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Sunday, January 26, 2014

And I Spoke Too Soon!

Just when I thought everything was going easy-peasy with PT (see last post), the therapist in charge of "recertifications" showed up on Friday and discharged Bob! GAA! Just like that.

Of course, I was floored. And asked why. And she told me it was because the insurance did not approve his therapy and that they (the home health agency) had not been paid for any of the visits in January.

Well, this didn't seem right to me and I thought I'd gotten an approval letter in the mail. So I dug the letter up and found, oops, I didn't thoroughly read it, because it was only approval for nursing visits, not for PT. But the strange thing about the letter was the doctor's name was wrong, it was not the GI doctor's name, but the neurologist who orders PT... so I figured something is really screwed up here.

I told the therapist this, and I also told her I would call the insurance company to find out what's going on, then she tells me not to bother because Bob has not "progressed" enough and he's "been in the system too long" and it's time end therapy.

Of course, this threw me for another loop. And of course I argued. Then she told that me that Home Health Care Agencies do not provide long term "maintenance" for patients, and if I wanted that, I should put Bob in a nursing home! AARGH! So, I brought up the fact that the Medicare guidelines have changed to allow continuous PT for "maintenance" and the "progress" no longer necessary -- and she did not believe me. So I had to get on my computer and prove it to her. And I even printed out a copy of the article that I found.

Then, she told me that, really, I should take him to Outpatient Therapy instead, but I told her I didn't think Bob was strong enough to endure the rigors of Outpatient Therapy yet.

And, so, we went back and forth.

But it all came down to the insurance company hasn't paid a dime this year. So, Bob's been discharged. Poor Bob was listening to all this, lying in his hospital bed, saying "Exercise? Exercise? Please?" and I felt really terrible for him.

Of course, after she left, I immediately call the insurance company and, after being transferred around, and put on hold forever, and cut off once (grrrr) so I had to call back and start all over -- I finally find that the insurance company has no record of a script for either the nursing visits or PT for this year. When I tell them about the letter I received, dated January 4, with the wrong doctor's name on it, they tell me they have no record of that at all..... hmmm?

So I call the Home Health Agency, and after talking with a supervisor there for a good long time (because she can't figure out what's going on, either), she finally tells me she's going to talk to the insurance department and get back to me...

Which she does. And it turns out, they did send scripts in December, but because they were dated "December", they did not apply to the new year. So they have to send new authorizations through, dated in January, which she's going to do.

So no PT until this cleared up. If this gets cleared up. And IF the therapist in charge of certification will agree to it.

Meanwhile,  I am once again drowning in legal papers and The Green Machine has taken another dump so I am, again, without a car.

Just another day in paradise...

Saturday, January 18, 2014

Home Therapy Continues

The good news is that I managed to get 20 more units of PT approved and so the therapist is coming again, twice weekly.
 I don't know why, but it seems to be so much easier to get therapy ordered, approved and continuing than it was in the beginning... Is this because of a different doctor ordering it? Or because we have a great RN coming every 8 weeks to change out Bob's tube and she really keeps on top of things? Or because this therapist is more understanding of Bob's situation and does not expect HUGE leaps in "progress"?

Whatever it is. Knock on wood! And hope it continues this way.

Bob is standing much better, though he still refuses to take a step. And I'm not sure, is this because he is afraid? or unable? or a pain issue?......

Though he is up to 3 minutes, standing, with only a little assistance!

I know it really wears him out.

Some well deserved playtime with Ripley, after PT

And after an hour session, he is pretty much done for the day....

Wednesday, January 15, 2014

This Morning...

Today, I woke to the sound of Bob calling, "Hey? Hey?" which normally means he wants/needs something.

Tired, I roll over and feign sleep. Because I really don't want to deal with whatever it is. At least, not for a few more minutes.

From the next room, I hear him repeating, "Hey? um, Hey?" then, louder, "HEY-YAY!"

So I finally open my eyes and say, "Yeah?"

And he shouts, "I LOVE YOU!!!"

I tell you, this was big improvement over the last post....

And a very nice way to wake up!

Sunday, January 12, 2014

Some Mornings...

If I could edit my life, the way a writer edits a story,  I'd start this post out like this:

Yesterday, I woke to the delightful sound of birds chirping outside my window...

But, unfortunately, I cannot edit my life, so truth be told, this post will start like this:

Yesterday, I woke to the sound of Bob having a bowel movement. So, of course, I bolted out of bed, first went into the bathroom to change into the sweats and sneakers that I wear for walking the dog and then gathered all the supplies needed to clean up the mess. And it was a mess as I had given him a laxative the night before as, once again, he's been constipated. But I managed to get him clean, and get a clean, fresh pad installed beneath him and just when I was going to fetch a fresh pair of Depends, GAAAA! He goes again. All over the bed.

Which is enough to make me cry.

But I didn't. And I manage to get him cleaned up again, and get him into a fresh pair of Depends and install another fresh, clean bed pad under him.  And now I have two filthy bed pads soaking in bleach in the washing machine, not to mention shit smears down the front of the washing machine which I still have to clean up. I had just taken the second plastic grocery bag of poop out to the garbage can, when I return into the house and oh crap! I mean that quite literally, as that was what I stepped in.

Of course, I wanted to kill Boomer, but I didn't, because all this morning clean-up has made me run way behind schedule and the poor dog had been waiting patiently for his morning walk until then...

So now, I'm cleaning up dog poop on top of Bob poop, plus I've got poop squished into the treads of my sneakers -- and there's nothing worse than that. But I get it all cleaned up, and take a third grocery bag of poop out to the garbage can, and when I return to the house, I figure I'd better go the bathroom myself before walking the dog, and I walk into the bathroom only to find, GAAAAA! that one of the cats has missed the litter box....

Oh boy. I tell you, some mornings... and it makes me wonder: what exactly did I do in a former life that I deserve this???

Which brings us to this morning, when I woke to the sound of Bob screaming because his catheter had backed up all over the bed and then I go into the kitchen only to find--- well...  Actually, I think I will edit this:

Today, I woke to the delightful sound of birds chirping outside my window...

Tuesday, January 7, 2014


This morning it was 37 degrees here in sunny Florida and I nearly froze to death walking the dog! The high today is expected to hit 49 degrees. And believe me, I am not used to this. And, OK, I admit, I am a wimp when it comes to cold weather!

So add to my daily caregiving duties: hauling in firewood, and tending a fire all day long...

And now I must go do the daily laundry on our unheated back porch!