The Art of Health Insurance Appeals: My Battle for a Power Wheelchair Seat Lift

As I was strapped into my electrical stimulation bike while simultaneously lifting weights I had my Bluetooth snuggly positioned into my ear listening to my “Rock it Out” music to keep my motivation over that next hour.  Pandora played a song by the black-eyed peas, which came out in 2010 called “I’ve got a feeling.” It’s an incredible dance song when you want to feel pumped up and I used to play it on repeat before my accident in 2010 when I was living at my home in the Bahamas…

… It was a time in life that reflected simplicity, clarity, and pure joy.  Life was so simple back then.  I was pumping myself up last week because I’m in another battle of a lifetime with Blue Cross and Blue Shield (BCBS) for a new power wheelchair…

… I started the uphill mission of working with my durable medical supplier, my physical therapist, and my general practitioner…

… Two weeks ago I did, finally, receive a letter from BCBS saying that they were denying me a very critical function of the wheelchair called the seat elevator.  This allows my power wheelchair to go up and down.  Most insurance companies do not think this function is medically necessary for folks in wheelchairs.  I then called all the parties involved and there was a complete disconnect among my medical providers.  So, in a very Ali fashion, I decided to take matters into my own hands.  The age-old saying “when you want something done right, do-it-yourself,” holds true 100% of the time …

… Without further ado, this is the appeal letter I sent into the BCBS appeals committee last week.  I will keep you posted on what their decision will be, but when you really want something, you’ve got a fight tooth and nail to get it.  Sadly, this is the reality we live in and the fact that we have to justify why we need certain items to insurance companies to, not only survive with the spinal cord injury, but to thrive with it is slightly disheartening.  However, this is the healthcare system we presently have to navigate within!

Read the rest on Push Living Magazine: https://pushliving.com/the-art-of-health-insurance-appeals-my-battle-for-a-power-wheelchair-seat-lift/

 

A DAY IN THE LIFE OF ALI AT 17 – CHINESE JAIL 101

In light of world events and the seriousness of everything many of us are going through with Covid-19 I thought it might be fun to talk about something completely off topic and also nothing related to spinal cord injury either!

The following is a tale of my adventurous and crazy exploits when I lived in China at a ripe old age of 17 and how I managed to land myself in Jail in Northern China near the border of Siberia.

I graduated high school at 17 and had no desire to rush off to college as so many do.  I decided to defer my acceptance into college for a year or so, but I had no idea where I wanted to go or what I wanted to do.  I walked into my father’s office and found one of those globes that spin around in a circle.  I closed my eyes and my finger landed on Beijing, China. Continue reading

NAVIGATING THE CORONA PANDEMIC – A DIFFERENT PERSPECTIVE

Today is the first quiet moment I have had in over six weeks and I realized I had not engaged in one of my favorite activities – Writing!  Life has been a fast-paced world wind of excitement, chaos, joy, and hustle recently.  This doesn’t even include the elephant in the room at the moment of our current Pandemic of the Coronavirus!

In November my husband and I purchased our first home, started renovations, packed up our old apartment, and made the Herculean effort of moving a quadriplegic to a new home all before the race of the Coronavirus.  It has been nonstop for me and I’m elated to find a quiet moment today to get back to what I love.

We are finally moved into our beautiful new home, getting settled in, and trying to make our home finally feel like a home.  In short, we have been “Adulting!”  I had a singular mission of trying to move into our home, but on the tail end of moving the Coronavirus started moving at accelerated rate – although not before we were able to physically get into our new condo.  Thankfully, at present, we are quarantined at home and are both still busy working while still having endless To-Do projects.

My husband, Aaron, has been working tirelessly for the past 9 months and we have barely had time to spend together, so it’s a treat to be able to be locked in the house together.  When we don’t feel like it’s such a treat to be locked in together 24/7 — then we have wine 😉

Over the last 10 years I’ve never really been able to take a real shower and having my newly renovated bathroom is a dream come true.  Last week I had my ceiling lift installed, which was so fun as I was swinging like a monkey.

Now, I don’t have a shower chair yet as things have pretty much come to a stop from a retail standpoint with the pandemic, but looking at my shower at the moment is equally as gratifying.  I’m sure once I take a real shower I will have a different take on it.

The last several weeks have not been without their challenges though as millions of Americans are presently feeling.  I lost a caregiver, found a great new one, but am unable to physically work with him yet as we have “stay at home” orders directed by the state of North Carolina. Bringing someone into your home during a pandemic is probably not a brilliant idea considering I have a compromised immune system and less lung function than most.

I’ve spoken to dozens of friends who are disabled and able-bodied, and life generally is not looking rosy for most folks right now.  I don’t even know what this country will look like when we are done with this, how we will rebuild, how the financial system is going to recover after a $2 trillion stimulus, but there is one thing I do know.  The only way we are going to get through this is if we stick together and not trample thy neighbor for a roll of toilet paper. Continue reading

Aquatic Therapy – The Story of a Paralyzed Mermaid

 

Thinking back to my childhood I recall playing the “what do you want to be when you grow up” game with other kids.  My answer was always a resounding “mermaid.”  The water has always been such a central part of my life having grown up in the Bahamas.  When I broke my neck nearly 10 years ago, I couldn’t imagine how life would continue if I was unable to get back to the aquatic lifestyle I had become accustomed to.

When I was in the ICU and inpatient rehab the first few months after my accident, I was also battling a stage III pressure sore on my sacrum.   I could not wrap my head around how I would ever get back into the water.  I saw many other SCI folks start to dive back into activities in rehab, but I was not as fortunate. I was confined to bed rest all day, except for several hours of rehab, due to the raging pressure sore I had sustained during transport from the Bahamas to Miami after the accident.

While I stayed focused in rehab, worked on my computer, and made the best of my situation, I started to give up hope that I would ever get back into the water again.  Once I was released from rehab and sent home, I kept asking my caregivers and my mom every day if my pressure sore was healing, and I kept asking wound nurses how long it would take.  I didn’t know if I going to be able to get back in the water, but my family and I kept researching swim instructors anyway.  Somehow, I held onto a glimmer of hope despite the mounting medical challenges I was facing.

Read the rest on Push Living Magazine:  https://pushliving.com/aquatic-therapy-a-story-of-a-paralyzed-mermaid/

 

The Downfall of Our Healthcare System: A Harsh Reality

The battle I was fighting today was one of in-network providers. I need to give you little context as to how healthcare has changed over the last several years. While I understand Obama Care has many faults, several years ago the system was much more amenable to those in need than it is today. Frankly none of the systems we have work for healthcare today, but things have gotten MUCH worse over the last few years.

While I do work, this is really a fraction of what I do in my day. Many days are spent on hold for hours on end fighting with insurance companies, figuring out why a new part of my body has developed pain, driving around town to endless doctor’s appointments, handling the anxiety of hoping a caregiver will show up for work, and enduring the grueling process every single morning of having people put their fingers in my body just to go to the bathroom, and so much more – all at 36 years of age. This is not what I had envisioned my life to be no matter how much I make light of the situation I am in.

Today, however, my tears grew to rage as I finally got a human being on the phone from Blue Cross and Blue Shield. The fact that I have to fight for every detail to try and get covered by my health insurance is borderline criminal. Is it not enough to have to deal with the injury alone? I know I am not alone in this fight as so many of my other friends with spinal cord injuries are in a constant never ending war with bureaucracy trying to survive.

“Dear Cat Island, My Home – A Story of a Broken Heart & Forgiveness”

“Fernandez Bay Village (Home) – Half the homes are part of a resort and half the homes are private homes”

 

Several years ago I reached a point where I finally made the best peace one could make with breaking my neck and having my life change forever.  I spent so much time constantly pushing forward and not thinking about my accident through sheer determination of will.  This worked for a time, but eventually I had to find a way to dig deep in order to find some resemblance of happiness in my life and search for the best way I knew how to live a full life despite my circumstances.

Through quite a fair bit of soul-searching I arrived to where I am presently living the most fulfilled life I know how with work, finding love, getting married, spending time with friends & family, and traveling when able.

For the last six months Cat Island, Bahamas (my home) has been on my mind.  My family has had a home in the Bahamas for the last 40 or so years and it is a place so magical words simply cannot do it justice.  It is a beautiful out Island in the Eastern Bahamas spanning 60 miles long and 2 miles wide with a population of roughly 2,000 people.

The airport runway to the island is so short that no large commercial airlines are able land on the runway giving it its unique, and rustic charm because only those who know about it know how to get there.

I grew up on this island and made my first trip down when I was only several months’ old back in 1983.  I have lived in so many countries around the world that Cat Island has always been my home base, my center, my world, my escape, and my favorite place in the entire world.

I spent my time on the island with family and friends spearfishing, scuba diving, exploring caves in the middle of the island, taking Robinson Caruso style boat trips with my family to unnamed deserted islands, jumping off rocks into the ocean, picnicking on deserted beaches, kayaking through crystal clear lagoon waters, taking long walks on the beach, building bonfires with family, and countless other surreal adventures. Continue reading

A Change in Life Perspective – My Personal Metamorphosis

 

First off, Happy New Year to you! 

 

Coming into the New Year I thought it only fitting to discuss the concept of perspective.  I was asked by a fellow reader if I could touch upon the topic of how my mental perspective has changed over the last eight years since breaking my neck as opposed to just how my physical life has changed with being paralyzed.  I will start off by saying my life perspective has changed drastically and I can’t be entirely sure if this is due to my accident or the fact that I’m also getting older.  I suspect it is probably a little bit of both.

In general a change in perspective in life is quite gradual in my opinion, takes many years, and is usually preceded by many hardships along the way, which affect one’s opinions on many topics.  When I broke my neck my world got turned upside down, which violently shifted my perspective on a lot of things in life very quickly, but more from a physical standpoint.  I was so engulfed in trying to figure out how to live a life with a body 80% paralyzed that I didn’t have the presence of mind to think about how my mental health was going to change.

For the most part my perspective change has been for the positive, but there have definitely been some dark changes that I would be amiss not to dive into as well in light of always being open with my writing, and my life even though I run the risk of exposing myself further 😉

The old saying “we only have one life to live,” no matter how cliché it may be, means more to me now than it did prior to my accident merely due to the fact that I suffered a life altering event.  I see so many folks who live simple (and I don’t mean that in a bad way), but happy lives, and go about their business not realizing how easily life can change on a dime.  While it is easy to say that we will change our lives when something drastic happens – it is a lot easier said than done to take actionable steps each day to change.  However, these small steps are not only key, but they can take very long time to see the effects of as they require determination, and will over a long period of time. Continue reading

LOVE in a “DISABLED” World

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Last week I was on one of my spinal cord injury Facebook groups and I was reading a post where a gentleman was commenting on how he was in love, but he just felt so incredibly lucky that someone could love him with everything that comes along with dealing with spinal cord injury.

The endless comments that followed really resonated with me as folks told him stories about how they had been married for decades whether both the couples were injured themselves or whether they were with an able-bodied person.

This post really struck a chord as it got me thinking about the concept of love and what we as human beings can look past in order find the beauty within another individual.

Read the rest on Push Living Magazine: https://pushliving.com/love-in-a-disabled-world/?fbclid=IwAR1r3Cw3DfWrFQlRaP_GWIJ5JYiw-twhvBNUCWr8WIjCagasvJ8aEl-ZNK4

 

An Engagement to Remember

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… I was staring at a blank page while thinking how to write the perfect article on how I got engaged this past weekend. My mind kept wandering back to when I was first injured in 2010 laying in my ICU bed with tubes coming out of every orifice of my body, a neck brace immobilizing my head, and copious amounts of morphine coursing through my veins.

I distinctly remember several people huddled around me, thinking I was mostly unconscious, commenting on how devastated they felt that I would no longer be able to live a full life and likely not get married or find love. I know it was not meant to be hurtful as they were just intensely concerned for how my life would turn out, but I recall thinking at that exact moment the romantic part of my life was finished …

… The point of complete comfort, love, intimacy, and trust came for me when he saw everything I physically had to deal with on a daily basis. I always joke, but up until I met my fiancé I would never go out in public or let a man see me without mascara and eyeliner on … Seriously! One day I decided to not wear any makeup and he told me how utterly beautiful I looked, and that he actually preferred me without makeup. It was at that moment I knew I had a keeper; okay maybe there are a few other things that made me know he was a keeper, but that was definitely a big one for me …

Read the rest on Push Living Magazine: https://pushliving.com/an-engagement-to-remember/

 

 

 

Life’s Sacrifices & Choices with Spinal Cord Injury

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When we are growing up we are faced with all kinds of choices a consequences and as children that we are blissfully unaware of.  Do we want a cookie or a doughnut?  If we finish our vegetables then we get dessert; if we go to bed early than mommy will read us a bedtime story, etc.  At a young age we don’t really associate making a choice with sacrificing one thing for another either.  It’s only as we develop into young adults that many of us come to the realization that everything in life is a choice, sacrifice, or compromise.

Choices and compromises become exceedingly more complicated as we grow into adults.  If we want a family, then we have to save to have a baby; we can’t go on that family vacation because we are trying to save money to buy a house; if we keep eating donuts every day then we run the risk of becoming obese; the list goes on.

I was thinking about sacrifices and choices the other day as it relates to spinal cord injury, and more specifically, the compromises I have had to make and continue to make as a C6 quadriplegic.  As I was pondering some of these choices lately I was surprised at how many things I have had and will have to give up in my life.  I was having a challenging day, so of course this was a glass half empty point of view, but after waking up the next morning feeling more like myself I made a list of the things that I have gained, and given up over the last 8 years since my accident in 2010.

Living with spinal cord injury presents such a unique set of challenges that many folks, unless you are the one injured or know someone who is, may not think of on a daily basis.  I often play this game with myself because while I know that I am faced with seemingly insurmountable challenges at times, there is always someone who is dealing with A LOT more than I am.  This is not to say that we should go around comparing ourselves to other people, but I do find pausing on certain days to take stock of what you have in your life is a quality many of us lack.  This age-old saying may seem outdated and redundant, but I personally find that it rings true when the proverbial “ship hits the fan” in people’s lives … “You don’t know what you have, until you’ve lost it.”

Here are a few of my choices over the years: Continue reading