Sunday….funday?

It’s Sunday….gotta pack up stuff to get ready to go back to Iowa today.  I have lots to pack…both K and me.  Then we gotta clean up before we head out.  Oh what fun!  K wants to do the Wii…..ok…while I pack up stuff but done when it’s time to clean!!  She won’t be too happy, but oh well.  Such is life.

I got an email this morning.  I had emailed a lady about these cute little bulldogs.  Here is a picture of Nina:

I so want to get this doggie.  She is so adorable.  To adopt this dog, isn’t real expensive but I need to talk to my roomie about getting her.  After all this is HER house.  I do hope maybe she will be alright with me getting her.

Anyways….gonna take my computer with me to mom’s.  Books.  Drawing stuffs….music.

Have a wonderful Sunday!!

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another rough day

It was another rough day with K.  She was either very tired or just needed/wanted to push limits.  She did fairly well at Mayo Clinic with Robin and me.  I got my shot in my knee.  Robin took her to get some breakfast and they rode up and down the escalators for the 45 minutes I was in for my appointment.  LOL  the small joys of life.

The drive home was a bit rough.  Lots of I want and YOU need to let me…..

then the crying starts in.  and more whining.  uffda….I have a hard time with the whining part.  Came very close to losing my cool with her.

So we took her to get her hair cut after we got back home.  She even was a pistol in there.  Acting like a little kid.  She is 8 but acting more like a 3 year old.  I don’t know how to get her to “grow up” to her age of 8.  It’s so difficult to keep my cool when she is like that.  But I did.  We didn’t do anything today after that.  We get back home and she was still in her funk.  Finally, I just said, ok, that’s it.  Let’s go up stairs.  We are gonna lay down.  She was asleep within 15 minutes.  I laid up there with her.  I read a book while she slept.  She ended up sleeping almost 2 hours.  She woke up in a bit of a better mood.  Until she figured out that she couldn’t be on the Wii all evening.  another meltdown.  uffda.  I tell ya.  I just don’t know how to make this better for her.  She can’t always have everything she wants or thinks she needs.

I don’t know.  I think my parenting skills have gone out the window.  I try.  Lord knows I try.  But I don’t know what to do anymore.  I see where my mom has so many difficulties with her.  Why does everything seem so hard with her?

On a different note…..got some new clothes again today.  AMAZING!!  I am in a size that is 4 sizes smaller than last year at this time.  I am just floored.  My weight has kind of plateau’ed for the past couple weeks, but my inches are still coming off.  So I think that would still be a small victory.  I got 3 new pair of capri’s.  A couple shirts too.  I love it.  The only thing about WLS that suck is the skin that hangs after losing weight.  Seems I got plenty of that.  LOL  Maybe when I get down more towards my goal weight, I can have some of that taken off.  Will have to see how much that will cost etc.

I leave for Iowa on Sunday.  I will be at my mom’s doin the mom thing for about 2 weeks while she is in Texas.  I hope K’s behavior is better by that time.  I have no clue what I will be doing while there.  I don’t have anything there.  I will take my computer and my kindle and some paperwork I need to get done.  Maybe I can apply for jobs while there.  I don’t know.  What if they call for an interview while I am still there?  hmmm….will have to see how the time goes while there.  Y’all have to talk to me!  lol

26 Day Christmas Challenge – Day 13

Day 13: Have you ever had a white christmas? If yes, do oyu ever want to have christmas without snow and vice versa.

I live in Iowa….and have lived in Minnesota too.  We have a white Christmas and then some most years.  I love the snow.  I am not sure Christmas would be the same without it.  I wouldn’t mind being some place warmer at times, but I love living in the northern states.

My theory is this….in cold weather, you can always layer on more clothes if you get cold.  But if it’s hot and gets hotter out, you can’t just run around naked.  Well, you prolly could but you might get arrested.  Or in my case, get laughed at too.  LOL

 

30 Day Blog Challenge – Day 30

Day 30: A picture of yourself this day and 5 good things that happened since you started the challenge

I can’t believe this is the last day of this challenge.  It has really helped me to think about some things that I haven’t really given thought to for a very long time.  So here are the 5 good things that have happened since starting this challenge:

1.  I have gained more confidence in what I write and think and say.

2.  Reading people’s comments has been very inspiring.  New friends and old friends.

3.  The mess with Iowa Medicaid and payment for Bariatric surgery has been overturned.

4.  I had my VSG surgery done.

5.  Classes have started at UNI, and so far so good.

This is a picture of me from Monday, August 22, 2011.  1st Day of classes at UNI.

 

Weight Loss Surgery News

With all the crap stuff going on with Gov Brandstad in Iowa these days, I didn’t think something amazing would happen to me.

I got a call tonight from Dr. LaMaster’s Clinic.  I AM APPROVED FOR SURGERY!!!  Despite Brandstad’s signature on the Medicaid thing.  My stuff was in before Aug 1.  So, I still did get approved.  BUT, I will NOT stop fighting for all the other people that NEED this so that they may have LIFE.

I cried and cried tonight.  I am truly amazed and thankful to God for answering this prayer.  Not only is this good news for me, tomorrow is the celebration of my one year of no hospitalizations for mental health stuff.  My therapist is throwing this celebration.  She is amazing too.  So many happy things tonight.

I praise God for my unbelievable and loving friends.  And my family as well.  This starts the journey…..stay tuned!!!!

Iowa Medicaid moves forward with cost containment strategies

http://www.iowamedical.org/documents/Legis/advocate/2011/IMS_Advocate_07_15_11.pdf

This is where I obtained this information. The IMS Advocate use the above link to see the entirety of document.

Iowa Medicaid moves forward with cost containment strategies The Iowa Medicaid program is moving forward with various cost containment strategies as directed in HF 649, passed by the Iowa legislature this year. All of these will be detailed in Informational Letters sent out to Medicaid providers and most are effective August 1 of this year. Some of the strategies relevant to Iowa physicians treating Medicaid members:

1. There will be a 15-day supply limit on initial fill of select prescriptions that have high side effect profiles, high discontinuation rates, or frequent dose adjustments.

2. Medicaid will no longer cover drugs used to promote weight loss or prescription drugs used for symptomatic relief of cough and cold.

3. Medicaid will eliminate coverage for bariatric surgery for the treatment of morbid obesity.

4. Medicaid will eliminate payment for hospital-acquired conditions (“never events”).

5. Medicaid payment for some physician services will be reduced based on the place of service. A new procedure pricing factor code derived from Medicare will apply. Medicaid’s rationale is that it will be consistent with Medicare in paying less for physician services rendered in certain facility and related settings that they do not believe include the same sort of cost factors that are present in a physician’s office.

6. All Iowa Medicaid providers will be required to use Iowa Medicaid’s Medicare Crossover Claim Form when submitting them in paper.

7. Iowa Medicaid will eliminate direct and indirect graduate medical education payments to out-of-state hospitals.

**The Iowa Department of Human Services has yet to post the bulletin regarding Letter #1030 which was mentioned in an earlier blog from me. I don’t know why it hasn’t been posted yet. But I will keep checking back. I will keep looking and searching and asking questions. I will find an answer.

Posted Full Statement Re: Iowa Weight Loss Surgery

This is a full statement released by the Iowa Medicaid Enterprise.

IOWA MEDICAID ENTERPRISE – 100 ARMY POST ROAD – DES MOINES, IOWA 50315-6241

Cost Savings Strategy #12 SFY 12 Budget
Name: Elimination of Bariatric Surgery
Implementation Date: August 1, 2011
 Summary:
Medicaid will eliminate coverage for bariatric surgery for the treatment of morbid obesity. This coverage elimination applies to all forms of this surgery, including, but not limited to the following: gastric bypass, lap-band, roux-en-y, etc. These services have always required pre-procedure review (i.e., prior authorization).
• All authorizations issued through July 31, 2011 will expire on October 31, 2011.
• All members and providers with an active authorization in place will be notified by letter of the expiration date.
• No new bariatric surgery services will be authorized after July 31, 2011.
 Informational Letter: The Informational Letter announcing this change will be # 1030 . All Informational Letters can be viewed at http://www.ime.state.ia.us/Providers/Bulletins.html.
Rules: Rules will be posted at http://www.dhs.state.ia.us/PolicyAnalysis/RulesPages/Dockets.htm.
 Not posted there yet as of 7/19/2011. July 6, 2011

HUMAN SERVICES DEPARTMENT [441]
Adopted and Filed Emergency
Pursuant to the authority of Iowa Code section 249A.4 and 2011 Iowa Acts, House File 649, section 10, subsection 20(a), the Department of Human Services amends Chapter 78, “Amount, Duration and Scope of Medical and Remedial Services,” Iowa Administrative Code.
These amendments eliminate Medicaid coverage for bariatric surgery, including gastric bypass, lap-band, and other methods. This change is one of the Medicaid cost containment strategies recommended by Governor Branstad. Legislation passed by the Eighty-Fourth General Assembly authorizes the Department to implement these recommendations.

Concerns with bariatric procedures include noncompliance and complications. Patients who are unprepared or noncompliant put themselves at increased risk of complications following weight loss surgery, as this is a lifelong commitment for the individual. Noncompliance can lead to multiple medical procedures to manage complications such as vitamin and mineral deficiency, dehydration, gallstones, bleeding stomach ulcers, hernias, kidney stones, hypoglycemia, blood clots in the legs, leaking at one of the staple lines in the stomach, pneumonia, narrowing of the opening between the stomach and the small intestine, and dumping syndrome. These repeat procedures add additional cost to an already expensive procedure.
Although weight-loss surgery can reduce or eliminate such conditions as diabetes, hypertension and hypercholesterolemia (and the need for treating these conditions with costly medications), a patient may have increased need for treatment in other areas. It has been noted that people who have had weight loss surgery also needed treatment for gastrointestinal-tract disorders, anemia and vitamin deficiency.
  These amendments do not provide for waivers in specified situations because the savings assumed in the Department’s appropriations will not be achieved if waivers are provided. Requests for the waiver of any rule may be submitted under the Department’s general rule on exceptions at 441–1.8(17A,217).  After analysis and review of this rule making, no impact on jobs has been found.
The Council on Human Services adopted these amendments on July 13, 2011.
The Department finds that notice and public participation are impracticable because the Department’s appropriation for the fiscal year beginning July 1, 2011, assumes the implementation of the cost containment strategies recommended by the governor without delay for notice and public comment. Therefore, these amendments are filed pursuant to Iowa Code section 17A.4(3).

The Department also finds, pursuant to Iowa Code section 17A.5(2)“b”(1), that the normal effective date of these amendments should be waived, as authorized by 2011 Iowa Acts, House File 649, section 10, subsection 20(a).
These amendments are also published herein under Notice of Intended Action as ARC 9xxxB to allow for public comment.
These amendments are intended to implement Iowa Code section 249A.4 and 2011 Iowa Acts, House File 649, section 10, subsection 20(a).
These amendments became effective August 1, 2011.
The following amendments are adopted.
ITEM 1. Adopt new
h. Services provided for intestinal or gastric bypass surgery for treatment of obesity. paragraph 78.1(1)“h” as follows:
ITEM 2. Rescind and reserve subrule 78.3(4).

*I accessed this through this website:  http://www.obesityhelp.com/forums/IA/4428012/Please-help-reverse-WLS-coverage-suspension-in-Iowa-This/ ”

for more information…see the above website….

Something must be done soon.  Governor Branstad is making cuts wherever he can.  Not only in this area but also in the Iowa Education.  To me…this just isn’t right.  I read in the Des Moines Register this morning that others in the legislature are saying that “it’s his way or the highway”.  Isn’t that lovely for a governor to say?  I think NOT.  I will writing a letter soon.

the weight loss forum is here:  http://www.obesityhelp.com/forums/IA/