Two Years

I'm waking up this morning feeling sad, but I knew going to bed that today was going to be difficult.  It has now been two years since my Dad died, but sometimes I feel the loss so profoundly that the grief feels fresh and new. It is hard to believe that it has been two years since I've heard his voice. I wish I could pick up the phone and call him, to seek his advice or just to tell him about the kids. It hurts when I realize that his phone number now rings to somebody else, and that I won't be able to talk with him again. 

Today, whenever I feel sad I'm going to redirect the grief into doting and spoiling my kids. We're going to play some extra games, make some cookies and just spend time having fun. I don't think it will be hard to convince Robby to curl up on the couch with me tonight to watch Karate Kid (again.)  I know that my Dad would prefer today be spent doting and spoiling the children (his grandchildren) instead of dissolving into an emotional mass and crying.

I'm going to try to get all of my crying out of the way now so that I can be at least quasi-productive today. If I can stay busy enough, hopefully the anniversary will pass quickly.  I don't know what else to say, except that I miss my Dad.

Today Will Be Better...

Yesterday was not my best demonstration of parenting.  Timmy woke up obscenely early (3:30) and could not be rocked back to sleep. He didn't feel well and was tired, a combination which always leads to a crabby toddler. Nothing I did could soothe him, and he was just plain miserable all day.

We spent an inordinate amount of time flipping between Thomas the Train cartoons ("Oh bother!") and Paw Patrol.  I was exhausted from getting up with him, so my affect wasn't much better than his. Basically we were two grumpy and tired souls trying to get through the day until it was time to go to bed.

Hopefully today is better for both of us. It is 6:30 and he is still asleep.  This is a rare for him, and I'm taking it as a good sign that he is catching up on some much needed sleep.  Because he slept well, I was able to get to bed early. Today will be better because he deserves a happy Mom, and I miss my sweet little mischief maker.

Weight Loss Drawback

Since January I have lost nearly 30 pounds. While I'm delighted with my weight loss, it has not come without a cost. All of a sudden my leg doesn't fit, and I'm struggling to stay inside my socket.  My walking has been slowed because I worry that I'll step out of my leg entirely if I'm not deliberate and careful. I feel like this situation is the epitome of no good deed goes unpunished!

I have worked so hard to shed the pounds and I'm frustrated that my efforts to become healthier are directly responsible for my mobility issues. Where most people just need to change jean sizes when they lose weight, I need major socket adjustments for each 20 pound fluctuation.  A shrinking bum is something to be celebrated, but a reduction in limb size is not nearly as fun. Unfortunately there is no way to lose weight without impacting the girth of my limb, but that doesn't mean I have to be happy about it.

I am going to need to get a flexible liner made for the inside of my socket. Hopefully this will tide me over until my weight loss is complete, or until I lose enough to completely justify a new socket. I hate wearing a leg with the flexible liner, but I detest falling more so I will suck it up and wear it.

I've put a lot of work into losing the weight and I'm trying to not become discouraged by my ill-fitting leg. I know that the need for a new socket is a milestone in my weight loss journey. I am not yet at my goal weight, so I expect that this won't be the only time I shrink out of my leg. Looking on the bright side, at least I need a small leg instead of a bigger one!

Writing an Investigational/ Exerimental Appeal

One of my great professional pleasures lies with writing and winning appeals for prosthetic devices. Insurance claims too frequently are subjected to the rubber stamp denial in a quest to deter patients or, at the very least, to delay payment.  This approach must work or the industry would change tactics. I abhor the thought of amputees in need of a prosthetic being bound by needless red tape.

I wish I could lay claim to the method I use when writing an appeal, but it was taught to me by my friend and podcast partner Dave. The method is brilliant in its intuitive simplicity, yet the nuances of presenting information in a specific method stacks the deck in the patient's favor. In this week's episode of amp'd, Dave and I presented the method for writing a strong appeal for an insurance denial on the basis of investigation or experimental.

One of the lingering side effects of the Medicare LCD from 2015 is the resurgence in vacuum technology denials based upon being experimental or investigation. The LCD proposal opened the door for insurance companies to change their stance on this thoroughly vetted suspension system. Although elevated vacuum has been around and accepted for more than a decade, and the benefits have been well documented in numerous research studies, patients are being once again being denied this previously accepted suspension system.

We recorded this episode in hopes of helping those who are facing experimental and investigational denials. While we based our sample appeal on a vacuum denial, the system can be tailored for any device deemed experimental or investigational. Our goal is that the tools we provided will empower patients to fight and appeal their denials. As always, we are happy to answer questions!

Cotillion Teasing

With the wonky weather this past weekend we didn't do anything of consequence.  Timmy and I played with trains for what felt like an eternity. For a little boy who is a thrill seeker, I am amazed at his focus when trains come out to play. He becomes an intent little engineer, purposefully connecting and pushing them through various tunnels and over and around obstacles. I don't really understand his delight with trains, but I have come to accept that he loves them and thoroughly enjoys my filling the role of assistant engineer. 

When I wasn't busy with trains I was on the internet, scouring for speech therapy options for Robby. In the days since the Cotillion Ball he revealed that he was teased both during the classes and at the dance because of his speech and hearing impairment. It hurts me to my core to know that he is being made fun of for something that is entirely out of his control. The fact that he was teased during a course that was supposed to instill manners and etiquette is an irony with which  I am still trying to grapple.

I cannot fix Robby's hearing, but we are going to do our best to augment his speech. As a family, we have decided to double down on therapy to try to hasten improvement with his articulation issues. After research and talking with some specialists, we have decided to proceed with Skype speech therapy. As he is getting older, I know that the opportunity for teasing will only increase. We are going to be enrolling him in an intensive program to try to minimize the issue before middle school (gulp).

Scott and I are walking a fine line between supporting Robby's speech endeavors without making him feel inadequate for having an issue. My normally secure little Koopa has become sensitive about his speech differences. More than one time we have stopped him from skewed self- assessments. Every time I hear him refer to himself as "stupid" or "dumb" I want to wrap him in a bubble and remind him that he is perfect to me. I know that isn't what he needs to hear, especially at ten years old, so instead we acknowledge that he has trouble making some letter sounds while discussing his many cool talents and abilities.

While I expect that he may always have some mild articulation issues, I'm optimistic that we can normalize his letter sounds in the coming weeks. Through intensive "speech boot camp" I'm hoping that Robby will hear progress and take pride in the fact that he is tackling an issue head on. He is a strong, smart and caring young man. Together, we're going to tackle those silly /r/, /s/ and /y/ sounds.