Sunday, November 6, 2016

Sunday Stroke Survival: What's Going On

Thanks to Obamacare <choke, choke>, my medical insurance changed as it did for most of us. As a result, instead of having 75 hours for PT, OT, and speech a year coverage I had 40 hrs of PT, 40 hrs of OT, and 40 hrs of speech therapies for a calendar year. This was good and bad. My premiums definitely went up. Big surprise there...not.

Old history, right? It's been enforce for a couple of years now. With these limitations in mind, here's how I work my therapy visits to last a whole year. Or, at least since I lost my old physical therapy group. I'll start the year with physical therapy (PT). Since I normally get Botox injections in January, it makes sense. I get both dry needling and PT stretching to gain the most I can. Since I've got a year of dry needling behind me, I can track when dry needling is for the optimum results. I use this accumulated data accordingly. I get Botox injections every 3 months so my therapies schedule sort of goes like this...

OT once a week for for 30-minute session the two weeks before and after Botox is scheduled. Just general heat, e-stim, and stretches to the best of the therapist ability. Believe me when I say, that even a 20 degree stretch on spastic muscles in my arm is a great relief. It hurts so good.


Two weeks after Botox is twice a week PT and dry needling. They are 30-45 minute sessions. This will continue for about 6 weeks.

I'll take a break from therapy for two weeks, and then start all over again. It comes pretty close to all of my PT and OT hours used by the end of the year. The beautiful part is the $30 copay disappears by February each year because not only have I met my deductible, but also my maximum out of pocket expense for the rest of the year. That equals to 80 hours of PT and OT a year. I actually gained 5 hours of contact time not including speech. What a novel concept.
 
Notice I only used my PT and OT hours. I still have 40 hrs I can use for speech therapy each year. I haven't yet used any speech therapy hours since the change. While in the Golden Isles, my stroke support group also had free, weekly communications meeting where we practiced speech and writing. Which was a blessing when my insurance only paid for 75 hours of all three. But since the change, the weekly meetings were enough, but I got plenty of practice with this blog and speaking for my husband.

Since moving to north Georgia, I don't see the need for structured appointments either. I write two blogs a week, videos on YouTube, and have a roommate who was in graduate school for speech therapy before moving here. No, Mel didn't graduate nor become an actual speech therapist, but she is an excellent prompter. Having someone around to interpret is a valuable resource for the aphasic. You get plenty of practice speaking.

My writing as in holding a pen to paper hasn't improved much, but then most of the time I'm on my computer typing. It takes me three to four days to write out a blog post so sometimes this blog suffers from the effort I use up on my homesteading blog. The YouTube channel keeps both of us busy producing quality products. Yes, I may mess up my words, but as with the blog, I can edit it out or correct myself while filming. I'll often mention my aphasia especially when I mess up too bad. I've coined phrases like "arm pit tight" instead of fingertip tight while canning and "using the tools God gave me" when using my teeth to open or close zipper lock bags. They have been endearing phrases to my two able handed viewers. To my disabled viewers, it's shown them nifty tricks of doing things. If I make a mess, I'll always clean it up while cooking. For pouring things from one big pot into another, I have my lovely assistant to help. I make no excuses and tell no lies. What you see is what you get just like this blog.

Remember...
Nothing is impossible.

6 comments:

Rebecca Dutton said...

You are an absolute genius and an inspiration for others who need to navigate the health care system.

Barb Polan said...

I'm confused - you can use your PT and OT hours every year even though the stroke was so many years ago? BTW - I love the ACA - my husband and I had the opportunity to buy insurance when we retired 4 years ago, something that would not have been possible previously; we would've had to wait until Medicare kicked in 8 years later to get coverage.

Toward the end of his working years, my husband was in a soul-sapping job (that provided medical insurance) and used to complain that he was putting up with it all just for insurance. Sorry that you have had such a poor experience w it. Our PT co-pays are $50, but it's worth it.

Alex J. Cavanaugh said...

Well, glad the changed worked in your favor.
I bet you have a lot of tricks for doing things that most people never would have considered.
It is good to hear from you!

Cockeyed Homestead said...

Yes Barb. Even after four years post strokes. A great amount deals with my spasticity. It's an up and down cycles with no end nor cure. I would have some function back in my arm without it. It's just the rate hike and reduction in some services that got me with the ACA. Our premiums jumped over $100 more a month.

Zan Marie said...

Your ingenuity is amazing! {{{hugs}}}

Elizabeth, John, Jack, and Luke said...

ACA has cost my family a small fortune. We pay almost $900 a month vs $400 previously for 4 people plus copays and coinsurance which also went up. Grrr. We have great insurance, always have, but it shouldn't cost that much. I'm looking forward to a price reduction....hopefully!