Avastwin!

Remember that expensive drug Avastin of which we've (mostly Pete!) been fighting with our insurance company to cover the cost for over a year now?

As of 15 minutes ago, our insurance company has approved payment of this drug for me retrospectively to January 2008 through December 2009!!!!!!!! HORRAY!!!!! WE DID IT!!!

WE WON!!!!

You may ask, what in the world did you do to win this battle? Well, first of all, although it was overwhelmingly emotionally, mentally and physically taxing, we persisted in the fight because three important people in my life (Mary, Candace and Kairol) told us to not give in, not to give up; to keep up the fight and eventually they will cave and give us what we want! I didn't believe them back then but I kept trying to and now I know that it works! They were right! THANK YOU, LADIES!

Secondly, Pete did tons of research on the drug and it's benefits with regards to my diagnosis. This seemed almost impossible since such research barely even exists anywhere on the planet (lucky me, I got the Super Rare One!)! But again, he persisted in his search, collecting journal articles from anywhere he could get his hands on them. He learned and taught me Avastin's purpose and how exactly, biologically, chemically it works to stop tumor growth! Very detailed but facinating stuff! Way beyond what we learned in Chem 101! Click on that link up top to learn some of this.

Third, we drew up a lengthy appeal letter. UCH had previously submitted their own appeal on our behalf in order to get their money back that they had already spent on me receiving the drug last year. In our process of compiling appeal #2 (3 was the max then we'd be SOL), we were finally put in contact with an actual individual human being, a person, at the insurance company who was able to help us track the process of the previous appeal and what Their Doctors and Specialists were saying about this drug, etc. It took a while for her to gain our trust but finally she did and after we sent her our completed appeal, she reviewed it and suggested that we hold off on our current appeal until we get complete information from the first appeal by UCH so that we might incorporate some of that information and their research into our appeal; in doing so, we could strengthen the impact and intelligence of our own appeal. Although she had our appeal in hand, it wasn't formally submitted to The Powers That Be yet so that we could have time to gather this info from the previous appeal. For almost three months now, we have been in that holding pattern, waiting for said information, of course running into red tape left and right. In fact, we were almost to a point where we'd revisit the issue and find out what and how to do next when I got the call a little while ago.

The fourth thing we did was something suggested by both Candace and Maggie: I wrote to my congressman. I sent him a summary of my story and begged for any help his office may be able to offer us. Within a week, I got a brief but clear response from someone in his office, simply saying they can't do anything for us but "so sorry to hear of your struggles." Yeah, whatever, heard it before, take a hike! Mysteriously, though, a week or so after that, I got another response from someone else in the congressman's office, saying they would look into the matter some more and see what they could do. I have never heard back from anyone in the congressman's office since then but who knows, maybe they were able to do something!???

The persistance, the constant battle, the lengthy phone calls, being tossed from robotic and soulless person to robotic soulless person, handed off to people with such worthless titles as "Patient Advocate" (don't need one, thanks, we're fully capable of being our own advocate!), "Member Champion" (wtf does that even mean?!), and a variety of other titles that include words such as "Wellness," "Assistant," even "SUPERVISOR"...all of these gave us more headaches and sleepless nights than any sort of helpfull guidance in the right direction!

The stress brought on from all these phone calls really took its toll on us. Needless to say, at the end of an 8 hour work day that began at 6am, balancing the often frustrating task of "putting out IT fires" as his job title dictates while being put on hold, transferred, "accidentally" hung up on, leaving messages for people who would not return his calls, and blatantly being told there is nothing more they can do to help us, Pete would come home mentally and emotionally exhausted. Drained. Completely worn out. They were turning my Honey into a zombie! I couldn't help but feel guilty since I'm the one with all this spare time on my hands, thinking that I should be the one to make these phone calls but then getting more frustrated and guilty because my train of thought is regularly compromised, leaving me confused and distorted (yes, it's chemobrain and yes, it is as real as a car crash). At any rate, I would only be able to get so far before I'd have to turn to Pete for explainations and assistance anyway. Truly, though, it came down to the simple fact that this is just ONE THING that he can do to help me endure and overcome this disease. The mounting frustrations of the continual red taped buerocratic road blocks were mere symbols of our lack of but desperate attempt to control the progression of this cancer. He felt powerless and weak but he persisted, never gave up. Despite the arguments we'd have out of sheer annoyance, my feelings of hounding and pestering him to "call someone today" over and over every day in a constant attempt to not let him give up, and the migranes we'd both aquire at random times of the day or night, the persistance of this fight was obviously worth it in the end!

So.....when I sit down to reread this post and review all the fighting, work, frustration and tears that we put into this seemingly worthless battle, I can't help but compare it to the broader picture: cancer. If we put all of this insane time, energy, emotions, patience, explainations, research and fight into getting this drug covered and we WON, why not apply the same process and hope for long term success to this cancer I have?! Most of the time, this fight with the insurance company just left us feeling defeated; much like my cancer does. But we'd fight, keep making calls, doing research, talking to people; much like my going back and forth for chemotherapy, blood tests, taking shots at home, feeling as if I'd been hit by a MAC truck most days of the week. How blatantly obvious is this comparison?! If it worked on the Avastin fight, why can't it work on the Tumor Fight?! This gives me a renewed sliver of hope!

HORRAY!!!!! We are going out to celebrate tonight!!! Meanwhile, you can find me doing the Happy Dance with Dobby, Scarlett, Merlyn and The Almost-Toothless Girls!