Clusterheadaches.com Message Board


    
      
        Clusterheadaches.com Message Board
        (http://www.clusterheadaches.com/cgi-bin/yabb/YaBB.cgi)
      

        Cluster Headache Help and Support >> Cluster Headache Specific >> Back from Doctor---Insurance Question
        
(Message started by: Drew_Va on May 4^th, 2006, 6:36pm)

Title: Back from Doctor---Insurance Question
Post by Drew_Va on May 4^th, 2006, 6:36pm

I just got back from seeing my Doctor. We mapped out a course of treatment. I am going to be taking 240 mg of Cardizem as a preventive. Anyone had any success or stories to relate about this drug? He also prescribed Imitrex injections and nasal spray. I will use this the next time the beast rears its ugly head. However, my insurance will only pay for two doses of the injectable and 6 doses of the nasal spray every 26 days. My Doctor warned me this might happen and even wrote an explanation on the Rx to see if they would do 12 hits of the injectable. Anthem Blue Cross Blue Shield would not. I have started the appeal/pre-approval process. Anyone been down this road with Anthem before? I sure hope that:

A: They approve this for me and

B: The process does not drag out for weeks.

It would suck to find something that works effectively and then not be able to use it.

Here's hoping this strategy works!

PFD

Drew

Title: Re: Back from Doctor---Insurance Question
Post by BlueMeanie on May 4^th, 2006, 7:00pm

Hi Drew,

I've changed insurance plans 4x in the last 8 years. Not one yet has allowed me to have more than 4 boxes a month. Luckily, most docs give out free samples. I usually manage to get 4/6 boxes walking out the docs office. Best thing is to do STOCKPILE when not in cycle.

Have you read about the imitrex tip ? It's on the left side of this page. You can abort 2 CH's for every shot. Some people can abort 3.

Good Luck to ya. PF vibes heading your way.

Title: Re: Back from Doctor---Insurance Question
Post by marlinsfan on May 4^th, 2006, 7:15pm

O2 is the best abortive for me. SInce discovering it (thanks to this place) I hardly touch the trex.
It's also cheap as heck!

PF wishes.

Title: Re: Back from Doctor---Insurance Question
Post by Drew_Va on May 4^th, 2006, 7:18pm

Blue Meanie,

Thanks for the info. I read the immitrex tip and will have to give that some thought. First and foremost I need to see if the injections will do the job for me. This is unchartered territory for me. I have had the headaches for 24 years but for the most part have just sucked it up
and held on for the duration of my 6 week cycles. In the early years I tried a number of things (O2, Verapamil, Fiorinal, Immitrex tablets, etc. etc) but nothing helped. This site has opened my eyes to the fact that I do not have to take this lying down anymore. I stated this in an earlier post but I feel compelled to repeat it: I have learned more on this site in one week than I did from numerous visits to my family doctor, neurologists and the emergency room. I think I quit going to the Doctor about three cycles ago.
Luckily, along with finding this site, I have found a Doctor (my family doc) who admits he is learning like me but is willing to do homework and allow me to actively participate in making decisions about my treatment. My Doc was quite apologetic that he did not have samples of either injectables or inhalables. I may put a bug in his ear to try and get some from the rep next time they visit.

Thanks for the good thoughts and wisdom and here's hoping for PFDs for us all!

Title: Re: Back from Doctor---Insurance Question
Post by Gator on May 5^th, 2006, 1:34am

Hi Drew and welcome to the asylum. Maybe you can get some mileage out of these articles about BCBS limiting triptans.

Blue Cross Limits Access To Meds from About Headaches and Migraine

http://headaches.about.com/library/weekly/aa-bc-trip-limits-a.htm

BCBS Says Triptan Limit Was an Error -- About Headaches and Migraine

http://headaches.about.com/library/weekly/aa-bc-error-a.htm

Good luck.

Title: Re: Back from Doctor---Insurance Question
Post by Drew_Va on May 5^th, 2006, 6:54am

Gator,

Much thanks for these articles. They cover the exact situation I find myself in. In fact, the monster visited last night at 9 p.m. and I tried the inhaler and within 15-20 minutes I was pain-free. This never happened with me before. I have always had to ride the ha's out. I believe the inhalers and injectables will really help me. I just need to bring my insurance company around. I intend to call my employer's HR department shortly and see if they have a patient's advocate. Thanks again for the information.

PFD

Drew

Title: Re: Back from Doctor---Insurance Question
Post by Bob_Johnson on May 5^th, 2006, 12:31pm

Ask your doc for a sample. If it works for you, the insurance conflict will be resolved, pills are easy to carry and use under any circumstances, the per dose cost is less.
Headache 2001 Sep;41(8):813-6

Olanzapine as an Abortive Agent for Cluster Headache.

Rozen TD.

Department of Neurology, Jefferson Headache Center/Thomas Jefferson University Hospital, Philadelphia, Pa.

OBJECTIVE: To evaluate olanzapine as a cluster headache abortive agent in an open-label trial. BACKGROUND: Cluster headache is the most painful headache syndrome known. There are very few recognized abortive therapies for cluster headache and fewer for patients who have contraindications to vasoconstrictive drugs. METHODS: Olanzapine was given as an abortive agent to five patients with cluster headache in an open-label trial. The initial olanzapine dose was 5 mg, and the dose was increased to 10 mg if there was no pain relief. The dosage was decreased to 2.5 mg if the 5-mg dose was effective but caused adverse effects. To be included in the study, each patient had to treat at least two attacks with either an effective dose or the highest tolerated dose. RESULTS: Five patients completed the investigation (four men, one woman; four with chronic cluster, one with episodic cluster). Olanzapine reduced cluster pain by at least 80% in four of five patients, and two patients became headache-free after taking the drug. Olanzapine typically alleviated pain within 20 minutes after oral dosing and treatment response was consistent across multiple treated attacks. The only adverse event was sleepiness. CONCLUSIONS: Olanzapine appears to be a good abortive agent for cluster headache. It alleviates pain quickly and has a consistent response across multiple treated attacks. It appears to work in both episodic and chronic cluster headache.

--------------------------------------------------------------------------------

Olanzapine has a brand name of "Zyprexa" and is a antipsychotic. Don't be put off by this primary usage. Several of the drugs used to treat CH are cross over applications, that is, drugs approved by the FDA for one purpose which are found to be effective with unrelated conditions--BJ.
+++++++++++

Here is a link to read and print and take to your doctor. It describes preventive, transitional, abortive and surgical treatments for CH. (2002)

http://www.brightok.net/~mnjday/chtherapy.pdf

Title: Re: Back from Doctor---Insurance Question
Post by superhawk2300 on May 10^th, 2006, 9:30am

1. Stockpile. If your doc won't keep writing scripts when you are out of cycle "never" go out of cycle or get a new doc.

2. I never used 02 until coming here. It doesn;t work great for me but it is so cheap I still use it, and I'd rather use it instead of drugs.

3. Samples of course. This is dpendant on your docs drug rep more than your doc. My doc is also a friend of mine and sometimes he doesn't have enough because of how much the rep brings and I ain't his only junkie.

4. My doc wrote different prescripts at the same time and I had to experiment to see what I could get. I respond AWESOME to most meds so I would get a script for all the trips (becareful not to mix doeses) and a spray. So when I run out of Imitriex I switch to Relpax, then to Frova, then to Zomig.

Sometimes I can get all filled at the same time, sometimes not - I don't understand my ins co logic on this but it works to get multiple scripts sometimes.

5. Pick your meds by number allowed. Frova comes 9 toa box, and Relpax 6 to a box. Relpax work better for me (best actually) but ins co seems to cover "by the box", so I get the frova first since it has 3 more per refill. Doesn;t sound like much but when those three are 8's, 9's or 10's it is HUGE!

6. Come here when you are empty - you'd be surprised where you've "accidentally left some of your meds" and how fast they can be sent "back" to you.

Never in the history of mankind has there been so much potential end to suffering existing that goes unused becasue it is not accessible to those that need it. CH'ers story is just one of thousands in this regard. BLEAK, HOPELESS PAIN and SUFFERING and DESPAIR to all politicans (except a few).

This is my deal and it works, because it has to I guess.

I hope this helps you.

Jamey

Title: Re: Back from Doctor---Insurance Question
Post by Drew_Va on May 10^th, 2006, 11:36am

Jamey,

Thanks for the info! I see my Doc again Friday and will try to take advantage of some of the tips you provided. This has been a particulary bad cycle and it is more frustating because I finally found something that works and can't get it because of $$$ decisions by B/C-B/S. I have an appeal working with them but, ever the pessimist, I figure it won't be decided until the cycle is complete!

Title: Re: Back from Doctor---Insurance Question
Post by seasonalboomer on May 10^th, 2006, 12:01pm

I found myself in a similar situation this spring. Only 1 injection of trex left and a pretty active cycle. BC/BS wouldn't pay for more than 2 injects a month. Luckily I had a little in the kitty and told the pharmacist, "I don't care if BCBS will pay for it or not - I'm going to pay for the damn things because I need them so give me 4 boxes" While the bill was not pretty, it did allow me to be a little more at ease for the remainder of my cycle. That falls into the category of "I'd do anything to not have to deal with these f&*kers" and putting my money where my mouth is. I understand not everyone has that option but for those that do - just because insurance won't buy them for you doesn't mean you can't buy your own.

Scott

Title: Re: Back from Doctor---Insurance Question
Post by Drew_Va on May 10^th, 2006, 12:10pm

Scott,

I hear ya. And I will take that step if necessary (which it is rapidly becoming). Its just a matter of principle to me that I pay for my insurance and then when I need something they will not help me. I hope to hear something today re my appeal. I've already called 2x today. However, if I don't I will more than likely lay principles aside and buy what I need. It won't take many days like yesterday to make me willing to pay for the relief.

Drew