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#20046 03-31-2006 10:52 AM
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Delia and Charlie,

I have NEVER heard of an insurance company having any right to deny an insured pain meds. You MUST speak to the doctors and nurses about this. Keep asking until you find someone that will give Charlie what he needs.

Good luck.

Jerry


Jerry

Retired Dentist, 59 years old at diagnosis. SCC of the left lateral border of the tongue (Stage I). Partial glossectomy and 30 nodes removed, 4/6/05. Nodes all clear. No chemo no radiation 18 year survivor.

"Whatever doesn't kill me, makes me stronger"
#20047 03-31-2006 11:33 AM
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I must say I agree with Nelie that the insurance company would have the audacity to tell anyone how much pain meds they could have. I would contact a lawyer and sue their asses for all their worth. Talk about a claim for pain and suffering - I am sure you could get a lawyer to take it pro bono. Who is your insurer - we need to know this!?!?!!? DO they have an omsbudsman? Pain meds aren't all that expensive I might add. The high ticket drugs are the Cisplatin and the anti-emetic SRI types like Zofran.

The salt water rinse is a great idea unless you have open sores then your pain threshold will go right through the roof so be careful -proceed with caution. Club soda may be a little easier to take.


Gary Allsebrook
***********************************
Dx 11/22/02, SCC, 6 x 3 cm Polypoid tumor, rt tonsil, Stage III/IVA, T3N0M0 G1/2
Tx 1/28/03 - 3/19/03, Cisplatin ct x2, IMRT, bilateral, with boost, x35(69.96Gy)
________________________________________________________
"You are a mist that appears for a little while and then vanishes" (James 4:14 NIV)
#20048 04-03-2006 01:36 AM
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Thank you for the suggestions! I have new news to report- his 6 day pain medicine, Oxydose is covered by his insurance for 30 days (They only give .25 ml, and Charlie takes .75ml every 4 hours) But on the plus side- I have a phone number where the doctor can call and override this (hopefully). He has done this once. The insurance Company is Horizon Blue Cross and Blue Shield of NJ.
Charlie has one more week of radiation treatment. GOOD NEWS- the doctor said that his tumor has shrunk and his right vocal cord (which was paralized because of the cancer) seems to be moving when they scoped him on Friday.
I keep on praying!


Delia- Caregiver and fiancee to Charlie ,age 30,(SCC of Larnyx-Stage IV) chemotherapy and radiation- no surgery finished tx:4/7/06 SURVIVIOR!
#20049 04-03-2006 12:28 PM
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Glad to hear the good news about the tumor shrinking and the vocal cord moving.

Not surprised that BC/BS is the carrier giving you a hard time. Keep fighting them. It works...I know this as a patient and as a provider.

Jerry


Jerry

Retired Dentist, 59 years old at diagnosis. SCC of the left lateral border of the tongue (Stage I). Partial glossectomy and 30 nodes removed, 4/6/05. Nodes all clear. No chemo no radiation 18 year survivor.

"Whatever doesn't kill me, makes me stronger"
#20050 04-03-2006 01:11 PM
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OCF Founder
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I had to threaten to sue BC to get any coverage at all, and the process of dealing with them was one of constant aggrivation. Here in CA the attorney general is looking to to their practices as we speak to see if they are denying payments, coverage, that they have contracted to provide, or if there are other improprieties. Of course now that any of us has had cancer, we are stuck with the carrier that we have love them or hate them, because as cancer survivors, no one new will touch us with a ten foot pole.


Brian, stage 4 oral cancer survivor. OCF Founder and Director. The first responsibility of a leader is to define reality. The last is to say thank you. In between, the leader is a servant.
#20051 04-04-2006 04:41 AM
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Well yesterday was quite the trip. HBCBS only approved 2 ml of the oxydose when it should be over double that (4.5)! So I was on the phone with one of the nurses (who is wonderful) for over 30 minutes trying to get an over ride. Finally they did!
Other then that- Charlies neck burns have cleared up to the pink tissue (but he picks at it).
I hope everyone is doing really well!!!


Delia- Caregiver and fiancee to Charlie ,age 30,(SCC of Larnyx-Stage IV) chemotherapy and radiation- no surgery finished tx:4/7/06 SURVIVIOR!
#20052 04-04-2006 06:21 AM
Joined: May 2002
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Try Biafine on the neck burns and no picking.

I'm not happy to hearing about these problems with BC/BS of NJ since they are my tertiary carrier and will be my secondary next year. Is he a State employee? I had a friend, state employee, who was on megadoses of Oxycontin etc. for over a year and I don't think there was ever a problem with BC/BS covering it.

Take care,
Eileen


----------------------
Aug 1997 unknown primary, Stage III
mets to 1 lymph node in neck; rt ND, 36 XRT rad
Aug 2001 tiny tumor on larynx, Stage I total laryngectomy; left ND
June 5, 2010 dx early stage breast cancer
June 9, 2011 SCC 1.5 cm hypo pharynx, 70% P-16 positive, no mets, Stage I
#20053 04-04-2006 06:50 AM
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Eileen:
As long as you work with them and have the doctors override their decision...it will work out. Even though we have had these problems- there is always a solution.
No, he isnt a state employee.
Good Luck to you!


Delia- Caregiver and fiancee to Charlie ,age 30,(SCC of Larnyx-Stage IV) chemotherapy and radiation- no surgery finished tx:4/7/06 SURVIVIOR!
#20054 04-05-2006 04:39 PM
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Delia,

What a difference in Charlie over the past week! It's so good to hear how well he is doing. Way to go both of you...him for fighting through this, and you for fighting BC.

Best of luck to both of you.

Jennifer


Jennifer
Stage II (T2N0M0) SCC diag 4/21/05; partial glossectomy & selective neck dissection (good margins and lymyph nodes negative), jaw split, 1/3 of tongue removed, free flap from left forearm - 5/23/05; 42 years old at diagnosis
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