that the 75mg capsules are two for $19. The 150mg are $17 each. So I suppose they are saving themselves a few dollars. Although anyone in healthcare can tell you that Medi-Cal rarely pays more than a tiny percentage of what they are billed. I have some outrageous examples from my son Ricky's past hospital bills. But I will save that for another time.

So to save a few bucks, Medi-Cal delayed Andrew's prescription. And he ended up in the hospital. It may have worked out okay, but what if he had hurt himself or someone else? What then? I am very angry about this. I don't know what can be done but... It seems to me that something needs to change in this state, to the state of the mental health care/general health care systems. Red tape is coming before patients' health and safety. Where did things go wrong? They are so, so wrong.

Thanks for the nudges. I really am alive. As some of you know, we did score a great house and moved in, in the middle of May. It's a charming little 98 year old farmhouse in the Rosegarden area of San Jose. It's actually not TOO little... Four bedrooms and two baths, with a 10,500 sq ft lot. It's HUGE. And I finally have my own garden. Like, an in-the-ground garden, not in containers.



There are lots more pictures of the house here. It's an old house and as such we have been dealing with lots of old house issues... Windows that won't open or are otherwise defective, a garage that needs work (and therefore we have EVERYTHING in the house... it's still quite cluttered and maddening, especially to Liz), no air conditioning (I'm the fan queen), funny construction (the house seems to slant downhill in places, for instance). But overall... We love it. We have christened it "The Farmhouse in the Garden" (or FiG). :)

(And if any of you would like my new address, please let me know.)

Things with the kids are going okay. We've had to shuffle around school placements. We are now in San Jose Unified School District, the biggest one in the area but not without its faults and frustrations. At this point it looks like Andrew will be allowed to keep his county program placement. Ricky will be going to the same high school as Liz's son Kevin, which is down in south San Jose by their old house. There's a life skills program there that's a lot like the one he was going to transition into in the old district. Both boys are going to be in summer school. Well, Ricky is right now; Andrew starts on July 5 (my birthday). Andrew's county program is the same one Ricky was in for 2-1/2 years so ultimately Andrew will graduate from the same middle school Ricky did. :) Misty is going to be starting kindergarten in the fall (!) and turns 5 next month. She will be going to the neighborhood school. And she is EXCITED.

In June I have had plenty of hours but that will be changing because the library's hours are changing drastically starting next week and all branches will be on a four day schedule. I am not sure how this will ultimately affect me; we shall see.

Oh, the new house is a block and a half from the Y. So we have renewed our membership and have been walking over to swim a lot lately. In fact tomorrow I am going back there with the kids (mine and Kevin).

And now... The knee saga. Sigh. I'm on state funded insurance. I injured my knee in December. My doctor refused to do anything until March, saying it could heal.  Then I had a negative x-ray and she referred me for an MRI which I finally got 3 months later (because the wait was that long). Then she waited 3 more weeks even to give me my results and I had to hound staff and dial random extensions to get an appt. Turns out I have a torn medial meniscus, torn MCL, and patellofemeral syndrome, which has caused knee instability and made me fall down the stairs in the new house twice, injuring my other knee similarly. It has now been 6 months since my original injury and I am looking at a wait of at least 3 months to see a surgeon. And then? Who knows.

So that's it for now... I will again promise to be a more regular correspondent. I spent a lot of today catching up on other people's LJs. I hope you haven't all given up on me!