Medicare Proposals- Time to Act!

In terms of technology, there is no better time to be living with limb loss. I have witnessed the great strides made in suspension systems, socket design and components during the decade since I became an amputee. From high tech bionic devices to specialized fins for swimming and blades for sprinting, the possibilities appear endless. Alas, the dirty little secret of accessibility to devices continues to limit the potential of amputees across this country. 

Medicare recently proposed changes which, if enacted, could significantly impact the millions of amputees in this country who rely upon a prosthetic device. It is important to understand that private insurers, including Blue Cross, Cigna, and United, typically follow Medicare's lead. If these disabling proposals materialize, it is assumed that they will be adopted by all insurers without hesitation. 

The proposed changes are lengthy, but I will highlight and attempt to clarify the five that I feel are the most dangerous.

1. All new amputees must complete a rehabilitation program utilizing a "preparatory" prosthesis. An individual must prove competency on the bare bones device before progressing to a definitive device. This proposal will force the amputee to utilize a device that does not meet their needs and is flawed by the assumption that one must be adept at lower technology devices in order to utilize and benefit from technology. There are many above knee amputees who are able to ambulate because of the microprocessor knee. If they were forced to prove competency with a preparatory prosthesis, they would be unsuccessful and would not qualify to receive a prosthetic under the proposed regulations. 

2.  The patient's potential will no longer be considered when prescribing a prosthetic device. Currently, a prosthesis can be provided if the team proves that the patient has the potential for increased activity once the device is received.  Instead of providing tools to enhance an individual's abilities, the prosthetics provided will meet only the current functional level. In other words, if you weren't going to the gym before your amputation, don't expect to become healthy now that you lost a limb. So much for the government's Get Moving campaign!

3.  Regardless of your current abilities, if Medicare has ever provided an assisted mobility aid (crutches, knee scooter, wheelchair), your prosthetic can be denied. I was provided with both crutches and a wheelchair following my amputation. Under the current proposals, this could be terms for a denial.

4.  If an amputee is not deemed to demonstrate a "natural gait" utilizing the preparatory prosthesis, the more sophisticated device can be denied.  Yikes! How much of a limp can be present has yet to be clarified, but this is a dangerous precedent. Not everybody with two legs ambulates with a smooth looking gait, yet amputees are going to be held to a higher standard than the regular population. 

5.  The prosthetist, the college-educated expert in the craft, will no longer be considered relevant in determining the components for a prosthesis. With his expertise muted, these professionals are relegated to basic suppliers. The determination of components will be made by a medical team which lacks insights into the various features of the available devices. 

I used to believe that amputees could do anything and that we were limited only by their own desires and motivations. I have come to realize that the community is disabled not by the physical loss of their limbs, but by the archaic insurance policies that stymie our potential through denials and by limiting available technology. These Medicare proposals threaten to put prosthetic access out of the reach of millions of people in this country, and it is time we stood up and fought back. We may be living with limb loss, but we will no longer be disabled by insurance companies. Help me stand up to these Medicare proposals by writing to your elected officials. Together, we can make our voices heard. 

Anniversary Memories

Yesterday was our wedding anniversary. I didn't reference the significance of the day in yesterday's post because I wanted to see if Scott would remember without a prompt. He surpassed my expectations by wishing me a Happy Anniversary after dinner. We have been together for eleven years, so surprising me has become rare.

It is hard to believe that we have been married for more than a decade. In some ways it feels like just yesterday, which is a refreshing change from the days that I feel as if we have been together for an eternity. Through it all we have remained a team, and I love him dearly.  Nobody can frustrate me more than Scott, yet I couldn't think of anybody I would want by my side more than him. 

Perhaps the anniversary prompted my reflections, but yesterday my mind kept drifting to past memories. At first I was remembering back to memories with Scott when we were first dating, and I smiled. Then I was thinking about when we first moved into our townhouse so many years ago, and my smile morphed into a smirk. Then I was thinking about my Dad showing up on my doorstep one snowy Sunday night, asking if he could "stay for a few days" and I giggled. Then I was just thinking about my Dad, and I cried.

It angers me that my wedding anniversary can prompt such a visceral grief about losing my Dad. I know that, had he been alive, he would not have remembered the date. I also know that I probably wouldn't have talked to him on that phone that day because we were both busy with work. Yet for some reason, I really began to miss him.   

Like so many things, I have to experience them in order to fully relate. I never understood the fluidity of grief until I lost my Dad. This is a lesson I wish I could unlearn.

Smiling and Faking

I've been home from Arizona for several days, and things are starting to settle back into place. The laundry mountain has been turned into a small hill with each load, and I am beginning to believe that someday we will be caught up. I spent yesterday working nearly non-stop, allowing me to take a chunk out of  my to-do list. After a few more days, I hope to be completely caught up on everything that was pushed to the side during the trip.  (It's a good thing that we aren't going on a proper vacation this year, I don't think I could handle the work afterwards!)

I have accepted that one lingering effect of conference will remain long after the housework and reports are complete. In a hotel bursting with amputees, I was normal. Back in my hometown, I am again the oddity. It is taking me some time to readjust to the stares and second glances.  I know that I will eventually acclimate to the attention my prosthesis garners, but it is going to take me a few more days.

Yesterday we went to the grocery store, where I was acutely aware of the not so concealed attention from the twenty-something in the yogurt aisle who proceeded to knock over a row of little cups in her attempt to act natural.  Typically, watching her try to reassemble the yogurt display would have made me giggle, but yesterday I felt like crawling into a hole. I asked Scott if I was receiving more stares than normal, because it felt like I was walking around with purple horns plastered on my forehead, but he promised that the attention has not increased.

Obviously I can try to conceal my leg by wearing pants, but it is 95+ degrees out and I am not terribly keen on overheating and being uncomfortable.  I will eventually adjust to the reactions my prosthesis receives, but it will probably take another few days. In the meantime, I'm going to hold my head high, but a big smile on my face and fake it. I'll pretend that I'm confident and comfortable, and eventually my feelings will follow suit.  I continue to be amazed by the impact of a few short days of being in the majority. 

Teamwork

Everybody is finally reunited under the same roof, and it feels wonderful to be together and to be home. I had a fantastic (albeit busy and hectic) time at conference, and it was difficult to say goodbye both to the beautiful location and to my dear friends. However, all good things must come to an end, and I was ready to come home. At my core, I am a homebody.

After a long day of traveling on Sunday, yesterday was spent doing nothing of consequence. I picked up a little bit around the house, but primarily just relaxed and enjoyed playing with the boys. I was away from Timmy for a week, but it felt like he grew up significantly. He is quicker and seemingly more mischievous than he was when I left for Arizona. I was content just to spend the afternoon playing with him.

Although I know he had a great time with his Nana, Timmy seemed delighted to return home. He was all action and giggles when he returned. He was excited to show me his new trick (walking backwards) and spent hours rediscovering all of his toys. Robby was happy to be home, but his reactions were a bit more tempered. He was content to quietly play his XBox and relax with cartoons.

Today we will settle back into our routines, which means that I will be busy. It is amazing how things pile up after just a few days away! Thankfully Scott is home from school and will be able to help with the laundry, eliminating one looming item from my to do list. Hopefully, working together, we can finish everything in time to visit the pool before it closes.

Leaving Oz

This past weekend was one full of emotions. I missed Timmy terribly, and couldn't wait to get home and hold him again. While I loved hearing the tales of his (mis)adventures from my Mom, part of me hurt with each conversation because I was missing everything. Logically I knew that I was being silly, that he wasn't going to completely change or forget me in a few short days. My heart fluctuated between believing my logical explanations and missing my baby so much I was ready to start walking home to get to him.

By Sunday morning I was awake early, packed and ready to go home. Walking down into the hotel lobby, I was swarmed by my amputee friends saying goodbye. I always hate goodbyes!  Not only was I hugging dear friends, I knew that I was also bidding farewell to the wonderful feeling of being in the norm. I left the fantastic and empowering land of Oz, where nobody stares and gawks, where legs and arms setting by the pool was the norm, where those missing limbs were in the majority and we weren't considered "disabled," as soon as I exited the hotel lobby and climbed into the van for the airport.  It will definitely take me a few days to acclimate to being the oddity. 

I flew all day (and most of the night), finally walking through my front door around three in the morning. I had a wonderful time at conference, but it is time to get back to reality. I can't wait to be reunited with Timmy later this morning, and to spend some quality time with my family.  Oz was wonderful to visit, but there is no place like home!