How Do I Set Up My Child’s Services at Our New Duty Station?


The dust is finally starting to settle down on our pcs roller coaster ride. The boxes are almost unpacked and I’m starting to get the layout of the land. The first important step I need to take next is to set up our children’s services. But how do I do that? Well I am here to give you a little help.

If you didn’t know- once you change Tricare regions you will need to get all new prescriptions for your referrals. We went from TriWest to TriNorth, because we switched Tricare regions we have to get new referrals before our children are able to start receiving services again. Which means we had to go to our new PCM to get the new referrals to our specialists to get the new referrals for our services and prescriptions.

I would suggest calling to make a appointment with your child’s PCM ASAP. If you are unable to get a realistic appointment day scheduled, try asking if they have a clinic case manager or speaking with someone at the base patient advocacy department. For example, we arrive mid July. We were given an appointment date of mid August. Bug has a rare medical condition that requires mail ordered supplies and medication. We would be out of those items if we waiter until the system worked. Therefore, I had to call the base patient advocacy who informed me they actually have clinic case managers. The case manager was able to get us next day appointments. Now all our referrals to their new specialists have been placed and we even have scheduled a few appointments with the specialists.

It really just takes time and patience. One last piece of advice is to alert all parties involved of your move. A month prior to our pcs I informed the medical supply company that we would be moving. They were then able to alert the new branch of our incoming and our needs. This worked well as the new branch called us and set up a delivery before we even seen by the specialist. They also called our insurance to see what needed to be done on their end to speed the process along.


Mommy Moment Monday: Nothing Completes a PCS like a Trip to the ER


I think I have read that title phrase a million times and sadly it is still true. So here to entertain you on your Monday is the first story from PCS hell.

Our first PCS was a overseas tour four years and one kid ago. Of course there was a lot of stress in anxiety trying to move our entire lives and two kids (one with a life threatening medical condition) two under two years of age across an oceans and away from family. Joy oh glorious joy how I was so thrilled to be taking that trip that involved three layovers and over 24 hours of travel. Needless to say by the time the movers showed up at 10, I already needed a drink. However, that had to wait since Diva woke up THAT morning with a 105 fever. She was not herself and we decided that we didn’t want to chance her getting worse and with a fever for the first time that high and not knowing at the time if she shared Bugs medical condition, a trip to the ER was needed.

However, before I could load her up in the car, we needed to pack it.

Here is a little PCS pointer: anything you DO NOT want the movers to pack you need to isolate. I have heard of people designating certain rooms with “do not pack” signs on the doors, people standing 24 guard over the items to make sure they are not packed by mistake and more. We chose to pack everything not going crated into our car. After our belongings were loaded and driven off, we were driving 15 hours to our families house. So it was easier and made since to pack the car before the movers got there. What ever method you choose; choose one!

So the epic day arrived, pack out day. Diva woke up with a 105 fever and the movers were due at any moment. Hubs and I threw all our luggage into the luggage topper we bought and used on top of out vehicle. The movers arrived and I left with Diva barely lucent in the back seat.

Strike one: Hail. Yes, hail. I drove over to the nearest emergency room in the neighboring town through a hail storm. I was scared out of my mind, but Diva needed medical attention. I arrived and tornado sirens where screaming at us. Not only giving us a warning of the storm but also more to come for our family.

Strike two: We spent 6 hours in the ER with no cell phone service. I have a slight problem with needing to be in control. Not knowing how the move was progressing was sending me into a panic attack. Being locked in a mouse hole sized white sterile room was taking its toll. I held it together for Diva. Finally, she was discharged after her fever was under control and tests showed nothing serious. So I ran her out to the car in the storm. Luckily the hail and sirens stopped. But not the sheets of rain.

Strike 3: We arrived home just as the rain stopped. I walked in the house and instantly realized one flaw with our plan of loading up the car pre trip- standing there with only a PINK pull-up on was Bug. Diapers. I forgot to leave diapers. Hubs was smart enough to call one of my friends with a small child and asked to borrow any diapers she had. Sadly for us, her daughter was potty training. I just kept reassuring Hubs that all real men wear pink. He then informed me of how it all happened and strangely kept reassuring me that Bug was ok. . Never start off a story by reassuring me the kid is ok.

Apparently Hubs was busy helping the movers. He knew Bug would be content watching tv. Bug was content. He was also content drinking the 6 cups of juice Hubs kept feeding him. Needless to say, the one and only diaper in the house filled up fast. Leaking through his clothes and my favorite embroidered silk thread pillow (which promptly went into the trash). He tells me how he called my friend to get diapers and how she showed up quickly only to discover that Bug must have still been thirsty because they found him and the floor covered in weed killer! Bug must have been searching for a drink and thought the weed killer was a tasty choice. However, poison control didn’t feel that was a humorous conclusion. We had no way of knowing if he actually ingested any and how much. Try advised us to watch him, which we did much more carefully. Lucky enough, he never reacted.

And the home run: After the lecture and lesson from poison control I felt we needed to get the some clothes on the kid. Hubs scaled the car to get into the car topper and our suitcase. After he opened it up he discovered our “waterproof” car topper wasn’t. He further found out that everything in it was drenched. He opened up the black suit case and here it is folks… The grand slam… All our clothes in the suitcase were dyed black; an entire and only suitcase full our our clothes ruined… All our clothes we had with us for the next two months.

Yup. It was a glorious experience. Obviously we all survived and we got a new wardrobe to boot.

** keep us in mind the next two days as we travel across the United States on the longest and almost last leg of our PCS. From St. Louis to Richmond, VA. What I love best as I drive is knowing I am every kids road trip bingo dream ~ Hawaii plates!

Mommy Moment Mondays: My Reaction to Less is Better in Family Size


I was trolling Facebook last week while waiting for my spawn to visit all the oh so lovely snakes in the reptile house at the zoo. I made a adult decision to not expose my children to my fear of snakes and save their ears and noise sensitive bodies to my ear piercing screams. While on Facebook I ran across an interesting article from the blog Tales from the Mommy Trenches.

She wrote a post recently regarding the negative connotation today’s society has placed on families with multiple children and the choice to have medium sized families. I say medium sized because it seems people make some rational justification for families with over 4 children. However, families with between the average 2 and up to 4 require the average Joe to question why. Why would someone want more than two and no more than 4? Take the Duggers for instance. People watch their show with love and respect for a family that can raise a gaggle of children, or the past show Jon and Kate Plus 8. But when someone decides to have a third or fourth it’s met with disgust and questions.

I was fully pregnant with Diva when Bug was diagnosed with Hypogammaglobinemia. Horrifically a friend ask how we could possible consider having more children. I was confused and angered. Being 7 months pregnant I wondered how they thought I would approve and then act on their comment. Did the bulging belly of our second child not ring a bell that our choice of more than one child could not be undone? They never apologized, however they eventually followed up her comment with “your sure defiantly done now.”

Errrr….. Last I knew I was in charge of my own reproductive organs and furthermore, my husband and I were in charge of making decisions for our family.

I guess by the time SB came around they and most others assumed my child bearing days were over. Anytime a fourth is mentioned we get gasps, horrified looks and pity. I love how everyone feel they have bearing and weight on our choices of procreation. Furthermore, why was having one child ok, but additional children a horrific thought? It makes me feel like they see our children as a burden on us; that their diagnosis’s are so time and life consuming the thought of sterilization should be more on our minds.

I just don’t understand why a medium sized family is such a odd personal choice. Maybe it’s because with more than two children- you are out numbered. Then with more than four you can employ the buddy system within the ranks. However, what makes me the most irritated is when people assume the reason we need to be done having children is because of the special needs of our current children.

My children are not a burden, they are a blessing. Blessings that have taught me more than unconditional love. They have taught me to manage my time better, prioritizing and being thankful for when people give them clothes instead of toys for birthdays because I hate laundry and love spending more time with my spawn.

Tricare and Therapy Thursday: Medical Radius


When we were awaiting orders we dreamed at all the amazing possibilities for our first duty station. I never dreamed I would ever move away from my home town, let alone, home state. Then there we were waiting to see if we would be moving to another country. When the word came in it was a like a bomb had gone off. We didn’t know what to think or how to react. We were scrambling to pick up the pieces and quickly get our affairs in order. We didn’t get Germany as we had always dreamed, and what we did wasn’t even on our radio as a possibility. But there we were faced with a realization we needed to get packing… and fast.

One of the steps you take when moving to a new base is often clearing EFMP. If you don’t know what EFMP is, take a quick read over at a article we wrote a while back.  For the rest of us, lets move on.

During our personal process of EFMP screening when leaving our last post we had to go through the EFMP clearance process. What we told was a scary realization we had not realized was going to be a issue. Due to the medical radius of the base we were currently at, we, as dependents, were told we could never reside there again (there are always ways around this). Why? The medical radius for that particular base was 40 miles. Care for my child had to be within those 40 miles. It was not! It was a 3 hour one way drive to a larger city to find the medical specialty he needed for care and his weekly medical treatments. That’s right folks. I was drive 3 hours one way for a 30 minute appointment 2-4 times a week! A WEEK!!!!!

So the questions come. I know your thinking them.

1) How were you still stationed at the post if you were traveling outside the medical radius that often for care?

Our son was diagnosed with his medical condition after we had been stationed at the base. They were in a frantic search for someone in the state to be able to manage his care. Due to the isolated location of the base, honestly, there was no medical care within the 40 miles. So (here is where an exception comes in), somewhere along the lines they approved his EFMP paperwork that stated he needed said medical care outside of the radius. It seems however, some where along the way no one really noticed how far we were driving. Upon exiting and pcsing from said base, this is when they caught it and said there was no way we could live there as dependents.

2) If you can’t live there as dependents what happens if your spouse is stationed there?

Great question. No real answer. We have yet to reach that point, but I have a feeling we are going to get our answer shortly. Due to the high specialty of the medical care Bug needs and the combination of the MOS Hubs does, we are very limited to bases that can accommodate both. We are literally currently trying to figure this out. However, from I have have been told in the past it would resemble something like an unaccompanied tour for Hubs. Which will not fly with me. Sorry, but separating me and three small children (all requiring specialized care) from my husband will require you to sedate me and lock me up. All that will do is create more hardship on my family. I would rather drive 3 hours for a 30 min appointment to be able to keep our family together. But there in lines a greater question- would staying together do you more harm than good?

3) What is the medical radius for my base?

In order to find that out you will need to contact your base or your gaining base EFMP office. Every base is different. Some bases have larger radius than others.

4) What will happen if you can’t find a base with medical needs and your husbands job?

Another amazing question and another one I am in the process of discovering. Where there is a will there is a way. The way? Talking to my children’s doctors and explaining to them the situation.  If we are having this issues, I am sure other families in the past have had similar if not the same issues. And I am sure the mommy in that family was just as feisty as me to find a way to make it all happen.

5) Do you want to move?

That is the question of the year. I have also wrote about this a bit earlier this year; the first time we were told we were pcsing (which was a lie!). We are now facing the same situation again, just a different base. Yes, we want to move. There are so many reasons that will end up being another post.

Ideally in the end we will move to a base that will have both the medical care we need and Hubs job. Realistically that will probably never happen and we might be stuck in paradise forever. If not paradise forever, then an base with limited medical access that will require weekly road trips but our family will be together.

Part 3- Treatment

It began with us driving three hours to the neatest pediatric clinic that dealt with his disease. (Here is where EFMP, Exceptional Family Member Program, can come in real handy.)

At first they had no idea on how to handle him. Because of his age he was the youngest the state had seen. They were not sure if treatment would work or what lasting side effects the treatment could pose. But there is no other option. There is no cure, just a treatment.

We started out at 7ml of Hertzina every four weeks. At this point we were now traveling three hours one way 2-3 times a week. When I say we I mean Bug and myself (I was 6 months pregnant with Diva).

His treatments lasted hours. They would admit us to same day out patient in a children’s infusion clinic. He would get doses of Benedryl and Tylenol. They would take his vital signs and we would wait for them to prepare everything. They were always afraid of a allergic reaction. So he was watched like a hawk.

Finally they would insert a iv. His treatment was called IVIG. His medication went in interveniously. All we could do was watch movies, play games and sleep. But at 18 months old he didn’t understand what was going on.

It would take 4 nurses and me to hold him down to get a iv in. Then we would cocoon him until the Benadryl would kick in and knock him out.

It is a mothers worst nightmare to see their young child hooked up to iv’s and monitors fighting against every body trying to help. I cried. Every month.

His reaction never got better. Although his health improved. It wasn’t good enough. Every third week he would end up sick and on antibiotics again. Eventually I was making those weekly trips with Bug AND a colicky Diva. Talk about wanting to run screaming out of a room. One child screaming because of fear and a incurable disease and one screaming newborn. (Hubs was in training this entire time and could never attend any doctors appointments or treatments).

After months of road trips our orders for Hawaii came through and we were on a entirely new adventure.

We landed in Hawaii and immediately had to continue on with Bugs treatments that week. But getting settled with new doctors and a new state, let alone on a island was a tough road to travel.

There is one doctor here who at the time was dealing with one other boy Bugs age with the same disease. To my knowledge they were the only two in the state (since then the other patient has moved and is in remission!). Bugs new doctor was adimant in a new treatment plan. However, the description of it was something we both felt was not in our sons best interest. We had no choice. His doctor refused to refill Bugs “prescription” for the IVIG treatment.

Our hands were tied. No longer would Bug received his IVIG every month. He would now get a new treatment every week.

Sub Q is a alternative form of treatment for this disease. The cons associated with IVIG was that at a certain point (week three for Bug) the valley would hit. The bodies antibodies levels reached a peak within the first week. Then slowly the numbers sluff off and fall into a trough causing the bodies immune system to become compromised.

With Sub Q, the body has no peaks and troughs and instead maintains a common baseline average. Although in theory Sub Q seems like the better choice, once we realize that meant inserting needles in our child weekly it scared the crap out of us.

We have now been doing Sub Q for over a year. It is still a weekly nightmare. Even though we numb the sight the fear and anxiety always sends Bug into a panic of kicking, screaming, biting and flailing. The sobs of my son breaks my heart. I will never forget his pleas he screams every week. “Mommy don’t hurt me!”, “mommy, ill do anything!” And “mommy don’t you love me?”

It’s hard, I just want him to understand why we have to so this so bad. But he doesn’t get it. Of course; why would he? To him nothing is wrong. He is hardly ever sick and doesn’t remember how it used to be because he was so young.

One day I hope he understands. And one day he will be able to do them on his own. I hope. But until then we battle on. Normally Hubs is at work and it is left to me and a volunteer to help.