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Cluster Headache Help and Support >> Medications, Treatments, Therapies >> Insurance http://www.clusterheadaches.com/cgi-bin/yabb2/YaBB.pl?num=1282348967 Message started by his wife on Aug 20th, 2010 at 8:02pm |
Title: Insurance Post by his wife on Aug 20th, 2010 at 8:02pm
First time poster. My husband has had cluster headaches for 20 yrs. Start usually by June (or as early as March) end in Sept. A couple of years were headache-free, the worst years were 5-6 a day. Currently at 2 a day, major meltdowns in eve (as you all know). He's on the daily prednisone, verapamil, melatonin, oxygen, imitrex cocktail. Here's the problem...INSURANCE! Will only pay for 2 shots to last 15 days. Have had dr. re-write prescrip, word it differently, doesn't matter. Pulled a Shirley McClain from "Terms of Endearment" in CVS yesterday crying and felt like screaming "Somebody just give him a shot!!" The gal looked at me and said yea I get headaches, I have one now...REALLY?! Do you want to go blow your head off because it's the only thing that would relieve the pain? My big strong husband has taken the tip of this finger off without batting an eye so I know his pain tolerance. To watch him on his knees crying, wimpering, and threatening suicide...because the freakin insurance company won't give him a stinkin shot is beyond belief!! (I know I'm rambling..sorry nobody else understands) Does anybody know what his dr. needs to write on the prescription to get these more often..or is it that the manufacturer recommended that dosage, so that's all they'll pay for? Has this been an especially bad year for everybody else too? He's maxed on the pred (puffed up and feels like crap) & verapamil...oxygen isn't kicking it like it use to (I'm going to watch the imitrex video, affraid I'll screw it up and lose this precious gold, going to have him try the H20 and red bull therapies too)...help please...thank you for reading. Peace and wellness to all..
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Title: Re: Insurance Post by Linda_Howell on Aug 20th, 2010 at 8:11pm
Check your PM's.
O.K. you're new, so look up to the left of the top of the page where it says...Good afternoon "his wife" you have 1 PM Linda |
Title: Re: Insurance Post by Guiseppi on Aug 20th, 2010 at 9:06pm
Just confirm HOW he is using the oxygen as that's proven critical in it's level of success.
Pure oxygen, at a high flow rate of at LEAST 15 LPM, using a Non Re Breather Mask, started at the first sign of an attack. Some for whom oxygen totally failed them at 15 LPM, found success at 25 LPM. A relatively new theory on the board revolves around maintaining your arterial PH at a level which makes you less succeptible to attacks. It goes as follows: Magnesium, Zinc, Calcium Citrate and Vitamin D, washed down with fresh squeezed lemonade, up to 4X daily. I did it 2-3X a day this last cycle and it had a substantial benefit in number and intensity of my hits. It's cheap, no real side effects to sweat, may be worth a shot. If he hasn't looked at clusterbusters.com it's proven succesful for some when nothing else worked. Thanks for being the supporter you are, you guys keep us sane and we love you! [smiley=heart.gif] Joe |
Title: Re: Insurance Post by his wife on Aug 20th, 2010 at 9:55pm
Thank you all for the great advice. I will do all!! This website has always been a source of great information, but just joining tonight and your quick and heartfelt responses have touched my heart. Thank you, I feel like I just made some new friends today...Blessings to you..
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Title: Re: Insurance Post by Art S on Aug 20th, 2010 at 10:08pm
Yea, insurance sucks. I had to go around mine and pay for stuff myself. I know not everyone can do it but I only use imitrex as a last resort. Kinda my backup. I agree with Joe on the O2. Many more aborts for the money if used as instructed. Works for me most of the time.
You may want to check into getting a script for the 6MG vials that way you get a real syringe if your not afriad to use it. I only use 1/3rd of that when I need one. Works, a little slower than a full shot but never fails to knock one out. |
Title: Re: Insurance Post by Ginger S. on Aug 20th, 2010 at 11:17pm boski wrote on Aug 20th, 2010 at 11:12pm:
PERFECT analogy/description!!! ;D |
Title: Re: Insurance Post by boski on Aug 20th, 2010 at 11:32pm
It's true and they are full of air! I would get a burning
sensation and turn black and blue after a shot! After 6 or 7 a day in shorts you look a mess! ;) Boski |
Title: Re: Insurance Post by Katherinecm on Aug 21st, 2010 at 2:25am
The easiest way of dealing with this is probably to beg for free samples from the neurologist. I don't even like trex but I can't seem to visit mine without getting a baggie full of it.
The magic word for dealing with insurance is a "letter of medical necessity" from your physician. That will usually do the trick, as long as it's an insurance policy and not a self-insured plan. You may want to look into the side effects/safety issues created with constant use of triptans. High usage is a bit controversial, which you'll discover if your insurance company does approve you. At that point the pharmacy might refuse to dispense as ordered. I ran into that a few years ago with a trial of Amerge as a preventative and a few people posted they had to threaten pharmacists with turning them in for practicing medicine without a license. I was such a wreck at that point I insisted to the pharmacist that potential heart damage was not a big of a threat as the suicide I was likely to commit if I didn't get the pain under control. It was a tad over dramatic, but it worked. No more fights with the pharmacy. |
Title: Re: Insurance Post by boski on Aug 21st, 2010 at 3:29am
Heart no head - Head no heart?
Well right now it is the head that's the problem! When the hearts the problem I hope they have a shot for it! Because I have over used over and over again, guess I should be pushing up daisies soon! Boski |
Title: Re: Insurance Post by Katherinecm on Aug 21st, 2010 at 3:34am
Well, I think it's only a theoretical problem. I've never heard of anyone actually having heart damage unless they combined trex with other drugs they shouldn't have.
In fact, I seem to remember reading a study on the robbins clinic site that said for a small number of people (something like 50?) who didn't have other severe side effects or rebound headaches, daily triptan use caused no heart issues. VERY small study but perhaps means it's fine. |
Title: Re: Insurance Post by his wife on Aug 21st, 2010 at 4:44pm
Thanks everybody for warm welcome and insurance advice.
You all certainly know your stuff and are a wealth of information. When we first started this journey 20+ yrs ago we went to his regular dr., got referred to a few different neuros, went thru the cat scans, mri, and many different diagnosis and meds. (Were even told maybe it's all in his head...yea no $hi* sherlock, it IS all in his head!) Finally went to the Cleveland Clinic Headache Center and got correct diagnosis. Since then when his cluster period starts he hits the pred hard then tapers down. He takes 480mg verapamil a day. Sometimes this works, sometimes not. If headaches come back he's suppose to start the high dosage pred again and taper down. He has the oxygen, which he is now using everynight when they start from about midnight to 4 a.m. And if it's day one of a refill imitrex.. I did get some good advice from the pharmacist today which is probably pretty obvious...get dr. to write script to fill year round...stockpile. Thanks again to all. |
Title: Re: Insurance Post by boski on Aug 21st, 2010 at 5:25pm
Stock pile YES!!!! We should have mentioned that tooo!
I'm on 600mg Verap 150mg Topomax Imitrex Sipping 5 HR Energy seems to be helping kill the last few hits |
Title: Re: Insurance Post by Guiseppi on Aug 21st, 2010 at 8:25pm
Yes we should have mentioned that too. I have a 3-6 month supply of prevents and a horde of trex on hand in or out of cycle. Always keep the oxygen on hand too.
Joe |
Title: Re: Insurance Post by Bob P on Aug 22nd, 2010 at 8:05am
I went to my MD once with a list of all the abortives and quantities covered by my insurance. Told him I wanted a script for 6 Imitrex jabs, 6 trex tabs (get the 100's so you can break them in half and have 12 50"s), 6 Amerge, 6 Maxalt, 6 Zomig, etc.
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