Here are some things that medicaid will pay for. (Correct me if I'm wrong...sometimes it's hard to keep track because we have both private insurance and Medicaid so it's hard to know who is actually paying for things). Obviously don't take my word for it...check with medicaid. But these are things I have either gotten or continue to get.
Large DME
Safety Bed (ie: Sleep safe bed or Beds by George as examples) (Purchase)
Wheelchair or transportation chair (1 every 5 years) (Purchase)
Bath Chair (1 every 5 years) (Purchase)
Freestanding lift (not ceiling mounted) (Purchase)
Stander (1 every 5 years) (Purchase)
Carseat (1 every 5 years) (Purchase)
Vibrating vest (might take several appeals) (Purchase) (May need to be a particular brand...mine is the "In Courage" brand, but they didn't want to cover "The Vest" brand)
Light Therapy Light Box
Pulse Ox
Pulse Ox machine (sometimes a purchase, most of the time a rental)
Replacement sensors
Suction
Suction machine (usually a purchase after a few months of rental) (if it breaks they will pay for the repairs)
BBG's
suction caths
saline bullets
yanaukers
suction canisters
Suction extension tubing
Nebulizer
Nebulizer (Immediate purchase)
Neb cups
Neb meds
Neb masks
Bipap/cpap
Bi-pap/cpap machine (Usually purchase after a few months rental)
Hhumidifier chambers
Masks
Ttubing
Filters
Other
Oscillating mattress topper (Immediate purchase) (to prevent bedsores)
Diapers/Briefs/Incontinence
Diapers/Briefs (156 for medicaid and it doubles to 312 if you are on a waiver)
Doublers (inserts to absorb more in a diaper...these count against your diaper totals)
Chux (13 packages for 195 total count per month)
Lube (KY)
Gloves (boxes)
Cathing supplies
straight caths
Betadine swabs
Foley Caths (leave in caths)
sterile gloves
Sterile (small packets) KY (Lube)
Formula/G-tube supplies/GJ-tube supplies
Formula (if Dr. says it is "medically necessary") (I am not sure if they have to have a g-tube or not??? And I am not sure if they qualify if they eat by mouth??)
3 gtube extensions per month
1 peg cleaning brush per month (to clean the gtube extensions)
4 replacement gtube kits per year
Feeding pump (Rental...I have never heard of a purchase)
1 feeding pump backpack per year
Y-site extensions
60 mL syringes for feeding
A few slip tip 5 or 10 mL syringes for changing gtube...but no syringes for meds
30 feeding pump bags per month
Split qauze sofwiks (2 X 2's)
Oxygen
Oxygen tanks (You can have as many as you need and trade them out as often as you need to. You are not charged per tank)
Oxygen concentrator
Portable oxygen concentrator for traveling (You borrow it from homecare) (May need a new prescription)
Nasal canulas
O2 extension tubing
O2 swivel connectors
Water bags or canisters for humidifying O2
Small Miscellaneous
Coban
Tape
Sterile qtips
Toothettes (pink mouth swab on a stick)
Alcohol wipes
Adhesive remover
Wound care
Need RX for specific item you want/need
Glucose/Blood Sugar
Glucose monitor (Ask which kind of test strips will be covered, then get that kind of monitor. Your endocrinologist often has free monitors they can give you. Or you can call the glucose monitor companies and they will send you a free monitor)
Test strips
Lancets
Meds (I have listed ones you may not think to ask for)
1 pain med (either ibuprofen or acetaminophen...but not both) (can be liquid or pills)
Calcium (liquid or pills)
Miralax
Suppositories (but not enemas)
Multi-vitamin (only up to age 5)
AAC/Communication
AAC Communication devices (ie: switches, computer programs, dynavox, tobii, etc...)
Therapy
PT, OT, Speech
I think they may have recently started covering Autism therapy???
Nursing
In home nursing services depending on where you fall on their "acuity grid"
Dr. Visits/hospital stays
Dr. Visits (Well child and sick visits)
Hospital Stays (Inpatient)
Surgeries (Inpatient or Outpatient)
Ambulance rides
Immunizations
Glasses/Hearing Aids
I haven't done this one for a while so I'm not sure...if you know...please comment below
Hearing Aid Batteries
Dental
Dental Checkups
Cleanings
Xrays
Dental Work
Fluoride
Chiropractic
Chiropractor visits
Things I have been UNSUCCESSFUL at having Medicaid pay for...
Insulin syringes (but I haven't really tried that hard) (sometimes pharmacy will throw them in for free)
Wipes
More than 1 pain med (only ibuprofen or acetaminophen, but not both)
Vitamins after age 5
Bed bath wipes (spongy wipes)
Dry shampoo or liquid leave in shampoo
Hand sanitizer
Distilled water
syringes for meds (they will provide 60 mL)
cotton balls
med bottle adapters (sometimes pharmacy will throw them in for free) (these allow you to draw up liquid meds into a syringe more easily)
red tips that convert an oral tip syringe into a slip tip
lysol
lysol wipes
enemas
Probiotics
Tuesday, December 22, 2015
Monday, December 14, 2015
How to organize meds (medications) when you have A LOT of them
My daughter, Ellie, takes A LOT of meds. She uses a g-tube for all meds.
*I prefer pills over liquids, there are several reasons. #1) they are cheaper per mg #2) they are easier to find at pharmacies or over-the counter #3) If you need to grab a dose and bring it with you you can just grab a pill instead of having to bring the whole bottle of liquid med or drawing up the liquid med and risking it spilling #4) They don't have the sugar in them that liquids do #5) They don't have to be refrigerated #6) you can use syringes forever because you don't care if the numbers wear off the side
* I don't care if the numbers wear off the side for most of my syringes because I have chosen to crush my pills. But if you want your numbers to stay on longer, when you get new syringes, paint over the numbers with clear nail polish and allow to dry.
* Some people do not crush their pills. They draw water into a syringe, drop the pill into the water and let it sit and dissolve for about 12 hours (or more). Check with your pharmacist to make sure this will work with your meds, especially if they are time-released. I have never tried this method.
*Some people draw up a whole months worth of meds into syringes and label the syringes. I have never done this method.
Here is the method I have developed over 13 years...
#1) Label the top of each bottle with a round sticker like these. http://www.amazon.com/Round-Circle-Labels-Inkjet-Printers/dp/B00WMRH33Q/ref=sr_1_1?ie=UTF8&qid=1450110605&sr=8-1&keywords=3%2F4+inch+circle+labels The 3/4 inch ones fit on top of a medicine bottle perfectly. I would recommend NOT getting the removable ones, they fall off. I write three things on each sticker. The name of the med, the time it is given, how much to give (ie: 1/2 pill or if liquid 1 mL).
#2) Have a basket that all daily meds get thrown in to, I will call this the "Daily Med" basket. I used to try and line them up neatly in the basket, but it was a waste of time. If you follow my steps, it won't matter that they are a jumble. I set the liquid meds to the side of the basket because I don't want them to spill.
#3) Only keep 1 bottle of the med in this "Daily Med" basket. Have a different bin/box for what I call the "2nd tier" of meds. For example, you have 4 pills left in your bottle. That goes into the "Daily Med" basket. But you have already picked up your next bottle of the same med that you will start after you have given the 4 remaining pills. This new bottle will go into the box of "2nd Tier" meds.
#4) You will have a separate container of meds given occasionally. For example Ellie sometimes gets Ibuprofen, Acetaminophen, Miralax, etc...but they are not everyday. (I also have a 2nd tier box for nebulizer meds.)
#5) When it is time to give meds, pull out all of the medications. Look at the stickers on the lids and throw back any that are not given at this time. For example, if it is morning I throw back any that are only labeled PM. If they are labeled AM or is they are labeled AM/PM then I keep them out.
#6) Have a paper typed up that lists each med and the amount given. I don't really care about the actual dosage (ie: 8.8 mg per tablet) at this point, I just need to know how much to give her. If dosages change I just hand-write them onto my typed up sheet, then other people giving the meds will take notice of the changes (because of the handwriting). After awhile I will retype it. It might look something like this...
7 AM
Senna 1 pill
Calcium 1 pill
Multi-vitamin 1 pill
blah blah 10 mL
2:30 PM
Blah blah 2 pills
7 PM
blah blah 1 pill
blah blah 1/2 pill
blah blah 10 mL
#7) Go down the paper and line up each med as you read through the list. This verifies that you don't miss any, or give doubles. If they have a temporary med like an antibiotic, put a sticky note on this paper, then toss the sticky note when done with course. Speaking of antibiotics (or temporary meds) write with permanent marker the end date you will be giving the med on the actual bottle and on the sticky note.
#8) Start drawing up meds into syringes. As you toss a pill into the pill crusher, throw the medicine bottle back into the "Daily med" basket. This way, if you get distracted, you know which pills you have already done.
#9) Have some little drawers that hold your syringes and feeding tube extensions
#10) Have a bin to toss dirty syringes and feeding tube extensions into, then you only have to wash them once in a while and you can get it all done at once
#9) Have a set day that you order meds each week. Mine is Monday because if there are problems, I want a few days to figure it out before the weekend. Go down your typed up list check each bottle in your "daily med" basket. See if there is at least 8 or 9 days (because you will not be ordering for 7 more days and if you ordered it next Monday it may take 2 days or so to get a refill). If not, check your 2nd tier meds to see if you have another bottle. If you do not have 8-9 days of that med, jot it down and set that bottle aside. Once you have been through all of the meds and know what you need to order, go ahead and order. Usually there is an automated system you can call or text or do it online to reorder meds. If they give you any type of info about your reorder such as "This med will be ready today after 10 AM" or "We need to contact your Dr. for additional refills" jot that down on your paper.
You can usually get a refill at 24 -28 days after your last refill (depending on your insurance). I fill my meds as soon as they will let me, this lets me get a little tiny stock-pile of meds in case of emergency.
If your insurance will let you do a 90 day supply, this is often cheaper and you only have to reorder every 3 months. Sometimes when getting a 90 day supply, your insurance will make you do it by mail-order instead of a local pharmacy. If you want to try a 90 day supply, just ask your Dr. to write the prescription that way whenever you get a new prescription.
Here is a link to the pill crusher I love. It is pointy at the bottom which helps crush the pills more easily. I have about 5 of them, Several at home, one in her wheelchair bag, one at school, etc...
http://www.amazon.com/APEX-PILL-PULVERIZER-Size-1/dp/B000J14PR4/ref=sr_1_2?ie=UTF8&qid=1450109591&sr=8-2&keywords=apex+pill+crusher The other option is to get a mortar and pestle, I know several people who prefer this option.
Here is a link to a video I made. It is not the best, I was trying to film it myself. I would like to say I will redo it, but we all know how busy life is with a kiddo with complex medical needs. So let's just say, that is not going to happen!
How do you organize your meds? What tips and tricks can you share?
*I prefer pills over liquids, there are several reasons. #1) they are cheaper per mg #2) they are easier to find at pharmacies or over-the counter #3) If you need to grab a dose and bring it with you you can just grab a pill instead of having to bring the whole bottle of liquid med or drawing up the liquid med and risking it spilling #4) They don't have the sugar in them that liquids do #5) They don't have to be refrigerated #6) you can use syringes forever because you don't care if the numbers wear off the side
* I don't care if the numbers wear off the side for most of my syringes because I have chosen to crush my pills. But if you want your numbers to stay on longer, when you get new syringes, paint over the numbers with clear nail polish and allow to dry.
* Some people do not crush their pills. They draw water into a syringe, drop the pill into the water and let it sit and dissolve for about 12 hours (or more). Check with your pharmacist to make sure this will work with your meds, especially if they are time-released. I have never tried this method.
*Some people draw up a whole months worth of meds into syringes and label the syringes. I have never done this method.
#1) Label the top of each bottle with a round sticker like these. http://www.amazon.com/Round-Circle-Labels-Inkjet-Printers/dp/B00WMRH33Q/ref=sr_1_1?ie=UTF8&qid=1450110605&sr=8-1&keywords=3%2F4+inch+circle+labels The 3/4 inch ones fit on top of a medicine bottle perfectly. I would recommend NOT getting the removable ones, they fall off. I write three things on each sticker. The name of the med, the time it is given, how much to give (ie: 1/2 pill or if liquid 1 mL).
#2) Have a basket that all daily meds get thrown in to, I will call this the "Daily Med" basket. I used to try and line them up neatly in the basket, but it was a waste of time. If you follow my steps, it won't matter that they are a jumble. I set the liquid meds to the side of the basket because I don't want them to spill.
#3) Only keep 1 bottle of the med in this "Daily Med" basket. Have a different bin/box for what I call the "2nd tier" of meds. For example, you have 4 pills left in your bottle. That goes into the "Daily Med" basket. But you have already picked up your next bottle of the same med that you will start after you have given the 4 remaining pills. This new bottle will go into the box of "2nd Tier" meds.
#4) You will have a separate container of meds given occasionally. For example Ellie sometimes gets Ibuprofen, Acetaminophen, Miralax, etc...but they are not everyday. (I also have a 2nd tier box for nebulizer meds.)
#5) When it is time to give meds, pull out all of the medications. Look at the stickers on the lids and throw back any that are not given at this time. For example, if it is morning I throw back any that are only labeled PM. If they are labeled AM or is they are labeled AM/PM then I keep them out.
#6) Have a paper typed up that lists each med and the amount given. I don't really care about the actual dosage (ie: 8.8 mg per tablet) at this point, I just need to know how much to give her. If dosages change I just hand-write them onto my typed up sheet, then other people giving the meds will take notice of the changes (because of the handwriting). After awhile I will retype it. It might look something like this...
7 AM
Senna 1 pill
Calcium 1 pill
Multi-vitamin 1 pill
blah blah 10 mL
2:30 PM
Blah blah 2 pills
7 PM
blah blah 1 pill
blah blah 1/2 pill
blah blah 10 mL
#7) Go down the paper and line up each med as you read through the list. This verifies that you don't miss any, or give doubles. If they have a temporary med like an antibiotic, put a sticky note on this paper, then toss the sticky note when done with course. Speaking of antibiotics (or temporary meds) write with permanent marker the end date you will be giving the med on the actual bottle and on the sticky note.
#8) Start drawing up meds into syringes. As you toss a pill into the pill crusher, throw the medicine bottle back into the "Daily med" basket. This way, if you get distracted, you know which pills you have already done.
#9) Have some little drawers that hold your syringes and feeding tube extensions
#10) Have a bin to toss dirty syringes and feeding tube extensions into, then you only have to wash them once in a while and you can get it all done at once
#9) Have a set day that you order meds each week. Mine is Monday because if there are problems, I want a few days to figure it out before the weekend. Go down your typed up list check each bottle in your "daily med" basket. See if there is at least 8 or 9 days (because you will not be ordering for 7 more days and if you ordered it next Monday it may take 2 days or so to get a refill). If not, check your 2nd tier meds to see if you have another bottle. If you do not have 8-9 days of that med, jot it down and set that bottle aside. Once you have been through all of the meds and know what you need to order, go ahead and order. Usually there is an automated system you can call or text or do it online to reorder meds. If they give you any type of info about your reorder such as "This med will be ready today after 10 AM" or "We need to contact your Dr. for additional refills" jot that down on your paper.
You can usually get a refill at 24 -28 days after your last refill (depending on your insurance). I fill my meds as soon as they will let me, this lets me get a little tiny stock-pile of meds in case of emergency.
If your insurance will let you do a 90 day supply, this is often cheaper and you only have to reorder every 3 months. Sometimes when getting a 90 day supply, your insurance will make you do it by mail-order instead of a local pharmacy. If you want to try a 90 day supply, just ask your Dr. to write the prescription that way whenever you get a new prescription.
Here is a link to the pill crusher I love. It is pointy at the bottom which helps crush the pills more easily. I have about 5 of them, Several at home, one in her wheelchair bag, one at school, etc...
http://www.amazon.com/APEX-PILL-PULVERIZER-Size-1/dp/B000J14PR4/ref=sr_1_2?ie=UTF8&qid=1450109591&sr=8-2&keywords=apex+pill+crusher The other option is to get a mortar and pestle, I know several people who prefer this option.
Here is a link to a video I made. It is not the best, I was trying to film it myself. I would like to say I will redo it, but we all know how busy life is with a kiddo with complex medical needs. So let's just say, that is not going to happen!
How do you organize your meds? What tips and tricks can you share?
Friday, December 4, 2015
Shoes for kids with braces/DAFOS/AFOS
DAFO stands for Dynamic Ankle Foot Orthosis (or Orthotic). They are braces to help your child's feet grow properly or to keep them in proper alignment or to support them properly while walking. Because they are adding extra bulk to the foot, it is difficult to get shoes to fit over the top without looking like clown shoes.
Many people like converse or DC shoes (skater shoes) to fit over DAFOS.
New Balance has triple wide shoes.
Another suggestion is to cut the tongue down towards the toe so the shoes will open up more widely. You can also cut the tongue out completely.
You can also remove the insoles from inside the shoes to give you a bit more room.
You can look for wide shoes and buy them in a little larger size. Some people like Stride Rite.
It is a good idea to take your child's DAFO to the shoe stores (possibly even leave your children home) and slip the DAFO's into the shoes this way you are not trying a hundred shoes on the kids foot...the DAFO does the work for you.
They make special socks, but personally I just shop tall/crazy socks at the dollar store...I hardly ever pay more than $1 for a pair of socks for the DAFOS. If your child has problems with sweating you may want to look into knee high running socks that wick the moisture away (we do not have this problem so I don't have any advice).
Here are some other options...
Nike Flyease
https://store.nike.com/us/en_us/pw/flyease/pjp (Nike flyease have velcro and zippers to use with AFO's)
Hatchbacks Footwear
http://www.hatchbacksfootwear.com/
Keeping Pace
http://keepingpace.com/
Easy ups
https://www.easyup-shoes.com/
Pedors
http://www.pedors.com/ (very interesting slipper/stretchy type of slipper or hiking boot with a hard sole)
SoftStar shoes
http://www.softstarshoes.com/ (moccasin type shoes and soft soled shoes. You can even design your own)
Plae
https://www.plae.co/pages/adaptive-orthotics
Do you have any comments or tips on buying shoes to fit over DAFO'S? Please share below!
Many people like converse or DC shoes (skater shoes) to fit over DAFOS.
New Balance has triple wide shoes.
Another suggestion is to cut the tongue down towards the toe so the shoes will open up more widely. You can also cut the tongue out completely.
You can also remove the insoles from inside the shoes to give you a bit more room.
You can look for wide shoes and buy them in a little larger size. Some people like Stride Rite.
It is a good idea to take your child's DAFO to the shoe stores (possibly even leave your children home) and slip the DAFO's into the shoes this way you are not trying a hundred shoes on the kids foot...the DAFO does the work for you.
They make special socks, but personally I just shop tall/crazy socks at the dollar store...I hardly ever pay more than $1 for a pair of socks for the DAFOS. If your child has problems with sweating you may want to look into knee high running socks that wick the moisture away (we do not have this problem so I don't have any advice).
Here are some other options...
Nike Flyease
https://store.nike.com/us/en_us/pw/flyease/pjp (Nike flyease have velcro and zippers to use with AFO's)
Hatchbacks Footwear
http://www.hatchbacksfootwear.com/
Keeping Pace
http://keepingpace.com/
Easy ups
https://www.easyup-shoes.com/
Pedors
http://www.pedors.com/ (very interesting slipper/stretchy type of slipper or hiking boot with a hard sole)
SoftStar shoes
http://www.softstarshoes.com/ (moccasin type shoes and soft soled shoes. You can even design your own)
Plae
https://www.plae.co/pages/adaptive-orthotics
Do you have any comments or tips on buying shoes to fit over DAFO'S? Please share below!
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