Tuesday, June 23, 2009

The Cough, part deux

So we just got back from the doctor's office. As predicted, Claire didn't cough once. I tried, but I couldn't get a video of her coughing before we left. The kids were super good. Claire didn't cry once. MG played with the germ toys and let me talk to the doctor. I even remembered to Purell their hands twice, so hopefully we won't get any creepin' crud from all the germy toys.

He thinks it's reflux, which she also had and took medicine for when she was 6 weeks old, and gave us a prescription for liquid Pepcid (I think... see below) that is not covered by insurance and is going to be $60. There's no generic alternative, either. Here's hoping it doesn't work, because giving her a $60 prescription every night until she outgrows this is going to get spendy.

I'd do it, of course. And I'd be thankful that we could afford it. But I reserve the right to hope that something cheaper works, instead. She'd totally chew up a Tums and think it was candy. Not sure why I can't do that. Hmmmm...

I said, "I think," because our pharmacy didn't have any, so they're calling around to the other pharmacies in town to see if anyone has it, and they're going to call me if/when they find some. It could've been Mylanta or some other form of antacid.

Phone rings, time passes.

Oh hey - they just called, it is Pepcid and no one in town has it. Lovely. Called the doc back to see if there's an alternative, preferably something that's 1) available and 2) covered by my insurance. It's five minutes until 5 pm. I'm not going to bet the farm that I'll hear from them tonight. Anyone know what the pediatric dose is for Tums? She weighs about 25 pounds.

Someone explain to me why we spend $14,000 a year on health insurance, plus co-pays, that doesn't cover anything! We spend more on health insurance than we spend on our mortgage, insurance, and property taxes combined. We spend more on health insurance than we spend on both of our cars, including insurance.

Oh, but national health insurance is a horrible idea.

Grumble, grumble...

I'll keep you posted, but the good news is that it doesn't seem to be anything scary like asthma.


Leanne said...


I'm a pharmacist, and here is what I've suggested to others with the Pepcid dilemma. I might suggest asking you doctor to change to Zantac. It comes as a liquid for kiddos, and is available as a generic, and usually then covered by insurance.

Both drugs are in the same class of drugs, H2-blockers, which work differently than traditional antacids like Mylanta or Tums. The generic name for Zantac is ranitidine. The generic name for Pepcid is famotidine --note the similarity :)? The patent hasn't yet expired on the trade name Pepcid which is why there is no generic yet. It is also probably why your insurance won't cover it. Generally speaking, if there are drugs in the same class which are similar in effectiveness, they will usually have the ones with a generic available on their formulary.

The main differences between all of the drugs in this class have to do with varying side effects, drug interactions, frequency (zantac is usually twice a day, pepcid usually once a day), etc... and I would have no problem giving my son generic Zantac if the option was to pay for the Pepcid, unless my ped had a rationale argument to the contrary.

Also generally, depending on the diagnosis, H2 blockers can be better for reflux than antacids like Tums. Doesn't mean that Tums wouldn't work but that's a call I'd defer to your ped.

Good Luck!

Amy said...

Leanne - you win the prize for most helpful comment of the year!

He did switch to Zantac (I keep wanting to say Zyrtec - stupid similar drug names!) which was available at our regular pharmacy. I just gave her the dose so we'll soon see if it helps.

Thank you so much for taking the time to comment!

And just in case anyone misunderstood, that line at the end of the post about national health insurance was sarcastic (Bumpa!).

Anonymous said...

I'm wondering if you have sat down and figured out what you, on average, actually pay out for health needs... I absolutely hate people being 'insurance poor'. There is actual scientific evidence that the average female in the US doesn't need any health insurance because if she has any incident... it will be due to a car accident and everyone on the planet has health insurance through their auto insurance... it would be interesting to know, aside from giving birth, what your annual pay out is for health care... I'm willing to bet it's less than $14k a yr... but if I'm wrong... it was a good exercise for the brain... I've had others' find out they spend far less than they realized or thought. xo

Anonymous said...

I babysit for 2 small children (ages 3 and 5) who take a tums every night. It is not the regular adult tums, but the bottle says kids tums. I don't know where they buy it at but I thought it might be helpul to know for future reference!
Hope little Claire feels better soon!!
-cousin Kelly

morganna said...

My son's reflux is under control as long as he sleeps with a pillow under his head (doctor-approved!). Claire's might be more serious, but I just thought I would pass it along.

Amy said...

Would totally levitate her bed or make her sleep on a pillow if she didn't sleep in circles like a puppy. I just went in her room to check on her before going to bed, and she was curled up on the rug on the floor. I often find her in odd places. Raising the head of the bed wouldn't do any good.

Connie - of COURSE we don't spend $14K a year on insurance, but we also spend $80 a month on life insurance, and by your logic I haven't died lately, so why bother? :) The insurance is really for if someone gets cancer, or needs her appendix out, or something horrible happens. Meanwhile, I'm going to use the crap out of it for the little stuff, so I at least feel like I'm getting something for all that money.

We did look into a Health Savings Account, and the high deductible health insurance (that covers only catastrophic stuff, and is supposed to be cheaper) would actually have cost us more, per month, than our HMO does. So we stuck with the HMO.

Good to know that they make Tums for kids! I'll look for those, thanks Kelly!!

Mom - we'll talk about the gluten thing tomorrow.

I just realized, as I was falling asleep, that I hadn't made a reservation for the kids at the drop off program tomorrow, so I came down to do that and now I'm going back to bed. It's almost midnight! I'm going to turn into a pumpkin!!