Agent Murphy and I made a grocery run this morning, and then this afternoon he helped me put apples and brownies in the lunch bags.  He caught on really quickly to what I was doing and just pitched right in.  So I explained to him that we were making the lunches to help volunteers who are helping babies.

Mr. Tldz did the rest of the assembling while I cranked out the ham and cheese sandwiches.  Chef Knight is stopping by in the morning to pick up the lunches and deliver them to Georgia Tech.

So we’ll have to be looking into this more.  But a quick skim of the routes listed in the article to be cut suggests that routes are being cut heavily in areas where the population is not primarily African-American.  Even if that means leaving an area without bus service to a major train station, as is what happens with the elimination of “our” route.

The article even quotes the head of MARTA as saying that service cuts like this could start a “death spiral” because ridership is expected to decline drastically as a result.  Yeah, so, ummm….  do something else?

Agent Murphy had his regular speech therapy on Monday.  After we got home, the CHOA location we go to contacted us to tell us they had just been informed by Aetna that all the visits since the beginning of February are being denied.  Mind you, the therapy site contacted Aetna sometime in December to re-verify benefits for 2010 and were told everything is fine and we’re covered for 60 visits per calendar year.  He’s had maybe 13 so far in 2010.  And all the appointments in January processed normally.  By the time I spoke with the insurance specialist, Candy, at the therapy office, she told me our therapist was already going to war pulling together information on medical necessity.  She was drafting a letting about it which she was going to get over to our pediatrician’s office so they can sign off on it too.

Candy asked me to call Aetna to find out what I could from my end while they start the appeal process.  I spoke with Lisa C. at Aetna, who informed me that after some number of visits billed under the same treatment code, they want additional information to find out if the treatment will bring the patient to a “restorative state” before they continue to pay.  She said I was in a good position if the provider was going to go to bat on the Agent’s behalf, because they’ll have all the medical documentation Aetna is looking for.  Her sense was that when they have the documentation they’ll go back and pick up all the denied claims and reevaluate them.

Well, okay, wanting to know if a course of treatment is effective rather than futile makes sense.  But is denying coverage to force an appeal the only way we can accomplish that?  How about a simple request to provide certain medical documentation by a certain date, after which treatment won’t be covered until the documentation is provided?  No, no.  We can’t do anything so reasonable.  Just deny the claims.  And interrupt the treatment.  (Unfortunately, Candy was out sick today so I couldn’t talk to her about whether we should keep proceeding with his visits normally or suspend them until this is resolved; so the person I did speak with suggested that it was best to be safe and cancel tomorrow’s appointment and then get better guidance from Candy when she’s back.  Fact is, if they’re going to end up denying coverage in spite of the documentation, we can’t afford to be on the hook for more than we already are; even on the covered visits, we’ve still paid a pretty penny.)  Of course, we’ve just started gaining some momentum since introducing the communications book and device.  And I hope this interruption doesn’t mess that up.  Fabulous, right?  We’re not sure if this treatment is effective enough, so we’re going to interrupt it and make it less effective.  Stupid, stupid, stupid.

Anyway, we did get our communications book from Miss Lindsay on Monday and we need to start using that at home.  (We need to make braille labels on it for Daddy, too.)  The plan is to primarily use the book at home and the device (the loaner) in therapy.  Yesterday Agent Murphy did really well using the device.  And he’s even trying to say the word himself when he pushes the appropriate picture.  Miss Lindsay’s theory is that with the device as back up, he’s less frustrated about not being able to make all the sounds so he’s more willing to try them.

The cup is now up on our mantle.  Hopefully it will be a productive prayer week for us.

Monday night we had dinner at the B.’s house.  G. and A. and their 2 kids were in town from Alabama because G. had a work-related week-long training. So it was a big gathering and nice to see everyone.  The kiddos seemed to have fun together.  J. looks just like G. and M. has A.’s wonderful red hair.  Many thanks to Aunty N. for putting the evening together and including us.

This morning after Mass we were finally able to take Jerry up on his offer to take us to breakfast.  He invited us I think our first time attending Mass at All Saints, but we were in the throes of packing and preparing for the move then.  And then Mr. Tldz was in the Fathers for Good class after Mass for a number of weeks.  And then we didn’t see Jerry for a number of weeks and we thought he’d given up on us.  So it was good to be able to accept his generous offer today.  There were 8 of us at breakfast — a nice time.

Today’s therapist agreed with us that he understands a lot.  She said when she sees such a big gap between comprehension and expression, she expects there’s something oral-motor going on.  She agrees with our speech therapist’s unofficial diagnosis of apraxia — an inability to make a particular sound on cue.  Apparently it’s something you might see in adults who’ve had a stroke.  They can make all sorts of sounds and say lots of words, but if you say something to them like, “Say ‘mother’” they struggle and think really hard and can’t say it.  And then an hour later they’ll just blurt out “Mother.”

An occupational therapist observed his session today, too, and she said she thinks he might have slightly low tone in his facial muscles; but nothing that seems to require intervention now.  We’re just supposed to keep working with him on imitating sounds and such.

And we’re going to work on putting together a communications book for him — pictures of various things in different categories that he can use to communicate.  They also loaned us a basic communications device to see if he’ll get passed the stage of “let’s just push all the buttons” and actually consider using it more reliably to communicate.  Her preference, like mine, is to stay pretty low-tech with assistive stuff at this point, given that he’s still pretty young and hopefully will start vocalizing more.  (Of course, he vocalizes much more at home than he ever does in therapy; but it’s all still pretty random.  Although he does seem to be learning to say “No” — like when we tell him he has time out — though it’s a bit more like “Nuh.”)

We’re supposed to see the AAC specialist again in about 6 months to see where we are and if we need to change course.

They had lots of interesting things to say, and clearly they typically do longer missions of 2 or 3 days.  They condensed that into about 2 hours, so it was really something of a highlight reel.  I bet they’d be worth seeing in a lengthier format.

Anyway, the parish provided childcare in the church nursery and dinner (heavy hors d’oeuvres, really, but it sufficed) for the mission attendees.  So it was a full service evening for the bargain price of some gasoline.  Good times.

Agent Murphy was the youngest kiddo in the nursery and apparently had a great time.  (He always seems to like the nursery of whatever parish.)  Fortunately for him, unlike the other parents, his parents thought to pack him a dinner so he wasn’t starving.  It was a late bedtime for him, but he’s back to his normal sleeping now.

We’ve been reading God Gave Us Two and A Baby Sister for Frances.  Agent Murphy has started picking out God Gave Us Two for story time.  We wonder how much he understands of what we’ve been telling him.  At this age, especially with his not talking, it’s hard to tell.  So after reading God Gave Us Two last night I was explaining to him that we were going to go to the doctor’s office today and they would use a special machine to look inside Mommy’s tummy so we could see his baby brother or sister.  He patted his tummy.  So I told him, “Yes, but Mommy’s tummy.”  Laurie gave him his own copy of an ultrasound photo today.  I’ve taped it onto his dresser where he can look at it while he’s in bed.

We hadn’t been in quite a while.  Don’t remember exactly when the last time was.  I know it was before Agent Murphy was born.  Mr. Tldz thinks it may have been before we were married.  Yeah, a long time in either case.  It was helpful to have the nursery available for the Agent to make getting to confession a little easier.

It’s funny.  I always dread going to confession.  And then I go and it’s really not a big ordeal and I feel better afterwards.  You’d think I’d learn…  I’ve done my prescribed penance, and hopefully I can turn over a new leaf for Lent.  Whenever I receive penance at confession, I’m reminded of the story of St. John Vianney, the patron saint of parish priests.  He gained a reputation as a wonderful confessor and was known to hear confessions for 12+ hours per day.  He received some criticism for being too lenient in the penances he gave.  He is said to have said, “I give them what I think they can handle, and I do the rest myself.”  I’ve often wondered, when I’m given what little penance I receive, if the priest is taking something on himself on my behalf.  In persona Christi and all that.

Mr. Tldz had an honest to goodness Irish priest, with full brogue.  I had a priest of some African extraction.  Indeed, this Catholic church is catholic.