And Anthem Blue Cross for the block!

Well, I've joined the legendary ranks of the HMO-denied. They have determined that the ketamine treatment is experimental, so I can't have it under their plan. I'd have thought the simple math (1 ketamine treatment costs about the same as 1 ER visit) would have helped tipped things in my favour but no.

So where do we go from here? I can pay out of pocket under the PPO portion of my health plan, or I can appeal. I haven't thought much about either yet, although the former isn't tempting, what with the lack of a job sitch and all.

I hadn't honestly considered that they'd turn me down, not with all the wrangling it took to get this far.

::bites lip::

Everything has been pointing towards this. The meds juggling was just treading water, as far as my hopes have been concerned, such as they are.

Well, I see the migraine specialist again this coming Monday. That should be fun.

More Medication Manipulation

Still on the trail of the ketamine treatment. I understand that my specialist is pursuing it with my insurance company. I leave that in his hands, but I am impatient. My next appointment is the coming Monday. Hopefully there will be news.

Last tweak he performed was to add an anti-psychotic (Zyprexa) to my regimen, and to drastically drop the beta blocker (Inderal) and the anti-seizure (Depakote) medication. The goal being to lessen my dizzy spells and improve my appetite without "all the wheels falling off" (his words).

Jury's back in. I gained weight, which is good, but the migraines are wicked bad. Looks like Zyprexa is well known for weight gain, so that in addition to the lessened nausea are positive. But I'd trade some levelling off and even some dizziness for lessening the migraines again.

Huh. I notice that Zyprexa also has insomnia as a side effect. Check.

Hmmph.

Closing in on K?

We may be nearing something--there's someone in LA who might administer me ketamine. He does it for another condition, but my specialist seems guardedly optimistic.

Remuneration might be an issue. It remains to be seen how it will work out with insurance, although there is guarded optimism about that too. The specialist did say he considered paying half the costs if Blue Cross wasn't going to come through...his wife threw the appropriate fit. I couldn't do anything but laugh. I wasn't sure how to react. He just feels I've been this way too long.

Him and me both.

So if this happens, it could be soon--within a week or two.

Cross your fingers.

Beta-blockers and Vitamin D

It's motion, I guess. I didn't get to see the article, but Dr. Specialist found mention of a combo treatment with depakote (which I'm already on) and beta-blockers, so I'm adding propranolol to my bouquet of medications. Another blood test scheduled to be taken--something about possibility that my levels are too low, and that that could be tied in.

As for things that don't go into my blood P.O., he's still angling for ketamine or propofol, but he needs to convince the companies to pony up, and then UCLA needs to come round. Sounds like fun, huh? A backup plan involves borrowing Cedars Sinai resources, in case they're more accomodating than "home."

He's also presenting my noggin to the internal headache group. Dunno what's taken him so long.

I whined to him about the ER--the last two visits were nearly pointless...medication doled out in dribs and drabs, even though the last ER doctor managed to get in touch with the specialist while I was there. 8 hours, maybe 2 points reduction in pain.

I think it made him angry. They've gotten to the point where he's taking affront--when they say no one gets 6mg of dilaudid ever, and I say that's what I got last time, and they tell him they can't find my records...well, there's this nifty web interface he showed me. I can just about find my records. And that's before you get to the bit where one of his patients is in pain. Hmmph.

COBRA better not break my budget during the job gap. Things are going to be hard enough.

How Special is your K?

I see my GP every 4 weeks and he handles my MS Contin. I see the migraine specialist every 3-5 weeks, and he handles, well, all the other migraine drugs. With those frequent appointments it's easy to lose sight of a big plan, but I finally remembered to ask the specialist where exactly he was headed.

Ketamine. Special K to the crazy kids. Horse tranqs. In some scenarios it's used to induce comas, but I'm rooting for that not being me. He wants to use that to break the cycle of headaches, and then find the right prophylactics, since we're currently rooting around blind.

Problem is, it's not an established procedure, and I'm not even sure ketamine's in use at UCLA Westwood. So he's wrangling with some Boston folks on my behalf.

It feels very slow. The pain's building up on a weekly cycle. I need to tough it out so that's not Thursday/Friday, but Saturday/Sunday. To make work easier. I mean, I'm here. I just want it to be easier.