Living a SPIRITED life filled with wanderlust, emotions and everything in between

Category: Health care

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Medical Aids…what THEY don’t tell you… Part 1

Disclaimer: The views and opinions expressed are MY own. This is NOT a sponsored post. I am in NO way referring to any one medical aid. The aim of my post is to shed some light on the terminology referred to by medical aids and/or medical professionals and to hopefully help YOU avoid going through unnecessary drama in case you have to deal with your medical aid.

With a new year brings a healthy new balance of medical aid funds 🙂 If you have kids, you will understand how towards the end of every year you use your funds cautiously, to ensure that you are covered right up until 31 December!

Medical Aids

We JUST can’t live without it. Well, my family can’t. We have two kids. Albeit, they are NOT sickly/unhealthy, we have had our fair share or trips to the Emergency Room and being admitted to hospital. We have a comprehensive plan that cost quite a bit every month. It is becoming more prevalent that people are seeking out only hospital plans as opposed to a full comprehensive plan.

For me, the pro’s outweigh the con’s when it comes to a full comprehensive plan. I heard people saying, “save the monthly premium that you would give to the medical aid”. In my experience, even if we saved up a full year’s premiums, we would still NOT have enough money to cover everything that the medical does. Also, none of the people who say this actually have a savings plan as they advise…

I get that life happens and you might save the first month or three, but  then other expenses creep in and you suddenly use “that saving” towards something else. And before you know it, the year is gone. What have you actually saved?

Medical aid is my family’s perk!

What your medical aid doesn’t tell you

Do you know what a PMB is? PMB=Prescribed minimum benefit. That means that YOU are entitled to receive the necessary medical attention and the medical aid SHOULD pay for it as long as your treating doctor deems the diagnosis as a PMB. Every medical aid has a PMB list. This list should be readily available to members on their websites or sent to members upon request. Do you know what YOU are eligible for under PMBs? READ THE FINE PRINT!

Some doctors will motivate a diagnosis and others won’t. The gist of the matter is that medical aids are slightly more inclined to pay for your expenses should your doctor motivate certain procedures and/or medication.

Co-payments for medical procedures

Do you just pay or do you question WHY you have a co-payment? Fact is that I have been told I needed to pay and then in fact it was NOT the case. Refer back to getting your doctor to motivate a procedure and/or medication. Do not just pay the co-payment. Question them. You are entitled to an explanation as to why this expense is your responsibility. You might be pleasantly surprised at the outcome.

Another situation that has surfaced is that so many doctors are contracted out and require a payment upfront from the patient or patient’s parent/guardian. I get that some medical aids will pay only the bare minimum and I also get that some doctors charge exorbitant fees. BUT can doctors and medical aids not reach a compromise? Not everyone is by means to fork out cash upfront, that’s why you pay for medical aid.

I also understand that as a patient, you are the customer, and it is your right to shop around. But what do you do when doctor X is the only doctor closest to you that can do whatever procedure is required BUT they charge 300 sometimes 500 % of medical aid rates?

 

This discussion on medical aids can go on to infinity and beyond. Hence, why I said that this is only PART 1. I know that I won’t change the situation with just one post BUT I do think that we, the customers, CAN and WILL make a difference is we SPEAK UP!

Do you have a medical aid?

Do they cover everything without you having to donate an organ?

Spirited Mama

x

P.S. Happy 2019 folks!

 

Tooth fairies are overrated and freaking expensive!!!!

gettyimages-588491761-56ddf4bb5f9b5854a9f62ab4

(Image from Getty images…)

So on Wednesday Dudie jumps in the car after soccer practise and announces that his big tooth, central incisor (did you know that it actually had a real name), is loose. I inspect, now bare in mind that teeth pulling is not my thing. I will wipe your arse and clean up after you. Hell I will even clean up blood spills and wounds BUT DO NOT ASK ME TO PULL YOUR TOOTH. It freaks me out! Just the thought of it gives me the hibbejeebees… That is Dude’s job. So I say don’t worry you can ask Dad later to pull it for you.

Fast forward all other extra mural activities and this is how it went down at home…I say can you guys not pull that tooth before we have supper then that way Dudie can eat properly without having to worry about this loose tooth…So Dude and Dudie go off to the bathroom, with Dudie yelling Come on Mom come see…

No thank you Mom is happily setting the table for dinner. I hear the moaning and arguing because now the tooth seems to be tight and slipping and now they are looking for a pliers. I STAY AWAY! Next minute Dude comes out of the bathroom, looking like a surgeon who just completed a 12hour surgery and Dudie comes racing to the table, blood dripping from his mouth I kid you not, but so ecstatic that his tooth is out. I am just elated that shit is over and I did not have to witness any of it. Oh my greatness, I am beyond scared that if anything happens to Dude what the fuck am I going to do??? And the resident alien will also have to go through this process. I am not scared of a dentist, not at all. In fact I have very good teeth. Up to today, I still have my own teeth and NO fillings  whatsoever. I will religiously brush my teeth, to point where Dude has told me I am going to brush the  enamel off.

During our dinner conversation, Dude says wow that tooth is so big maybe the tooth fairy will bring you R50. I choked a little but thought, Fuck am I glad it’s not my turn to be the tooth fairy! Later I say to Dude, don’t you think it’s a bit much? But he feels the kid deserved a royal treat. Then I say, well does the tooth fairy even have cash? Now, please note that I never carry cash, like never. The money that you do find in my possession is probably just the daily aftercare fee that I have to withdraw else my kid and teachers get confused about when he has casual aftercare days…(Tried paying upfront but they fucked up my system so now I withdraw the exact amount and ensure that I have the exact denominations per day for casual aftercare) Anyway, so I had to borrow Dude, aka Tooth fairy dad, R50.

You may have read about our mishap with the tooth fairy last time, if not you can read it here

This time I was so not going to mess this up. When I went to bed Dudie was most likely having his 3rd or 4th dream, so I carefully removed the tooth from under his pillow and placed the R50 there instead.

Can I just say that this kid was so chuffed when he woke up the next morning. Why? Because Daddy was right. The tooth fairy also thought that that was a big tooth and that he deserved R50.

Let’s just hope the next tooth he loses is a smaller one, else I am fucked….just saying…

Happy Friday!

Spirited Mama

P.S. My Tooth Fairy will be standing at the traffic light with a cardboard sign…

tooth-fairy-beggar

( I randomly sourced this image on the net and just inserted my own words…)

 

 

 

How to Unlock vertebrae?

Somebody? Anybody? Body?

I’m not sure how I did it but somehow I managed to lock to vertebrae in my neck… I woke up on Friday thinking I must have not slept properly hence the stiff neck… Well, Saturday wasn’t any better. Sunday morning wa seven worse. Now I considered a trip to ER but really wasn’t in the mood for drma…and I really wish I knew some medical staff as I thought I just needed some injection of some sort…

This morning I decided I needed to sort this neck issue as I can’t turn my head to the left… As I walked into the office I made an appointment with the physiotherapist. Well let’s just say that she couldn’t unlock my vertebrae and that  have to go back in the morning… And that I now take anti-inflammatory medication and I use a heat pack all day long…

I have never experienced this before but apparently it can be caused by previous incidents like whiplash Any how, let’s see what tomorrow brings.

This morning I couldn’t put my chin on my chest after physiotherapy I could BUT now I can’t look up because then my left side pulls stiff??? Can’t wait for tomorrow…

Spirited Mama

 

 

 

Laryngitis and Lindt Chocolate Bunnies

Ok, so after we attended my brother’s wedding in Cape Town we got back and I was still feeling under the weather… Ok ok, that’s an understatement. I was “vrot siek”!!!!

I got back to work on Tuesday, I was supposed to be at work on Monday but due us not being able to get seats on a flight home we spent and extra day in Cape Town. We did nothing but behave like tourists. We went up Table Mountain. We went to Lagoon Beach in Milnerton. Had drinks at Wang Tong… Then off to Canal Walk where somehow we ended up at Cape Town Fishmarket and had the yummiest food…. Yes we were hungry but the food was glorious!

We headed back to my Aunt’s place and laughed and chatted and repacked and got ready for bed… (we were to be at the airport at 4:30am — SERIOUSLY— as we were on standby and we didn’t want to miss a seat to get home).  We I fell into bed just after midnight and when my alarm went off at 4am I was dead on my feet.

We left a little late but got there just after 5am waited and eventually was told that we will be put on the next available flight. Now bear in mind that it was Post Cape Argus Cycle Tour weekend and getting a seat on a aeroplane is well almost impossible  – even to those who paid the full airfare… So I took Dudie t the side, we played in the terminal building a bit, the boys went to get coffee and we ended up flat on the floor very close to the standby counter drooling over our weekend pictures.

Dudie eventually drifted off to sleep on my lap.  <Why do we always need to pee at the most in opportune times? Murphy!!!> Luckily, we were checked onto the 7am flight so it wasnt too long of a wait. When we left on Friday morning it was raining in Pretoria. When we landed in Johannesburg it was raining! WTF! We got home. Unpacked like SPeedy Gonzalez, and all fell into bed for a nap!!!! We woke late afternoon and teh boys went to get takeout whilst I tidied up a bit.  We packed and got ready for work and school and just had hot baths and back to bed.

It was a tiring yet amazing time spent with family. We created memories that we will treasure forever. And my Dudie is strengthen his  with the family more and more…. <We’ll be back in April guys>

But back to the point. I managed to get through my work day, without a voice on Tuesday. On Wednesday, I headed to the Doctor, as a precaution because the voice was just not coming back. And I lost it the previous Friday already….Well, turns out my vocal chords were badly swollen and with all the bugs, colds and flus going around I was not doing myself a favour by going to work. I was booked off for the rest of the week with strict instruction to stay in bed and rest. As Dudie was also suffering with post nasal drip for 2weeks things in the Spirited Household was not all fun. interrupted sleep. Snot. Coughs. Aches and pains… And just when you think you’re on the mend someone gets the sniffles again…. I was about ready to put us all into a freakin bubble.

I had intended to do the 21km “Old Mutual Om die Dam” race at Hartebeespoort Dam on Saturday but was given a very firm “NO Racing” instruction by the GP too. So what do you do when you are booked off sick???? I absolutely can not stay in bed for more than 24hours unless I’m hospitalised and they force me to. I have too many other things that I want to do than lie in bed all day 🙂

This is what I did:

Wednesday:

Drop Dudie at school, late of course. Off to the GP. Get home. Administer meds. straight to bed. Fetch Dudie as the guilt just get s to me that I can’t fetch him everyday cos I get home too late.

Thursday:

Drop Dudie, even later than yesterday. Off to shops to pick up few thing. Off to Makro, for a road trip must have – another cooler box just smaller cos we need a plug in “inside” too. It’s just no fun having to stop to grab stuff from the back. LOL. Fetch Dudie early again….

Friday:

Drop Dudie midway through his music lesson – total mommy fail….LMAO! STraight to the shops. Hunt for that perfect bikini 🙂 I found one. Just not convinced it’s  “that” one. Off to other shops for a jacket that I made the store assistant locate on the system for me. Fetch Dudie and veg out in the lounge. We even set up the tent in the LOUNGE! That’s how we roll…

Amongst all of this Dudie was loving the fact that I couldn’t talk…I couldnt say NO or reprimand him. I raised my voice a few times out if frustration for the boys but they obviously didn’t even realise that I was upset…. I consumed copious amounts of Lindt chocolate Bunnies, this is in preparation for EASTER! Of course. That’s my story and I’m sticking to it. LOrd knows you can go into shock when you consume too much chocolate. So I was not about to take a chance.

I’m still a bit croaky but on teh mend. I’m at work but ready to dash out of here to gp pack for our Road Trip.

We’re road trippin tomorrow!!!!!!! Happy Dance!

Spiritedmama

P.S. I need to do soem work but will post soem pics from our Cape Town trip soon.

How I ended up at Wilgers ER on Friday morning…

So a whole week went by with me NOT blogging. Don’t get me wrong I have loads to blog about and believe me it’s blogworthy but I’ve just been living, working, being mom, being wife…. It’s been busy but good busy.

So after my Dudie miraculously recovered, I thought ‘Yippee’ we are in the clear… Until Friday morning, I woke up at 5am with an itch just above my knee. I took a shower and then realised that my face is hot and it stung to the touch. I exit bathroom as I now feel nauseous from the steam in the bathroom. I go and examine myself in the mirror. Big mistake. I had a rash of some sort spread all over my left side of my face, on the upper chest area and it was spreading to the rest of my body fast… Within minutes my face, neck, chest, arm etc was covered.

I go to check Dudie, as he snuck into our bed in the wee morning hours, but he was clear. So I take a pic, send it to Dude nd call him. He’s response was go to ER now… Don’t be stubborn and wait for 8am. Go! now!

SO I dress Dudie hurriedly, grab keys, wallet and Dudie’s school bag. Dudie stared flipping out as  he kept saying “mamma, you got an eina! YOur face got an eina!!!!

We arrive at ER, the nurse gave me one look and said you must be the patient, he’s way too happy 🙂 They did the routine check and within no time they adminitsered meds via IV. CAn I just add that if at all possible do not take your 3yr old to ER with you. UNless of course said child is the patient. My child tampered with my IV. At one stage I felt very dizzy, only to realise that my child has increased the flow of my meds. I’m not kidding. He climbed everywhere. Played with the staff, ran up and down the passage all whilst I lay, dizzy, on the bed.

The nurse offered him toast for breakfast which he politely declined but requested Calamari:-) Ai, you must love this child of mine. I said we could get Calamari later when we left. after 2 IV’s they gave me the ok to leave. BUt I had to get home and to bed soon. So I vowed that I was going to take Dudie to school and then get to bed. They reiterated that the meds I had just received is quite heavy and that I will not function properly. As I dropped Dudie, I could feel my head buzzing.

By the time I reached home I was floating. Now, I know what a “high” feels like. LMAO! I called Dude, armed the alarm and went straight to bed. When I opened my eyes, it was after 1pm and I had no recollection of my sleep time.

The doctor called it an allergic reaction, wheels and flares because of the severity and rapid spreading. Blood tests confirmed no infections. So up until now, we still don’t know what caused it. I did not eat anything different or do anything different…

After my morning slumber, I happily packed our bags and when Dude got home we headed to Mount Amanzi for our weekend getaway. I was still high on meds but we had a nice weekend away none the less. Oh. I also baked a bread and red velvet cupcakes…..

And I can safely say that all spots are gone. No indication of what happened what so ever. And thank goodness it was not contagious…

Spirited Mama

 

Guaranteed to burn Calories Solution. Even for the least motivated….

As 2013 approached, I heard yet again about probably the most used, most over rated  New Year’s Resolution….. Weight LOss!!!! Really, I scrapped that resolution many many moons ago and I’ve been so much happier ever since.

But now my inbox is flooded with best wishes for 2013 and countless lists of people’s New Year’s Resolutions… And guess what tops it …Yep, WEIGHTLOSS.

So I found a Guaranteed “to Burn Calories” Solution. This is how Women in France burn Calories.

Click here to watch it.

Spirited Mama

xoxoxo

P.S. I actually don’t make any New Year’s Resolutions. I generally just spend some quiet time thinking about how and where I’d like my life/my family life to be or go for the year….

*PG* Germs were killed!

I received a delivery at work last week and I knew exactly where it was coming from. What was in the box was a mystery….

The kind people over at Dettol sent me a gift. *smile* Oh who am I kidding, I was over the moon just to receive a parcel.

<Even if you send me a box filled with nothing but bubblewrap I’ll still be excited 🙂 >

 

They have asked me to review their Daily Care soap. Now, I don’t generally use soap. Heck, I’m embarrassed as whenever we receive guests, I have to dash to the shops to go buy whatever soap is available (read: on special as the guests are not likely to finish it then I end up throwing it out). I don’t keep soap in the house.

Both Dudie and I have sensitive skins and I’m extremely careful when choosing body products. The Dude is easy going. So, in preparation for our mini getaway, I decided to pack some Dettol soap and travel sans body wash/shower gels…

This is our experience:

Spiritedmama – It’s a win win situation. It doesn’t dry out my skin and I definitely don’t have that tight feeling afterwards. My skin felt softer. I forgot to pack my face wash and braved it with the Dettol soap on my face (I know you’re not suppose to use soap on your face but hey I needed to wash my face) my skin was fine. I also liked the soft fragrance, just enough not to irritate my sinusitis.

Dudie – His skin felt soft and I do think that it helped with eczema that he has behind his knee. See this child of my also suffers with eczema. Looking at his eczema this morning I wonder if this Dettol soap is aiding with healing this eczema???? I did notice that he had fewer dry patches on his body.

Dude – He loves it! At the breakfast table on Monday, he pipes up “I smell so clean”. Well, I think so too. It’s a fresh smell rather than a soapy smell.

I would definitely recommend Dettol Daily Soap to anyone. It’s easy to pack too. Rather than having a bottle of some body wash expand in flight and explode in your face as you open it after you’ve landed…. (This has happened. Please do not try this at home. It’s dangerous).

P.S. Thanks for my fluffy gown too. And the boxing gloves are a “hit” with Dudie.

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