I need to Vent...

I love HMO's. Don't try to tell me they provide inferior care. Don't try to tell me they run you around and referrals take forever. Don't try to tell me you don't have enough choices for Doctors. And don't try to tell me they are inconvenient because you can only go to "their" hospital, urgent care or office.

If I could get my HMO back, I would do it in a heartbeat. NO hesitation.

When we moved to Arizona 4 years ago, I was really disappointed to give up Kaiser. Yeah, I know, the big bad HMO... they have a similar reputation to Walmart. But, hey, you aren't allowed to complain about Kaiser on my blog. I just won't listen to you.

We were able to choose an almost comparable HMO plan down here. One where we had Cigna and they contracted out their services to private doctors. We had a list to work off of, but it was a huge list and there were plenty of options. Almost too many options! We still had $15 copays and a trip to the urgent care, ER or hospital would never cost you more than $50 out of pocket. You never saw a bill for your medical care and you never had to talk to a claims representative of an insurance company.

A year and a half ago we got the news that our HMO plan was being dropped. They cited all kinds of "valid" reasons, but the bottom line was they needed cheaper plans. HMO's cost companies a lot.

Since we have a relatively healthy group of people in our family with no real chronic health issues, we opted to go with a "Health Fund" from Aetna. Every year we get "X" amount of money in our fund to spend on health care. We don't need referrals and we can see any doctor we want that takes Aetna insurance (which is everyone.) And even better, our annual "well visits" are free. No charge to us, and no deduction out of our "fund". So, for example, when Ian had pink eye on New Year's Day, I took him to a local Walgreens mini urgent care type clinic and they charged $50 to my fund for the visit and I walked away just having to pay for the prescription. It's a pretty sweet deal, most of the time, as long as everyone is pretty healthy.

Here's the down side... when I was suffering from really bad asthma and allergies a year ago, my PCP recommended I go see an allergist. He couldn't give me the answers I really needed. So, I went to an allergist and got skin tested. She recommended that I take allergy shots for the local pollens/trees/grass that I'm allergic to. IF I had still been with Kaiser, I would have been able to schedule a return appointment and get the allergy shots going immediately. Out of pocket cost would have been minimal. But instead, I had to call the office back and find out how much such a treatment would cost. Turns out that the first year supply of serum they make especially for each patient and their needs costs anywhere from $1000-1500. That is just the serum. Not the cost to inject it into your shoulder twice a week for six months. After mulling it over for a couple days, I decided not to go ahead with the shots because it would completely drain my family's entire fund for the year and I'd likely have to pay several hundred dollars out of pocket on top of that. It just wasn't worth it to me.

For the first time in my life - EVER - I had to make a decision about my medical care based on how much the procedure would cost.

That SUCKS!

But that's not the real reason I started this post.

Today, I had to call Aetna again to find out why they wouldn't cover Megan and Taylor's physicals last month. Here's the deal... they are only allotted one every 12 months. Yeah, that makes sense... but literally every 12 months. If you have your next physical less than 365 days after the last one, guess what? They deny your claim and bill you for the visit. Last year, Megan's physical was on May 2. This year on April 10. Denied.

Ridiculous. I'm not giving up on this one. The Aetna representative I spoke with said she can re-submit the claim and try to push it through because of a 30 grace period they have for this type of thing. If they have a grace period built in, why can't they just pay the claim? Of course, because they think if they bill me for it, I might just stupidly write them a check. Now I have to pester them for the next two weeks and call my peds office to explain why they haven't been paid for these visits yet.

I hate dealing with insurance companies. I hate having to make decisions about medical care based on how much it's going to cost. And I hate the fact that next spring when I make appointments for physicals, I'm going to have to make sure that the next one is scheduled at least 366 days after last years exam.

Okay... rant over... feeling much better. Time to crash!

The Batcave

A couple summers ago I made an amazing discovery at Joann's... Black Out Fabric! (Pictured below... please try to ignore the stained carpet!)

We live in the desert. We start hitting the hundreds during the day in May. We don't get out of the hundreds until sometime in October. It's a LONG summer with TOO MUCH sunshine...

I have 3800 square feet on two stories and 38 windows in my house. (You do not want to know the cost of my July electricity bill....) Unfortunately, my house didn't come equipped with those wonderful full window sized sunshades that most houses around here have. Most of my windows don't even open... they are just decorative. That's all fine and dandy in the winter, but in the summer? It's more like a greenhouse effect, and trust me, that's not a good thing.

So, two summers ago in desperation to keep my boys' room cool and dark in the summer (better sleeping hours), I went to Joann's in search of some black fabric. I was going to make some kind of giant (temporary) window shade with it. It would be ugly, but functional.

After getting some help from a wonderful employee, I came home with 10 yards of white black-out fabric. This stuff is amazing. It's fairly lightweight, blocks out all light and is white. It also doesn't fray, so you can cut a piece out to put in your window and not have to worry about hemming the edges.

After many different attempts with velcro, etc., I came up with a simple and cheap way to hang my shades.

Binder Clips! These babies do just the trick. So, this is what you do. Cut a piece of black-out fabric to be the exact size of the window you are covering. Then use the binder clips to "clip" the fabric onto the back side of your blinds. The fabric should hang down the length of the window between the blinds and the window. I clip the fabric to the top of the top most slat. One on each side is fine, unless you have a wide window and the fabric sags. Then you'll need an extra one in the middle, too.

From the outside, your window should look like it has white roll down shades, and from the inside, your room will look like this:

The window on right has been blacked out... window on left is without the fabric. Yes, it's like creating your own personal batcave! So now, you know my personal secret for battling the Arizona summer greenhouse effect in the house! I think I might have been an engineer in my former life....

Murphy's Law

Why is it that when something has a problem, you arrange for a qualified repairman to fix it, and then, voila!... it suddenly works again?

My A/C has been making weird noises for a couple weeks. One evening last week, I couldn't get it to cool down the downstairs without playing with the thermostat A LOT. So Monday, I called in a professional and had them come take a look. An ounce of prevention is worth a pound of cure, right?

After two hours outside in my unshaded side yard (102 degrees) or up in the second story attic (110 degrees) he found nothing conclusive. It doesn't help when suddenly the broken "item" decides to behave, huh?

Today it's already 83 degrees in my downstairs. It should be more like 79 this time of day. It's warm and it's only going to get warmer. Clearly, the problem is back. And based on his "theory" of what might be wrong, I think he's right.

But this is what I want to know... if I call in the professionals, will my a/c be scared into compliance and work again? Because that's how Murphy's Law works, you know. I think I'll put in the call and when my body can no longer take the heat, we'll spend the rest of the afternoon swimming. Thank heavens for swimming pools!

Why I haven't blogged much lately...

I've been reading this... it's kinda like a Lara Croft/Indiana Jones/Dirk Pitt novel:

And I've been listening to this on my ipod:

And I need to finish watching this... I'm like 4 episodes behind...

And when I can't resist temptation, I play this online:

Thumbs Up!

I took Taylor and Megan to see X-Men Origins: Wolverine today. It was EXCELLENT!

For whatever reason, I had never seen the X-Men movies when they originally came out. The first one I saw was X-Men 3 at Jeff's house. We then found the trilogy on DVD at Best Buy and bought it for $30. We've watched the X-Men movies many times since then and have loved them. I don't know why, but Wolverine was always my favorite character.

Of course, I'm a huge fan of Hugh Jackman. I have Kate and Leopold and The Prestige. Loved both of those movies. I watched the Oscars this year for the first time in several years, just to watch him sing and dance. I want to see Australia... I think I'll rent it from Redbox next week while Eric's out of town. I even picture Hugh Jackman as the main love interest in a book I love, Austenland. If they ever made a movie out of that book, I'd be heartbroken to see anyone cast other than Hugh Jackman. He is Mr. Nobly to me. And, I hear they are already talking about a X-Men sequel to the prequel... if you understood that, you're a true Wolverine fan!

And on a completely unrelated note, the girl in X-Men (can't remember her name) who had diamond skin... that was awesome looking.... Twilight producers... hope you noticed!

Third Time's the Charm?

Yesterday, I officially commited to my sister-in-law that I would hike Mt. Timpanogos with her on 4th of July weekend. This will be the 3rd attempt for us. I say "attempt" because we have never successfully made it to the top. Click here to see some spectacular photos of this mountain and hike.

I dug through my digital photo files and then through my scrapbooks to find out exactly how long it has been since I've hiked this trail. So long that I have no digital photos of this mountain. That's reason enough right there to try again!

Our first attempt was in 1995. We made it to the lake and bad weather turned us around. It wasn't very difficult to find an excuse to quit. We were ill prepared for this hike. We didn't bring enough water and would have had to turn around hours before because we ran out of water. If it wasn't for a very nice family that shared their water pump with us, we would have been in big trouble. By the time we made it to the lake, it was threatening rain and thunder/lightning. We turned around, headed down and walked the last mile or two in the rain. I remember crawling back into my in-laws beater van and feeling like a drowned rat.

Our second attempt was in 2002. Eric's youngest sister had just graduated and we were in town for a family reunion, so the three of us went up the mountain. We picked a weekday, which we thought would make for better hiking/parking conditions, but the problem was that when we finally reached the lake, there was NO ONE around. And we didn't know which way to go to continue on up to the summit. It was freezing cold and windy, so we turned around and headed back down. We didn't want to get lost on the mountain and have to spend the night up there! On the way down, I had horrific knee pain (what I now know to be ITBS) and limped and wimpered all six miles down the mountain. It was really discouraging to be defeated by the mountain again.

Until I recently discovered the source and cure for my knee problems, I'd always assumed that attempting Timp again wouldn't ever be a possibility. I still have knee flare-ups, but now I know so much more about preparing for this hike. I know to bring water, a water/filter pump and a jacket for the top (maybe even gloves and a beanie now that I'm acclimated to AZ heat). I know that I'm going to have to do yoga like crazy over the next two months and squats too, so I can prep my thighs for the trip down the hill. I'm going to start walking on the escalator machine at the gym to prepare for the hike up the mountain.

Any of you Timp experts out there have more advice? It's do or die this time... and I don't really want to die... if you know what I mean!

Toddlers

I've decided I'm actually going to be a little sad when I don't have a toddler in my house anymore. Brayden just cracks me up all the time and watching him discover and learn new things is worth all the crap he dishes out in return.

Some of my favorite things about having a toddler:

Using them as an excuse when you have to go to the bathroom in an obscure public place (like Walgreens, etc.)

Using them as an excuse to keep church visits short and sweet.

Being able to cancel everything and stay home in jammies for a day when they are sick.

Laying down with them to take naps.

Cuddling under a blanket together while watching a movie.

Making cookies together.

Letting them help you wash dishes or clean windows (they are still excited to work!)

Getting (and giving) lots of kisses and hugs!

What do you love about toddlers?