WWYD re: tubes in ears and $$$

fricksgirl

Alex has had several ear infections this fall- he had a go-around in September where he had a VERY stubborn infection that would not go away- it took 4 rounds of antibiotics to get rid of it.  And he had another one a few weeks ago. We worry about him when he gets ear infections because he has a history of having febrile seizures from high fevers (he hasn't had one in almost a year, and they are supposed to grow out of it totally by age 6).

In any case, I took him to the Ear Nose & Throat specialist last week and they said he meets the criteria for tube placement, they'd call our insurance to get the outpatient surgery cleared, and call us for scheduling an appointment.

So the nurse called me yesterday, and says that she wants to warn me before we schedule, that she checked with our insurance and this entails a $500 co-pay plus 25% of the total cost of the surgery.   She said, "For me, of course the health of your child comes first, but you may want to think about it, I'd want to think about it if I were you."  Um, yeah. 

So I call Blue Shield (which we have, but we have crappy coverage from DH's company, it's just so expensive) to confirm, and they say yes, that's correct.  And, before they will cover anything we have to meet the yearly deductible which is $2,000. 

So... we're basically looking at $2K for tubes in his ears.

I had the ENT doc call me today, I explained the situation, and he said there is no rush on the tubes, if we want to wait and see how it goes, he feels comfortable with that.  He said the reason he really recommended it was that it's winter and ear infections are more prominent in the winter.  He seemed very on the fence, could go either way. 

I guess looking at it- meeting the deductible right away could be a good thing- at least we're done with it right off the bat in January.  But really- we don't have an extra $2K just lying around.  I know the hospital can put us on a payment plan...  that's just a LOT of money.  But you can't put a price on his health, right?  I just don't know what to do.  What would you do?

Lexi & Orion's Mommy

personally, i know we would wait. If he gets another ear infection, and it takes weeks to heal and then due to fever, has a siezure we would re-evaluate.

I know you can't put a price on health, but since the dr is on the fence, and he hasn't had a siezure in almost a year, it doesn't seem worth it to me.

kittylove

I would talk to the EMT a little more before deciding. When I was a nanny the 3.5 yr old I watched got tubes, and then 6 months later had them put back in. And then a yr after that had to get another set. From what I remember this was rare but not that rare because ear canals grow around 4yrs a lot. If the above info is correct (and I am not sure it is) then I would be very likely to wait. The fibrial seziures aren't hurting him, so to me waiting a few weeks or months getting all your questions answered and finances in place.

secretkeeper321

Is his hearing suffering? If he hasn't had a seizure in quite some time and the doctor is on the fence, I would wait.

Money issue aside, one of my major concerns with the tubes (this is starting to come up for us possibly) is putting H under to do the procedure.

Give yourself some time to really weight the pros/cons and then make your decision for A...the money will all work out and you'll be making the best decision that you and CF are 100% behind.

fricksgirl

secretkeeper321:

Is his hearing suffering? If he hasn't had a seizure in quite some time and the doctor is on the fence, I would wait.

Money issue aside, one of my major concerns with the tubes (this is starting to come up for us possibly) is putting H under to do the procedure.

Give yourself some time to really weight the pros/cons and then make your decision for A...the money will all work out and you'll be making the best decision that you and CF are 100% behind.

Totally good advice.  I'm going to email is regular pedi and do some more research.  The anesthesia makes me nervous, too.  This whole mommy thing is hard.  Yikes.

LV2006

Looks like you've already made the decision to not decide quite yet, and I just thought I'd chime in to say I would do exactly what you are planning to do.  Great minds think alike!

 

amyfelice

I agree it is not urgent. Agree with PP about checking his hearing, for sure, but most likely it is fine between infections. I think that nurse or whomever you spoke to was a little rude to you actually. Would definitely watch and wait for a bit longer.

jsugrin

A few things, I wouldn't let the Febrile issue dictate getting tubes.  While I know that's a super scary situation you have a really strong plan for handling it and getting tubes would only eliminate that issue in relation to ear infections but it's still on the table for other viruses.  Also, do you usually meet your deductable and/or Out of Pocket Maximum?  If you usually meet it or come close than I would do it, I wouldn't let the big chunk at once stand in the way.  You're definitely correct, the hospital will put you on a payment plan so you won't have to shell it out all at once.

gsbabygirl

Bella had really bad ear infections all the time as a kid.  She was about 4/5 when they started talking about tubes but also said it was up to us, because they will grow out of it.  We decided not to and she's gotten maybe about 2 more since then and she'll be 8 in a few days. 

We decided to put tubes in Mariessa's years when she was about 18 months old because she was getting them every month.  One fell out about a year later but so far (knock on wood) she hasn't gotten any since.  Her thing was mostly allergy related, so if I kept up on her allergy meds and gave her something to dry her up when she had really bad runny noses.. it helped keep them away.  

I think you have an awesome sense of intuition when it comes to Alex and how he's feeling and I think I would wait.  Not just because of the money, but because you really don't want unnecessary procedures done to him.  Has his Dr. said anything about being preventive about them?  Could they be allergy related?