UMDF Symposium – D.C.

Last week I had the opportunity to attend the UMDF Symposium in D.C., what an amazing experience.

The evening I arrived was registration and prep for Day on the Hill.  I really had no idea what to expect.  Upon arriving later than I wanted due to a delayed flight, I made it in time for the prep session in which we got a packet of information and were organized by regions of the country.  A few minutes into the welcome from the staff, I started to get a sense my perception of the day was not going to be the way I had thought it would be.  I opened the packet to find two pages of talking points and a group of named individuals that I would be attending meetings with along with the names of the Congress member and the person we were meeting with.  I was slightly crushed at this discovery, intimidated by the information, feeling like an undereducated Mito mom for not hearing of any of these issues and the nervous that I was not going to get my agenda taken care of.  I immediately was feeling defeated and sad that I left Daphne and Rich in California and was questioning my purpose.  Of course I kept this to myself and just tried to listen and focus on the job at hand.  I felt like a puppet of sorts for a great cause nonetheless but still not what I was expecting. 

I stressed that evening trying to read and understand the information, talked to Rich and mainly tried to calm myself down.


The next day, bright and freaking early for a Californian, WITHOUT Starbucks, I got on a bus loaded with advocates headed for the Capitol.  Ironically on the bus we were sitting in our group.  So I was also intimidated by Dr. Boles who was in my group and a well-known and respected Mito doc in California, near me.  We walked what felt like forever to the other side of the Capitol to the Hart Building and did not really prep much on what to say, grabbed some breakfast and waited to meet with Senator Feinstein’s staff member, Dr. Pete Curran.  I think everyone in our group was a little nervous, it was the first time for everyone and we really didn’t know each other.  We have brief introductions on how we are involved and then started with the scripted Asks.  Little did I know that my mission ran alongside beautifully with the UMDF topics so I was thrilled.  After our first meeting and having more confidence we realized our group was rock solid!  We had a Mito Doc, a mom of a 22yr old woman who is undiagnosed, a diagnosed and legally blind 42 year old that was just impacted 1 yr prior who also used to be Chief of Staff to a Govenor in Australia and myself, a mama to a beautiful 2yr old girl.  There wasn’t a question we couldn’t answer and not an angle that we couldn’t relate to.  Basically you go through the asks and depending on Republican or Democrat you have different requests and ways to approach a subject.  The hardest part was explaining what a Mitochondria is to those that were completely clueless and no fault to them because that was me over a year ago.  Each staff aid seemed to have different knowledge on the topics and thankfully the health care reform act vote was delayed so we could still have the day.  We typically had 30 minutes to give our presentation, pass out materials and answer any questions, not much time if you think about it.  We were asked to snap a picture from each meeting and #dayonthehill so they could get all the pictures. 


Next we met with Senator Kamala Harris’ aid.  He was clueless on what a Mitochondria is, did not even introduce himself and did not seem interested in anything we had to say but for this meeting we had a lobbyist with us and thankful for this meeting that we did, she understood him and he understood her so our portion was short and sweet.  I think Kamala may be too new and young to take a position on anything Mito related but I will try. 

Our next appointment required us to hike back across the complex, a portion of the grounds were closed due to we think a session being held and visitors and he new fad of protesting.


We were dropped off at Garfield Circle, walked over to Hart, then to Cannon and then Rayburn.  Once in the buildings the walls were long as well getting to each office.  I regretted wearing heels and noticed every single staff member had flats on 😩.  The underground tunnels were only available within the house and or senate but we could not take the connection between since 9/11.  The heat and humidity were unreal.

The aid for MiMi Walters was nice and engaging, hopefully we can make strides with her.

Our third visit was with Congresswomen Chu herself, this was exciting as it was our first meeting with the elected official and not an aid.  She was knowledgeable on Mitochondria since she had her PHD in clinical psychology so we could skip that part of our talk and just focus on the asks and a quick background on us.  The personal stories seemed to hold more merit then the science or the asks, but of course you couldn’t have one without the other.  She however only had 10 minutes for us.  The lobbyist prepped me on what to ask her to get to my local government to make my ask a reality.  I was so excited!!  Maybe this is a good time to tell you what ‘my ask’ was…


Mitochondrial Diseases’ do not have a cure or treatment or an FDA approved drug.  They are progressive and ultimately fatal.  This has created the issue of no interest in researching the disease or creating a treatment.  It would not be “profitable.”  However to slow the progression of the disease and make patients feel and function to the best of their ability the Mito Cocktail is needed.  This is comprised of over the counter vitamins and supplements.  Since they are over the counter, insurance e companies will not pay for them, although the dosing is significantly higher than the normal recommended dosing an adult would take.  So this alone makes it very expensive for families to afford.  On average families pay between $500-$1,000 per month.  My first thought for a ask was for these costs to hit your out-of-pocket max so a zero dollar deductible could be reached sooner for already approved tiered drugs so families could get a little relief.  After hearing a few days before this the long arduous process of getting a bill in place, I decided to focus on my other and more main ask and that is to get another bill in place like the one currently in play in Massachusetts, to have Insurance companies pay for the Mito cocktail.  It had been in a favorable position but has been amended a couple times and I believe this can happen in California and then make efforts for it Nationally.  Dr. Boles really explained why this was worthwhile versus going for the orphan drug expense that can be at least $10,000 per month. 

I was so thrilled that somebody I spoke to actually got it, most I mentioned this to looked at me like I was crazy. 

The day was going great and we were on a pretty good high, until our last appointment.

It started off rough, we tried to get in early, so we didn’t have to wait 2 hours, they would not even entertain us unless the Congressman’s constituent was with us, umm what?! Not once during the day did anyone ask that.  

This guy was a real special person, a very radical Republican who loved Ronald Reagan and made Trump seem normal.  Almost every inch of his wall was covered in memorabilia (mostly Reagan and 3 surf boards).  He told us he just turned 70 two days before.  He did not let us introduce ourselves, we were late getting in and he immediately asked what we were asking for.  We knew the approach to take with a Republican (cost savings) so Dr. Boles took that angle.  Our first request was for him to join the Mitochondrial Disease Caucus, he shot it down before we could even finish saying the name, he said caucuses are worthless and a waist of money and he would never join, “oh great” I thought.  Then we quickly mentioned the NIH and DOD efforts just to highlight, asked him to lead the NIH letter and he questioned us hard about it reallocation of funds for NIH and we explained it was not for that but just inclusion of he Mito community into the studies.  Next came the Medical Nutrition Equity Act and my specific ask and he shot those down, all of this talking was by Dr. Boles and his actual constituent was another Doc and she was silent in awe of his behavior.  He said he would never sign a bill that told Insurance companies they had to pay for something but would rather pay the $10,000 a month and have Medicare or medical pay for it, we were so frustrated and confused by his behavior.  He complained about government insurance and how hey had to switch to Obama care and it was expensive out-of-pocket for him, I was dying.  Then he told a story about when his daughter was 9yr old got Leukemia and went through Chemo and how much he paid and not to worry she was cured and was going to be fine.

I was seriously about to jump out of my seat in anger and could see the jaws on the floor around me and pulled out my phone, got my latest family picture up and interrupted the conversation and said “I am so grateful that your daughter was able to get treatment and that there is an FDA approved drug for her, let me introduce you to my 2yr old daughter who has a very rare Mitochondrial disease that has no cure, no treatment and is progressive and fatal and Insurance does not pay for her.”  I am pretty sure my spiel went on a little more but it has taken me this long to cool down.  I did start to breakdown but sucked it up and finished.  I did not breakout a picture of Daphne all day, the others were respectful, this guy was not.  The reality is though we will likely need him and I can’t burn that bridge.  We did have to excuse ourselves from his office to catch the bus and that was after almost 45 minutes, I think in one way or another we made an impression.  He made my glass of wine taste even better that night 🍷.  I had to give him some endearing comment about his similarity to a certain guy in his office, he loved it 😖.


Oh and the picture had to be from the waist up per his young wife so his belly did not show.

The rest of the conference was about networking and attending sessions which was great.  I need to follow-up with everyone I talked to yet and will but also trying to manage my inbox from work 🤦🏼‍♀️.

Every two years UMDF goes to the Capitol, if anyone is interested in joining me, just let me know.

Xoxo desiree

BIG NEWS ALERT

After 3 tough months battling the insurance company to continue coverage for Daphne’s medicine (N-Acetyl-Cysteine) that may partially reverse her disease…
I WON!!!
Excitement is an understatement 🙌🏻
My last update on this topic was winning the appeal to get a 3 month courteous fill to give me time to fight them, many hours on the phone with various agents, trying to figure out the right form and process, trying to get the doctors office to do their part because in the end I can do all the work except complete the final paperwork, so annoying but thankful they stuck it through with me and I will be sending them a sweet 🎂 treat for being so sweet (a little exaggerated 🙄), but my dad always taught me “you attract more bees with honey”!
A special shout out to Paula at the insurance company.  I fell in love with the first agent I made an appeal with several months ago but Paula took it to a whole new level and really cared and took ownership in helping me.

You may think it’s easy but seriously some people and processes are setup just to be difficult just to make you quit, I swear.  

Follow me for a minute here…. 

Believe me it’s true, in my own job I see it and even play off it ( sorry not sorry sometimes) so that is just the case in other careers as well.  

One thing that has always given me the edge to not giving up are those people that say “Who’s going to own it?  Are you going to own it?”  They are saying this knowing good and well they should be the ones owning it but you being the better person, steps up and says, yes I will.

In the back of your head your doing this, because 1. You’re so good at it 😜, 2. You will learn valuable lessons along the way, 3. At some point in the future it will benefit you.

So thank you to all those who have done this.  You have gotten me to this point.  Thank you for teaching me how to help others want to do this as well. My rule in dealing with the insurance folks is to be nice, courteous, understanding, listen, be realistic in what I am asking for and take ownership of the issue.  Paula did all of those things and more.  She called me everyday when she said she would, to check on the status and she made the final step to get this approved happen!  Paula my dear, you have just made my dreams for Advocacy for Daphne’s Lamp a reality.  

I think this shirt was made for me and every other Mito mama I have met!

***It’s not my most glamorous picture but I will be honest I am usually in pajamas by 6pm and tonight squirmy little Daphne would not cooperate very well but that’s my life.

This is just the beginning, I am going to D.C to meet with Congress June 29th and I will be pushing for the next big thing.

Until I have to appeal again in another year, I am making steps to make this fight even easier, stay tuned for those details.

This is for my daughter Daphne and what the future of those involved in with #daphneslamp will look like. I don’t take NO for an answer and I will put up one hell of a fight, so get ready. Get on board with the movement it’s going to be BIG!

#mitostrong 💚 #daphnestrong

One thankful and Happy Mama tonight 😊

Charlies Fight

This is very important to me and if you are a parent it should be very important to you as well.

There is a little boy in the UK with a rare Mitochondrial Disease that is being denied treatment by the government and the hospital that is caring for him.

The hospital is stripping the parents of their parental rights for this baby.

He was supposed to have his ventilator turned off last night at Midnight to die, but the parents have an appeal in with the Supreme Court who will make a ruling June 8, 2017, this is their last option.

The parents have raised the over 1 million pounds needed to transport him to the US to a doctor that is willing to try a life saving drug on him that has worked for other children.

There is a US Facebook Group where you can follow along called Charlies Army USA.

There is also www.charliesfight.org

Charlies mums facebook page is public:  Connie Yates

ITV London documented the parents fighting for their son you can watch the video here Charlies Fight

There are several petitions to sign, they do help so do it:

Petition 1

Petition 2

Petition 3

I would not lead you all down the wrong path, I promise.  Please take a few moments to sign the petitions and follow the facebook groups.

This issue and disease hits home.  I would have to die before I would let anyone tell me how they were going to care for my child let alone tell me they were going to kill her!

If you have any questions let me know and I can get them answered.

xoxo Desiree

 

 

The Insurance Fight

For those of you that are reading this and are not living and breathing the many struggles of the Mito World, here is a little explanation as to why this post is so important to me:

There is no cure or treatment for Mitochondrial Diseases, so drug companies rarely spend the dollars to research drugs that will help improve the lives of those living with a Mitochondrial Disease.  This means over the counter vitamins/supplements are the only options for the “Mito Cocktail”.

Today I had some time and decided to pick the “fight” back up with the Insurance company that I started Jan 1 when I tried to REFILL a prescription that I had been getting for months for Daphne.

Dec 2016 the Rx was $0

Jan 2017 the Rx was $50

We could get a similar drug over the counter for $15 but it is 500mg and Daphne is prescribed 300mg.

Your probably saying not a big deal just split the capsule and call it a day.  Yeah we did that until I found a compound pharmacy to make the EXACT dose that she needed and ladies and gents I worked hard on that so I was not going to be told different now in 2017.

*Note a capsule cannot be perfectly divided as the contents inside are not guaranteed to be equally distributed.  So you see my driver here?  I want it to be perfect for my child, she deals with enough crap we cannot control, this I can.

Well I had a great experience with Gloria from Georgia at the end of 2016 figuring out why insurance would not cover this drug and how the pharmacy was running it incorrectly and how a filler they use was not an allowable cost and she got the pharmacy to just give me the $9 filler for free.

*Note I have a little history with this pharmacy, they screwed up a very, very expensive prescription for my dog and I did not flip out on them so yeah basically they owe me big since they didn’t lose their license over that.  My only comment with a smile on my face was, good thing it was just my dog and she is still alive and you know my daughters Rx is filled here so don’t screw that up or we will have a problem, love mama bear.  So yeah I basically get whatever I want from them.

So when I started having issues I wanted Gloria back but Jessie didn’t want to give her to me and he wanted to help and said I understand and will call you back in 45 minutes.  Over a month later and yeah I was real busy in that time….nothing from Jessie.  Don’t worry Jessie I will never ask for you so you will never have to deal with me.

Today I called and spoke to a few people and a few different numbers and was frustrated as this was not how things were handled in 2016 and then had to hang up on them when a coworker came by (probably someone watching out for me above did that) and so I called back and spoke to the most lovely of humans and I forgot her name.  Anyhow she was with Express Scripts within our insurance.

Lovely lady in Express Scripts let’s call her “G” walked me through, answered all my questions, probably appreciated my knowledge to date and gave me the tools to be even more informed and have all kinds of access at my finger tips.

  • I learned my In Network out of pocket max (OOPM) which includes Prescriptions not just Medical ( I did not know that, you will see why that is important in a min)
  • I got access to express scripts online which shows me the out of pocket stuff, all prescriptions filled and the cost since we have had the plan, mail ordering, etc.
  • I learned that the drug in question was $0 to us in 2016 b/c our out of pocket max of $7,000 was met (I took a big gulp and said what, wait, how, I did not pay that much)*
  • I learned that our doctor can call in a larger quantity of her prescription and I can get more for the $50 for now until our OOPM is met.  UMM YEAH!
  • I also asked how I can get other supplements we buy that are not a prescription to go towards our out of pocket max and its simple….well kind of, our Doc has to file an appeal on our behalf and ask for an exception to include the cost of the over the counter meds towards our OOPM deductible.

*You may have known this and maybe I did since I answered the questions that I asked but basically if you get a RX filled that costs $5,000, insurance pays $4,000 and your EOB says you owe $1,000 (eventhough we never pay what the EOB says) that $1,000 goes to my out of pocket max.

SO….I called her Mito Doc Nurse, explained my craziness, she was excited and said let me put the request into the doctor.  I am asking right now for a 3 month supply for the $50 versus the 1 month supply and I also asked for him to appeal the ubiquinol and for him to provide a larger quantity for the other Rx she gets so we have a buffer.

I am going to UMDF on the hill this summer and didn’t know what or how I was going to talk to our congress person about health care, insurance and prescriptions and present and defend something that is obtainable but I believe this is it.  This is one step to helping Mito Families.

To get Over the Counter Vitamins and Supplements to count towards In Network Out of Pocket Maximums!

The company I buy Daphne’s Ubiquinol (CoQ10) from is fighting the Mito Cocktail be covered by Insurance so I am sure this will be a start and have some backing.

The ultimate message here is:

Don’t give up or give in, talk to people, talk to doctors, talk to your pharmacist, talk to the insurance company to learn as much as you can.

Be polite and nice, it’s never the person on the other end that made health care the way that it is, it is however their job to ADVOCATE the best that they can for you.

My dad always said “You will attract more bees with honey”

I am not a person that is easily defeated, I do not take NO for an answer.  There is always more than one way to skin a cat.

There is only one person that will be the best Advocate for your child and that is YOU!

xoxo desiree

 

 

Army Crawl

We take Daphne to PT 4 days a week. 

Since she is able to sit for a couple minutes unassisted her therapist has moved on to teaching her how to army crawl.  

I have tried but felt like I was just getting her in a frog position and she was trying to move her arms but her mama was failing guiding the legs.  

Here is a short video of her therapist showing me how to do it, this is at the end of her session so she is a little tired.

Proud of My Girls

Both of my girls this weekend accomplished something and succeeded at something they have never done. 

This is something every parent wants to say and experience. 

You may look at these two videos and think they are on different scales but they were equally hard for both with all factors included.

I will never smile bigger than when I watch my kids do something amazing. 

I hope this makes you smile.




xoxo Desiree

Follow-up on Gluten

Back in August I wrote a post on “To Gluten or Not to Gluten” and promised to follow-up.

Trust me when I say I have been reading and asking and looking and posing questions to the doctors and just now got somewhat of a direction.

The skeptic in me, tells me this will change just as the advice on when to give peanut butter does but for now this is what we know….

Daphne does not and should not go Gluten Free.

The diseases that are autoimmune diseases (type I diabetes, celiac disease, and multiple sclerosis, etc.)  benefit from this diet but Daphne does not.

Whew…thankful!

xoxo Desiree

Twenty

I am so excited!

Honestly it’s almost better than the unsupported sitting.

Almost!

Daphne has FINALLY reached 20 pounds!

20 pounds 4 ounces to be exact

This is a huge feat with her disease and with all the sickness she has gone through recently.

She lost over a pound just a month ago which set her back to 18lbs.

Keep praying, sending good vibes or whatever you believe in because it is working.

As my mom says “Daphne is writing her own book!”

The other big part of this weight gain is I told the pediatrician we would start vaccinating again once she hit 20 lbs.

When we received her MRI results and diagnosis we stopped vaccinating do to the unknowns of how the mitochondria handles vaccines, especially the MMR (eek, just saying it freaks me out!)

I have always given both of my kids one shot at a time with plenty of time in between and this restart will be no different but things are going so well I hate to risk it.

I just love our pediatrician, I scheduled her shot appointment for next week with another doc b/c our normal doc was booked for the rest of the month and we are going to Disney at the end of this month and wanted to get the shot in her before visiting that cesspool of everything and I just received a call that our normal doc has made time for us since she knows Daphne best and would like to be the one doing the shot appointment.  Good Doctors ROCK!

Wish us Luck!

xoxo Desiree

It’s a Christmas Miracle  

Well…

Not really, but I have always wanted to say that and this is probably as close as I will get, but it is after almost a year of therapy.

Miss Daphne Poo is doing really well with unsupported sitting.

Rich was able to capture it on video today

One Whole Minute!

​​
The little things for me are being able to sit her on her changing pad while getting dressed and button the back of her shirt or comb the back of her hair, it’s really just great!

XO Desiree 

Little Inchstone

So as I have mentioned before Daphne had a regression in April of 2016.

What that means is, it is a form of brain damage.

It is unknown if the skills lost will be regained or get worse.

For Daphne she lost the ability to use her hands, she could not even open them, they were in clinched fists all the time, unless she was sleeping or completely relaxed then they would open slightly, also her arms and legs became very stiff and she also lost the ability to rollover. 

She was about 10 1/2 months old and this was so hard for us to see. We continued therapy, working with her and at this point in her life she really loved massages all over her body to help with I think sore muscles.

So now that most of her skills have been regained but glimpses of the regression still exist and she is definitely much weaker in those areas which were already her weakest areas, any little inchstone makes us all so happy and we cheer “Yay Daphne, good job” she gets so excited and is so proud of herself, she has this little grunt/laugh that she does when she has accomplished something. 

Earlier this week she had a dentist appointment and we did not have any oatmeal made so she and Rich were going to have a breakfast date at our local breakfast spot but while getting ready to leave I tried one of Adelaide’s pouches of applesauce. 

Note, neither one of my kids liked purées or mashed potatoes as toddlers (guess it was a texture thing) and Adelaide did not like applesauce or oatmeal for years, probably not until she was in elementary school, so this was super cute to see little miss poo poo eat from a pouch and hold it all on her own.