Thursday, November 27, 2008

TMI Chapter 2: rheumatoid arthritis and “Big Dog” medicine

The Remicade begin failing in the spring . Anticipating the need to change to a different biologic, my RA doctor gave me brochures for Orencia and Rituxan in June. And the head nurse was given instructions to begin the paperwork to get insurance approval. During the July appointment, approval in not yet been received and the doctor’s clinic had been bought out/merged with a larger group which required a completely different computer system, different billing department, different insurance department, different lab protocols, and different lab personnel.

By August the office changes were not as stressful. And, they had received insurance approval three days before my appointment day. good enough. So I started Orencia August 4 and had appointments at two week intervals for the first three doses. I found out that Orencia is a “slow load" During the first infusion (it is delivered via I. V.), and that results are not usually noticeable until three months. That was well past the date for comprehensive exams and I was quite concerned about my ability to function.
I was having pain that my doctor identified as nerve pain rather than the usual muscle and joint pain. I don't remember my RA being inflamed enough to add nerve pain during any previous flares. But once identified, Lyrica was added. It made a dramatic difference in three days time. It gave me, “Swiss cheese” brain but managed the pain.

So my thought processes were not what I wanted. I had significant difficulty walking, and my shoulders were very painful. But my hands were fine for typing and writing.

I'm now far enough into the dosing that I can tell it is working, but it's not fully effective yet. At least that's my hope; that I will continue to feel better. I still battle fatigue that is very thick. As a side note,. There was an interesting event that developed in October when the insurance declined to pay for the Orencia . Yes, The pre-approved medicine was denied. It is billed at $3000 per dose. I think it's straightened out now, but it made for some frustrating phone calls that involved too much Muzak and too many transfers with not enough clear answers.

3 comments:

Songbird said...

(Vicar)
That's a very gentle hug, to avoid teh painful.
The insurance stories are scary! Why can't people get things straight, I wonder?

zorra said...

As a veteran of the insurance wars, I sympathize...glad it got straightened out this time, and pray that it will get straightened out when the inevitable next time comes...praying that this med continues to help.

mid-life rookie said...

Last week, as I tried to work through the automated phone system maze of my prescription drug provider, I finally in frustration yelled, "HUMAN BEING" into the phone. The response? Automated voice saying, "Oh, you want to speak to a representative. Let me connect you." Who knew it would recognize the words human being?

Best wishes and prayers for continuing improvement.

word verification beight - did I bingo?

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