FIGHT FOR 2ND TRANSPLANT IS OVER . . . OR IS IT?

The Arbitration has gone in favor of the insurance company. 

While Mr. Thomason states he believes there to be more benefit than risk he could not find the insurance company negligent in the wording of the policy that clearly states there will be no tandem SCT for those considered "high risk".

It has been brought to our attention that while the insurance won't cover the actual transplant, the plan would cover some of the procedures pre and post transplant.  We have started an investigation into just what that would mean and the total out of pocket it would take to move forward with transplant.  This will take all week.  In the meantime the biggest or first question that needs to be answered is:  given that Glen had the 1st transplant 6 months ago, is there still time to continue our efforts in order for the 2nd transplant to be effective?

I've had my day of tears.  I know without doubt who is in charge.  I feel I'm being guided and told it is still not time to give up.  Maybe there is still yet another hurdle we have to get over before we reach the end of this particular quest.

I'm so very sadden in that a favorable decision could have meant something of significance for many others who find themselves in this same situation.

I am ever determined,
Vannette

Nothing!

Well it is the end of business on a Friday.  Not one word today from Mr. Thomason.  Nothing.  NOW, we have the whole weekend to wait and wonder.  Glen does have to be in clinic first thing Monday morning for Day 1, Cycle 2; Velcade.  A decision today may have brought a change to the schedule for Monday.

I am not patiently waiting,
Vannette

The Calm Before the Storm???

All is quiet as to the arbitration.  For days many e-mails have flown back and forth between interested parties.  We have heard nothing, not one thing for two full days.  Mr. Thomason, the Arbitrator stated on Tuesday evening that he was preparing his answer with week's end as a goal to rule.

"Trust in the Lord with all thine heart" . . .

Trying so very hard to keep strong,
Vannette

HOWITZER vs. BB GUN

This past Thursday, September 22, 2011 was our session with the arbitrator whom I will call Mr. T., the  HIPUtah Executive Director , an Assistant Attorney General for the State of Utah, Glen's doctor, Dr. Tricot, ourselves, Glen and Vannette and by speaker phone, a doctor who sat in on the board (I believe, trying to keep all my facts straight) on the last appeals level.

Our session lasted about three hours wherein much was discussed.  We are to have an answer by the end of this coming week.  The arbitrator has the right to reverse the denial, however, he will have to be able to justify his decision.  The biggest obstacle to overcome is finding a loop hole contractually.  If that makes sense.  I will cover more when the decision comes in.

Dr. Tricot and Dr. Gxxxxx had an extreme difference of opinion about the care Glen should be receiving.  They went head to head over the NCCN guidelines for treating MM.  Dr. Tricot as well as the arbitrator are having a hard time understanding why and "Internist" has been given this privilege rather than a myeloma specialist.  After Dr. Tricot had left the room and Dr. Gxxxxx had been dismissed by telephone the arbitrator made a comparison.  Dr. Tricot being a  HOWITZER and Dr. Gxxxxx being a BB GUN!!!!!
Glen and I had too much fun with this during our drive home.

Please continue to offer prayers in Glen's behalf.  We are so grateful for all those who are supporting us.  Thank you.  We'll be letting you know the outcome of all of this.

Keep Strong,
Vannette

Home again, home again, jiggity jig!

Yesterday, September 12, Glen's counts were recovered well enough for us to get to come home.  Once again he exceeded the projected dates of recovery from the D-PACE making it possible to come home sooner than later.  While he did experience a lot of nausea, he did not throw up, did not need any infusions or have any other side affects.  He is, however, wiped out.  He has very little strength and stamina.  This is hard for him because he is a "doer".  He has a hard time sitting still and not feeling like he is accomplishing anything.

Beginning next Monday the 19th  he will begin cycles of VTD.  Twice a week, every other week.  So . . . that next Thursday, which is the 22nd, he will have treatment before heading to the conference room for arbitration.  Should we be successful in our efforts fighting for the 2nd auto SCT we would move into that instead of the cycles.  Otherwise, he will move forward with a maintenance schedule.

Arbitration is going to take place in a conference room at the University of Utah Hospital making it most convenient for Dr. Tricot to attend in Glen's behalf.  We are going up against the Utah Attorney General's Office.  Did I say "SCARY" and "SO NOT FAIR"! 

The Utah Attorney General, Mr. Mark Shurtleff has most recently been  having his own battle with cancer:     http://desne.ws/pHdMf8    .  Ironically, I graduated in the same high school class with Mr. Shurtleff who was either the class or student body president.  That's too many years back for me; can't recall exactly.

Moving on  . . .  our grandson has not arrived, yet!  I was able to make it to the baby shower last night.  It was grand and very enjoyable.  A nice distraction from labs and infusion rooms. 

Have a grand day everyone,
Vannette

ARBITRATION

Today we were able to schedule arbitration with all involved for September 22, 2011.  I welcome any advise.

Vannette

A Busy Week Ahead

D-Pace was tentatively scheduled for September 06, the Tuesday after Labor Day weekend.  Today we received a call moving that date up to this Thursday, September 01.

Tests at the Huntsman all day tomorrow.  Home on Wednesday; get things packed to stay in Salt Lake for 1 1/2 to 2 weeks if all goes well.  Back to Salt Lake either Wednesday evening or early, early Thursday morning.  It is about a 3 hour drive.  Hopefully not more with all of the road construction going on.

We also heard briefly from the insurance company that an arbitrator has been chosen.  We did have input on that.  Scheduling is still unsettled.  I'm hoping that the arbitration session can take place while we are in Salt Lake. 

Keep Strong,
Vannette

D-PACE and Arbitration

August 24, 2011

Glen and I traveled yesterday out to Salt Lake City to the Huntsman Cancer Hospital where he is being treated .  He was scheduled for an iron infusion and also a line study.  His port has been bothering him.  Everything checked out okay.

For any of you who follow Kris Kelly, we too, see the belgium doctor on floor 2, clinic b.  Thanks Kris for your post yesterday.  (I really do know how to spell "belgium").  You really can't get better than perfect and we are so elated for you.

For a second stem cell transplant to be effective Dr. Tricot is recommending that it take place within 6 months of the first transplant.  Glen's first transplant took place in April.  With the appeals process being as it has we are approaching 5 months post-transplant and time is very critical now.

Our next option for approval is through arbitration.  This can be lengthy but it is our only option.  We are going to move forward with that.  In the mean time Dr. Tricot has scheduled Glen to begin a round of D-PACE beginninig September 6th.  This is treatment that would be part of pre-transplant anyway.  We will need to be away from home for at least one and a half weeks.

We have arrangements to make . . . . .   :)  this is me --- off and running. 

Keep Strong,
Vannette