Welcome back, can you believe we have been running the "Wee Answer Wednesday" series for a year and a half now? Time sure does fly. In this week's video, Wendy addresses 3 questions from Men's Liberty users. Check it out below and keep the questions and comments coming. Have a great week!
Topics: Wee Answer Wednesdays
Welcome back everyone! As you may remember, several months ago we released a "checklist" on what steps you should take when being discharged from the hospital. Well a recent article published by Slate Magazine revealed a few items we may have missed, so we are back with a new, revised list. Check it out below and don’t forget to leave your questions and comments.
Topics: Video Blogs
Have you ever gotten a prescription from your doctor and then found out your insurance won’t cover it? They probably said something along the lines of, “you need to try this generic/cheaper version first. If that doesn’t work, then we’ll consider the medicine your doctor actually prescribed.”
Well, they’re probably not quite that honest.
This is what’s known as “step-therapy” – more actually called fail first. It’s increasingly common among insurance plans and if you haven’t seen it yet – just wait!
Fail first essentially supplants your doctor’s recommendations with your insurance company’s formulary. Sometimes its minor – my insurance company won’t pay for the brand of inhaler my ENT recommends but they will cover a similar generic. It doesn’t work as well but it’s covered. But it’s not limited to inhalers – fail first also affects thousands of other medications for chronic pain, diabetes, Alzheimer’s, COPD and many more.
Right now, it seems limited to prescription drugs. It’s no secret that the cost of drugs is increasing – 11% last year alone – and insurers are under enormous pressure to cut costs and keep premiums down. But what happens when cost undercuts quality? What good are limits that are set entirely by insurance companies without review by physicians, patients or the department of health?
Check out the Global Healthy Living Foundation for more information on the consequences of Fail First therapies including depression, increased medication non-compliance and deterioration of chronic medical conditions. The law currently does not limit the length of time a patient is required to use the alternative product before being prescribed the thing they need – for some it’s nearly 6 months!
There are literally dozens of stories out there about patient’s suffering under fail first. We hear about it all the time at Men’s Liberty. While medical equipment like Liberty isn’t yet covered by fail first, many of our clients have multiple issues alongside their incontinence so they tell us all about it. Some insurance companies will even try to take the same tactic with Liberty saying a patient needs to fail first with a condom catheter before they will cover the Liberty. It’s simply unacceptable for patient’s to be forced to use a product or medication that won’t work before insurance companies pay for one that will.
So what can you do?
One solution was posited in the Tampa Bay Times this weekend from FL State Senator Don Gaetz. His “Right Medicine, Right Time Act” would require insurers to have a step protocol reviewed by the Department of Health to ensure that any step protocol meets a basic “burden of proof” when supplanting their judgment for a doctors. The bill failed in the last session but it’s coming back in January 2016 – and you can get involved to make sure this time it passes!
To get involved here in FL or to get similar laws passed in your state – write or call your State Representative and State Senator. You can also share your fail first story, talk to your friends and family, or even ask your insurance company about it! You and your loved ones deserve better than fail first – demand better, we’re beside you all the way!
Topics: Health Literacy
Being a retired art and language arts teacher, I can’t claim to be an expert research analyst. However, here is what I learned:
I filled a fresh Liberty unit with water for measuring purposes. It holds one cup. I then poured water onto a major absorbent that also holds one cup.
I used another absorbent brand that claims to be reliable that only holds 2/3 cup.
On the top shelf of my closet, I have some briefs with built-in absorbents which hold two cups.
How much does a filled, two-cup absorbent weigh? One pound. A couple of ads on the web show a male walking with a brief on, smiling.
If I were carrying two cups of urine in my crouch, I wouldn’t be smiling. I’d be walking “funny” (waddling) for one thing. For another, I’d be panicking, looking for a restroom where I could change. Maybe the briefs were just meant for sleeping. Even so, any pressure on the absorbent will cause leaks. I remember the continued moisture in my crotch resulting in something called yeast infection. Not a good thing. (Yes, I bathed each day. Yes, I changed absorbents several times a day. Yes, I changed absorbents two or three times at night.) That condition resolved itself when I began using Men’s Liberty.
I realize this isn’t an extensive study, but it is enough to prove: Men’s Liberty units don’t cause “funny” walking. The unit hangs easily down my pant leg. With Tucson weather running 100º through the summer, I usually wear cargo shorts with an eleven inch inseam. The drain nozzle comes right above the hemline. Draining is a simple matter. Ten seconds and I’m “good to go”.
My situation is easy compared to people with Spinal Cord Injuries and other serious circumstances. If Men’s Liberty can work out the problems for them, then I have no complaints.
Good afternoon everyone! This week's video blog is a follow up to our previous video "Understanding Your Insurance Coverage". We understand insurance can be complicated and confusing. So check out the video below and don’t forget to leave your question and comments, we are always here to help.
Topics: Video Blogs
Do you know what today is? Today is July 26, 2015. It is exactly 25 years since the signing of the Americans with Disabilities Act or ADA for short. It seems for every step forward we make as a species we take two steps back.
Every summer the Prospect Park Band Shell hosts free concerts. I have lived in the New York City area for fifteen years and never availed myself of this culturally-enriching opportunity. So upon hearing that one of my favorite artists was going to be playing this past Friday I thought it was time I added another well-rounded edge to my musical education and loaded into my Honda Element with my brother Ethan and jetted off to the big city.
I have a Love/Hate relationship with cities. For people in chairs, at least me anyway, they are like that one girl you love to love, you want to love... but... she has that one guy she's crazy about who smacks her around, he leaves for weeks at a time, then when he shows up she drops everything and runs to him. There's museums and theaters and restaurants and great music and when she calls with her bright lights and charm you run to her hoping for that big moment, only to hit the broken sidewalks and filthy puddles, high steps and cramped shops, restaurants without an accessible bathroom and Doormen who say "Oh, sure it's right up the stairs!". Arriving home filthy and smelling like car exhaust, back sore from bouncing over potholes, it's then you realize, you will always be stuck in the "Friend Zone". Like all long and emotionally complex relationships it got me thinking and between two very interesting experiences while on said city excursion and the anniversary of the ADA I came to an interesting revelation.
While I would never equate anybody's ethnicity with a disability, I can safely say that the same system which marginalizes the races and social classes treats those with a disability the same way. Most Americans do not know that most colleges and universities, including so-called "Black Colleges" refuse to institute accessible infrastructure, alternative testing and even continued training for professors on how to assist students with disabilities! This is a total violation of ADA regulations. When I attended college myself I can remember being pushed by my brother through 100 yards of foot-deep, unploughed snow to get to class only to be told by the teacher "try to be on time next time". How can anyone get an education like that?
Once through the traffic and the usual wait-in-line at the gate Ethan and I settled into our seats. As the crowd began to fill in I noticed a young couple seated in the reserved wheelchair seating. The girl had transferred from her wheelchair and was sitting in a regular chair. It was obvious she suffered from cerebral palsy, but not to the extent that she could not get around. They sat together smiling and chatting and after my brain was satisfied it had taken enough visual data it looked elsewhere. About twenty minutes later I noticed the two of them returning to their seats from somewhere like the restroom or merchandise table. This time I noticed that he too had cerebral palsy. This in and of itself is not remarkable, but these two devoted souls were determined to face the world together with the chance that their own government may never let them get married. Yes, you heard that right. While legally, anyone can get married, those in the "disabled" community who are dependent on certain government programs that only exist through services like Medicaid and SSI can be penalized for tying the knot. This government believes if those like myself who are dependent on the physical assistance of another should be monitored and watched. If you cannot work (or rather employers refuse to hire you) and need daily care and you decide to marry the responsibility of your care in their eyes then falls to your spouse. They wash their hands of you. So tell me something... if I need help almost all day long when is my wife going to work? This puts us in the place where we are forced to make the choice between health coverage, coverage often providing life-saving services, and marriage.
I will take it a step further. Inevitably the person will come along and say, "Why don't you just get a job and buy your own coverage?" Most private insurance companies will not cover 24/7 PCA assistance, so unless you have a job that pays you enough money to pay a PCA $35,000-$55,000 per year out-of-pocket, you have to utilize some form of government assistance. The system was not designed for upward mobility... or love either, but it's just that. A system. Systems can be changed.
Laws can change. People can change, but it starts with people changing themselves first. Don't see the walls that shut you in as prison walls, but mountains to be climbed. Stop seeing that chair or lack of education as one-way train to nowhere, but as an opportunity, a vehicle for change. Yes this discrimination is real. I believe we can change the world, but just not by laws or rules. You can't just tell someone to stop being a racist or a bigot because it is illegal. He must see it in his heart, that it is wrong and know why it is fundamentally against the very life force that makes us human. Change comes from the heart. That is why we can change. Because within each of us is the power to do so.
Do something today. Do it now. Change your point of view. Don't have an education? Get a library card. Don't have money? Share what food you have with someone who is hungry. Are you paralyzed? Get online and use it as chance to encourage others. Do you have a job, but it barely pays? Work harder, smarter, smile and laugh. Ring up those groceries like you're a millionaire. Do have a little spare cash every month? Support blogs like these and research projects like the Reeves Big Idea. Do you have a lot of money? Pay it forward and invest in somebody else's dream. If you don't have anything? Give words, give words of life and encouragement. These are the things that supersede laws and governments and will last when this wheelchair I sit in is a rusted mass at the bottom of the ocean 500 years from now.
Civil Rights, ADA... they are written pages that mean nothing without the spirit of the men and women who believed in themselves enough to fight for them. It is the spirit of a thing that gives it life that makes it breathe. That spirit is colorless, genderless, it is neither sick nor paralyzed. It knows no border or creed or flag. The moment we recognize this is the moment we will love each other.
Thanks for reading.
Good afternoon. It seems there has been some confusion on how to properly use the bed bag's that are included with your supply of Men's Liberty. In this week's video blog Wendy explains how simple it is to use the and properly clean your bed bag. Check out the video below!
Topics: Video Blogs
Happy Tuesday! Wendy is back this week to give you a few tips and strategies to help manage your urge incontinence. Check out the video below and as always don't forget to leave your comments and questions. Have a great week!
Topics: Video Blogs
Hello everyone and welcome back! In this week's video blog Wendy goes over new drug prescription data that has been released by The Centers for Medicare & Medicaid Services. Check it out below and don’t forget to leave your questions and comments.
Topics: Video Blogs
When our son died of sleep apnea on July 2, 1997, our life shattered. Ours was a colorless world of black and white. Well-meaning family and friends advised us to “get over it and get back to normal”. That wasn’t going to happen. Nothing was “normal” again. Eighteen years of monthly meetings with The Compassionate Friends helped us move out of the “Valley of Grief” and into a new normal. We began to see color again. I’m mindful of this quote:
What the caterpillar calls the end; the rest of the world calls a butterfly. ~ Lao Tzu
The following year, I took a sleep apnea study through the University of Arizona. Eight weeks later, I was wearing my first CPAP and adjusting to a “new normal”- sleeping with an air tube. I looked like a SCUBA diver. I had to learn to turn from one side to another without kinking the tube. That became a normal procedure. A new normal where I no longer snored meant no more bruised ribs from She-Who-Must-Be-Obeyed.
And thus began my journey along this new learning curve including hearing aids and a De Vinci Robotic Radical prostatectomy, where my surgeon said I would “probably” have to wear diapers. “Probably” was an understatement. My extra briefcase held a load of men’s absorbents. My new normal was four or five absorbents daily and two or three nighttime changes. Shortly after the prostatectomy, I had a penile prosthesis implant that allowed me to move in a new direction. (No pun intended.) I was moving along this curve of “new” normal faster than I realized.
Later, there was cataract surgery for both eyes. Driving at night is no longer frightening.
Except for the absorbents, I found I could have somewhat of a normal life. Not the life we had when all four of our children were alive, not the life when I didn’t use a CPAP, not the life after the prostatectomy, or a penile prosthesis, but a new normal where, in my eighth decade, I could adjust and adapt.
Men’s Liberty entered a year ago, July 2014. On a one-to-ten scale, I found myself around the curve toward a new normal of confident comfort. There is more to learn, but Wendy La Torre’s TV training program makes negotiating this curve easier. I am closer to the “ten” than ever before.
Topics: Guest Blogs