09 Traumatic Brain Injuries and Visual Consequences - a podcast by The InBound Podcasting Network

Dr. Stephey welcomes Celeste Palmer to the Move Look & Listen Podcast. Celeste is a brain injury survivor and the founder of Bridging the Gap, a traumatic brain injury support group & resource network.

With roughly 1.2 million optic nerve neurons per eye, there's almost no who escaping the negative visual consequences when suffering from a brain injury. Dr. Stephey and Celeste discuss how memory, gait, balance, risk-of-fall injury, motion sickness, headache, dizziness, speech perception, visual motor integration, etc. are affected in traumatic brain injuries. 

Bridging the Gap - Connecting Tramatic Brain Injury Survivors: http://tbibridge.org

Douglas W. Stephey, O.D., M.S.

208 West Badillo St Covina, CA 91723

Phone: 626-332-4510

Website: http://bit.ly/DouglasWStephey

Website Videos: http://bit.ly/DrStepheyOptometryVideos

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If interested in producing a podcast of your own, like the Move Look & Listen Podcast, contact Tim Edwards at tim@InBoundPodcasting.com or visit www.InBoundPodcasting.com

 

Transcription Below:

Tim Edwards: The Move Look & Listen Podcast with Dr. Doug Stephey is brought to you by audible. Get a free audio book download and a 30 day free trial audible membership at audibletrial.com/inbound. You'll find over 180,000 titles to choose from, including several books mentioned here in the podcast. Support the Move Look & Listen Podcast by visiting audibletrial.com/inbound. 

Dr. Stephey: If our two eyes are not working together well as a fast synchronized team, our internal mapquest continues to be off. It's consistently inconsistent with our ability to judge time and space. Those that don't feel well-grounded, those that have some measure of anxiety, oftentimes it starts in the visual system. If you can't move, look and listen in a fast, accurate, effortless, sustainable, age appropriate, meaningful way, you're in a world of hurt. There's a whole world in vision and how it affects brain function that no one's ever shared with you. 20/20 is perceived as a holy grail of going to the eye doctor. Well, I'm here to change that paradigm. 

Tim Edwards: This is episode number nine of the Move Look & Listen podcast with Dr Doug Stephey. I'm Tim Edwards with the Inbound Podcasting Network. And today Dr. Stephy, this is exciting. We have our very first guest ever in this podcast and I have to say you've chosen a really great one to join us today. 

Dr. Stephey: That's fantastic. I'm glad Celeste is here. 

Tim Edwards: We're welcoming Celeste Palmer, the founder of Bridging the Gap and a traumatic brain injury survivor. And we're going to talk about what you do at your practice, Dr. Stephey in helping people that have suffered a traumatic brain injury. One of which of course is our very own guest, Celeste Palmer. Celeste, thank you for joining us today. 

Celeste Palmer: Oh, well thank you guys. I'm really happy to be here. 

Tim Edwards: Now, Celeste, if you wouldn't mind before we get started, I want to introduce our audience to you and let them know your story. You and I had a wonderful conversation a couple of weeks ago and you explained what happened to you and how you have bounced back with flying colors certainly so and to influence the lives of many of those who are benefiting from Bridging the Gap. So please start with your story. Celeste, if you wouldn't mind. 

Celeste Palmer: Well, as I've been told my story is that I was in a near fatal car accident on May 1st 2000. And from that it was a retrograde and an antegrade amnesia. So the first 50 years of my life, I don't know, I've been told about them kind of scheduling. And the main thing is that I decided to start over. And to make a new Celeste and in the process of creating that, I've had the wonderful opportunity to meet and know a whole community of people and experiences that have turned out to be just amazing. From Peter Drucker at the Drucker School at Claremont Graduate University to numerous hospitals, rehab hospitals, organizations like the university and, and other schools. And so, that brings us forward to last summer. I believe it was when I met Dr. Stephey and through another one of our participants in a support group and said, "oh my gosh, this is timely." Because I had had vision therapy years ago after the accident because yes, it isn't about being 20/20. It's about being able to see and get your balance back and be able to walk without walking into things. And so it was absolutely amazing to have Kim introduce us and be able to then have someone to talk to and not only talk to, but to have him listen. 

Tim Edwards: Have him listen, yeah. That's one of the things that certainly separates Dr. Stephey from, from the rest, for sure. Celeste, you said something that really struck me when you said, from what I've been told, I've suffered a traumatic brain injury. So you're telling us you have absolutely zero memory of the first 50 years of your life. 

Celeste Palmer: Right. 

Tim Edwards: And if that is not the epitome of reinventing oneself, I don't know what is. I can't even imagine having to relearn everything. And is that the truth? Literally relearning how to move your body, how to speak? Tell me how that worked. 

Celeste Palmer: Well, when you're asked if you're in pain, you have nothing to compare it to. So the initial experience was I couldn't answer the questions. The first neurological evaluation you get is, you know, who's the president? Do you know where you are? Questions like that. And I didn't answer them according to the initial first responders, doctors at emergency and things like that. So it was pretty clear from their reports that I really didn't know what it was to be human and I didn't recognize my son when he was brought to the hospital. There were bits and pieces of information, but nothing that really stayed for any length of time or really was the glue of history. But the body and the brain hold muscle memory, I'll call it. So there was 50 years of learning that was in the muscle, bones, tissues that make up the human body. And I think that is what continued on. And so as people told me things, as I started, you know, walking. The fact that I couldn't get through a normal doorway made me think that I was huge. That I couldn't fit through the doorway then to come to find out that that had to do with how the eyes, we're not working with the brain the way they used to and things like that. So, fascinating.

Tim Edwards: It is fascinating and an amazing journey of which you've been on. And you've discussed briefly about that journey on how you and Dr. Stephey intersected. So Dr. Stephey, if you wouldn't mind joining the conversation now. Letting us know what your thoughts were when you first met Celeste and what you did for her. 

Dr. Stephey: One of the most striking things for me is, here we are in 2018 and yet the brain injury community through absolutely no fault of their own, don't know that optometrist like me exist. And part of the reason it seems is that we seem to have an identity problem in getting our message out there. And it's not from lack of trying. I don't know exactly what the obstacles are. I have a feeling I have some idea and some idea is that I almost get the impression that parts of the rehab community doesn't want to know that we exist or doesn't believe that what we do is as powerful as it is. I know, when I first met the member that introduced Celeste and I, and I told you this story a couple of weeks ago. She's been riding horses most of her life and suffered a brain injury herself 12 or 13 years ago, had done lots of rehabilitative therapies but not vision therapy. Came and started to do some work with us and it changed the relationship that she had with her horse. That really had been disrupted and I think was a significant social bond that had been severed. And so it was a powerful testimony to the work that we do and the way it can change people's lives in ways that it's easy to lose track of and not understand. So when I had the opportunity to meet Celeste, not only was I grateful for that opportunity just because of her own history, but it allowed this forum where she's got this support group and they were gracious enough to, for the first time, invite me in September of 2017 to come out and do a talk to the group. And Celeste had got the word out and I can't remember for sure. Maybe there was 12 or 15 people that were there. I think the message that I was conveying resonated with the group and then they invited me to come back again. I think it was in October and then the word spread further and there might've been 25 people that showed up at the second meeting and then they've been kind enough to invite me out a third time and hopefully in the next month or two I'm going out on for a fourth time. 

Tim Edwards: Wonderful. 

Dr. Stephey: Because the, so the forum that Celeste has created, it's a powerful tool. Because it's an opportunity to spread a message through the people that need it the most. And yet it's a message that has not been heard very frequently or very loudly or not often enough. 

Tim Edwards: Well certainly a little bit later on the episode, Celeste, we're going to talk about Bridging the Gap. This wonderful support group that you've created that connects traumatic brain injury survivors. And let's go back to your story now. Celeste, if we could and tell us about your meeting with Dr. Stephey and what he did to help you on your road to recovery. 

Celeste Palmer: The main thing I want to say about Dr. Stephey is that when you have someone who is making a change that rapidly, whether it's putting on tinted lenses or putting on the prism lenses and there's a change in how you can walk down a hallway without bumping into walls or just the fact that standing in place is not so riotous and, and you can actually think about looking at a picture and, and observing your surroundings rather than am I going to fall down? It was pretty significant.

Tim Edwards: After how many visits with Dr. Stephey did you notice that difference? 

Celeste Palmer: Oh, immediate.

Tim Edwards: Immediate. 

Dr. Stephey: Well, I think there was some change on the very first visit. 

Celeste Palmer: Yes. Yes.  

Dr. Stephey: The power of lenses should not be underestimated. You know, most people who know anything about the eye care community has the idea of you get lenses to see 20/20. What most people have no sensitivity to is the role that vision plays in our balance, in our gait, in our posture. One of the things that struck me with Celeste, and this wasn't initially. We had done some work together. I had prescribed her lenses with color in prism and they did provide her some level of relief. And then several weeks might have gone by. I don't remember the exact timeline, but I do remember she said, Doug, you know, I think things have changed again. Okay. Tell me more about that story and let me contemplate what we're going to try differently, and one of the memories I have. This is from several months ago, we were in the hallway and Celeste had made a comment to me about how I believe the left side of her body felt numb, including her fingertips. And I took the smallest lens change that I can make. It wasn't color, it wasn't prism. When you think about farsightedness and nearsightedness, farsightedness has to do with plus lenses. Nearsightedness with minus lenses, and then there's the word astigmatism, which is a whole different thing. But I took a plus, 1/8 of a diopter Lens. The smallest change that I could make and put it over her left eye and she could feel their fingertips when she wrote, when she rubbed them together. 

Tim Edwards: That's amazing. That's amazing. Wow. I mean having. Really, it seems like such a simple solution, not to demean or devalue what you do, but it seems like it's such a simple solution that how many thousands of people are not coming to see someone like you to fix that problem. Going to neurologists or some other type of medical professional and the thousands of dollars and time and wasted time and money is spent. 

Celeste Palmer: Sorry to interrupt, but the thing is that I've gone through 18 years now of seeing different levels of the medical community trying to help people in my situation and personally to go through nerve conduction studies and all these other things, you know, with people from their expertise trying to help and finding that they had to say we've done everything we can. So you're stable at the level you're at. Not meaning I was getting better or worse, but I was stable at the level I was at. Until well in back, what was it 12, 15 years ago I went through vision therapy with somebody in Texas who did similar to what Dr. Stephey does. It's been a long time since then and obviously technology is, has done amazing things as well and he stays current with what's available and so it is amazing the things that he has done that well I watched him do with others at support group where I have him bring his bag of magic tricks to support groups. So that he tries different things on different individuals and you see somebody coming in and doing the duck walk and he puts blue lenses on them and they walk across the room for the first time in front of a friend in a normal walk with his hands at his sides and his friend says, I haven't seen that in three years. 

Tim Edwards: Wow. Yeah. You know, Dr. Stephey, we've mentioned several times in this podcast that I've produced several videos for you and some of the videos that we have not yet released that you have showed me through the permission of your patients, were something you see like if you were back in the old days,when you watch TV and they'd hold their hand over their head and they'd say you are healed and they get up and walk. You know, these videos you showed me where people walking on beams and they couldn't. And then you'd show me a video a moment later with a pair of lenses on and they're walking the beam without falling off. 

Tim Edwards: It's, oh, I can't wait to show those videos. Absolute proof of what you do and how you adjust their lives by a simple adjustment in their lenses. 

Dr. Stephey: And on a similar note, one of the reasons that I think this community of brain injury survivors is getting short changed is because medicine looks at them and says, well, there's nothing wrong with you because you look normal. And yet, when patients got a pounding migraine most days or they sit in the reception area in my office and the cars drive by on the street outside my office and they double over in pain because they are so sound sensitive, those kinds of outcomes don't show up on medical imaging. 

Dr. Stephey: Right, it's not going to show up on a cat scan or an MRI. And I'm telling you, these patients' lives are being discounted because of that, and of course invariably when you still complain about the panning headache that you have or that you can't fit through the door because your body feels too big. Or you've got numbness in one side of your body. Or you're so sound sensitive that a whisper sounds like a Jackhammer in your brain when medicine doesn't understand that and ultimately just discounts that, the end game at that point is when medicine says, you know what, you need to go see the psychiatrist because you're just making this up now. I mean, that happens when somebody goes to qualify for a permanent disability and those kinds of behaviors are getting discounted. It's extraordinarily frustrating for me to hear these stories and I'm not living it every day. I kind of live vicariously through the patient's lives that I have the opportunity to see. And I think it's in great part why I do what I do. Why I listen to patients when they come and why we experiment with different lenses and different colors and different kinds of therapies. Because at the end of the day, if I don't share this information, I've had the opportunity to learn. I don't feel like I'm doing my job every day like I'm supposed to. And that's clear in the reception that I've had when I come to the support meetings and feel the gratefulness of me coming and practicing this way and simply spend time listening to what patients are telling me and then trying to come up with a solution. And you know, I think sometimes a great part of the benefit is just that we've got somebody in healthcare who's taking the time to listen.  And that's, I think, very validating for patients who have been trying for years and years and years to get someone to listen and try and help and they get pushed to the side and discounted. It's so wrong. 

Tim Edwards: Well, I can also can't even imagine though, until I met you that somebody with a traumatic brain injury would even consider or think about or the thought entered their mind that they need to go see an optometrist to help them function better when really it's a weird connect, right? I mean it's kind of strange. But then, you know, you showed me the videos and we've interviewed people. And Celeste, you're joining us now of course. And the connection is quite clear. And Celeste, are you seeing that from some of the members of Bridging the Gap too? That have used some of Dr. Stephey's methods to help them function and live a happier, healthier life? 

Celeste Palmer: Oh definitely. Definitely. We have, we have several that are already seeing him. We have several more that have just haven't met him yet. That's why we keep having him come back because we have people come through that are just hearing about the voodoo doctor. The magician and want to see. So even if he's coming to talk about a different subject, I have him bring his bag of tricks because there are those that haven't met. It would do them well to see the kinds of things he's offered to many of us. And the thing is he does extend, you know, have them come on over for 15 minutes off their insurance or whatever else. Or to deal with the other issues that we're dealing with. The frustration of trying to deal with the denials at insurance level. And to go the extra mile for us to get that coverage that is included back on, on, on deck. So it is a matter of understanding the, not just the vision frustration we're having because you can be told by an optometrist, well here's your 20/20 vision, but, and go home and get used to wearing these 20/20 vision glasses and still not be able to see even after months. So obviously the issue isn't entirely with the eyes being able to see with 20/20 vision. But it is the fact that the eyes aren't tracking together. The other issues that come with it, the as you mentioned before, we have sound and light sensitivity that's involved so, you know, although the eyes are so predominantly affected, hearing can be as well. And so it's, it's amazing the different aspects and watching. Well I think he was, I think he was being humble because I think we had one meeting where word had gotten out about the vision doctor. We had 45 people in the room. So yeah, he was, he was well, well received and, and folks wondering, well how do you do this and how is it that you do it, other people don't. So the questions that evening were really significant. 

Tim Edwards: Well, a question I probably should have asked at the beginning of the episode is, you were talking about traumatic brain injury survivor. And that seems like a pretty broad stroke. So for our friends on other side of the speakers listening, tell us about the type of brain injuries that you can help Dr. Stephey. I mean, is this across the board? Anybody that's, I mean we're talking a concussion, yes? I would assume. But from a concussion up to what point? Is there a scale, a spectrum? 

Dr. Stephey: I would say that there really is no upper end to that limit. So I'm going to say that we have the potential to help all brain injured patients. Doesn't make a difference if he had a brain injury from a car accident, a motorcycle accident, a fall, and a stroke, a concussion, repeated concussions, it doesn't make a difference. And what I would have the listeners know if they know somebody who's had any sort of a brain injury, whether it's mild or significant, almost all patients who've had a brain injury have some sort of visual consequence to it. 

Tim Edwards: Dr. Stephey, you shared a story with me, I don't know, six months ago or so that really resonated. And if you wouldn't mind sharing that with us here today, and the story is about a gentleman who had suffered several concussions and as a result of those concussions, had some behavioral shifts. And those behavioral shifts lean towards a form of violence or agitation, strong agitation.   

Tim Edwards: And through either vision therapy or lenses, he was able to squelch that to some degree. That's my remembrance of your story. Please tell me, I'm not sure how accurate I am.  

Dr. Stephey: No, I think that's a reasonable description of what has happened. So, this is a patient who's had multiple concussions over his lifetime and repeated concussions. Right. There's an increase in risk of longterm consequences to it. And one of those consequences is to feel like you spend most days walking around on your last nerve. And so the slightest of things can just completely pushed you over the cliff. And the more I contemplate about this, the more I believe that's likely connected into this Polyvagal Theory of affect, emotion and self-regulation. And the Polyvagal Theory tied into the 10th cranial nerve or the vagus nerve. And vagal nerve tone, and how it contributes to your ability to correctly read and interpret gestural language, including facial expressions and the vagal nerve tone also facilitates your ability to read intent correctly in somebody's voice. So if you have a vagal nerve dysfunction, we'll just, we'll use that term right now.  If you've got vagal nerve dysfunction, you might glance at me across a room and think that I'm like staring you down. And all I did was make eye contact for a half a millisecond, right? Or, I might say something like, you know, hi, how you doing today? And you're like, what? How am I doing today? Like, what are you talking about? 

Tim Edwards: You talking to me? 

Dr. Stephey: Yeah, you're talking to me. So it's, striking the power of lenses in vision therapy to help reset that vagal nerve tone. That's what I think is happening. I don't know if I, I don't know if anybody right now is clear on the exact neurology, but that's the model and the theory of what I've learned to date that makes the most sense to me. I had a similar situation recently where somebody was complaining about the tinnitus or the ringing in the ears that was so severe for them. And I think that there may have been a recommendation to do surgery to try to reduce this ringing in her ears. And I said, let me pull up my bag of magic tricks and let's put some lenses on you and you tell me if that makes a difference. And she's like, it's dropped by 80 percent. 

Tim Edwards: Wow. 

Dr. Stephey: Like hitting the light switch. Now again, do I know the exact neurology of that? I have a couple of theories about it, but I don't know. And at the end of the day, would I like to know the neurology? I would love to know that. But does it diminish in any way the clinical effect of, I put the lenses on her and her tinnitus has dropped by 80 or 90 percent and I take it back off and it comes rushing back? No, I mean I don't need an experiment of 100 people at that point. If it changes your quality of life, do you care if there's some experiment or some article that's been published? 

Tim Edwards: Especially one would not care because no medication is being consumed either. You know. There's no side effects.  

Dr. Stephey: There's no medication, there's no surgery.  

Tim Edwards: Right. It's just a pair of glasses.  

Dr. Stephey: You're going to tell me I got to wear these purple glasses around. No, I'm not telling you anything. I'm telling you if you want to walk around and see and feel better then you probably should do that.  

Tim Edwards: Not to mention look like a rockstar too with the cool purple lenses too, right?  Yes.

Celeste Palmer: And I'm not walking around with the purple shoulder because I'm running into the door.

Tim Edwards: Well put. That's right. 

Dr. Stephey: That's a good one. 

Tim Edwards: That's the line of the day, Celeste. 

Celeste Palmer: It's all about, you know knowing where you are in your environment. And what that difference is to us. So the frustration, the anger that you're talking about with one person, yeah, it's very prevalent in our community. And we recognize it in each other. We recognize it in ourselves and not being able to do something about it without being told, oh, well you're anxious, so we'll give you a pill. You're either depressed we'll give you a pill. But to recognize that you put on these wonderful colored lenses and find out that all of a sudden the world is at peace around you when it wasn't and whether that's through the tinnitus, the sounds of things that they glare at lights. Just that there is a calm place to live without having to go through pills and the balance of, of going through what dosage works and everything.  It's just that moment. And so harking back to what we said earlier that you know, how fast after going into his office. Well, it was as quick as he said, okay, let's try these lenses. And yes, it is extremely, well it's why I had to invite him to the support group because we had caregivers as well as family members as well as survivors in there and family members and caregivers were thrilled to see their loved ones that were survivors of stroke or a concussion or experiencing PTSD, all of a sudden find a place for a few seconds even that was a much calmer place to be in that meeting. And, and already in a support group, you're in a safe place to discuss the things that are, you're having difficulty with. So on top of that, to find that with Dr. Stephey they're talking about, he was talking about explaining what we were going to be experiencing and then to all of a sudden have the magic glasses on and have that improvement of just your sense of well-being was pretty amazing. 

Celeste Palmer: So you know, something else that Dr. Stephey has done for many in our group is the frustration with insurance companies denying their claims. And the fact that he is, has been willing to go the extra mile for those folks that, once you have that frustration and you try as a person already dealing with a situation like a TBI from concussion or stroke or whatever, and trying to make sense out of going after, getting your denial handled so that you can go to a doctor and get the help you need. He's gone ahead and gone to the insurance companies. He's gone ahead and stood up for us in order to get that waived  and make sure that they understand. I love the fact that when I first had my opportunity to talk to the membership services at my insurance, that what they said was well, his letter that went to them said, okay, here's what my patient needs. 

Celeste Palmer: Here's what I can do for therapy for them. Here's the treatment and the bottom half of the letter was, you're going to deny this. So by the way, here's the next step. And they immediately said, okay, so that part's done. So we're going to go ahead and let you go ahead and be treated by Dr. Stephey. And that was so proactive compared to what other doctors are doing and so I can already say what goes in group that are saying, gosh, he's saying that he can help me and I can see that he can help me. So he could go ahead and with that first letter have two steps in to getting into his office and getting the treatment they need. And that was number one, the best thing. The second part was that we were finding that there are some insurance companies out there that weren't going ahead with the basic things that say Medicare approves, and he was taking that extra step and getting the federal administrative judge to approve and, and make them do what they should do by law. So to actually go that far, to stay on the phone with a frustrating process that his patients can't do because of their situation. I mean, if you have a brain injury and you're trying to make sense out of what they're saying to you, it doesn't make sense even more. Plus, it can be a trigger for those things that you're already dealing with, with a brain injury. 

Celeste Palmer: So I don't have all the words, I guess right now. But to say it the most simple way, but that's part of what's wrong is that it's just the wrong thing is to ask a brain injured person to follow through with insurance companies who are there to make sure that they don't have to do what they should be doing. And here was Dr. Stephey stepping in to say, oh, I'll just go ahead and make this call to an insurance company. And then to another insurance company and at a different level take it that extra step. And he did that. So that's pretty amazing for a provider to go ahead and say, let's make this happen and since I can't make it happen overnight, I'm going to go ahead and see some patients that obviously are going to benefit right now by seeing coming to the office and getting some help. 

Dr. Stephey: So in a nutshell, here's, the insurance issues and there's kind of a flow chart of things. So the first question to be asked is, is this insurance code for vision therapy, a covered benefit? And that's a yes or no question. If you have a medical plan where this code typically nine, two, zero, six, five, it's one of the insurance codes. If you're a medical plan says, well no, that's a specific exclusion in your plan. You're probably not going to win on appeal. It doesn't mean that we shouldn't try, but it's harder to do. But I'll take Medicare as an example. Medicare covers the nine, two, zero, six, five code. But if you have a Medicare HMO, you don't have the same freedom to see who you want to see. So you're confined to your medical group network. If you've got a Medicare HMO, I will write a treatment authorization request letter on your behalf. 

Dr. Stephey: Here's the patient, here's the findings, here's how it's showing up in their real life. Here's the treatment plan. If you don't have an in network doctor that does this work, I'm happy to provide the care on this patient's behalf. Send me a contract and let's move on. Now I know that medical groups don't have anybody like me in their network. But they don't know that yet or they don't want to know that because the doctors that owned that medical group, if they don't have a contract, a doctor already in network, the doctors that's on the medical group have to pull out their wallet and pay me to do this work. With a premium dollars that the patient has put in their wallet. So it's really the patients money to start with, right? It's not the doctors' money, it's the patients' money, but I'm telling you this is a monster problem and it's true. 

Dr. Stephey: Most doctors would just go, oh your medical group said no. If you want this help, I'm happy to provide them for you and it's going to cost you x number of dollars over the next number of months. And of course if you're a brain injury sufferer, you don't have a lot of money. So I've decided that I need to step up my advocacy game and try to push this through and get this changed and let me tell you it's not easy. And there's one patient specifically that I met in September, the first time it came and spoke to the group, I wrote to her medical group. She has a Medicare HMO. They denied her care. They sent her to somebody in network that doesn't do this therapy. I followed up with a letter to the medical group and said, where you sent her was inappropriate. 

Dr. Stephey: So I want you to reverse that denial and allow her to come and see me. The medical group said no again, but this time they said, well, it's not because you're out of network that they've denied care. It's because her blue shield insurance said that this is not a covered benefit. So I wrote to Blue Shield and said, what the heck? This is a covered benefit by Medicare. You have to step up your game and provide the same things that Medicare does. Blue Shield said,no, we're not going to. I said, fine. Then I will appeal it to an independent third party who I've dealt with before and they're useless. I'm telling you this third party, I don't even know why they exist, so I knew the third party was going to be a continued denial, but that's the game and I said I'm going to see this out, so appeal to the third party, the third party without really any investigation of their own, sided with Blue Shield and said we uphold their denial and I said, okay, what's the next level of appeal? 

Dr. Stephey: And they said, well, you can appeal it to a federal judge with the Office of administrative hearings for Medicare. Great. Sign me up. That's what we're going to do next then. Now mind you, this started in September and I had the phone call with the federal judge and Blue Shield in late March and so the judge and the Blue Shield representative and I are on the telephone and I explained my situation. Judge this is a covered code as an in network regular medicare provider. I build this code all the time. Medicare covers it. I've had other Medicare HMOs cover the code. I don't understand what blue shield is saying. And the judge says to the Blue Shield Rep, so what do you have to say? And the Blue Shield rep says, well, you know, judge, we've looked it, we just can't find anything in Medicare laws that says this is a covered benefit. 

Dr. Stephey: And that's what I did to him. I shut my head. I'm like, what are you talking about? I, I said, judge, you want me to get you paperwork from Medicare? I'll do it. She said, I'm going to leave the case open for three weeks because I'm going to go on vacation. I said, I will have you information for Medicare before the day is out. And she said, great. I got all my Medicare stuff together. I faxed it to her and the Blue Shield people about an hour after we had the phone call, it took another six weeks for the judge to finally find in favor of the patient and said, Blue Shield you're misinterpreting Medicare law. You're going to approve this therapy. So this can be done. And my mission, it's a slow process, but my mission is to make these Medicare HMOs and the medical groups raise their game. Because these are people that are suffering every day, get no help when actually help is here and it's available and it's benefits that are covered by Medicare and they're still getting denied care and that's just wrong. 

Celeste Palmer: We don't want this to be on the 6:00 news as a news flash. We want this to be common knowledge that doctors like Dr. Stephey are out there and it's not news. It is something that is when you need it, you go to that person and, there's the help. You know, this isn't, this needs to become common knowledge and, that's why I'm doing this. That's why we put it on the website, our website. That's why we have this support group to get the word out there any way that we can. 

Tim Edwards: Well that of course is a beautiful, wonderful segue too, if you wouldn't mind, Celeste. Tell us a little bit more about Bridging the Gap, connecting traumatic brain injury survivors. You just kind of did a little bit with the type of people that have suffered various forms of brain injuries, but tell us what to say. Say Somebody is listening and they have themselves suffered or someone in their family or a friend that they know. How could they benefit by joining your support group other than what you've already told us here in this episode? 

Celeste Palmer: Well, when I was going through this, I had several people, including the folks at the university, Peter F. drucker and his wife Doris were calling me the wonder woman. And I thought, well, I don't know any other way to be other than I could hide under the quilts, but instead I was researching trying to find my own help because I was told by some of the greatest neurosurgeons in the area that they were learning more from me than they could really help with diagnoses and how to recover from what had happened to me in a near fatal car accident. So, all of the research I was doing though, my friends were finding out that some could help me. But 98 percent was for somebody else, some other recovery, and they said, well don't lose that research, put it on a website, become a nonprofit. 

Celeste Palmer: And I said, I'll find a nonprofit that I can help. It sounds like too much work. Nope, nobody else was doing it to the degree they are today. So the growth of this thing after starting Bridging the Gap, which is tbibridge.org, is to have a bunch of resources for folks that have been tried and proved that they work and to have the interviews and talks that we have and the books and the movies and videos that we've seen a place to go and find those things to help others. Because it's difficult to find obviously Dr. Stephey and others who are a benefit to, to all of us and all the different areas of recovery. What works for one won't work for another because every brain injury is different. So every recovery has to be unique. 

Tim Edwards: Well, you're unique. And this is a wonderful resource for those that have suffered a brain injury. And we invite everybody to go visit a tbibridge.org. If you know somebody who has suffered a brain injury, we will of course have the links on the show notes. And Celeste, you have been a delight to join us today. Thank you so much for your time and being with us here in the Move Look & Listen podcast. 

Celeste Palmer: Well thank you so much and thank you Dr. Stephey every time. 

Dr. Stephey: Thank you. 

Tim Edwards: Thank you for listening to the Move Look & Listen Podcast with Dr. Doug Stephey brought to you by audible. Get a free audio book download and a 30 day free trial of audible membership at audibletrial.com/inbound. You'll find over 180,000 titles to choose from, including books mentioned here in the Move Look & Listen podcasts. You can listen to these books through your iphone, your android, your kindle, your computer, or even an MP3 player. And if for any reason and at any time you choose to cancel your membership, you keep all of your audio book, downloads. Give it a shot for 30 days. You got nothing to lose. Support the Move Look & Listen podcast by visiting audibletrial.com/inbound. We will include a link for your convenience, in the show notes of this and every episode of the podcast. And of course if you like some more information regarding Dr. Stephey's practice or to make an appointment, we will include links in the show notes to Dr. Stephey's website and his youtube channel. 

Tim Edwards: Dr. Stephey's website is stepheyoptometry.com. That's s t e p h e y optometry.com. You can also call the office at 626-332-4510. Again, all of Dr. Stephey's contact information will be included in the show notes of each and every episode. One last request before we let you go on to the next episode, please subscribe to the podcast from whichever platform you might be listening in. Of course, it is free to subscribe and it ensures that every time we post a new episode, you'll find it right there waiting for you to listen in your podcast app of choice. We really do appreciate your listening and until next time for Dr. Stephey of the Move Look & Listen podcast. I'm Tim Edwards with the Inbound Podcasting Network.  

 

 

 

 

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