Unfathomable Choices

The past few weeks have been stressful. Since Timmy received his autoimmune diagnosis, our family has been hyper focused in an effort to help him regain his health.  We have traded our typical adventures for home activities, a change that has required adjustment and flexibility from both me and Timmy. I have been keeping myself busy in order to avoid the anxiety and sadness I feel for my little Hamlet. 

In the middle of this chaos, I was reminded last week that we are extremely fortunate. Timmy was lucky to have received a diagnosis and he will regain his strength. This is a quick hiccup in his childhood, and it is definitely causing more angst for us than it is for him. He is only two, and he won't remember not feeling well for a few weeks or months.  Last week Scott told me the situation of one of his students, and my heart broke.

The child, only 14 years old, is facing surgery in two weeks. The surgery is imperative to saving his life, yet because of some cardiac issues the surgeons are uncertain if he is strong enough to endure the procedure. His family has been faced with a decision that I cannot even begin to fathom. Without the surgery, he will suffer excruciating pain as his body collapses upon itself, ultimately resulting in death. A successful surgery will eliminate the pain and prolong his life, but he has only been provided with a 10% chance of surviving the involved and lengthy procedure.

I look at my two sons and I cannot even imagine the grief and anxiety that has befallen that family. I remember the horrendous drive to the hospital on the morning of my amputation. As I try to imagine driving my child to the hospital for surgery, knowing that there is a 90% chance that he will not survive, I find myself emotional and angst ridden on the families behalf.  I pray that I never have to experience this impossible situation, and I find myself thankful for our seemingly trivial issues. 

Unfortunately the child knows the situation and the odds that have been presented. Again, I can't imagine being fourteen years old facing such an overwhelming situation. My heart breaks each time I think about him, which happens frequently since Scott shared his struggle. 

A Go-Fund-Me page has been started to help cover the medical costs and to minimize the financial struggle for the family during this time. If you feel inclined, I'm sure that they would appreciate your support. In the meantime, I'm going to go hug my kids a little more. I may be stressed out and worried about Hamlet, but I was reminded that his issues are minor compared to those faced by many others.  

Using Our Lock Down Time Wisely

While I know that staying in and away from germy society is best for Timmy, I have to admit that I'm going stir crazy. My little guy is still not up to par, so I am prepared to hunker down as long as necessary. His doctors are in agreement that he needs to safeguarded from infections, and I won't do anything to jeopardize his health even if that means I become antsy.

Since we have been put on society lock down I have purged and reorganized our basement into a toddler wonderland. While Timmy has been breaking in his new play land, I have framed a decades worth of memories and hung them prominently on our walls. We are not only caught up on laundry but the laundry room has been cleaned and my detergents have been categorized. My pantry has been cleaned and our Christmas decorations organized.

In the past four days I have stuffed 12 yard sized trash bags with crap that has been stuffed in drawers, on shelves and in the corners of my closets. Mr. Bill came to my rescue, schlepping all of the bags to the dump for us. I'm not cleaning and organizing because it is fun. I just never realized how much stuff we have stored and stashed throughout the house. Staying home all the time has forced me to face our clutter head on. On the positive side, my house is going to be amazingly organized and completely decluttered by the time Timmy is cleared to resume normal activities!

New Liner Day!

Today is going to be a great day! 

I don't have any grand plans. I'm not expecting surprises or accolades. I am not expecting anybody to help me around the house, nor am I convinced that Hamlet will remain tantrum free. But I know that it is going to be a great day because today is "new liner day."

Unlike new leg days, where I receive either a new socket and/or a new feet, on new liner day I feel nothing but benefits. Sometimes new sockets can be frustrating as the kinks are worked out in the quest for a perfect fit. A new foot forces me to reevaluate my gait pattern, which can become tiresome. The compression and cushioning of a new liner leaves me with a spring in my step without any of the frustrations associated with other prosthetic changes. 

There is nothing quite like the feel of a new liner on my limb. Cool and crisp as I roll it on, my limb feels happy with the cushiony support that is only provided by a new liner. As the days go on and the liner becomes worn, it is inevitable that the compression will loosen and the cooling gel will wear away. But today, the liner feels awesome and I plan to enjoy every step.

Lessons on Slowing Down

The days at home have been beneficial for me in unexpected ways. I have been forced to slow down and relax. Whereas I'm always used to running around to visit various play areas with Timmy, we are now staying put. Not going anywhere was initially uncomfortable for me, but I am now finding the solitude relaxing.

Timmy doesn't seem to be missing our excursions. I worried that he would become cranky and bored without the excitement of adventures, but the opposite has happened. He and I have been spending hours playing in his new playroom, making up games and rediscovering toys we have long ago put away. He seems to be relishing the alone time playing with me.

The quiet time has done us both some good. My leg has almost completely healed, and I am no longer feeling pain or discomfort when I walk. My anxiety tracker is not buzzing nearly as frequently, and I am now caught up on laundry and housework. It turns out that my compulsion to remain in constant motion was a source of stress and anxiety. Now that I've slowed down, I am feeling more centered and comfortable.

Timmy is still not feeling well, so we will be holed up for awhile longer. When we are cleared to interact again with the public, I am going to take the lessons that I learned over the past two weeks to heart. Adventures are fun, but there is also value to staying still and playing at home.

Every. Single. Day.

I used to love to cook. When I was in my twenties I remember looking forward to coming home from work so that I could start whipping up some kitchen magic. Although my skills are neither gourmet nor fancy, I have always prided myself on my solid 'home cooking' results. 

As both myself and our family grew, my love for spending time toiling in the kitchen has decreased exponentially. While I still enjoy baking, especially with my little helpers, cooking has turned from something that I adored into a daily chore. I jokingly tell other Moms that I don't mind cooking dinner but the fact that they want something every single day is exhausting. 

I know that my boys (Scott included) are not picky eaters by definition, but they are averse to trying something outside of our taste repertoire. If I were to count, I would probably guess that they all enjoy 12-15 meal plans. I try to rotate those throughout the month, but after more than a decade the culinary routine has become monotonous. In order to try to rekindle the same enthusiasm from my youthful days playing in the kitchen, every once in awhile I like to try new recipes.

Last night was one of those occasions. With Timmy occupied with his new playroom,  I excitedly planned, prepped and worked in the kitchen to prepare what I was sure to be an epicurean delight for everybody in the family.  I couldn't wait for everybody to taste, and of course rave, about my newest masterpiece.

Well, it didn't work out as planned. The littlest boy, feeling no compulsion to mask his displeasure, promptly threw noodles at my head.  The middle boy turned up his nose and picked at his plate as if he was dissecting a biology specimen. (If he only put as much attention into cleaning his bedroom!) The biggest boy ate the most modest of servings, proclaiming that it "wasn't bad." 

Not exactly the home run I was expecting. I guess I'll return to the rotation later today.  I'm bored with it, but at least I know that the food will be both enjoyed and consumed. 

Timmy's Playground

With Timmy ill, our quarantine remains in effect until he is both fully recovered and has a strong immune system. Needless to say, I'm hunkering down for the long term on this one.  Despite not leaving the house our weekend was busy, mainly because my being home all the time has caused me to note some neglected projects.

Our downstairs, which I had painstaking cleaned last year, again has become a dumping ground.  Timmy no longer played in the space because he was forced to tiptoe around the minefield of junk scattered about the room. Robby refused to enter in the evenings because he was convinced that it was haunted. Essentially, nearly one-half of our house was not being utilized.

Clean up phase one was completed last week when the couches and larger items were removed by the donate/junk man.  With the large objects removed, it was obvious that the room had become overrun and needed a lot of work. Saturday morning I turned on my music, grabbed some trash bags, and headed into the cluttered abyss.

I emerged four hours later exhausted, dirty and out of trash bags.  The room had been completely purged of junk, decluttered an reorganized with Timmy in mind. He won't be going to his beloved indoor playground for awhile, so my goal was to bring the experience to him.

Shelves were lowered on bookcases so that he could reach more toys. Labeled canvas bags were hung at his eye level for easy retrieval. I attached Lego plates and magnet boards to the walls in different "stations" of the room so that he can build and play. His slide and his trampoline have all been set up and are ready (and safe) for use.  

Yesterday Scott and Robby moved my rockers downstairs so that I had a comfy place to sit and work while he played. We may not be visiting any toddler playgrounds for awhile, but I think he will be content with "Timmy's Playground" in the basement. I know that I'm delighted with the result of our efforts!

Your Insurance Denial Battleplan

Helping individuals fight their insurance companies to obtain the devices that are both necessary and entitled policy benefits has become a professional highlight. Over the past decade, rubber stamp denials have become the industry norm. I suppose that these multi-million dollar companies are hedging their bets that people will become lost in the sea of red tape and eventually give up pursuing their benefits. Enough people must accept the denial to make the process profitable for the insurance company, otherwise claims would have always had a fair review upfront. 

Declaring a device or component "Not Medically Necessary" is one of the hallmark rubber stamps used by insurers. This often blanket verdict is baffling for the patient and cumbersome for the practitioner to fight. Although it shouldn't be this way, far too often the patient is left to fight for the device with little or no support from the provider.  Ideally the prosthetist would take the lead during the appeal process, but the emails I receive from frustrated patients tells a different story.

Dave, my podcast partner, and I have been talking for years about providing a guide for individuals to fight their insurance denials. We have wanted to map out the method that we have both successfully utilized to overturn denials during the appeal process. In full disclosure, I can lay no claim to the method. I learned it from Dave during a seminar and have applied it (with success) through the years.

In last week's podcast, we finally walked through the process to fighting an insurance denial on the basis of medical necessity. We have provided a clear method to drafting an appeal with the greatest likelihood of overturning the denial. While nothing is 100%, we believe that following the steps that we have outlined and explained provides the best chances for a positive outcome.

I always feel more comfortable writing something after reading an example. With this in mind, we have created and included a full appeal on our website. It is our hopes that, by using the steps we outlined in our podcast and after reading the example, patients will have a better chance at obtaining the devices that they so desperately need.  If you have any questions, please don't hesitate to reach out to us either through this blog or ampdpod@gmail.com.