Behind the Curtain: Honest Conversations about Foster Care and Adoption
Each episode will feature a conversation between host Rebecca Harvin and foster/adoptive caregivers or members of the community who support foster care and adoption.
Behind the Curtain: Honest Conversations about Foster Care and Adoption
Turning Shame Into Care: A Guide To Trauma, Incontinence, and Advocacy with Peter Mutabazi and Mica Phillips
We open the door on incontinence in foster and adoptive homes and talk plainly about shame, trauma, and the mental load. Peter Mutabazi, founder of Now I am Known, shares the daily realities of children with incontinence issues and advocacy wins. Mica Phillips, Vice President of Aeuroflow Urology, explains how to qualify for medical-grade supplies through Medicaid and why it restores dignity.
• why stigma follows older kids who need diapers
• trauma, autism, ADHD, and constipation as drivers
• the true cost burden and poor retail fit for bigger sizes
• using physicians as allies and documentation that works
• navigating Medicaid, managed care, and approvals
• school and camp accommodations, IEP hurdles, and dignity
• refill timing, product quantities, and fewer last‑minute store runs
• practical steps to apply via Aeroflow Urology and what to expect
www.petermutabazi.com
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Hey guys, thanks for joining me today on Behind the Curtain. I'm your host, Rebecca Harvin, and this is where we have honest conversations about foster care and adoption. Today we're talking about a topic that often stays hidden but deeply impacts many foster and adoptive families. We're talking about incontinence and the shame around it. Joining me today is Peter Mudabazi, founder of the Now I Am Known Foundation. You may know him as foster dad flipper on social media. Peter's journey began in Uganda, where he ran away from an abusive home at just 10 years old and spent nearly five years living on the streets. Today he is a single dad to many foster children and the proud adoptive father of Anthony, Ryder, and Skyler. Through his parenting and his work, Peter brings a powerful voice to what it looks like to reduce shame and create safety for children whose bodies and stories carry trauma. We're also joined by Micah Phillips, Executive Vice President of Aeroflow Urology. For more than a decade, Micah has helped individuals with complex medical needs access continence care through their insurance, restoring dignity and easing the burden on caregivers. In this episode, he walks us through how families can receive diapers at no cost through Aeroflow Urology and their Medicare provider, and why advocating for our most vulnerable kids matters so much. Today we're pulling back the curtain on incontinence, how it shows up in foster and adoptive homes, how we can reduce shame for our kids and ourselves as their caregivers, and how practical resources can make a real difference. So, with that, here is our conversation. Hi guys, Peter and Micah. Thank you so much for joining us today on Behind the Curtain. I am very excited and a little surprised by the topic that we're going to cover today, which is incontinence and how we can get resources to foster and adoptive families that might have children who struggle with incontinence. So, Peter, you are an adoptive and foster dad. And Micah, you are the vice president of Airflow Urology. Welcome to the podcast. It's so nice for you to be here.
SPEAKER_03:Thank you for having us. Thank you for having us. A joy. A joy to be here.
SPEAKER_00:Yeah. Peter, let's start with you, if that's okay. Can you tell us as a foster dad, as an adoptive dad, how how you came to like partner with Aeroflow and what and why you know that this is a thing. I know why it is from my perspective, but we can, I'll jump in in just a second.
SPEAKER_03:I think like as a force of parent, first, you know, it's kind of what I love the most is you know helping kids. Uh that it's I'm a single dad. So it's not like I have uh help at all, you know, and most of them, you know, I feel like I'm in the in the in the gata that I never come out. You know, like you're always just, you know, when you think you've reached here, that you find out like, oh, you haven't even started, you know, that I never felt I have a place to go or I have a uh someone that can understand me, you know, or sometimes someone understood me one way, but they didn't understand the other way, you know. Uh all my needs were sometimes minute to my to someone else, but yet they were so important to me, you know. A simple need as diapers to someone who's like, yeah, you can give them a casco. But when you have five kids that are using diapers at an older age, you know, it it is stressful. But also, too, to be honest with me, sometimes it brings shame as well. Like I'm afraid to send my kids somewhere else because I'm not sure that they will, not like they're judging me, but I think for me, that to have a five-year-old, a six-year-old still wearing diapers, like what are you I are you a good parent? Are you like all those, like really? So it's not just about the diaper, it is everything that encompasses me as a parent and gives me the dignity, but also gives me that courage and pride of being a foster dad and adaptive dad, when those resources get in the way. So for me, that was a joy to know that there's a company that really, literally, literally, that I can type in and say my needs, and somehow they will get to me. Like, what? Is that possible? You know, right? And that was for me the attraction, like, wait, where? Where do I sign up? And I think for me, seeing what they get to do, that I know as a false parent and many other false parents out there, that they will need as much as I need. But also they're going through the same way that I need sometimes we are afraid or ashamed to ask for help, and knowing that there's a place I can go where they really understand me, but also like that's what they stand for, that we're here to support you and to make sure that your journey is a little easier by doing what sometimes people see as the simplest thing, but for us is the greatest thing that we need the most. So for me, that's why I love you know uh the airflow, just really what they get to really do uh for our families.
SPEAKER_00:That's awesome. I remember um years ago in 2021, my husband and I and our then two children were in um the we were out west at the Tetons and we were driving past the mountain range and talking about there's a possibility we might have to, we might be asked to adopt the children in our home at the time. Sibling set of four. And at the time they were six, five, four, three, and two. And my husband said, I'm so tired. I'm so tired, like we're we're wiping all these butts, we're changing all these diapers, we're doing, we're tying all these shoes, right? And I said to my husband, like, you're in the wrong stage of life. Like if you're worried about this stage of life, like eventually they're not going to be peeing on themselves. Eventually, they're not going to be like they're gonna tie their own shoes. You should be worried about teenage years when we have a 16, 15, 14, and 13-year-old in the house, right? And like my I'm I'm very much always like in the future. And I so distinctly remember that conversation because now it's like, well, now we have a 9876 and we're still in diapers. And it's something that like we never saw, I couldn't have fathomed that I would still be buying diapers. Like our oldest kid is 15. That means for 15 years we have been buying diapers in my house. Micah, how much money is that in diapers?
SPEAKER_02:Thousands of dollars a year on the low end. I mean, it it is amazing. I mean, like the whole concept of the diaper gap, the idea that diapers cost the same, what no matter what your income level is, therefore, the expense burden that they carry for most folks who qualify for Medicaid and for folks who are juggling multiple different um foster children, the expense looms even larger than it would for other people. And so, and you make a great point there too about the individualization of each child's developmental track, right? So a child that needs to be in diapers for longer, it presents particular issues, such as, and we see this all the time with parents we help, they'll literally call us and say, I can't, my child is seven or eight. I cannot find a product off the shelf in the store that will actually fit my child. It's too small in the waist, it's not long enough, it doesn't have the leg gathers that are needed. And so we, for instance, deal with some really specific medical grade products and things like that that are centered on older children who may have delayed developmental milestones that relates to um body training. And so it is a really complex issue that is not, to Peter, to your point, it's not just as simple as, oh, just go to Costco and get some diapers. It's it's far more nuanced than that. And I think that the real value of being paired with a medical supplier that helps you coordinate insurance benefits is it closes the gap of you know, the physician, the insurance supplier, and the parent to really make sure there's a good holistic plan of care that's centered on that specific child's needs, you know.
SPEAKER_00:Yeah. And I think, I mean, just as a parent that is at last night, literally last night, 30 minutes before bedtime, send the kids to go put their diapers on, and they're like, we're at a diapers. So 30 minutes before bedtime, my husband's running up to the store to make sure that we have the supplies necessary in order to not have to wash every sheet in the house the next day, right? No, I think like the mental load for this, the mental like Peter, what you were talking about of like you're worried to send your your children, like to send my kids to an overnight camp here in Florida that they love so much. And they they like they find Jesus at this camp and they have friends at this camp and they have all of these things. And I'm like, bud, what's the social stigma of wearing a diaper to bed is gonna cost, right? You want to do you want to talk about that a little bit more? Like the having that conversation with the counselor, having that conversation with your friend's parent, their friend's parent.
SPEAKER_03:You know, in in full scale, like, you know, to get anything almost you you always have to advocate. You always have to ask someone to give you a little bit more recommendation to get anything. So it's almost like I'm always bribing just so I can get the need, the help that I need in some way, you know. And it's not just one child, it's everywhere. You know, I need uh therapies. Yeah, well, we you got a six month to wait. Wait, what? You know, but my child needs it right now, you know. So there's so much of our needs that sometimes for us the simplest are the ones that put me in the hardest place, you know, simplest as in a diaper, like not having enough, or having to, if my child is going to go for a night out or a camp as well, like I have to secretly talk to one not everyone at the campus, say, hey, you are taking care of this camper. Here's where I would like you to be there for my child. Please don't do it in the public, you know. Please don't embarrass him. You know, here's how you can help him get on his diapers without making it a big deal. Like, I am constantly advocating for my child for the simplest thing, yet they're the ones that matter the most or would impact them socially, you know. So for me to have an era of where you, you know, like literally, where I you can type in what you need and it comes in at the right time and it it always fits the child that you need. Like there's no, I know I'm crazy, but to someone that's the simplest thing, but for me, it is the it's the stress relief relief. It is a moment feel like I'm seen and had and known. It's a moment where I feel like for the world of paperwork, like I don't have to feel a hundred of them to prove I need that. Like they are there for me. But also, too, that they aren't just doing me the diapers, but also they know the medical need of my child in now. So for me, like being it's like it's like having one basket, but in that basket, there are few things I can use from one basket that is rare for us as forced parents, like rare, rare to have any place that can send you the medical supplies you use every day, you know, and most expensive is to share these days. So for me, that that button, that stress of just saying, oh hey, you know what? I'm gonna type in here and I know my supply will arrive in time, you know?
SPEAKER_00:It's amazing. It's amazing. Um, Micah, can you tell us a little bit about the underlying causes of it? Because I think one of the things that we experience, and um, Peter, I'm sure that you have heard this too, is when you say something about like, oh, oh, I have to wash sheets, like Mike, like you know, we're never trying to shame our kids, but when you're just mentioning it in a kind of a normal conversation, somebody will say, Oh, it's so it's so normal for your kids. My kids have accidents, and I am always like, mm-hmm, mm-hmm. I see your face. Like, you're just like, yeah, it's not what we're talking about, is not actually normal. Or, you know, you go to a place and they say, Well, it can be normal. And and Mikey, I'm sure that you'll say this when you start talking about it, it can be normal for a child to have bed wedding accidents up to a certain age, or it can be normal for it to, and so there's like a level of normalcy that we want to, of course, honor, but what you and I experience in our homes, Peter, is not, does not fall under the category of normal. And so, Micah, can you explain to us some of the underlying um causes that that cause bedwetting and then or incontinence in general, because it's not just always at nighttime, and then also kind of paint a little bit of a picture of what one would see as typical behavior and and maybe a little bit past typical. Like what does it look like with the case?
SPEAKER_02:So with our with what we find so often, as you said earlier, is that you know, autism and autism, various things on the autism spectrum are obviously huge contributors in some cases. That can be for physiological reasons, it can be for behavioral reasons. We serve many patients with Down syndrome, many other less well-known um chromosomal conditions. Um, we also see a lot of post-traumatic stress disorder, failure to thrive in more kind of environmental circumstances where it may be a function of, you know, the history that that child has had with their home life and things like that have presented them with, if not in many cases, specifically overnight incontinence, sometimes in ways that manifest throughout the day. So I think we have over 3,000 unique diagnoses on file for our just our pediatric population, which speaks to the breadth of conditions that contribute to what is actually a common underlying symptom that's coming in for just a multitude of different reasons. And that goes back to kind of the subject we spoke to earlier, which is the individuality of every child. So you know that a child has a symptom, but the specific way, reasons why that symptom is manifesting, and also whether there's treatment that's needed to address the root cause beyond just treating that symptom is highly individual to the child. So what I think is so critical about the Medicaid benefit that we're tapping into when we coordinate benefits for children to get them these supplies through Medicaid is the, and I said this earlier, is the involvement with that child's physician. Most Medicaid plans want to see that child's medical history on file with us, the supplier. And the reason they want that is it helps one validate that it's an appropriate need to be able to gain those supplies through insurance. But two, it's to kind of, as I said, close that triangle of making sure that the three advocates, the parent, the doctor, and you know, the supplierslash health plan in this case are all looped into what is going on with this child and what's going to be the best way that we that we manage this. And I think what we see a lot of the time as well is that in some cases, the insurances have extra benefits that are available, waiver programs, behavioral health services, and things like that. But obviously, navigating what's available for each child, every every insurance is different, right? So you pair every child is different, their needs are different with every insurance, it is different. As Peter said, it's an enormously complicated situation that you have to really, in a lot of cases, be inquisitive and advocate yourself because no one's going to spoon feed you the information you you need to get the information or to get the services and products that your child specifically needs. We pride ourselves on trying to look at one very specific part of that and say, let us at least take this off of your plate as much as we possibly can.
SPEAKER_00:That sentence alone, let us take this off of your plate as much as we possibly can. That's it, like you had me at hello. Like I am, I am, I am so in. So um, can you tell us what this looks like? Like, what is the process? Somebody somebody's listening and they're like, oh my gosh, I didn't even know, right? Like it's like that you have to start with even the awareness that this exists. So we step one is there. We're buying diapers at Costco for our family of abnormally large sizes that is still with an abnormally large number of children still in diapers at some point, either during the day or at nighttime. Um, probably we're seeing, or maybe we're seeing at this point, we've already seen our local urologist. Maybe we've already seen our um it here in Jacksonville. I'm located, there's like a constipation clinic at our local children's hospital where you go see the constipation doctors because it's a it's a it's a very common cause of incontinence. When we're talking about children who can control very little in their life, one of the things that they can control is when they're using the bathroom, how they're using the bathroom, what they're doing with what they're doing in the bathroom. Like they can control all of these things. And so, you know, a five-year-old doesn't know, oh, this is gonna make me actually also pee on myself too. And that's 100%. Right. So, so how does somebody get the services? How do how do they it would never cross my mind to go to Medicaid? So let's start there. Like they're gonna go to Aeroflow and do what?
SPEAKER_02:Um, so we have a form on our website um where it says qualify through insurance. And we ask for some basic information about your child, their name, their date of birth, your phone number, your email, as well as their Medicaid information. Um obviously it's more complicated, as I'm sure you both know, than just my child has Medicaid, because most states have set up what's called managed care, which means they've broken up Medicaid into anywhere from three to in some states like New York and Texas, 15 plus different insurances. And by the way, if you have multiple children in foster care or just multiple children in general, your multiple children may be under the care of different managed care plans, which is just another one is fragmentations. You're probably gonna get tired of me hearing the word fragmentation, but it's one that I say so often because it is the underlying contributor to a lot of the complication we deal with. But anyway, we collect that information, we process uh the insurance and say basically, based on the information you provided, one, your child either looks like they qualify or don't qualify, and we are contractually in a certain in a place to service or not service that request based on whether we have the contract. And then we're gonna, you know, ask questions like how many times per day do we does your child change, need a change of product? We deal with a lot of children where they only need a single disposable product per day because they just have the occasional overnight episode. And so they're just going into an overnight product one time a day, and that's gonna be on the simple end of the spectrum. And we have other children that have total incontinence where they may be actually going through six to eight changes of product per day. Six to seven changes per day is typically the maximum covered by insurance. So we're gonna present how many your specific insurance can cover. We're gonna ask about your needs, we're gonna let you know that any other products that may be available to help manage that condition, such as disposable wipes or potentially underpads for additional protection when sitting or in the bed at night. We're gonna show all that to you based on your insurance. We're gonna collect that plan of care and then we're gonna send that over to the physician that for your child, the pediatrician that you provide for us, or a urologist. If, for example, you're engaged with that. We're gonna ask you the best doctor on file for discussing and obtaining records related to this request form. We're gonna send that plan of care, which we've worked on together, to your physician, ask them to validate that, and also ask them where required by insurance to provide us any kind of clinical information or office notes from the most recent visit to validate that it's a medically appropriate request. The most important thing that a parent can do, having completed that part of the process, is to pick up the phone, believe it or not, and whether that's Aeroflow or some other supplier like us, calling the pediatrician and letting them know a couple of things. One, I did request this. Two, this is legitimate, and I actually have reached out to this company because we actually deal with a fair amount of uh mistrust or lack of recognition from physicians, where because the request is coming to us initially, and nothing is necessarily Been said to them. They sometimes don't know if it's a legitimate request or if we're not somebody that's just gotten your child's information or trying to do something unscrupulous on their behalf. And so helping build, again, I keep going back to that triangle concept, the awareness that you are actively involved in and advocating for the process can help definitely speed up the root the speed with which we get back from the physician what's necessary to get those supplies delivered to your doorstep as quickly as possible. So that's one of the biggest pieces of advice I give is just make your physician aware that, hey, this is important to me and I'm actively engaged. And also, by the way, while I'm on the phone with you, do you need to see us for a fresh appointment to validate this need? Because we see that pretty often too. You know, if you've if you've not had a well child visit in the last eight or nine months, when we send our request over, a lot of the time the physician's response to our facts to them will be, hey, I really need to see this child for a follow-up appointment to discuss this in person. We're going to let you, the parent, know that, of course. But the more you can hear that directly from the physician, sometimes you can go ahead and get that appointment scheduled as quickly as possible. So it's really a team effort to try to navigate the complexities of insurance to try to get everything, you know, resolved as quickly as possible.
SPEAKER_03:Right. And I could give an example. So for me, you know, once I go to win, you know, talk to Aeroflow and what they do. So my child, who was a daycare, the daycare was asking me that they're gonna demo him. In other words, they're gonna put her back to to third grade to teach her how to pad it. So I was like, I don't, it has nothing to do with training, you know, or untrained. Like something in her brain is doing something that she has one control, and one control is when she wants to let it go or not let it go. So I had so with Elfra, so I went to the doctor, I said, hey, by the way, my kid at daycare, they're trying to really put her back, and I don't think that is right. You know, her waiting on herself has nothing to do with lack of training. You know, something in her little brain is telling her something else. But I cannot have that authority unless you help me do that. And so they're like, absolutely, we'll write a note for you, you know, that I had to take to the daycare, you know, for them to say, Oh, this is a medical problem, not just Peter isn't training the child. And that's the shame that I had first, because the shame was I show up there, Peter, your child is about to be five. Why is she doing this? You know, and then sitting there saying, My child has trauma, you know, on Monday and Tuesday, she's gonna pee left and right because it's visitation the next day. But for them, they're like, uh, but why can't you train her not to do that? You know? So, and I knew I wasn't going anywhere that they could not understand me. But with the doctor's note, that really helps me. But I got to learn that from Elpha, like, oh, my doctor is actually my best advocate, but I have to go for that need and say, hey, you know, my child is being my child is not being advocated the way I should, but your note will help me do that, you know. And I'm able to say, okay, Peter, we'll we'll come down, you know. But at first, I was dealing with shame. Two, I love my child. I didn't want her to be taken back to third grade to three years old in order to like it has nothing to do with that. I'm not training, I'm training high level shape for my camp. But it's trauma, and I can't stop it. And I don't want to force my child to, you know, like uh she will, but at some point I'm gonna keep doing what she's doing, and that's okay. But it took that, it took that knowledge that I didn't know I had. Like I didn't know my my my pediatrician can actually would help me be able to advocate for my child if they knew the need or if they understood why I needed that. And that was like, so yeah.
SPEAKER_00:Do you ever want to be like, you've you have fostered, Peter, like 40 or more children, right?
SPEAKER_03:47, yes.
SPEAKER_00:47 children. Do you ever want to look at them and go, yeah, I know how to be a dad. I've parented 47 kids. Thank you so much for telling me that this kid needs to be potty trained. I got it. I understand that. Do you ever just want to say that? Because sometimes I'm like, we we fostered 23 children in over six years, and I am like, yeah, I got it. I I know. Thank you so much.
SPEAKER_03:Right. Oh, sometimes I'm so angry because they're like, Peter, why can't she? Why are you doing the right thing? And you're like, how many times do I have to tell you like hey, yeah, it has nothing to do with party training. My kid has trauma. And they're looking at like, what do you mean, trauma? And I'm like, and that's that's the shame. That's the shame that comes with that. Yeah, and that's the bidding that we get to advocate for children that you feel like nobody understands, you know. And for me, really working with Aerofraud really helped me to know how to use the professionals to give me the tools that I need for my child. And that's been the best.
SPEAKER_00:That's that, yeah, that's so amazing. I mean, it's it's kind of like so. I've I've had I have experienced this so many times and with so many children. Where I had a doctor one time look at me, and doctors are great, doctors are wonderful, I love them. I had a I had a child, and they said uh it probably wasn't what I thought, or whatever. They had not used the bathroom in 24 hours. And he was like, it probably did. You probably just didn't notice. And I was like, No, I'm very certain that they did not go to the bathroom. No, they probably did. Like I would feel it if I if it was here. And I was like, Okay, do you have an x-ray machine? Or so like it was like this, like, I don't know the language, right? And so they go do imaging, and the doctor comes back and he's like, their bladder is about to burst. It's so full. And I was like, Okay, well, do we have a catheter that we can use? Like, what can we do here? So then I kind of like casually mentioned, by the way, I haven't, they they also have not like done anything else in the bathroom, right? And they're like, no, that if they didn't, I would be able to feel it. And I was like, okay, but I think you are wildly underestimating the effects of trauma right here. Like the herb, this body is not gonna show you from the from the get-go what is going on. And he was like, I would be able to, he just kept telling me. And I was like, can we get some imaging? Like, can we just it's free, it's Medicaid. Like, let's just do some imaging. He comes back and he's like, they're compacted. And I was like, mm-hmm, mm-hmm. There we go. So we have this now with our like in the constipation clinic where they're like, Well, use Miralax. And I'm like, if mirroracs worked, sir, we wouldn't be here. This is not, this is not.
SPEAKER_03:That would be easy for me to get. I can get it anywhere, and I could just put in every food for my children, but that won't make anything.
SPEAKER_00:Yeah, like like fruit that starts with a pea, or fruit that has a anything that has a pit in it, or what all of the there's so many things. And I think I think that that one of the things you're hitting on, and one of the things I'm hitting on, is like the overwhelm of like we've tried all of the things. If I could make my three, four-year-old, if I could, if I could flip a switch, I would do it, but we can't. And so here's Aeroflow that is like, hey, let me take something off of your plate without adding shame and looking and saying you're not a good parent because you need our services. Micah, your company is like, we see you.
SPEAKER_03:I want to walk, I want to work for them so badly. I don't think they know that. But we're gonna find a way to believe. But just so I can tell every false parent, every adoptive parent, like you don't have to feel ashamed. People don't have to make your world so small that sometimes you walk in and you have shivers because you're afraid of what they're gonna think of you. Like they they will just for me, that that was enough. That uh as a false parent, we parent kids out of the box. So the normal people uh have this box, but for us, we live in like uh this box that I cannot describe in at any time of the day. And suddenly they like literally for me as a single dad, they're like, you're a man, of course, you don't know how to train the girl to party, of course. Like that's kind of what they're saying. Like, are you sure? Like, do you even know what to do? You know, and that really makes me mad sometimes.
SPEAKER_02:I'm like that that's the other thing related to that. You know, you all were talking about, hey, I'm treating the symptom here, but there's obviously probably underlying conditions and other ways to come at this. We'll hear from parents a lot. Hey, I know my insurance covers behavioral health, or hey, we're on the list for these different types of behavioral health benefits, but either there's nobody remotely close to the rural or even not necessarily rural I live in that provides those services and is in network with my specific Medicaid, or hey, I'm on the list, but there's a four-month wait list to get in for those behavioral health benefits. And so there's all this complex issue where it's like, yes, you're treating the symptom, and yes, there may be other things higher up the totem pole that can help with the hierarchy of medical issues and things like that. But whether or not you're in a position to be able to access those therapies for a variety of reasons may or may not be a given as much as just saying, oh, insurance covers that. And so that's one of the things that we hear a lot of the time, and it just this about uh you know fragmentation idea is just it there are things there, but one, you've got to know they exist, and two, you have to actually pragmatically be able to access them for your child.
SPEAKER_03:So Micah, I I drive two hours drive to go to Greensboro so my child can see an orthopaedic.
SPEAKER_02:Perfect example there. And you have no idea how often we hear that sort of thing. And it's not so it's not a single state, it's not a single region, it's not a single city, it is an endemic problem nationwide, and just something that I think, unless you're actually in the weeds of actually nav, you would never imagine unless you had to navigate one of those things.
SPEAKER_00:Two hours round trip or two hours each.
SPEAKER_03:One way, one way, because because any other place I go, I'm on a waiting list for six months. Like, no, I'm I'm gonna just keep where we've been going because that's where a child comes from. So we're gonna drive literally four hours, two hours, two hours.
SPEAKER_00:Two hours there, two hours back, and the appointment time. Yep, and the appointment time. I do this for one of my children to see doctors in Gainesville. We live close to where the University of Florida is, and the team of doctors there, it's it's such a good team of doctors that it's like, yeah, this is worth the two-hour drive for the specialty, the kind of specialty care that he needs. It is no small thing what you just said, Peter. It is no small. I mean, we just did that for an infusion every single day for 14 days. And the the shortest day was six hours in addition to all of the wheels spinning in your house that you have to keep up. That's one kid. Oh, yes, you know.
SPEAKER_03:So when you have aerophilia, like drop diapers for me that I need, like you haven't like it's hard to explain to someone else like that the the stress you just took off for me not to worry about where it's gonna come from.
SPEAKER_00:Yes, incredible that it's just on the door, you don't have to go to Costco, it's just sitting there. It's like, oh, the diapers just got in today. Micah, I love that you said, what were you gonna say, Peter?
SPEAKER_03:And the size that I need for my child.
SPEAKER_00:Yes. Yeah, that was one of the things earlier that I was like, oh, when you touched on the individual sizes is and the cost, right? So our kids have technically moved up to where they need a bigger size, but you get less diapers at the higher size for the more money. And so because we're buying for four children in our home, we're like, the Lord bless you and keep you.
SPEAKER_02:I hope this one keeps that's the beauty of the insurance benefit, too, is with very few examples, and obviously every state and every Medicaid works a little bit differently, but in most cases, they they give a fixed maximum number of units, that is, individual diapers. And so you don't fall, you don't fall into that trap of my child needs a larger size, so now I can get less for the same. So as long as you're utilize you're in a position to utilize the Medicaid benefits, that's a fantastic thing about the Medicaid benefit.
SPEAKER_00:Yeah, that's amazing. And then the other thing that I loved is when you said, and I think that this is where people don't um they think maybe this isn't for me. We don't need it, or my child's not wearing diapers all day long. Now, there's a there's a caveat here that I will say, but I want to I want to finish this thought before I lose it, is that when you were like most people need one unit a night because it's for the child that is still regularly or occasionally experiencing incontinence at nighttime, right? Like that alone, you where you go, oh my five-year-old can qualify for this because they're still my six-year-old, my I mean, I past three or four, I would imagine, is the is the normal um age. We have what I don't know if this is like this everywhere, but in in Duval County, where we are, um to wear a diaper at school for your children that that have incontinence issues, um is requires an IEP, but it also requires a special classroom. And so, Peter, what you were talking about where um like they were gonna move her back to the threes, but you love your child and you're like, she's not in the threes developmentally, she needs to be in the fours, like she needs to be my children who need to be in Gen Ed population classes can't. I and I've got two of them that that regularly have accidents during the day to put it to to have a diaper is puts them in not gin ed, right? And so the workaround is um you guys we buy underwear in like subscribe and save on Amazon in bulk.
SPEAKER_03:Yes, like no, they're shipped to me on a monthly because I yes, we buy underwear.
SPEAKER_00:I can't risk it because we can't put them in diapers, and I'm so tired of cleaning dirty. I mean, I just won't like if you poop in underwear, throw it in the trash can. I'm not cleaning this out, right? So it's like, what's the cheap pack of a pack of 12? And every literally every two weeks, one of those is gonna show up at the house and we're gonna we cycle through. We cycle through underwear in my house as if they are diapers because of the because of the requirement for school. That's like, but they can have a change of clothes in their bag and they can just change their clothes and they can throw out the underwear. You know what I mean? Anyhow.
SPEAKER_02:That's just another curveball, though, right? Because in the next county over and certainly the next state over, that requirement may be different, it may be more stringent, it may be less stringent. So again, you just talk about folks juggling multiple children with multiple IEPs, with multiple medical plans of care, with multiple supply needs. We have we have patients in our pediatric patient base that they also need a continuous glucose monitor because they're type 1 diabetic. They also need a CPAP machine because they have sleep apnea. They also, you know, they also need urinary catheters because they have spina bifida, and so they have an inability to empty their bladder, but they cannot, you know, stop um they have fecal incontinence. And so it just that individuality aspect is something to net for people to never lose sight of when they're making policies, when they're setting up procedures related to insurance, working with insurance coverage guidelines, physician requirements. I mean, it's it it I have so much admiration for what you all do because you're juggling so much when everything's going well, but then when you have these things that you these these accommodations and these you know specializations, like it, it it becomes just the plate spinning, like you said. I I can't even imagine.
SPEAKER_00:Until you got to Spina bifida, everything that you had mentioned we have in our house. Typoint that like every every I was like, when is he gonna name something that we not exist that does not exist in my house?
SPEAKER_03:Well, you know that too, you know that. Oh, yes, yes.
SPEAKER_00:We uh we didn't we haven't even talked about ADHD is on the list of things that cause incontinence, right? Sensory integration issues where you're talking about like the ability to regulate your regular internal.
SPEAKER_03:That's how I felt when I you know when I got to know about uh LFO, I was like, are you sure? Because what I'm reading as a first print, it's not possible. Like I have never had those services, you know. So I was I I told my agent, I was like, I need to know if this is true. And sure enough, I was like, wait, I've been forcing for nine years and I'm just getting to know this today. Like that's just not nice, you know? And that's really what when I fell in love with what they do, and and to imagine what we could do for for for parents who are in the same, you know, I call it that. What's that what animal that is always running in the circles? What is that?
SPEAKER_00:That the hamster on the wheel, yeah, hamster on the wheel, yes.
SPEAKER_03:Like I feel like that's our lives. Like we are always running on the hamster, and you don't know what way it's gonna go, but it's always moving. It doesn't stop, you know, to be in a place where to work with an organization or a company that for me that can really think about my child as a whole, not just like, hey, they need this, but also in order for us to help you here, here's how we can help you navigate that as well. To me, that is all I needed, you know, that that really made sense for me, that I wish every parent knew that, but also for nine years that I wish I knew even just the hundredth of what they get to do for kids in care.
SPEAKER_00:Well, I think it lines up right with exactly what your mission is for your nonprofit, Peter, right? Like I see you, I choose you, you are known, you are cared for, you are loved. Like I didn't memorize all of the affirmations that you have at Now I am Nom, but I it like Airflow, you guys are doing that. Like you're looking at foster and adoptive parents and saying, like, I see you, I want to come alongside you without causing any shame. And I want to help you, and I want to take something off of your plate. And if diapers can show up at your door, fill in this little tiny box that says, like, give us your name, your phone number, and the Medicaid number, and we'll take it from here and we'll start the like process.
SPEAKER_03:Right. Well, me, what I maybe what I love the more the most, one thing that helped me the most was hey, Peter, we can help you. But he's the language you need to talk to your doctor to help you really get to where we need to be. Sometimes I think I didn't get the services because I didn't have the professional notes to come with. Like, yeah, my child needs this, and everyone's looking at me like, what do you mean? You know, there's no medical um report we have here. That really helped me. They're like, wait a minute, you know, actually, the the doctor can advocate or the producian can advocate for my child to get the services that they provide that I need, you know? And for me, that was super helpful because I didn't connect those, those, those lines. In the false scale and adoption, we are always kind of like thrown out here, thrown out there. We never have one place where you can say someone is thinking about me in three-dimensional ways. So for me, that was really helpful to know that even if they cannot help me, they will guide me on how I can get that help. Like, hey, right now we need a little bit more information, but here's where you can go get it for us to help you go over the humpfield. That to me, that I I feel our sin and our heart by just knowing they can do that.
SPEAKER_02:And I appreciate hearing that so much because we see that a lot, right? We see, we say documentation, right? Because as I said, insurance sets forth all these guidelines that say we need a you need a prescription and all these medical records and specific. Documentation that certifies the doctors on board and that it's a legitimate medical need. A lot of times the process of establishing that documentation with your child's doctor that actually starts basically when you reach out to a medical supplier like Aeroflow. We, to Peter's point, we help make you aware of what those guidelines are going to be and set those expectations, which are very specific to your child because it's specific to their insurance. And at that point, it becomes that team effort working with the physician to pack to button up everything needed for insurance. And then by the way, that process is going to repeat every six to 12 months, depending on the specific insurance, because we have to continuously reestablish that ongoing need with new prescriptions, or when a new size is needed, or when a greater quantity is needed, or a pull-up is needed instead of a diaper, any number of things. And so the better that tether is with the child's physician, the more they're bought into that therapy through insurance and prepared and inherently documenting that way as a part of your ongoing normal, well child or emergency visits, the more smoothly the process is going.
SPEAKER_03:Right. Right. And now when I go to the SP, anything you need for us to help you? That literally, because they understood that, hey, you helping here will help me down the road for my kids. And forget the supplies. And now they understood, they are like, absolutely. What do you need and how can we help you get there? And that's really been the best way for me that they understood and they want me to get the best. But they knew that also their documentation is important for me to get there.
SPEAKER_00:I feel like what you're also describing though is that it takes the overwhelm away, like having a guide and the language of advocacy, right? Because if I'm being really honest, um so many times, remember when at the beginning when you were like, sometimes I feel like I'm in a gutter and I don't know how deep the gutter can go. Like the gutter is just, I'm just like, I live in this, I live in this like state of overwhelm, uh, right. I'm paraphrasing and also speaking just for myself there, of um where the system that I have in place is easy. It's not easy, it's it is overwhelming, but the hard that I know feels less overwhelming sometimes than the ease of something that I don't know. Right. Like, how how long is this gonna take me? I loved when you jumped in and you were like, let me tell you exactly how easy this was. Like, let me tell you that this is actually easier than going to Costco and doing it because it shows up on your, like there's a there's a little bit of a hump at the beginning, but then it's it flows. Am I hearing that correctly? Like there's yeah, and so so I just I I want to verbalize that because it's like I know for me, sometimes I can hear this. We have sunshine health in Florida at foster kids. Micah, you're like, yep, I'm aware of I know sunshine health, right? Like this is, and they have these benefits to sunshine that hand to Jesus, you guys, because it is so overwhelming for my brain to think to go on and make an account and log in and get the$25 of care that they have, like CVS stuff every single month for four kids. That's an hour of my time. Like, that's for me to like chunk it out and to do this and to do like I'm like, nah, I'm not, I'll just go buy Motron. And it's so much money that is possible to, and so my friends who this is easy for their brains, maybe they don't anyhow, their brains work in a smoother line than mine does most of the time, I feel like. But it's like, no, it's not that's not easy for my brain. But what I'm hearing you guys say is this is actually easy, like this is actually meant to create ease of access. 100%.
SPEAKER_02:I'll give you a peculiar again. And Sunshine's a fantastic partner of ours. They actually refer patients directly to us from their internal case management team. Um, I think they're one of the most proactive insurers that I'm aware of in the United States. So you've actually got a really good one on your hands. And that's the funny thing. Insurances, they're complicated, but they're not, and it can feel sometimes like they're set up to deprive care. I don't think they are. I think that when people are setting forth these administrative policies, though, they just it probably seems very reasonable to log into that website and get the thing you're talking about, but probably no one thought about. Gosh, what if you had to do this for multiple children right in a row? What if you have to remember to do this? And there's not inherently a notification system or a calendar or reminder or anything like that. So it's not intentional, but it is complicated and it does make things more difficult than you would think. We deal with some insurances where you can't refill the child's supplies through Medicaid, and this is true, but every 31 days. So not every month, as in you get some stuff on the first, but every 31 days. So if you get your stuff on the 21st, you can't get it until the 22nd the next month. And again, I don't think that's an intentional policy. It's just how their system was set up. Well, there comes the value that we, you know, keep track of when that day is going to be. And we remind you and say, hey, your refill date's coming up. If you don't need things and you've not run through as many products as you thought you would for your child, that's great. Um, just let us know you don't need anything. But if you do need something, here is when insurance is going to allow you to get more if you're ready to refill those supplies. And so again, it's just trying to take that complicated, opaque, behind the scenes kind of system and saying, like, let me try to foreground this for you and make this, you know, top of mind for you, the parent as much as we can.
SPEAKER_00:I love that.
SPEAKER_03:Are you listening though? Are you listening to what he just said? Remind you, remind you that, hey, you get a refill. Wait, wait, someone is, someone knows? Wait, wait, no one knows.
SPEAKER_00:I have this with one of my with with one of my kids. I get, I mean, anyhow, there's so much medicine in my house, guys. I can't, we could talk for days about the medical like alerts that happen and the medical, like all of this stuff. But um it's wild. It's like sometimes I joke that I went to school to become a history teacher and I should have been studying Latin or something else that could help me in the world of medical like needs. But okay, uh, just like final thoughts. Is there anything that I didn't think to ask that you guys want to make sure that you get a you get a chance to say? Is there um Micah? We go to the website, link the website, and that's how people um can utilize the service.
SPEAKER_02:Absolutely. Aeroflow Urology.com. Um, we're a division of Aeroflow Health, is our parent company. We're also providers of things like breast pumps for pregnant mothers, CPAP supplies, continuous glucose monitors, various different things, but Aeroflow Urology is this specific division. There's a link on our website that says qualify through insurance. There's also thousands and thousands of blogs written by our fantastic marketing team that are purely educational in nature and meant to instruct on dietary relationships to incontinence, behavioral relationships to incontinence, aging with incontinence, and so forth. And so there's a lot more resources out there about the about these types of conditions than you would think, about the links between certain underlying medical conditions and incontinence. And I just encourage parents of children who are dealing with this sort of thing, not that you all have a lot of free time, but as much as you possibly can and you know, educate yourself about the condition. It puts you in a position to be able to better work on that plan of care with the physician, advocate for benefits and things like that. Um, I have so much respect and admiration for what foster parents and parents with children of uh children with complex medical histories do in general. Uh, and I'm just honored to have the chance to speak to what our company does and also just continuously be an advocate for insurance benefits that help our most vulnerable populations. I think it's an absolute social imperative that we have. And I'm, you know, I'm thankful to play a small part in that.
SPEAKER_00:I love it so much. Peter, anything you want to add?
SPEAKER_03:Please go to their website. Please. You might say, well, I don't need I just just go to your website. You'll be amazed what you can learn and what you you can you can do. For me, it's having an advocate that really sees me beyond just my dad purse. That sees me beyond everything that I need, you know, and I'm sensitive to all those, you know, that my shame is no longer just my shame, but they're willing to come alongside and hear my shame and make it into a proud dad advocating for his kids. That that's what I love about you know uh LFO for sure.
SPEAKER_00:I love that so much. Well, thank you guys so much for being on the podcast. It was um a pleasure talking to you.