Medicaid might pay for night nursing

Usually night nursing is requested by discharge planning after you have been inpatient.  But it does not have to happen that way.  You can request to be evaluated yourself.

The nursing I am talking about is in addition to any respite hours you get such as from DSPD or MCCW.  You can have both respite and nursing.  They do not affect one another.  If you get approved for night nursing it WILL NOT lower your repsite.

If you have Medicaid, here are the steps I would take to see if you qualify...(I live in Utah, so I don't know how it works other places, but please comment below and let us know).

#1) Call Medicaid (which ever you have...such as Healthy U, etc).  Tell them you would like to look into getting night homehealth nurses.  Ask them which Nursing Agencies are on their approved list.

#2) Call one of the Nursing Agencies and ask them to come do an "Acquity Grid" for you because you would like to try and get approved for night nursing.

#3)  Make a list before they come out of all of the medical tasks that need to be done and how often they need to be done.  Make it sound as bad as possible.  Tell the truth, but lean towards when your child is really sick and not doing well at home.  When making the list make as many tasks be during getting ready for bed and during the night-time hours as possible.  So if you normally bathe them after school...list it as getting ready for bed.  This is a task that the nurses can do for you.  Same with meds and braces and range of motion etc.  Write them down as getting ready for bed and night-time tasks.

#4)  The Nursing Company will come out and do the Acquity Grid and submit it to Medicaid.

#5)  Several things they will want when they come out (other than your list of night-time tasks)...list of diagnosis, list of Dr.'s (names and type of specialist is fine), medications (name, dosage, reason for taking, times given).  And what hours you would want (I will talk about this below).

#5) If you do not hear back from Medicaid and/or the nursing company within a reasonable amount of time, follow up with them.  It took me 2 tries to be approved.  Somehow the ball was dropped the first time.

As soon as the acquity grid is filled out the nursing agency should be able to tell you immediately how many hours you should be approved for.  They will then want to know which hours you would want.  So with our acquity grid score we came out to 8 hours per night.  The nursing agency wanted to know right then what 8 hours I wanted.  They have to report this to Medicaid.  For some reason this is a really big deal to them.  I chose 8 PM-4 AM so that I could count all of her getting ready for bed things on her acquity grid.  If I had them come from 10 PM-6 AM then she would already be in bed and most of her medical things would already be done.

They will only do straight shifts and they must be during the night.  So even though I would rather have (2) 4 hours shifts, I have to have (1) 8 hour shift.

Once your nurses start working make sure they are doing and reporting the tasks that you get points on the acquity grid.  These reports are sent to Medicaid.  If those specific tasks aren't getting done, then you could lose services.

Here are some of the things I get points for on the acquity grid...Breathing treatments (vest and nebulized meds), suctioning, seizure monitoring, wearing braces, range of motion, giving g-tube meds and feeds, bath, monitoring vitals and oxygen, using oxygen when needed, cathing, bipap at night.

I am not sure if you can get a high enough score without bipap/cpap or trach.  But it can't hurt to try.  Let us know how it goes for you.

Here is a sample acquity grid that I found when I googled...I do not know if it is the most up to date.  But it will give you an idea of things that earn you points.
https://medicaid.utah.gov/Documents/pdfs/Forms/PDN-Grid(printable)4-13.pdf

Just as an FYI there is a nursing shortage so even if you get approved you may not actually get nurses.  I have been approved for over 6 months for 8 hours each night.  On my schedule next month I have 17 covered nights.  My friend that is with the same company has 7 covered shifts next month.

Please comment with questions or experiences below.

Please like and share our FB Page to see future posts.  
https://www.facebook.com/SupportedInOurTrials/

General Conference talks about disability

I bear witness of that day when loved ones whom we knew to have disabilities in mortality will stand before us glorified and grand, breathtakingly perfect in body and mind. What a thrilling moment that will be! I do not know whether we will be happier for ourselves that we have witnessed such a miracle or happier for them that they are fully perfect and finally “free at last."
https://www.lds.org/general-conference/2013/10/like-a-broken-vessel?lang=eng

72 Hour kit for a medically complex child (Bug Out Bag, how to evacuate)

I was recently asked this question and will attempt to answer it...How do you pack a 72 hour kit for your special needs child? Children with complex medical needs have so much stuff and can't carry their own backpack. How can the parent push the wheelchair, have their own backpack,carry all of the special needs child's gear and still be able to move?

It is seriously a hard one.  

First...attempt to shelter in place (stay at home).  Do you have food, water a generator (if needed for machines) and gas for generator?

Second...attempt to bug out (evacuate) by vehicle.  You still need a 72 hour kit packed for everyone including your special needs child, but at least it will be easier than walking somewhere.  Do you have a plugs in your car or a car inverter that can run your child's machines?  Do you keep your tank half full at all times?  (I don't...ha ha!).

Third...Bug out on foot (or by bike).  This is the one I am going to focus on...

If you are LDS, your ward should have a written emergency plan (each ward is supposed to have one).  Talk to your Bishop and counselors and Elders Quorum Pres and Home Teachers.  Ask to be included specifically on the written emergency plan.  Ask each of them that in case of emergency, as soon as they can get their families settled, to please send help.  Tell them that you will need help getting all of the necessary medical equipment evacuated.  If you are not LDS...talk to your neighbors.

We usually have about 1 day of supplies in her "Go bag" on her wheelchair with her at all times.

To build your 72 hour kit...just get started.  Know that it won't be perfect to start...but isn't it better than what you currently have?  Get a large Rubbermaid Bin (the heavier plastic kind).  Take a few hours and go through your child's daily routine and your spare medical supplies.  Pull out enough for 3 days (if you can spare it).  On top of the bin tape a paper that lists things you would still like to add to the kit.  Also tape a list of things you would grab at the time of evacuation (things you can't have packed up all of the time).

I keep this bin in my big van (the one with a lift that we use for Ellie) at all times.

I am currently revamping my 72 hour kit.  I think I will put her things in either 1 large backpack or a few smaller backpacks and then put the backpack in the bin.  The bin keeps kids from getting to it as easily and it getting stepped on but then you could pull the backpack out and wear it if needed.

I would really love to get a wheeled toolbox.  They are heavy duty and can hold a lot of things.  You can even lock them so your other kids don't get into them.  Here is an example. 

I am counting on my kids and hubby to wear their own backpack and then pull the toolbox.  Or in a real bind I could push the wheelchair and pull the toolbox.  (Come on...you know you've pushed the wheelchair and pulled a shopping cart before...ha ha!)

Some other ideas are a wheeled garden cart or a bike trailer.  We have a special needs bike trailer that could carry Ellie and a large backpacking bag (but it is not the most supportive for Ellie).  We also have a wheeled garden cart that Ellie can lay down on and we could squish a backpacking backpack on there too.  The wheels are not huge...but I think it could carry a lot of stuff in a  pinch.  Ours is about 2' X 3'.

If the terrain is rough we also have a large wheeled jogging stroller that we would use instead of her wheelchair.  Once again, it is not as supportive as the wheelchair...but for rough terrain it is the only way to go.

One last thought...Their stuff doesn't have to be in a backpack...a duffle bag or rolling suitcase might be easier.  A duffle bag could hang over the back of their wheelchair or a rolling suitcase would serve the same purpose as the toolbox listed above.

Advice to Dr.'s of rare or complicated or medically fragile kids

Dear Dr.

You cannot treat parents and patients the same if they have a rare diagnosis or are medically complicated.

I did a blog post touching on this subject a few years ago here.

Here is some additional advice for you dear Dr.

1.  Get to know the child as a person not a diagnosis.  Find out what they like.  Find out what makes them smile.  Who is their favorite person?

2.  Talk to the patient some of the time, even if they are non-verbal.  Don't always talk to the parent.

3.  Touch the patient in non-medical ways.  Touch their hand or their foot or wherever.  This shows compassion and that you see them as a person, not a patient.

4.  Compliment the parents.  Say "You know your child".  "You are doing such a good job".  "I trust you, you are so capable".  Parents are worried literally all of the time that we are not doing everything possible for our child.  We NEED to hear that we are doing well.

5.  Ask the parents what they think is wrong or if they have any guesses.  We have been around the block a time or two.  Even for our non-verbal kids we often have a guess as to the source of the pain, etc...

6.  Do not assume that you know more than the parents or the patient just because you are a Dr. Do not try and show off your knowledge.  We don't care.  We just want our child better. We have looked up more articles on our diagnosis and been to more specialists about our child than you have more than likely.

7.  Do not make up answers to our questions.  We would much rather hear you say "I don't know" or "I don't have an answer for that, but I will research it"

8.  Take notes.  Wrote down things you say you will do.  Make a written action plan as you are talking.  Then before leaving go over the action plan together with the parents.

9.  Know that parents are super tired physically and emotionally literally all of the time.  We live at levels of stress that most people only experience occassionally.  When we are grumpy with you please understand these things.  We are worried our child is going to die literally all of the time.  So when  new problem arises it stresses us out.  To you the patient is a diagnosis, to us they are our life.

10.  Offer your help.  Say "How can I help you today?"  or "What can I do for you today?"

Camping when you need power/Camping when you use oxygen

So you want to go camping, but your child uses machines or oxygen at night.  How do you get power?

My first suggestion is to camp in a place that has power.  There are lots of campgrounds that have power.  If you or someone is planning a trip this should be a top priority.  Tell the organizers they need to choose a location with power.

This may not always work out...but it makes life easier if it does.

I will split the rest of this article into 2 categories: Camping in an organized campground versus wilderness camping.

Power when camping in an organized campground
Organized campgrounds will usually make you turn off a generator at 10 PM.

1.  Often the camp host will have actual power (not generator) to their trailer spot or there will be power at the group site.  You can ask the camp host beforehand if they will let you run a long extension cord for your child's machines.  I have had them often say yes.

2.  You can put the generator far away from the camp sites and run a long extension cord back to your camp.  Ask your camp host beforehand.  Make sure to tell them it is for medical needs.

3.  You can buy a deep cycle marine battery (boat battery) and an inverter that hooks directly to the battery.  These are both available at the Walmart Tire center.  You will need to check power requirements of your machines and the power of the battery and inverter.  Inverters come in different power sizes.  Then you would need to charge up the battery with a generator during the day (when you can run the generator) and use the battery at night (since batteries are silent).  You can buy reliable and cheap generators at Harbor Freight.

4.  There are solar powered devices.  Once again you will need to check how much power you need and how much the device puts off.  A solar panel by itself will not help unless all of your machines have batteries.  If all of your machines have batteries then you can charge them with the solar panel during the day and run them at night.  If your machines do not have batteries then you need a solar panel and a battery.  There are many solar devices on the market.  I have been looking at one called "Goal Zero".  It comes in different sizes.  It is a solar panel and battery in one.  It is pricey, but looks awesome.  They are available online or at REI.

5.  For oxygen you can bring tanks instead of the concentrator.  Just make sure to calculate if you would need to change out the tank in the middle of the night.  If so, you may want to bring E tanks instead of D because they are larger.  There are approximate usage times on the side of each tank based on your flow rate.  You can also ask homecare to help you calculate this.

6.  You can borrow a portable oxygen concentrator from your homecare.  It is free and you don't need an extra RX to borrow it.  You just need to call homecare in advance and reserve it.  The portable oxygen concentrator has a battery.  You can also get extra batteries.  (I don't know how many extras you could get).  So you may need to charge the portable concentrator during the day and run it using it's battery during the night.  To charge the battery during the day you could #1) use a generator #2) use your car's built in inverter (double check that it puts out enough power) #3) buy a cigarette lighter inverter (check power before hand) #4) buy an inverter that hooks to a deep cycle marine battery (as described in #2 above)  ***note:  If using your car to charge things, make sure that the car is running so you don't kill the battery.  You may also need some extra gas for the car

7.  How far away from homecare will you be?  Could you bring half of the tanks needed and make a day trip into town to swap out your tanks halfway through your trip.  (Unlikely I know...but it can't hurt to look into all options)

Power while wilderness camping
In addition to suggestions 2-7 above you can do the following

1.  You can run a generator at any time of day or night.  They sell cheap and reliable generators at Harbor Freight.


What suggestions do you have for camping when you need power?  What has been successful or bombed?  Please comment below.

Please like share and tag our FB page for future posts.
https://www.facebook.com/SupportedInOurTrials/

Heal Diaper Rash

For kids who wear diapers their whole life...red bums are inevitable sometimes.

Here are some ideas to heal diaper rash once you have it...

#1) My number 1 tip is to let them be naked.  This keeps all moisture and acid off their bum and allows it to heal the very fastest.

#2)  If letting them be naked is not an option...use a cool temp hairdryer when changing them to completely dry the bum.

#3) Eliminate wipes while dealing with diaper rash.  if they are poopy, put them in the tub and rinse poop off with water.  (Optional) You can then let them sit in an warm oatmeal bath (put oatmeal in a nylon and tie top.  get wet and keep squeezing the oatmeal bag until the bath water is white.)  then when drying them off,  dab the bum with the towel instead of wipe.  Then let run or use the hairdryer tip.

#4) Mix equal parts of the following 3 things...
Maalox or Mylanta (cuts the acidity of the pee)
Lotrimin or Monistat (gets rid of any yeast or fungus)
Original Desitin (not creamy) (acts as a moisture barrier)
Seriously try it.

#5) Do not try to wipe all the cream off each time you change their diaper, this just causes more damage. Just leave it and slather more on.

Those are my tips, but here are some tips from other people...
Triple Paste from Walmart
Butt Paste
Bag Balm
Corona Cream
1/4-1/2 C. baking soda in a bath


What has worked for you?  Comment below

Like, share and tag our FB Page here

Sanitizing Surfaces

While out and about, I used to carry around lysol wipes in Ellie's wheelchair "GO BAG" everywhere we went.  I would use them to wipe the changing table, wipe the table at a restaurant before eating etc.

The lysol wipes took up a lot of space in her bag.

I have since discovered using hand sanitizer to sanitize those same surfaces when away from home.  I always had hand sanitizer with me, but now I have discovered this 2nd purpose for it, other than hands.

The hand sanitizer I like is called Avagard D.  It is the same hand sanitizer that they use in my local children's hospital.  It has lotion and does not dry out your hands.  I buy it in bulk.  But the size I carry is this small 3 oz bottle.  When it is empty I refill it from my larger bottles.

When I need to sanitize something I squirt some on the surface, then I wipe it around with paper towels (in a bathroom) or napkins (in a restaurant).


How do you sanitize surfaces while out and about?  What hand sanitizer do you like?  Please comment below.


Please like share and tag our FB page.

Cord Organization for Medical Equipment

I hate cords to all of the machines we have to use.  It drives me batty.  If I could make 1 medical device it would make everything completely wireless!!!!!

Until then, here are the solutions I have come up with...

Tip #1) Loop the cords loosely and leave as little extra cord as possible.  Wrap cords with a small piece of 1" coban.  It is secure, but doesn't leave the cords with sticky residue.  (Plus usually free...if you have a bunch laying around your house like me!)

Tip #2)  Label all of the cords with tape by the plug.




Tip #3) Have them plugged into the power strip in the same order you have them sitting on the shelf.




What tips do you have for keeping cords neat and organized?  Have you tried my coban method?  Leave a comment.


Like, share and tag our FB page.

Life Insurance for Medically Fragile Kids

It is nearly impossible to find Life Insurance for medically fragile kids.  Even the Gerber Grow up plan will deny them.  As soon as they find out they have a pre-exsisting condition, the Insurance company runs the other way.  I don't blame them.  But that sticks parents with knowing they will someday have to come up with thousands of dollars for funeral and burial expenses.

We have discovered one chink in the system.  If you/or your spouse (the parents of the child with disabilities) qualify for life insurance, then you can get something called a "rider policy".  The rider policy we have is $10,000 coverage and only costs a few additional dollars per month.  It covers all of our children until they turn 21.

When signing up for the rider policy I asked very specific and pointed questions telling them that my daughter is medically fragile, has a lot of medical needs, we know she is going to die, etc.  And I asked them if they would cover her and they said yes.

Have you added a rider policy?  Have you discovered any other life insurance "hacks"?  Please share tag and like our FB page.

Girls swimsuit with snaps (changing a diaper easily with a swimsuit)

This is genius.  A girls swimsuit with snaps that you can change diapers easily.  It looks like it goes up to a size 10.  Fairly cheap too...around $25-$35 .  It is called Fasten.

Click here to view.

Wish Granting Organizations

Here are a list of wish granting organizations.  They all have slightly different rules, so you will need to do a little research on your own.  I have not used any of these myself, so once again you will need to do your own research.

Charity Navigator.org rates charities, so you may want to check it out before donating.

Here are the wish granting organizations I found through a little digging...



Angel's Hands

Angelwish

A Special Wish Foundation

Bianca's Kids

Children's Wish Foundation International

Dream Come True

Dream Factory

Dream Foundation (Adults only)

Granted Wish Foundation

Jason's Dreams for Kids

Kids Wish Network

Make a wish

Sunshine Foundation

Wishing Well Foundation USA

United Special Sportsmen Alliance (provides outdoor experiences)

Weber School Foundation (Only for students being educated in Weber and Ogden School Districts in Utah) (They grant wishes such as bikes, hearing aids communication devices, switch toys, etc...  up to $10,000.  Can use more than once)

Wishes and More (only for Minnesota and surrounding areas)



Do you know of any additional wish granting organizations?  Please comment below

Have you used any of the above? Please comment below and tell us about your wish

Can you go swimming with a g-tube?

Yes!

G-tubes really don't get infected. Any bacteria or other yucky stuff that gets in while swimming is killed by stomach acid.

A person with a g-tube can go in lakes, swimming pools, rivers, bathtubs.  With no problems.

You DO NOT need to cover the g-tube with anything.  (No gauze or plastic or mepilex or anything.)

Cooler Ice pack

 We make all of Ellie's formula for the whole day at one time in a pitcher.  So when we will be gone for more than 3 hours, we need to take additional formula with us.  We have tried several containers over the years and this is the system we have settled on.

We put formula in cheap plastic baby bottles with lids.

 

Then we use this icepack from Walmart (made to keep a six pack cold).  It fits the bottles perfectly and keeps them upright in the cooler bag.  You can find the icepack by the coolers in sporting goods and it costs $2.

The ice pack fits into a neoprene cooler bag perfectly and can easily hang on the wheelchair on a carabiner.

We only put 3 hours of formula in her feeding pump bag at a time.  So we fill each bottle up with 3 hours worth of formula.

(The products listed below are not the exact items I have except the lids...but they look similar)

Medela Bottle lids $6 for 6 here
Cheap Baby bottles $11 for 12 here
Neoprene lunch bag $12 here

Six pack ice pack $9.50 on Amazon here or $2 at Walmart.

How do you keep your formula cold.  Comment below

Subscribe to this site by entering your email in the box to the right, ot subscribe to our Facebook Page to see future posts.  https://www.facebook.com/SupportedInOurTrials/

Feel free to share this blog or the Facebook Page.

Odor Eliminator

Let's face it...have a child with disabilities can be stinky!  We're talking...clear the room so you can breathe... stinky.

I don't know about you, but air freshner just covers up the smell and it makes me sneeze for several hours after.

Cue...M9.  This odor eliminator is a lifesaver.

It actually ELIMINATES the odor.  I'm serious.

It comes in unscented or apple, I have only ever tried unscented.  There is literally no smell and truly eliminates any unwanted odors.

Seriously...LOVE IT!

Here is an 8 oz spray for $14 on Amazon  here

Or a 2 bottles of 2 oz spray for $8.40 (to stick in your GO BAG...for on the go smells) on Amazon here .  (The bottle pictured is the 2 oz bottle)

Both links I listed are for the unscented version.  If you try the apple scent, let us know how it is.

There are also some M9 DROPS on Amazon...it sounds like maybe you put them in your underwear/brief to eliminate odors...but I am not 100% sure on this.  If anyone has any more info on the drops, please let us know.

What do you do for unwanted odors?  Comment below

Subscribe to this site by entering your email in the box to the right, ot subscribe to our Facebook Page to see future posts.  https://www.facebook.com/SupportedInOurTrials/

Feel free to share this blog or the Facebook Page.

Breaking pills by hand

Almost all pills (if not all) can be broken in half by hand, without a pill splitter.  They usually have 2 little lines along the edges, it breaks easiest along these lines.  (But I don't always use the lines...they will still split really well even without using the 2 little lines).

Try it.  Let me know how it goes for you.  

How do you like to split pills? Comment below.

Subscribe to this site by entering your email in the box to the right, ot subscribe to our Facebook Page to see future posts.  https://www.facebook.com/SupportedInOurTrials/

Feel free to share this blog or the Facebook Page.

How to clean syringes and feeding tube extensions (G-tube)

Syringes and tubes can be a bugger to clean.  Here are some tips we have discovered over the years.

Cleaning Syringes

(This first tip for cleaning syringes goes to my husband who invented it)

When you are being discharged from being inpatient there are usually a few of these laying around.  They are called hemostats.  They are like medical pliers.  At our children's hospital they throw them away, they are not sterilized.  So I just ask if I can take them home.  They have no problems with that.  It looks like you can also buy them on Amazon for under $5.  https://www.amazon.com/Aven-Stainless-Hemostat-Straight-Length/dp/B003E48ETS/ref=sr_1_5?ie=UTF8&qid=1495677863&sr=8-5&keywords=hemostat

Cut a small piece of rag (it might take a few tries to find a good size) and lock it into the hemostat.  This is now your cleaning tool for cleaning out syringes.

It works on 10 mL, 12 mL, 20 mL, 30 mL.  (I am not sure about 3 and 5 mL...I don't use that size of syringes.

\

When the rag gets old or smelly, just cut a new small piece of rag.

Cleaning large (60 mL) syringes

We use a normal baby bottle cleaning brush to clean 60 mL syringes.

Cleaning Feeding Tube Extensions

This is called a "Peg Cleaning Brush".  You order them from your DME where you get your extensions from.  They do not require an additional RX.  Insurance/Medicaid will pay for 1 per month.

Unlock the tube (if locked) and push the peg cleaning brush through the tube a few times to clean it out.

 The end should have this little tail on the end.  The tail eventually falls off and looks like the next picture. 

 

The tail has fallen off of this Peg Cleaning Brush above, it is time to throw it away.  (They still work without the tail, I just use it as my sign that I have been using it for a while.)

I also use the Peg Cleaning Brush to clean out the tip of the syringes.

I use a  regular baby bottle nipple brush for the catheter tip end of a feeding tube extension.

The tools of the trade!

How do you clean your syringes and feeding tubes?  Comment below.

Subscribe to this site by entering your email in the box to the right, ot subscribe to our Facebook Page to see future posts.  https://www.facebook.com/SupportedInOurTrials/

Feel free to share this blog or the Facebook Page.

Neck roll

I have purchased probably 25 different neck pillows and support over the years.  This is the one that works for us best...a rolled up blanket...ha ha!

You can wash it easily.  Once you find a good size blanket it supports just right.

I place it behind her head and grab both ends of the blanket and pull up slightly to tilt her head to the right angle.

What is your favorite neck roll/neck pillow?  Comment below.

Subscribe to this site by entering your email in the box to the right, ot subscribe to our Facebook Page to see future posts.  https://www.facebook.com/SupportedInOurTrials/

Feel free to share this blog or the Facebook Page.

I love this camping chair

This is a regular bungee camping chair I found at our local sporting goods store.  It was $80 new and I got it for $50.  It already has a recline built in.  Ellie is 65 pounds and is 4.5 feet tall.  I do have to put a rolled up blanket behind her head and a blanket under her knee pits (the edge seems a little abrupt).  Ellie has basically no trunk or neck control and this chair works great.  It also folds flat for easy storage.

Unfortunately the sporting goods store I bought it at has gone out of business nationwide.  This one on Amazon looks similar.  It is $50.  Just make sure you check the height with the height of your child.

https://www.amazon.com/Oversize-Bungee-Outdoor-Furniture-Camping/dp/B00PXCFFZ0/ref=sr_1_11?ie=UTF8&qid=1495676667&sr=8-11&keywords=bungee+chair

What chairs do you have for your child?  Comment below.

Subscribe to this site by entering your email in the box to the right, ot subscribe to our Facebook Page to see future posts.  https://www.facebook.com/SupportedInOurTrials/

Feel free to share this blog or the Facebook Page.

Caribiner/hook for hanging things on wheelchair

These large carabiners are $1 at Harbor Frieght.  They are great for hanging bags/feeding pumps/etc.  

How do you like to hang bags on the wheelchair?  Comment below.

Subscribe to this site by entering your email in the box to the right, ot subscribe to our Facebook Page to see future posts.  https://www.facebook.com/SupportedInOurTrials/

Feel free to share this blog or the Facebook Page.

Replacing handlebar foam on stroller or wheelchair

So the foam on your wheelchair or stroller has ripped...what can you do about it.

Here's what I did...I went to a local bike shop and asked for their help.  They suggested cushioned handlebar tape.  This one is by Bontrager and is called Double Gel Cork Handlebar Tape.  It is also available on Amazon.

The bike shop installed it for me for about $10 and the foam itself was $20ish.

If you are going to do it yourself, they used black electrical tape on both ends to hold it securely.

Tada!

Add snaps to your daughters swimsuit

Changing a brief (diaper) is no fun with a wet swimsuit in play.  

Buy the suit 1 size larger than they actually need.

Cut the swimsuit along the bottom seam.

Fold the material back 

Use a snap setter to put in some plastic snaps (plastic so they won't rust).

Put some swim shorts on over the top

Wah-lah!