Monday, September 24, 2012

Day Four: Urgent Care

Or hell.

We returned to the resort and Allie rested in bed while Rich took Anna and Emily for a swim.  Why didn't we rush her directly to a doctor?  Well, she wasn't having any trouble breathing, she wasn't in pain and she was acting lucid when she was awake and after her nap at Crystal Palace, she was awake.  There was no in and out of consciousness thing going on.  And her temperature was only 99.1 degrees. 

Allie has had two incidents that have caused the area around her eyes to swell and puff up.  The first was when she scratched to death a mosquito bite on the top of her head and it became infected.  The second was very, very, mild compared to the first.  She had had a cold for almost two weeks and her pediatrician diagnosed it as a sinus infection.

After about an hour or so of rest for Allie and swimming for Anna and Emily, we headed out the door.  When asked about the best way for Allie to be seen by a doctor, concierge provided us with a brochure and directions to Centra Care, an urgent care facility located a few minutes outside of Downtown Disney.  It was now almost late afternoon so we all decided to go because we would need to eat dinner at some point.  I was trying to convince myself that Allie had a basic ear infection.  The doctor would prescribe an antibiotic and we would be on our merry way.

Yeah.  Not so much.

Grammy stayed in the van with Anna and Emily to reduce the risk of them picking up germs.  I must have been at Disney too long because the receptionist was not happy to see us.  She almost seemed annoyed by our appearance.  There's a large sign on the wall stating that they accept most insurances.  If you don't have insurance, costs were broken out by "level."  So Level 1 was (approximately) $122, Level 2 was $220 and Level 3 was $308.  There were no explanations regarding what types of services would be covered by each of these levels.

After briefly explaining to the receptionist why we were there, she asked for my insurance card and my license.

"Harvard Pilgrim?  We don't take Harvard Pilgrim and we're really expensive today."


"Well, how much would it be for us to pay out of pocket?"

"308 dollars."

Yeah, love those levels.

Rich and I had a brief discussion on what we should do.  The waiting area was fairly empty so presumably, Allie wouldn't have to wait very long to see a doctor.  If we left, where were we going to go?  The ER?  The wait there could be hours upon hours and whose to say whether or not they would even accept our insurance.  We decided to stay.

I had to complete Allie's registration online in a cubby where someone had left a snot filled tissue.  After about 15 minutes or so of waiting, I realized that I couldn't find my license.  I went back up to the receptionist to see if I had accidentally left it up there.  "I have it.  I'll give it back to you once we finish your registration."  I still can't figure out what she had to do because I was the one who filled out the 20 screens online and since they were not going to take our insurance, I could have said I was Snow White and it wouldn't have mattered.  So give me back my freaking license.

We waited and waited.  A bad feeling came over me and I told Rich that I knew the doctor was going to say that it was "just a virus."

We waited some more.  I finally asked how many people were in front of us.  One person.

So apparently Disney sends employees there for random drug testing.  There were two Disney employees dressed in what looked like captain uniforms.  Maybe they run some of the boats or ferries.  Anyway, they were having a painful experience as well.  They emerged from the back area where the patients were seen and waited and waited next to us.  One of them began chuckling while reading his email.  "Listen to this spam email I just got.  My contact in Dubai tells me that you are dead.  Is this the case?  Well, I've been here for so long, I sure feel dead."

I watched a man I hadn't seen earlier emerge from the back and start shuffling through papers behind the desk.  My spirits rose when he walked through the doors and came out into the waiting area.  We were next.  Was he going to call us?  No.  He was checking the inventory of potato chips for sale.  Finally, one of the Disney employees approached him and explained that they were just waiting to hear that their paperwork was all set.  The man was like, "Oh, I just got here.  I don't know what's going on with your paperwork.  We'll look into it."  I wanted to jump up and yell, "They are waiting for you and you've been checking on potato chips!"

After about an hour, we were called back.  Well, Alicia-anne was called back.  Sorry about your hard to pronounce name, Allie!  A nurse took her temperature and weighed her.  (She's still a peanut at 31 pounds.)  We explained what was going on with her and waited some more.  Finally, the doctor came in to examine her.  Her ears were fine.  (Crap?)  She tried to open her mouth for him to look at her throat but she couldn't figure out how to get her tongue out of the way.  I finally told him that she hadn't been complaining of a sore throat.  He asked a few times if she had been coughing.  No.  Runny nose?  No.  Diarrhea?  No.  Throwing up?  Once but it was random.

He ordered the nurse to conduct a flu test and if I had known what it entailed, I would have told them no because I knew that she didn't have the flu.  They shoved a swab up both her nostrils and she cried hysterically for 20 minutes.  And guess what?  That's right.  She did not have the flu.  So the doctor comes back in and tells us that he doesn't know what's wrong and she must have a virus.  I asked him why her eyes were swollen.  What?  What do you mean her eyes are swollen?  Okay, did this man listen to me when I gave her symptoms?

He looked at her eyes and because there was no puss or anything, he said he didn't know.  Now, what I should have done was shown him Anna and Emily and said, "THIS is what she is supposed to look like."  He told us that it could be from being tired and that we should continue to give her whatever we had been giving her for the fever.  (I had told him it earlier that it was Advil.)  And of course, they never told us what her temperature was.

If I had given my $300 to a psychic, I would have had better results.

Because we had to drive by Downtown Disney on our way back to the resort, we stopped and picked up sandwiches at Earl of Sandwich to bring back to our rooms for dinner.  Following doctor's orders, I gave Allie another dose of Advil.  She did not sleep well that night, which means that I didn't sleep well either.  It took her forever to fall asleep and then she was restless.  I was awake in the middle of the night with her for about 2 hours.  She wanted a cracker and then some water to drink and then she had to go to the bathroom and she was so weak I had to help her on and off of the toilet.  I couldn't sleep because I needed to figure out what was wrong with her.  This wasn't a virus.

When Anna was sick back in August, I found myself awake one night watching over her.  I prayed to a god I don't understand and asked for Anna to be better.  It was the only thing that I could think to do.  Here I was again.  Praying.  I didn't know what else to do.

I don't remember my thought process but I began to focus on the Advil.  She's never had Advil before.  My mom can't take Advil because she's allergic to aspirin.  And then it all clicked.  She could be reacting to the Advil!!!  She has to be reacting to the Advil!!!!

We have since discussed all of this with Allie's pediatrician and he agrees that it sounds like she had a bad reaction to Advil.  I've done some reading with Dr. Google and interestingly enough, facial swelling is of the first symptoms listed under allergic reactions.  Also, excessive sleepiness can be a side effect of Advil.  (I won't list out all of the symptoms and side effects but Allie definitely displayed many of them.)  Thankfully, she only had about 6 doses of it over those 4 days.  I feel so very guilty that this happened.  If we hadn't given her anything, I think she would have been fine on Monday and none of this would have happened.

Also, Rich called our health insurance provider when we returned home and explained what happened.  We were told that we could submit a claim for reimbursement.  I'm not sure how much they will reimburse but the woman he spoke to said that it is fairly common to have to pay upfront for services outside of Massachusetts and then submit a claim.  It would have been nice if Centra Care had told us that inside of telling us that they were expensive that day.  And what does that mean anyway?  Are there days when they aren't expensive?


Sophie Slim said...

Far out, so glad you finally figured it out! Dr. Mum!!

the whole american health system just weirds me out, I'm in New Zealand, things are much simpler (and free) here!


Sarah said...

I can really relate to your urgent care description. It seems in FL everyone in urgent care in on NOT URGENT time. Years ago while at Disney I stepped off a curb during the Electric Light Parade and severely sprained my ankle/tore some ligaments. I couldn't stand on it at all. The next day we went to urgent care where it took them FOUR hours to wrap it in an ace bandage, give me ice packs and crutches and tell me to stay off of it. At Disney, on vacation, that of course meant a wheelchair. My treatments were all once I got back home. But I still recall, to this day, the torture of the urgent care visit. Oh, and we had to pay up front and our insurance then reimbursed us for all of it. Poor Allie....

Stacey L. said...

Glad you guys figured it out. Poor baby, and poor mommy for not sleeping well, and on a vacation too. Glad she is better.

Sharon Marie said...

Ugh. I'm frustrated for you. To wait all of that time, and get no help at all...

And I really hope that Centra Care is better about *actually* reimbursing than Kaiser Permanente is. Because they are an in-house HMO, I have to pay up-front in any Urgent Care center that is not theirs, and they only have centers in certain regions of the US (not including NJ, where we often go to visit my husband's family). I did everything as instructed when I had to been seen while on a visit up there, and never saw a dime back. Can't say I'm surprised, though. My father had to fight for over two years to get reimbursed for my out-of-network hospitalization while I was away in college. I don't have the energy (or the motivation, since my bill was much smaller) to follow up about my own issue now.

Wendy said...

Just wanted to say that I'm glad you figured out what was wrong with Allie. Sorry you had such a bad experience at the urgent care place. :(

Sarah said...

We've had to bring the girls (mainly Anna) to our local ER (I think we are up to 5 visits in total) and we've always had much better service than this urgent care place. The ER can be slow but they do try to speed things up with kids and they are nice.

Harvard Pilgrim didn't tell us how much they would reimburse - we are still waiting for them to process our claim.

Anonymous said...

Please don't beat yourself up about giving her the Advil. I just wish that Urgent Care doctor would have been a little more responsive and paid attention to what you told him instead of just going through the motions.

Annalise Kendrick said...

As I was reading I was wondering if it was an allergic reaction especially when you mentioned her tongue because I have those symptoms when I eat a peanut.

Danielle Carroll said...

:( Poor Allie!

And that receptionist was rude. So unprofessional to say they were expensive that day. Glad you figured out what was causing her symptoms though!

Michele said...

That's awful. My urgent care visits this year had them misdiagnose Fifth's Disease as lupus and ended up charging over $3500 in testing, not to mention 6 weeks of annoyance.

Lauren said...

I'm allergic to Motrin and I react pretty much the same way...swelly, exhausted, overall ill.

Anonymous said...

I feel for you Sarah. Several years ago I spent close to 5 hours at the Concentra ER there near Celebration just to be diagnosed with a sinus infection. It was torture and the only positive was that they had tvs in the rooms...which was unheard of then. But with the kids I can't imagine. I'm glad you figured it out with Allie.

Miss Rachel said...

Hey Sarah - they reset the votes on TBB! I'm sure none of us would mind if you put up a little reminder for us to vote :)

Mindy said...

My friend is allergic to ibuprofen and same thing: his eyes swell up. Not fun...

Also, I'm in Utah and I'm pretty sure Urgent Care doctors everywhere just SUCK. I've had several bad experiences with them, including extreme rudeness (is that required or something?) and my boyfriend went to one when he had pneumonia and they sent him home saying it was a cold. You could hear his lungs rattling even without a stethoscope. Really? REALLY?!?! So awful. I hope you get reimbursed in full!

Sarah said...

So many bad urgent care experiences! I imagine it's extremely difficult to manage those places but some things just are not acceptable - like rudeness and not diagnosing patients correctly.

Miss Rachel - I know! I'll have to add the button to my next post. Thanks for the reminder.

Mary said...

Poor Allie, I can't imagine a child getting the flu test. I had the test a few yrs ago. My Dr warned me before hand how uncomfortable the test was, I was so sick, I just wanted to know what was the matter. I got the results right away, the good news (haha) I had the flu, the bad news I came in too late, and it had to run its course. Thankfully Allie is feeling better, and Anna & Emily haven't had a turn. She deserves another vacation.

Leah said...

I just found your blog randomly, and would you believe that I had that EXACT reaction to advil after the birth of my first son? My whole face swelled up! Turns out I can take generic ibuprofin just fine but the Advil capsules caused a reaction. Great thinking on your part!!

Kitty said...

Hi! I'm another one that found you randomly. You're popular with Google :)
As a former Orlando resident and Contemporary Resort Concierge, I apologize that Centra Care is the best option we could usually provide. For your own future reference on any trips you may make, I cannot recommend the CareSpot Immediate Care on Kirkman Rd enough. It was my go-to urgent care as an area resident, and didn't suffer from proximity to Universal. The downside is that it's a 20 minute drive from WDW, but the upside is that my longest wait ever was 20 minutes... during Christmas week... with an ear infection. Get the prescriptions in the office to save even more time.
My family returns to the area often for visits now that we've moved back to the northeast, but they still take my insurance. Might be worth a look-into if you ever head back down.

Anonymous said...

Oh my! I'm sorry about your experience! I go to the urgent care in Tampa, Florida and they always do a good job!