Not Medically Necessary and Other Nonsense
On Thursday, I got a call from the surgery center where I'll be having surgery next week. They told me what my co-pay would be and everything seemed to be good to go.
On Friday, things changed.
It took one call from my doctor to reduce to me to a crazy lady who didn't know if she wanted to scream, cry, hit someone, crawl into a dark hole, or all of the above.
My insurance denied the surgery claim.
The plan for next week is that the plastic surgeon is going to open me up, remove the screw in my tibia, clean up the mess that is inside my leg, attach a piece of alloderm (commonly used for breast reconstruction surgery to attach implants to actual human tissue), cut out the nasty scar I have now, and close me up from the inside out.
The insurance has said this is "not medically necessary" and that alloderm is only approved for use in the "breast." They're also saying this surgery is "experimental," to which I'd like to say "Of course it is, you morons, because how many people have the 'common' problem of having a screw back out of their bone, complicated by the fact that they have no tissue in that area which means that the skin is basically indented and transparent. Oh, and it bruises and bleeds a lot. The screw also cuts me from the inside out if I happen to graze it on anything, even lightly."
So, in the world of medicine, where it takes almost two months to get a surgery scheduled and even longer to get an actual physician to call you back, I need two letters of medical necessity from a plastic surgeon and my orthopedic surgeon, by like Tuesday (as in tomorrow). As if that's going to happen.
To say that I am frustrated would be an understatement of universal proportions.
Because I knew I wasn't going to be able to handle speaking to anyone about anything regarding this, Mr. BBM took over and called the insurance company and my plastic surgeon's office.I tackled the office of my ortho guy and the lady on the other end of the phone from me made the mistake of saying "Humph, well I can't guarantee that he can have a letter for you." Yeah, because it's SO hard for a physician to dictate a letter and have someone type and fax it.
She was about ready to hang up the phone, when I reiterated that my ortho guy said he would do whatever I needed him to do so I can get this taken care of and that he, himself, had offered to write a letter for me. I told her that I didn't wait until the last minute to ask him. The insurance waited until the last minute to deny the claim, not even two weeks before surgery. This isn't my fault and I clearly need some help. She repeated her line and I had an internal debate about whether or not me telling her off would expedite the process or not. Instead, I opted to tell her that the screw is soon going to come out of my leg on its own if it's not fixed. I also gave her the visual of it cutting me from the inside out. I'm hoping that will motivate her to be a bit more helpful. My gut tells me it won't.
In the medical profession, people are just so used to saying the word "no" that it seems they say it without even considering the desperate person on the other end of the phone. Mr. BBM tells me I am having this surgery whether it's approved or not, and that we'll spend our lifetimes fighting the charges if necessary. I just wish something about this whole knee business would be easy, just once.
How To Teach Your Kids Stranger Safety
How do you teach your kids stranger safety without scaring them?
We've all seen the news and terrible things about child abduction. A lot of people get the attitude that they have when they were teenagers themselves. "It can't happen to me." "It can't happen in this neighborhood." "It can't happen to my child."
I bet that's what Jaycee Duggard's parents thought too. . .
It's a scary thought.
After many years of martial arts training, and after hearing many horror stories, and then having two daughters…talk about stressed out.
Shortly after we moved into our neighborhood, my daughter took off on her bike down the street and around the corner. She didn't come back as soon as I would have liked her to round that corner and I was a wreck. Here, she had decided to go around the block and while I was walking down the street to find her, she pulled her bike in the garage and went inside. I didn't know it and I started searching frantically. Several neighbors were outside and I began yelling to them and asking them if they had seen her. In my head were images of a car pulling up beside her and throwing her and her bike in the trunk. I was sick about it.
My one neighbor, recognizing my panic, yelled across the street to me, "It's a safe neighborhood. That's why we moved here." She was trying to be nice and calm me down, but all I could think was "Yeah, it's safe until it's not anymore." I didn't want to be the first person to break the unsafe ice.
When I went back in to recruit my husband to help me in my search, I found her sitting on the sofa watching the Disney Channel. I wanted to kill her and rejoice with relief all at the same time. Since then, I've taught my daughters to stay within view of me (although my 9-year old is enjoying greater freedom these days which is a whole other scary issue). But how does one go about teaching children about stranger safety without scaring them half to death? And how does one teach a child that the biggest threat they face isn't necessarily from a stranger, but rather from someone your child already knows? Over 95% of bad things that happen to kids are perpetrated by someone your child already knows.
Most often, people who intend to do your child harm will start a "grooming process" where they gradually build up your child's trust in them. This can come in the form of allowing your child to do something that you might not allow them to do. They also work on the comfort level of the parent so that parents trust these people as well. The Safety Kids instructor at my dojo, D. Nowicki, strongly recommends that every parent read "Protecting the Gift" by Gavin DeBecker. A mastermind of the human psyche (both victim and predator mentality), his book "The Gift of Fear" is a must-read as well.
There is a fine line between scaring them so much that they can't sleep at night and not telling them enough to be safe. Parents have to find a happy medium.
At my dojo, they teach a class called "Safety Kids." By combining fun and games, kata and self defense, and some basic stranger safety skills, it is introduced in a safe and non-scary environment while still getting the point across. But not everyone has a Safety Kids program nearby.
So here are a couple pointers for parents that I've found really work with my kids, and I've seen it work in the Safety Kids program that my daughter did for several years. . .
First, teach them this rule that has no exceptions: "Ask first before you go anywhere with anyone for any reason. And if you can't ask first, the answer is NO!" D. Nowicki says this: "Predators need privacy to do their dirty work. You are your child's best defense. Your child needs to check with an adult that is in charge of them. At home it is you (parents); at school it is their teacher; after school it may be a babysitter or Grandma. If your neighbor comes into your yard and asks your child to help him get something out of the car, even though he may have done it a thousand times before, he still needs to come check with you first."
Second, teach your kids your first and last name. In a department store of screaming children and desensitized parents, if your child knows to yell your first and last name, you'll hear them faster than if they're just yelling "Mommy!" Think about how many Moms are in the store at one time! If you explain it to your children in this way, they're more likely to remember to yell your real name. It can be presented in a less scary fashion too. "Hey sweetie, if you lose Mommy around the clothing racks, yell my first and last name so I'm sure to hear you. Let's practice!" Practicing is key to making sure they remember to do it! Role play is a wonderful thing.
While we're on the topic of "lost in the store," another thing you can tell your child is to "glue their feet to the floor." Kids love to pretend crazy things like this anyway, and this is a great tool to keep them from wandering even further out of range. If they stay put, you'll find them faster! Although it seems unlikely that your child would do this, in a panic you just never know, so tell them to NEVER leave the store. If someone comes to their aid as they're standing in one place and yelling your first and last name, your child can tell them to find you.
Third, at Safety Kids, they always teach kids to take a giant step back when a stranger talks to them. Martial artists know how crucial it is to establish space when being confronted by someone in a threatening way. It's no different with children. That casual step back could mean the difference between someone grabbing them or not. Teaching your children to keep some space between them and other people is a good idea. You can teach your kids to take that step back without scaring them, by simply telling that that establishing space between themselves and people they don't know is a good idea. They don't have to imagine all the things parents do in their heads. If you repeat this rule enough and practice it with them, they'll remember it.
Fourth, warn them about people who may seem nice ("Can you help me find my lost puppy? Would you like some candy?) by telling them that it's not safe to take anything from strangers and that if there's a lost puppy, they should come and tell an adult they know and trust instead of searching for it on their own. Other things predators might do or say: asking for directions, asking for help unloading a van, or even asking for help getting a book at the library when the person is on crutches (This technique was used successfully by Ted Bundy). Things you can teach them are the following: Adults don't need help from children. They get help from other adults. If an adult asks your child for help, then your child should come find you so you can help. The other important thing to tell your child (and this goes for bullying at school too), is that no one has the right to touch you, move you, or do anything that makes you feel uncomfortable. The best way to get someone to stop is to say, "Stop or I'll tell." D. Nowicki says "predators go for the weak. The thing they fear is being discovered." And remind your child that they should tell whether the person stops or not.
With women's self defense classes, we teach "Avoid, Escape, Report," and with children, we teach "Say No, Get Away, Tell Someone." It's crucial that your child tells someone until they find someone who believes them.
Finally, it's important to teach your children the best people to ask if they need help. Statistically speaking, the best person to ask is a woman. Sorry guys, but 95% of predators are men, not women. If you're out somewhere and you need to ask a stranger for help, you have a 1 in 10,000 chance of having a predator come to your aid. However, if you choose the stranger to ask for help, your odds get a lot better. You have a 1 in 100,000,000 chance of asking a predator for help. You're more likely to have a winning lottery ticket and get struck by lightening while wearing socks that don't match on a Tuesday, says D. Nowicki. When you need help, talking to a stranger can be the right thing to do. Kids need to know that strangers aren't always bad people, but rather just people they don't know.
If your child is lost in a store and needs to ask for help, their best bet is to ask a Mom who has other kids with her. Statistically speaking, their next best bet is to ask any other woman for help. D. Nowicki suggests walking around a big store with your kids and asking them who they would ask for help if they couldn't find you. Let them make smart choices and have them explain their answer. Then let them try asking that person what time it is with you nearby. You can teach them that not all stranger interaction is a bad thing. They just need to do it in a smart way.
Culturally, women are brought up to be nice and children are raised to respect their elders. It's important to teach them that it's ok to say "no" to an adult and that they don't have to do what an adult wants them to do just because that person is an adult.
Last but definitely not least is an important fact. Sometimes a little bit of fear drives the point home in just the right way. There are scary things happening in the world around us at times, and it's just not possible to shelter your kids from everything, all the time. We teach them not to chase their ball into the street because cars might be coming. They know what can happen if they chase that ball without looking first. If they run into the street, they could get hit and hurt, or even worse. If a child is having a particularly difficult time following that rule, as parents, we ramp it up and infuse a little fear. It's not always a bad thing to introduce fear. It's just important that you do it in the right way.
For more information on keeping your children safe, visit the Safety Kids website. Thank you to D. Nowicki, the Safety Kids teacher at my dojo, for a wealth of help with this post.
For more information on this topic, please visit BlogHer, where I am hosting the $100 question. Simply log in at BlogHer, answer the question, and you might win $100!
A Unique Icebreaker Among New (and Young) Friends
Last week, four neighbor friends and I went to see the premiere of Eclipse. We also went to a pre-viewing party where we won some swag bags and prizes. We drank Edward, Bella and Jacob themed martinis while there. Team Edward rocks for more than one reason people, not just because he's a deliciously hot and intense vampire. He is the muse for one of the best martinis I have ever tasted!
After the movie, in the IMAX theater, where we each ate our own bucket of popcorn (a bucket with Jacob, Edward and Bella on it), we decided it was way to early to end a great girls night out. So we decided to wash down our buckets of popcorn with some beverages at a nearby bar.
We had an absolute blast, especially because we were sitting with the brother of one of my friends who just so happened to be celebrating his 22nd birthday. At one point I realized that I was hanging out with boys who are the ages of some of my students. That sort of weirded me out a bit, but I tried to just focus on the fact that I wasn't quite old enough to have birthed any of them. That made me feel better. . . slightly.
Because it felt a little like a junior high dance (boys on one side; girls on the other), I decided it would be more interesting and introductory if we went around the table and said our name and something interesting about ourselves (or as some of my incoming freshman said in their placement essays, "ourselfs").
The boys started and went around the table. I realized I was sitting beside a student who goes to my alma mater, Pitt. We high fived and talked about cool hang outs in Pittsburgh. He mostly just told me that all my old haunts are no longer there or no longer cool, but it was still fun. As we went around the table, we made up some interesting nicknames for people which added quite a bit of laughter and delay to the whole event. For some reason, I thought the one guy's name was Steve when in fact it was Eric. I'm not quite sure how I messed that up, but he will forever be Steve from now on.
When we got to me, I said my name and some of my friends chimed in that I'm a black belt. But that wasn't my interesting fact to share. Instead, I pulled up my capri pants and revealed my Franken-knee, complete with nasty bruising and sticking-out-of-the-tibia screw. And then something funny happened. Instead of everyone cringing, covering their eyes and backing away in disgust and horror, the guys all leaned in about two feet each and eagerly reached out while asking if they could please touch it!
I let them all feel the protruding screw. Man, talk about an ice-breaker. More like a skin-breaker but whatever. In exactly two weeks, my party-trick Franken-knee will be history. Although it certainly breaks the ice with 22-year-olds, I can't say I'll really miss it. I'll just have to figure out something else interesting about myself. Perhaps I'll teach myself how to text with my toes. Ah, now that will really get them.
Saying Goodbye to a Long Lost Friend
When I went to Pitt, I volunteered and worked for Sexual Assault Services. I started out presenting programs to freshman, fraternities, sororities, and athletic teams on campus. Whenever we did these presentations, we did them with a partner. Although the coordinator really liked having male peer educators, it was tough to find good ones. One day, I was paired up with a guy named Jay. I was nervous. I had never met him before and I wasn't sure what to expect.
I never should have given it a second thought.
Jay was an amazingly warm and friendly guy. And he could turn it on in front of a group of people like no one else I knew. We instantly clicked. We stayed paired with each other for almost all the programs we were asked to do; and each time we did a program together, we nailed it. It wasn't long at all before we were hanging out after presentations and becoming really good friends.
Jay was not your typical guy. We would spend hours talking on the phone about all kinds of things. If I close my eyes and think about him, I can hear his laugh. He had the BEST laugh and the biggest smile you've ever seen. Almost as soon as I met him, I began thinking "Who can I fix him up with???" He was one of those guys.
After a couple weeks of getting to know each other, we were having a great conversation on the phone the one night. We would always fall into this funny conversation pattern of talking about the relationships that didn't work out. As I was telling him about a classic jerk in my past life, he responded, "Oh my GOSH! Did we date the same guy? I swear we must have!"
After spending weeks trying to figure out which one of my girl friends I could fix him up with, the truth was out. That wasn't going to be happening.
"Honey, in case you haven't figured it out yet, I'm gay. Jay is gay," he said as he erupted in laughter. It was one of the funniest moments of my life. I'll never forget that phone call.
We did a lot of hanging out in the months and years to come. He and his friends were the subject of one of my projects for a communications class about "coming out" to the world and what that means interpersonally in relationships. Jay was always so completely open with me about everything. He soon became good friends with Mr. BBM as well. I actually spent my 21st birthday with Mr. BBM, Jay and some of his friends. I had an absolute blast.
Jay lived in Brooklyn and over the years we kept in touch via email and sometimes through a phone call. He used to call me "Oshkosh" because he said he just knew I was going to marry Mr. BBM and have a bunch of babies. I called him after I had Big I and he laughed and told me he was going to buy the kid some overalls. We talked about getting together, but then life got in the way and we lost touch again for a while. It seemed that every time we would email back and forth or talk though, our friendship was always right back on track from where we left off in college.
Because I'm going to BlogHer in NYC this summer, Mr. BBM suggested I get in touch with Jay again. The mere thought of this had me so psyched. On the way home from the beach, I tried to look him up on Facebook but I couldn't find him there. I did a general google search and my stomach dropped. There was a blog name that included his name and "in memoriam."
I literally shook my head, trying to shake the existance of this site and what it meant away, and thought that there are lots of people with the same names in this world. This can't possibly be my Jay. And then the pictures loaded. . . and the tears came pouring down. I felt like I couldn't breathe at first. I had to catch my breath and then I said to Mr. BBM, "Oh my God, oh my God, oh my God. He's gone."
I did some more research and found out on one of his friend's blogs that he had committed suicide in November of 2007. It happened so long ago, but for me, it's like it just happened yesterday. I left a comment on the blog and his sister emailed me this morning. She'd like to talk and hear some stories about Jay from college. I gave her my phone number and I hope she calls.
I also hope that somewhere out there, Jay knows what a wonderful person I thought he was and how horrible it is to know he's no longer just an email or phone call away.
Rest in peace, Jay. I'll never forget you.
Today, the last of the Crystal Light reviews went live. Please head over to The BBM Review and leave a comment for your chance to win!
ER Vacation Curse Be Gone
It was inevitable. Someone in the family would probably have to go to the ER. I mean, it is a BBM vacation after all. A couple years ago it was me after having a stomach battle with some not-so-good scallops. (Hint: the scallops won.) Then it was Lil Cwho cracked her face on a hotel room nightstand and needed to be glued shut at 1 a.m. in the ER while singing the "Kung Fu Fighting" song. A year or two ago, Mr. BBM was attacked by a rabid spider and required antibiotics (Ok, I lie. It wasn't rabid.) Last night, Big I got her turn.
After complaining all day about a nasty bug bite on her finger, I was horrified to see that her hand looked like a giant Mickey Mouse glove, and it was growing. She was complaining that she was in pain and the swelling continued to increase throughout the day. It was off to the ER for the BBM family again. Thankfully, a nice big dose of some steroid and benadryl knocked it down by this morning. It doesn't look like we'll need to fill the prescription for the antibiotic.
Oh, and if you suspect your daughter has been bitten by a spider, do NOT, under any circumstances, google "spider bite and swelling." I kept thinking I was going to get a tearful call from Mr. BBM that would include the words amputation or death. Thankfully, this was not the case and it appears that the ER curse has made its way through my entire family now. So, ER vacation curse be GONE already!
We have had near perfect weather this week, with each day being in the 90's. The ocean has been pristine. You can stand in the water up to your chin and see your toes on the bottom. Big I has learned how to boogie board. Lil C learned she can not at all trust her pop-pop to take her out safely on the raft. I won't go into the details, but I will say that Lil C would be more than happy to tell you about how many particles of sand and pebbles she had to blow out of her nose post Pop-Pop wave and raft time. She went back in with Mom-Mom about five minutes later though. Tough kid.
I've read three books while here and am starting my fourth. We went to a wonderful arts festival where Mr. BBM bought me a beautiful copper fountain for my patio about the size of Big I. I've been wanting one for about seven years now. I can't wait to plug it in and hear the water. Hopefully taking a little piece of the beach and flowing water home with us will help me stay in that vacation mind-set. It has been a week of fun and a week of relaxation.
Yesterday, my grandmother would have turned 93. It was a day where we talked about good memories of her. We teared up, of course, but it's getting a little easier. This very much needed vacation, has helped with that. It's helped all of us.
In just a few days, we'll head back home. Here's hoping that this wonderful vacation is just the jump start our summer needed.
If you're looking for a little cash jump start, head over to The BBM Review for your chance(s!) to win!!! Go now!!!
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