Forget Careful Discussion with your Doctor

It's the paper pushers that decide what is ultimately best for you, or as we discovered this past week, what's best for our child.

Since getting Jane's official diagnosis of ADHD and understanding that with the obvious overlapping of her learning disabilities medications just might not work for her, I've had a desire to at least try.  Whether we find a medication that works for her or not, we at least know we've done everything in our power to help her succeed.   If something does work, I'd like to know before she starts high school.

So I made an appointment and we went to talk meds with Jane's doctor.  After some discussion of the pros and cons of different meds, I went with his recommendation of Stratera.  This is the one ADHD med that isn't a controlled substance.  It also has the bonus of working extremely well in teenage girls and women.  So the doctor called it in and we went out the door.

I had him send it in to a different pharmacy and I thought I'd better get her insurance information over there and while I was in the neighborhood, I renewed Kate's prescription for "Singular".  Her asthma is doing so much better but if that darn cough started again, I really want a filled prescription in the house.

So I went in and started with Jane.  A red flag popped up for the pharmacist instructing her that Jane's doctor has to send in specifically why he wants Jane on Stratera before they'd issue approval for it.  Faxes were involved and I wasn't holding my breath on how long the process would take.  Went straight home and the amusing phone call from the pharmacy came through to let me know there was a delay on Jane's prescription.

Really?

You mean the prescription I just talked to the pharmacist about fifteen minutes before?

Yes those automated systems are fun!

Anyhoo, the next morning I got a phone call from Jane's doctor and the Stratera was refused.  For ADHD meds, medicaid will only approve Stratera after two failed trials from the "Ritalin" family of drugs and "Ritalin" is the first that needs to be tried because, as a friend pointed out, "Ritalin" is cheap and works great on boys and everyone knows boys are the ones diagnosed with ADHD.

*Sigh*

Obviously our choices are limited because paying for the prescription ourselves simply is not an option right now.  Even with Kent's steady paycheck we're still living under the poverty line, which isn't hard in this recession for a family of seven.

The good news, we'll know really fast if the Ritalin works.

I hope the irony of the state's medicaid pushing the controlled substance for the sake of cost isn't lost here.  I wanted to try the safer drug first.  Silly me in thinking me and more importantly, Jane's doctor, had a say.