Gracie seems to be feeling better today. I did not give her the steroid and will stop it. She hasn't been urinating as frequently...knock on wood. I emailed Kristi and received this wonderful reply:
I am so sorry to hear about Gracie, your sweet pit bull terrier. I cannot say for certain that a raw diet will "cure" Gracie, but it will certainly make her feel better and make her healthier. The best way to judge how much to feed is to multiple her weight by 2% and that's the daily amount to feed her. So at 71 lbs., she would eat approx. 1.4 lbs. of food per day (approx. 11 ounces in morning and 11 ounces in evening).
Feeding raw is not as expensive as it sounds ... especially if you make the food yourself. And if you're already cooking their food, then it's really not more expensive to feed raw. I'm attaching a pricing list for some of my products ... of course the "complete" diet is the most expensive, but you could easily get the meat "grinds" and then add your own ingredients. For instance, my chicken grind is only $2.00 per pound so if you make your own food, it would cost about $2.00 a day to feed Gracie. You can also check other natural food stores and good quality pet stores to find inexpensive meat grinds.
Things I would definitely avoid are vaccinations and chemicals (topical flea treatments, prednisone or other steroids) of any kind. Myelopathy is an autoimmune disease so vaccinations would exacerbate the immune system. Also, keeping her stress level low would help a lot, as stress also wreaks havoc on the immune system.
Let me know if I can answer any other questions. I will be giving a workshop on how to make your own raw food in October if you're interested.
Sincerely,
Kristi King
I'm trying to live totally in the moment with everything. Each day is the only day. Each moment the only moment.
I also just wrote the following for another blog response regarding the LME's current projected short fall of 3 million dollars...
I don't know Jimmy... I think that may have been the case but I'm seeing now, one or two agencies we both are familiar with are "stacking services". For example, SAOP, Basic Benefit client (substance abuse out-patient client)...attending group therapy and individual therapy can also attend a mental health group, let's say "anger management" and be authorized for it. In addition they can also receive CST and med. management at the same time. So we have conceivably, 1.SAOP group ($19.00 per event) 2.Individual therapy (56.00 per event, not really sure about the reimbursement rate) 3. Med management (not sure what this is billed but they do see the NP once a month ),CST (not sure what that is billed per event but it is enhanced service) and anger management group (19.00 per event). Now...they can only come to one of those group events (Anger Management or SAOP twice a week. The agency doesn't make a lot of money off the basic benefit group, only 39.00 a week per client, not counting the individual sessions which they can have 2 a month. Let's say with one client, the agency can be reimbursed 116.00 for individuals, 39.00 per group x 2 times a week = 78.00 per week = 312.00 x 15 clients = 4,680 a month + whatever charge to see the NP once a month and what ever can be billed for CST services. What I'm seeing is a move to push a lot of smaller private practices out of the picture. One of the down sides of being CARF agency who receives money from the LME is that they also are expected to provide 24/7 crises management (remember too that many of the chronically mentally ill clients, high acuity and case management needs will be referred to you by the LME. You become their provider home and responsible for the majority of their care). This is one reason many smaller agencies have chosen not to become involved with the LME. Now…there is also the enhanced service, Intensive Outpatient Clients...the reimbursement rate for them is about 140.00 per event. This includes individual therapy, case management, and crises management. They too can see the NP but not receive CST. If there are 12 attending an IOP group (enhanced benefit) that is 3 groups a week (3 events-140.00 per event x 3 events per week = 420.00 x 12 clients = 5,040.00 per week x 4 weeks = 20,160.00. That is if everyone shows. To make sure you actually schedule so that you earn about that amount consistently you keep your group size at about 16 people. Add NP visits at one a month but not CST. I didn't include the amount of money earned from substance and mental health assessments which runs about (100.00 to 120.00 per event). My math might be off. It is 4:30 AM. The positive thing about being involved with the LME is the referral piece and the given reimbursement (if your agency is billing correctly). The agencies we are familiar with have at least two on going IOP groups and about 6 SA Basic Benefit groups. They recently have added an assortment of mental health groups like anger management, seeking safety, etc which do not seem to be getting off the ground but their substance abuse groups are soaring. In the last year since they took over one agency , they've cut their staff from 13 SA counselors to 2 and recently added a third. They have always had 4 mental heath counselors who have carried huge client loads and now they have cut that to 3 counselors. I know of three other big agencies in town who work with WHN and see smaller agencies being totally pushed out of the picture when it comes to IPRS and Medicaid monies. For what it is worth, I'm currently stressed out because I was facilitating two IOP groups and one BB group. I received an email from one manager who copied four other managers about a client that I had not "reached out" to in January. A client who I had no idea had been referred to me because of the clogged pipeline at the agency and the massive turnover they have had in both administrative support staff and clinicians. I believe I was making money for the agency. Which is good since four managers in the one agency including the regional vice president had to be informed of one error. None of the managers are responsible for any direct client care.
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