ArmyMommy: Traveling overseas with Tricare

ArmyMommy posts are specific to topics and experiences related to our being an Army family. Civilian readers might not care ;-)

Preparations for our Christmas trip are well underway. As a new mom, I find myself adding a few extra steps in my usual trip prep procedure. One overarching concern is anticipating anything that could happen to our almost one-year-old. On top of that list are, God forbid, medical emergencies.

If you're an Army family, like us, chances are you have Tricare for your health insurance. The good news is that Tricare will cover emergency care for you and any covered person while overseas (please check your coverage). But there are a few things that you should know.

One, make sure that your information is up-to-date with DEERS (Defense Enrollment Eligibility Reporting System). If you have to ask what DEERS is, than you might not want to read the rest of this post!

Second, be sure to carry your military ID with you. For kids without IDs yet, like our baby, request a Tricare beneficiary card to help facilitate things when seeking care overseas. Do so well in advance of your trip as the card processing might take a while (I have to admit that I have not done this yet). Absent a card for the kid, a parent's ID will often be enough, but in case you are traveling with other people who might be the ones who end up taking the child to the hospital or doctor, the child's own card will be necessary. Same goes for when kid is traveling to, say, grandma's, without parents in tow.

Third, collect the names and contact information of providers in the cities or countries you are traveling to. We are going to three cities in Europe. I looked up participating medical and dental providers in these cities here. With their contact info in hand, we will know exactly who to call in case we need a doctor or dentist.

Tricare directs its beneficiaries to get help finding medical care from the US embassy or consulate in whatever city or country one is visiting. But there's also an emergency phone number that one can keep handy. The international SOS number I found off the Tricare Europe web site is 44 - 20 - 8762 8133 (collect).

If you find yourself in a real medical emergency, do not hesitate to rush to the closest emergency room. You may seek care at non-participating providers. Just make sure that you contact Tricare after you get there, and definitely before you leave the hospital or doctor's office. And by all means, keep all records and receipts! Tricare Standard beneficiaries, for example, have to pay out of pocket and are then reimbursed stateside. I'm not too clear on this part since we are on Tricare Prime so please double check.

It might also help to have the contact info for Tricare where you are going. In Europe, its:
TRICARE Area Office: Eurasia-Africa
011-49-6302-67-6314
DSN: 496-6314
teoweb@europe.tricare.osd.mil
www.tricare.mil/eurasiaafrica

For more details, read this June 2010 news release about traveling overseas with Tricare.

Finally, pack a travel medical kit. Our doctor is helping us put one together. It should include items that you usually use to treat your child if he or she has a cold, or a slight fever, as well as dosing instructions. Realize that medicines that we are used to seeing at Walgreens might not be the same as what's available in other countries. There are many sites online that feature packing lists for such kits. Here's one checklist. Add and subtract as applicable. For our baby, for example, we are skipping the teething medicine and sunscreen, and adding saline nasal spray and Vicks Baby Rub.

If you have any medical concerns at all, try to see your doctor before you leave on a trip. Oh, and make sure your kids are up-to-date on all their shots.

Now, you can worry about packing!

Happy birthday, Chino!

Today is a good day. For today, we are grateful. Today, Chino turned one.

Miracles happen everyday, whether we recognize them or not. But today's particular miracle did not go unheralded. Weeks after his surgery, Chino is with his family celebrating his first birthday.

On October 4, my godson went in for his first open-heart surgery. Prayers and well-wishes flooded in from all over the globe as relatives and friends of the Nebrao and Adalla families joined in vigil for a successful operation and quick recovery.

There was good news after the operation. His mitral valve was repaired. Even better, a tube in his heart that was thought to be missing was there all along, just fused with another. The tubes were separated and were functioning well.

On to the ICU he went, where, for days, he battled a persistent fever. The risk of infection is always high after such an operation, and only a few people were allowed to visit Chino to limit those risks. Even so, he was stable and on the mend.

Then, this message via Facebook on October 12:

"CHINO'S POST SURGERY UPDATE: We were told that Chino's heart is not contracting well despite 3 blood transfusions & maximum med supervision. He will need to undergo the valve replacement a year from now (means 1 more open heart surgery!) since the said valve is not functioning back to normal. Intensive prayers... Ever faithful to the end."

Nonetheless, Clarke and Cynch were finally able to take their baby home on October 15.

At home, Chino continued his recovery, fighting off fevers, getting stronger everyday as his wound healed. On October 24, the family reported that he could sit up, though still with assistance, and was back to eating his favorite pasta dishes.

On October 26, they posted this picture on Facebook, bringing smiles to the faces of all those who have joined them in this journey.

Today (yesterday, Philippine time), they posted this message:

"As you turn one today, we praise God for the gift of you in our life. Thank you for teaching us so many valuable lessons in living and loving... Thank you for constantly reminding us to face our life's battles with full faith and trust in our God. We thank God as well for the overwhelming support ...and love from our family, friends and complete strangers who have generously shared their blessings and prayers to you during your first open heart surgery a few weeks back.

We pray that Papa God will continue give you healing and fix your broken heart, we pray that He will take away all the pain and "yayay" that you feel as you recover from your surgery and most of all, that He will always put that cutie smile in your little face everyday.

We love you Chino. We'll face your next fight holding hands and with our full trust in God. Happy 1st bday baby boy! We look forward to more wonderful celebrations of your life.

From Papa Clarke, Mommy Cynch, Ate Ikang & Ate Cacay"

Happy birthday, dear Chino, and thank you for the gift you have given us all. Ninang Abbie, Tito Vance and Mateo can't wait to meet you in person.

---

Their fight is not over. You can still help. You have until November 15 to vote for Chino here so he can win Php 100,000 to help pay for his medical expenses. Please take the time to vote now. Thanks!

Help Chino win Php 100,000

Here's another opportunity to give a gift for my godson, Chino. Please vote and help him win Php 100,000 (roughly $2200). All it takes is a few seconds of your time.

Follow the instructions below.

Chino's Hug

1. Go to http://www.facebook.com/poweredbyciti
2. "LIKE" the page
3. Go to "PRICELESS MOMENTS" on the Tabs
4. Enter site and register.
5. On the bottom right corner click "VIEW ALL ENTRIES."
6. Look for Chino's Hug (baby in blue "Future Atenista").
7. Click and then "LIKE" to help Baby Chino win the price for his operation.
8. Your every vote counts!


We have until Nov. 15 to put Chino on top of the voting list. Please click!

Update on Baby Chino

Just a quick post in between spoonfuls of baby food that M is refusing to eat.

Chino has undergone further tests, and has been put on some medication, to determine how fit he is for an operation. It looks like the latest advice from doctors is for him to have the operation in 6 months' time. His parents will be deciding when exactly the operation will be done.

As for the fundraising, according to their website, the funds donated has reached Php 625,592.36 or about $14,160. They still have a long way to go until they reach their Php 2 million goal. So if you have been thinking about giving, but haven't yet, please do so. Please.

You may give in the following ways. Please note that their Paypal account DOES NOT work.

Give Through Xoom

Use your credit card (US based cards) to give.
Log in to Xoom.com register and send to
Bank: Bank of the Philippine Islands
Account Number: 3106523407
Recipient: Cynthia Marie Adalla-Nebrao
Address: 349 Ortigas Ave. Greenhils East Mandaluyong 1554, Philippines
Email: championsforchino@gmail.com

Give Through Bank (if you are in the Philippines)

Deposit your donations to:
Cynthia Marie Adalla-Nebrao
Account Number. 3106523407
Bank of the Philippine Islands (BPI)
Edsa-Greenhills Branch

Please email championsforchino@gmail.com once you've deposited for accounting purposes.

Once again, thank you to all those who have given. I'm especially grateful to my friends who have come out in support of a family they do not personally know.

Please help. Be a Champion for Chino.

Tonight, I learned that someone I love is going through what I would consider my worst nightmare. Tonight, I learned that a sweet little boy is in for the fight of his life. Tonight, I will ask you, whoever you are, whether you know me personally or not, to please help keep their hope alive.

Carlos Aleixo A. Nebrao was born a little over ten months ago, the third child and only son of Clarke and Cynthia Nebrao. On August 27, his dad took him to the doctor for his routine shots. But during the checkup, the doctor detected a slight murmur when listening to baby Chino's heart. By the end of the visit, Chino was diagnosed as having a condition called a severe mitral regurgitation with mild stenosis. The baby needs open-heart surgery. He needs it soon. It will cost around 1.5 million Philippine pesos.

Go back a few decades. It's 1990 and I'm entering high school in a new town, without a familiar face in sight. Cynthia, or Cynch, and I were in the same section of the freshman class. That's how we met. I don't quite remember when we first started hanging out. Even then, I wasn't the best at making new friends. Thankfully, she was and over the next four years, we shared experiences that I knew would make us friends for life.

How many mornings did we meet, before it was even light out, to ride around our mountainside town on our bikes, hers green, mine neon yellow? How many times did we climb into that city-bound bus to spend the day at the mall, looking at clothes we rarely bought, just having fun? And how many times did I seek refuge at her house, arriving at all times of the day, and sometimes night, heartbroken about something or other? I still laugh at the memory of the time we drank mass wine out of coffee cups at her house, to keep from being caught by her mom.

Our lives and choices took us in different directions after high school. Different universities, then different countries. She got married, started having beautiful babies, and embarked on a life as a missionary for Couples for Christ. Her journey took her to Africa and back to the Philippines, via several other countries. Mine took me to the US. But when we get together now, no matter how few and far between those reunions, we are those old friends still.

The last time I saw Cynch was a few weeks before she had Chino, in Washington DC. We were both pregnant but still managed to see the sights. I met her husband for the first time. We talked like two moms for the first time. Decades after we first met, we still managed to experience things that are new.

This too is another first. As a new mom, the news of Chino's condition moved me in a way that would not have been possible before I had my baby. Though I do not know exactly what they are feeling, I can imagine, all too well, what Cynch and Clarke must be going through right now.

I always took it as a matter of fact that our children would grow up as friends. The thought that Mateo and Chino might not have the chance to be what Cynch and I are...well, it breaks my heart.

So tonight, while my baby sleeps soundly in his bed upstairs, I ask you, whoever you are, to help give another baby, halfway across the world, a chance to grow up--to be a kind boy, a good man, my son's friend, and his mother's son. Chino could be all this and more. He only needs the chance to be so.

You and I can help give him that chance. If I've tugged at your heartstrings, then let me move your purse strings as well. Two million pesos is what they need. That's about $44,000. Sadly, the clock is ticking.

Please help. I know that in these economic times, giving can be difficult, but for Chino, every little bit will help. There is no real health insurance insurance in the Philippines. Most have to come up with the cash to pay for treatment. So if you have even a dollar to spare, please consider giving.

Friends of the family have set up a website to help raise money for Chino's operation. You can learn more about Chino and his condition there too.

If you've read this far, I thank you. If you decide to give, I am ever grateful. As you hug your little ones, or not-so-little ones tonight, please say a simple prayer for baby Chino, his family, and my friend.

I'm going back to the Philippines...

...where a yaya is waiting!

While I sort out the ticket situation, I'm thinking about how best to spend the two weeks we have carved out for this trip.

So far, we have lined up a day trip to Corregidor, a weekend in El Paradiso, and a must-have visit to Los Banos. If you were going, what else would you see and do?

Here's one take on a balikbayan guide.

Breaking up is hard to do.

Like many of you, I've been through my share of difficult break-ups. But this one, I didn't see coming.

See, earlier this month, I decided that it was time to stop breastfeeding. And it's been harder that I ever thought it could be.

As a first-time mom, I've been fully indoctrinated on the value of breastfeeding. No one can argue that health-wise, it's best for baby. Some of the benefits include: less gas, diarrhea, and constipation; stronger immune systems; higher IQ; and less risk of childhood obesity. For mom, it helps in more quickly returning your uterus to its original size, and it burns tons of calories, aiding in shedding the pregnancy weight gain.

And while I don't mean to over-romanticize breastfeeding, it does create a kind of bond between mother and child that only the act of nursing can. That for the first months of his life, baby relies on just mom for his sustenance is a powerful thing. So is the feeling of holding baby close--the weight of him, the warmth. It's a unique relationship, and I'm hard-pressed to think of anything that comes close to the breastfeeding experience.

This "feeling" is what has me yoyo-ing between weaning and not. It has me resenting baby bottles, throwing dirty looks at the canister of formula, and longing for the lulling sound of my Medela. Strange. And difficult.

Unlike many others (I hope), my breastfeeding experience has been difficult from the start. There was pain, physically and emotionally. Baby lost an alarming amount of weight a few days after coming home from the hospital because he wasn't getting enough milk. Without the prodding of our then-pediatrician, a man who likened baby formula to junk food, I would have popped a bottle into my son's mouth right then.

Over the course of the seven months of nursing, I saw lactation consultants, attended support group meetings, got acupuncture, bought both heating and cooling implements, used a Boppy and a My Brest Friend, and pumped, pumped, pumped.

But in the end, only one thing led to my decision to stop nursing, my arch nemesis since the beginning: mastitis.

Mastitis is an infection of the breast tissue that results in breast pain, swelling, warmth and redness of the breast. And pain, did I mention pain? And fevers, chills, body aches, and some more pain. I got mastitis a total of five times in seven months, the last one coming at the end of July.

Mastitis alone is no reason to stop breastfeeding. Moms can, and are in fact encouraged, to continue nursing while being treated for mastitis. Nursing clears the milk ducts, and keeps the milk flowing. And if you feel iffy about giving baby the "infected" milk, docs say that baby's stomach acids can effectively kill any bugs that might pass through. I nursed my wee one through all five bouts of mastitis and he's never gotten sick.

So why stop now? First, and perhaps most selfishly, I want to feel normal again. By normal, I mean pain-free. Breastfeeding for me has also always been about managing levels of discomfort. Maybe I have faulty equipment, but my equipment have always been so sensitive that I couldn't wear anything but a thin cotton bra. So sensitive in fact, that I've had to encase them in plastic shells for days on end.

Second, I'm done passing harsh antibiotics on to baby. The frequency of these infections have caused doctors to give me more and more drugs to fight the infections. While all of these antibiotics have been deemed okay for breastfeeding moms, they also are always prescribed with warnings that baby will likely get diarrhea or suffer some other side effect. We've managed to avoid those (baby is on a daily regimen of acidophilus), but I just can't keep exposing him to such drugs.

Finally, I simply don't want to keep getting sick. I've gotten sick and seen more doctors in the past few months than I have in all my years pre-pregnancy. And when you can hardly lift baby because you are so weak and tired, well, that's just not good all around.

Upon reading what I've written so far, it sounds a bit like I'm justifying my decision to stop breastfeeding. And maybe I am, to myself mostly, and to other moms out there I suppose. Having gotten past the the recommended six months of breastfeeding, I feel a little bit better about my decision. Still, I think I needed this mental exercise to mollify the emotional uncertainty I have over the whole thing.

It's taken me weeks to wean baby, and we are still working on it. He's taken the bottle like a champ and seems to be doing well enough on organic formula. But at night, when he goes to sleep with dad and a bottle, I feel a little stab. He doesn't "need" me now, at least not in this sense, and it's more than just a little heartbreaking.

This feeling, the hurt of breaking up with the boob and with my baby, is a recurring theme in parenthood, I've been told. As baby grows up and becomes more independent, he will need us less and less. I look forward to it, and dread it as well.

For now, I will relish the last remaining days of this breastfeeding experience. I know I should give him a bottle now, but maybe I'll nurse him, just this once today, instead.

It's time.

It's 11:24 pm.

While nursing my baby to sleep, I did something I have not done in a while--blog-hopped--and stumbled upon a post by another new mom about taking time out of her very full day to do something for herself, something beyond her role as a mom and wife, something that she loves.

She's right. And it's time.

It's time I do the same. It's time to revive this experiment. It's time to learn how to be this new person without losing the old one.

It's 11:31 pm. Baby is asleep on my lap. I am typing with one hand, even as I feel my neck begin to cramp from the strain. But it's time.