Monday, June 29, 2009

Is is safe to spell "V-I-C-T-O-R-Y"?

I received a call from my *favorite" insurance company (ahem, Aetna) and it appears as though my hard work and perseverance has paid off!

WE WON!

Apparently, the guy at Aetna who was so lucky to get my case has been working with some of my people (I love it! I have people!) at my place of employment and an addendum has been put into my current policy that covers ALL DEVELOPMENTAL DELAYS!

WOO-HOO!

For the record, Kaitlyn's diagnosis of "childhood apraxia of speech" is NOT a developmental delay since it has a strong neurological foundation. But, this means that she will be getting ALL services that she needs with NO ANNUAL LIMIT and NO LIMIT ON THE LIFE OF THE CHILD!

WOO-HOO!

I promised myself that I would not get too excited as I fear the other shoe will drop. Now, I have to wait for all the paperwork to be shuffled here and there. In the meantime, I think I will sit back with a sense of accomplishment and gloat, if only for a little bit!

Deep breath.......aaaaaaaaaaaahhhhhhhhhhhhhh!

Thursday, June 25, 2009

Keep the good news coming!


Kaitlyn's teacher continues to flood me with great news on how well she is doing in school. She has her morning routine down pretty well, and is charge of attendance. I was amazed to hear that she knew all of the other children's names before the end of the first week. I have also heard that she sings along with the class to the "Days of the Week" song, too. Amazing, because children with apraxia having difficulty singing.

And, what I really find thrilling, is that my daughter is a little social butterfly! She converses with BOTH adults and children in the class, not just adults as she did in the pre-school setting. That is wonderful!

I believe that this self-contained setting is truly the right choice for her. I continue to pray that this gives her the much needed push that she requires to become the effective verbal communicator that I know she has the potential to be!

Keep talking, baby girl.

Keep talking!

Tuesday, June 23, 2009

The Decision to Have Children................

I would have to say that this has to be one of the hardest decisions one has to make because it requires a LIFETIME of dedication. By no means am I regretting the choices that I made when I had mine....they are the best thing that has ever happened to me.

When Mark and I decided to have a baby, we had the "talk" on our one-year wedding anniversary. Two months later, we rejoiced at the positive pregnancy test and delivered a healthy baby girl, our Kaitlyn, before we had the chance to celebrate our second wedding anniversary. She was a text-book pregnancy, labor and delivery. She came spontaneously on her due date. Now that I look back, she was so structured even back then. And she still benefits from structure.

Andrew, our boy and second baby, was in charge the entire time. We had the "talk" again about adding a second baby to the brood after Kaitlyn turned one year old. We always wanted them close in age. In hindsight, I am glad that there are more than three years between them because that gave us a chance to dedicate 100% of our time to her and her speech needs. But Andrew, the little man, took two years of hard work and even a trial of fertility medications to conceive. Well, we actually conceived him WITHOUT the meds, but one month before we were to dive into IVF. He was the complicated pregnancy: enlarged brain ventricles, low-lying placenta, large head circumference. He decided to make me pre-eclamptic and come 13 days earlier. He even put me back in the hospital when he was five days old because I continued to have lingering pre-eclampsia. Well, the ventricles are normal sized, the placenta migrated on its own, and his head is now proportionate to his body, and I have recovered. But he is all boy! We call him "the boss" for a reason. He, too, benefits from a schedule, but he is not as rigid as big sister.

It's amazing how children are now the way they were even before you knew them. Kaitlyn was my gentle butterfly when I was pregnant with her. She rolled and moved so gently. Her long legs extended up into my right ribs towards the end of the pregnancy, and she still has those beautiful long legs.

Andrew, on the other hand, appeared to be fighting with himself in utero. He was rough! And mean! I never knew the sex of either child, but knew that he most certainly had to be a boy.

Children are so amazing!

Friday, June 19, 2009

First Week of ESY is done!

And thank God Kaitlyn loves school! Can I get a big "WHEW" out there???

What a relief!

I have to give so much credit to her teacher. This young lady is basically a new grad (May 2008). But she has more enthusiasm, spirit, compassion, empathy and any other adjective that you want to throw in there compared to some of the more "experienced" teachers and therapists that I have encountered in this school district over the last three years. I have even received personal emails from this teacher with updates on Kaitlyn's progress (on top of the binder that comes home with her everyday detailing what she did in school). The latest email gives me so much hope that my daughter is in the right place and is succeeding by leaps and bounds. It is strange when someone tells me that she is "actively participating in class" and "interacts with peers". These are things I was never told in the three years that she was in the preschool setting. However, she was in a general ed class of fifteen students with support services (PT, OT, ST). Now, she is in a self-contained setting, being one of seven children. Maybe that was the key all along to get her to come out of her quiet shell and excel.

Kaitlyn adores Ms. Meghan (or as she refers to her...Ms Reagan). Funny, she can successfully say all the /m/ sound in all of her words, but not one /r/ sound. Here, she is substituting the /r/ sound for the /m/ sound.

I just don't get it, this whole speech thing.

Thank you, Ms Meghan, for making the nightmare of Monday go away.

Thank you, Ms Meghan, for allowing Kaitlyn to be herself and enjoy school again.

Thank you, Ms. Meghan, for bringing out the best in my daughter after just four days.

Thank you, Ms. Meghan.

(Insert hug here!)

Monday, June 15, 2009

Kaitlyn's First Day of ESY 2009


It started out to be a really good day. No, a GREAT day! Kaitlyn woke up in a happy mood, and I made her a special breakfast of scrambled eggs with cheese and some sausage links and toast. By far, her favorite breakfast of choice! Today was a special day because today was her first day of ESY (Extended School Year). She has gone through ESY for two years already, so I thought that this should be a breeze. Plus, we had the added bonus of ESY being held at a different school than the preschool that Kate just finished, but this school was also going to be her NEW school for Kindergarten, too! Perfect! Get to know the drive to the new school, get to know the layout of the new school, so when it came time for Kindergarten to start at the end of August she would be totally adjusted to the new environment.

I was wrong.

Very wrong.

First of all, the drop-off was chaos. No, massive chaos. None of the teachers knew what was going on. Buses were here and there, and kids were being shuffled in many directions. Mark and I promised each other that our children would NEVER ride the bus to school and that we would always make it a point to drive them and pick them up. End of subject. So Kaitlyn and I walked into school. We knew where the classroom was since we had previous experience with the layout last week for our "Meet-and-Greet-the Teacher". She found her room and ran to the teacher, wanting to give out one of her famous hugs. She met up with one of the other little girls in the class. I gave her one (OK, maybe 3) more hugs and kisses and said "See you in a while!" and left her sitting at her desk lookng at a book.

Well, 1145am rolls around and I go to pick her up. Again, there is no rhyme or reason how this process goes. I drove up and parked near a curb, then saw Kaitlyn walking out of school hand-in-hand with her teacher. I hopped out of the car since I missed my little bug so much this morning and she ran to me with a big smile and out-stretched arms. Then....tears. And I am not talking a few sniffles and tears. I am talking tears a la Hollywood fashion. Why? I looked at the teacher and she seemed as confused as I was. Poor Kate.

I still don't know why she was crying. Maybe it was the whole experience this morning: the new school, new room, new teacher, new assistants, new students, new plan for the day. Maybe it was a kind of culture shock for her since this is going to be the type of schooling that she will be in for a few years to come now. Maybe my little girl is now realizing that she is a bit *different* than other kids, and it is affecting her.

Whatever the case may be, I hope tomorrow is better. For everyone's sake...........

Thursday, June 11, 2009

It's in the Mail

........my second appeal, that is.

Fifteen pages of letters, documentation, and more documentation as to why Aetna should cover Kaitlyn's speech therapy.

Paid the extra money for Priority Mailing.

Paid the extra money for certified mail, too. I would love to see the look on someone's face when they have to sign for this package!

Now I sit and wait. And wait. I really don't think that Aetna is going to take a long time to make their decision. I have been a thorn in their side for so long I am sure that they want to get rid of me.

I thought I made a funny joke at the Post Office this morning, too. When I went up to the counter, the man asked the usual questions: "anything breakable, fragile, photos that should not bend?". I responded by giggling "Nope. Just a threat letter." Oops. Was I supposed to say that? Isn't that illegal? After I realized what I said, I tried to make a joke about the Post Office man pressing some button under the counter to summon the police for violating some federal terrorist law for making a threat via the postal service. I think he knew that I was joking as he laughed about it, too. They I went on to say "well, if they can send me threat letters, then I can, too!". The man just agreed with me. I think he was afraid of me.

I need to learn to keep my mouth shut sometimes.

Oh well. It's in the mail. Now I sit and wait...............

Monday, June 8, 2009

Insurance Denial


, this is should have been blogged about oh, I don't know, maybe two weeks ago or so now?!?!?! I need to contain myself. Then again, if I did blog about this a couple of weeks ago it would probably have been filling with so many %#@&@%$'s that Mr. Blogger himself would have deleted this post. Now that I am not so mad, I can tell you the story.

Back on April 22, 2009, I submitted an appeal to our insurance company(ahem...AETNA!) regarding their stupidity when they denied our claims for speech therapy coverage for Kaitlyn. It was a pretty darn good appeal letter, I must say so myself! Three pages in length, not TOO bitchy, but direct and to the point. I laid it all out for them as elementary as I could (seeing that they typically staff their appeals department with non-medical personnel, maybe even with GED's). I kindly asked for a Pediatrician, Pediatric Neurologist, registered Nurse, or Speech Language Pathologist to review the case. Simple, right?

Well. On May 19, 2009 I received a THREE PAGE DENIAL LETTER in response to my beautifully written three page appeal letter. What is this? Anything you can do I can do better? As I read this mockery of a denial letter, I can see that someone obviously read my letter as it was quoted and paraphrased throughout Aetna's letter. Here's the kicker! They even quoted my request of which medical professionals I wanted to review this case. As I turned to page two, this is what I read (and I quote): "A Medical Director, board certified in Internal Medicine and Infectious Diseases, who was not involved in the original decision, participated in the review of the appeal". What? This is a joke, right? Internal Medicine and Infectious Disease. You are kidding me, right? Internal Medicine = adult medicine. Kaitlyn is 5. Am I missing something, or is it a prerequisite to be a downright IDIOT to work for Aetna!!!!

Then, then......they go on to say something to the effect of "oh, since we did pay for some speech services in the past, we are resubmitting those for review because we think we paid when we shouldn't have and now we want our money back". HUH? Granted, that is not how it was written, but that is a summary of what they were saying. Wait! First, you deny services. Then you pay for them. Then deny again. Then threaten me for your money back? Something is fishy here, and it is spelled
A-E-T-N-A.

I got on the horn with my HR department and told them what was going on. Needless to say, they weren't pleased.

So now I am in the final phases of my Level 2 Appeal with Aetna. I was told that there are only three levels of appeal, so I know that they next one will go through my company.

How crazy is that? It's speech therapy, people! For a five year old! Do you think this is fun for me? Do you think I enjoy being my daughter's translator all the time? Do you think I enjoy watching my daughter NOT be able to talk to her friends and the alienation that she endures? People, I am not asking for plastic surgery or a breast augmentation for myself (although I can think of a few trouble spots that need some work!).

Once again, God does not give me more than I can handle. I can handle this. I can handle Aetna. They don't know me very well, nor do they know the hell that I am capable of bringing if they continue to discriminate against my daughter.

Remember: Aetna, you have been warned.

Thursday, June 4, 2009

Summer 2009 Plan

After much talking, praying, and crying about this whole speech therpay schedule situation that arose last week, Mark and I decided NOT to stop Kaitlyn's therapy altogether; rather, we are staying on once a week.

Kaityln will be in summer school for 3 1/2 hours a day (Monday thru Thursday) and will continue to work on her current IEP Goals with the new Kindergarten Team. Once a week on Mondays, she will still work with Jill privately. This allows her to have Fridays off completely, no school or therapy, and she can just be a 5 year old. This will give her a chance to sleep in and regroup, go swimming, go to the zoo or one of the variety of attractions in Chicago, and so on.

We still need to address the fall semester and what we are going to do. Granted, she still needs that therapy. But after a full day of Kindergarten, will she have the steam and stamina to sit for another hour of intense work and drilling? Will we be able to find a therapist that Kaitlyn will work with willingly? Will someone be available around 4:00 or 5:00pm? Well, it's only June 4th. We still have time to work on that one.

Now, I really need to update you on the latest battle with our insurance company and their refusal to pay for her therpay! But that is another long post some other time. Maybe this weekend.