Cyberknife and Insurance

[sgerrard]

First, an annoucement, I have taken the plunge, and setup an appointment for Cyberknife treatment at Stanford, starting Sep. 10.

Second, boy does it feel good to be able to say that! I feel better already.

Third, thanks to all forum users, and the CK'ers and GK'ers in particular, for your support and information.

Then last, the appointment process has just started, and I'm not sure yet whether the insurance company will cover it. I have talked to them, and they are certainly going to consider it, at least. It may be a week or so before I know for sure.

So a question: what might help convince the insurance company to cover Cyberknife? Or will the scheduling people at Stanford get it taken care of? Since my otologist suggested considering radiation and supports me having it, I think the insurance would cover Gammaknife here in Portland, OR. My concern is that they may not want to cover Cyberknife instead, since it will be "out of plan."

Does anyone know if this can be an issue, or have ideas of what might help to persuade the insurance company?

Steve

[aardvark]

Hi Steve -

The folks at Stanford took care of securing my coverage 2 years ago, and they were extremely efficient.  I had Blue Cross at the time.  It's a sad fact that insurance companies are becoming increasingly restrictive, and Bruce is right about the need to be proactive.  Give Stanford a call on Monday to discuss your situation......they're really good at what they do, and I think they'll go to bat for you with your insurance provider. 

Congratulations on setting a date - feels a little euphoric, doesn't it?

aa

[Betsy]

Hi Steve,

Congratulations on taking the BIG step of scheduling treatment!  So much of this AN business is unknown that being able to write your treatment date on the calendar can be a big relief.

My insurance company acted hesitant at first, but the approval actually came through within 24 hours of the day I called to make the appointment.  They were probably relieved I didn't go the more expensive route of microsurgery.  I was expecting them to drag their feet and would have been ready to do battle with them if needed, but it all worked out quite well.  Of course, they haven't paid for it YET, but I have it in writing that they will.

I hope your insurance will come through for you as quickly as mine did.

Betsy

[Sue]

Congrats Steve on your decision.  That's a big step in the right direction!  

I think that the insurance thing will turn out okay for you. At least I hope so.  Since this treatment is so specialized they must know that many patients travel out of the area and out of plan to get this done. You can't be the first patient to request this.  Anyway, I'll keep my fingers crossed for you.

Sue in Vancouver USA

[sgerrard]

Thank you all, I think I was also fishing for some "atta boy" confirmation, and I appreciate your encouragement.

My first step will be to give the insurance company a chance, they may come through up front. If not, it sounds like the Stanford people have experience at this, and there is also some good information available to bolster my case. There might be a flap with the insurance, depending on the experience of the person initially handling the case, but I suspect they will come through in the end.

One more thing to wait and see on, I guess, but I've gotten better at that, thanks to my little AN.

I will update when I know more. Thanks again,

Steve

[sgerrard]

I got the call today from Stanford, the insurance company has approved having Cyberknife. I am on for Sep. 10th.

The scheduler Scarlett said that what helped the most was when I faxed the RN at the insurance company copies of all the reports - radiologist on the MRI,  the audiogram, the vestibular lab tests, the radiation oncologist, emails from Dr. Chang at Stanford.

I get the distinct impression from my small case, and Adrian 'n' Sam's big case, that information flow is a big factor. In many cases, the key people simply don't have all the relevant information. Once they get it, they often do step up and make the right decisions. So get copies of reports from all your doctors.

Thanks to all for your support.

Steve

[Mark]

Steve,

Congrats on getting the insurance approved for CK at Stanford and getting your treatment scheduled. Sort of feels like getting a scholarship to attend college doesn't it? 

Dr. Chang and the team there are first rate , so you're in good hands. Good luck and don't hesitate to contact me if I can help with anything between now and then. Also, don't forget the traditional post CK treatment wine toast down at the California Cafe after the final treatment 

Mark

[sgerrard]

Thanks, Mark. Actually I do have a question, but it is general enough that it might as well go in the forum.

During the week of CK, which is consultation Mon, mask and scans Tue, zaps Wed, Thu, Fri, how affected will I be by the process? My impression is that I can drive in each day, drive back afterwards, and do normal things the rest of the day, almost as if nothing was happening. Does the procedure itself, or the little pills, take a toll? Can I go for hikes, or dine out, and such? Can I do a California toast every night? 

I'm not sure what else I would need help with, I am assuming that at this point, I am done making decisions, I just need to show up and lie still at the appropriate times. Any more last minute choices to make, I hope not?

Steve

[Lorenzo]

I had a great time, lots of energy, ate like a horse, and slept little. I guess those little pills DID have an effect. Eat vegetables and lots of fibre! I used to relax and sit back for an hour after each session, generally at the cafe in the Cancer Centre across the road from the CK centre. Then, the rest of the day was spent wandering around, maybe a bit of a nap if I could, eat out at the Cantor Arts Centre, browse the bookstore on campus, and do a bit of shopping. Nights were a different thing. Sleep wasn't really that great, but it didn't seem to mater to much, still had enough energy! Driving around wasn't a problem either, rented a car right after treatment.

Good luck with it, and remember, 'eat vegetables' as Larry the tech said to me. lol

Ciao, Lorenzo

[sgerrard]

Lucky me, I am going to be staying with an old college friend, and driving his second car as well. I guess I am wondering if I can keep up with him, he tends to get inspired when he has company, with all sorts of ideas for things to do. He will have me eating edamame while hiking up Mt. Tamalpai, followed by margaritas at some happening restaurant he knows, and so on for the entire week. I may need those little pills! 

[Lorenzo]

you'll manage. you might fall asleep in the middle of your edamame for a little while, but ye'll be up and running very quickly again! 

[aardvark]

I felt exhilarated during CK week.  You won't be falling asleep if you're hiking Mt. Tam, guaranteed.  You'll be watching hawks hunting below you.   As for the edamame,  I guess it'll depend on which day of your treatment it is - steroids are notorious for increasing appetite - so make sure you pack enough. 

Your accomplice's agenda sounds perfectly appropriate to me - fractionated margaritas.

Looking forward to your journal entries -

aa

[ppearl214]

Steve,

Congrats that all the red-tape is now done and now time to plan accordingly!   Ok, bring your own music/CD's.  Freak out the CK team with something good like CD's of Holiday music, Yanni or something that will throw them off for a good giggle... but make sure they giggle before the button is pressed.  Ok, now, look for the "eye" during the procedure.  Now, my eyelashes are too long so was difficult for me to keep eyes open as the lashes got caught in the mesh mask, but look for the "eye" when it moves overhead. When you see it, you will know what I speak.  Know that Oil of Olay Wrinkle Regenerist cream will not cure "mesh mask face" (you'll know what I mean when the mask comes off and you look in the mirror).   Now, make sure you do lunch after. I think Mark and Lorenzo and all others that went to Stanford have a favorite "haunt" for lunch (CA Cafe?)... they can tell you. If your body is slightly fatigued after, blame it on a full belly from lunch, but... pay attention to it and nap if you need to.  Now, shopping.... go shopping after lunch.... I need some new kitchen appliances so please keep a look out for me    Cocktail hour starts at 2pm, so I agree about fractionated margaritas... make it frozen strawberry!

So, you kind of get the idea..... you are going to do great... and looking forward to your "postie" status. 

Cheering you on!
Phyl

[Lorenzo]

i thought for a moment to bring Talking Heads' Road to Nowhere for a bit of entertainment. Instead I settled for Pat Metheny and Jan Garbarek, much more calming. The choice they had was muzak for Christmas! You'll be spared that. Nothing with much rhythm, you don't want to start tapping your feet while being zapped.

Eateries: Cafe Cool at the Cantor Arts Centre, cafe at the Cancer Centre, Liked Evvia too at Palo Alto.
Breakfast: Peets on campus not far from bookstore
Coffee: Bookstore or Peets again or Cancer Centre or Cantor

There's a couple of palces in Palo Alto itself too of course.

Food is important, gives you a place to sit, obey the cravings and while away some time with something to read.

Oh ya, the mask face: I called it The Onion Bag look. Also, don't be alarmed if you turn from bright red to a blanched almond look in the space of a few minutes right after CK. Happens to all of us.

Ciao

Lorenzo

[Mark]

Steve,

I think you have to see how you are feeling after each treatment and I would certainly not plan any activities for any of the three treatment days. Schedule them in your mind as down days and if you're feeling good it's a bonus 

The Stanford team will advise you to not drive and have someone come with you on each treatment day, simply because you don't know how you'll react. I felt fine each day and although my wife drove home the first day is was more because I was stressed out than anything. I actually drove the next two days but don't tell anyone  . Other folks feel fatigue or get some degree of headache, so you just don't know.

You'll get two pills after each treatment, anti nausea and decadron. I had no issues with nausea so I declined those pills the second two days. I don't think one glass of vino would upset the apple cart each day, but I wouldn't spend the evenings in the local pub given what your body is going through. Most people will tell you to up the H2O consumption before, during and after treatment week

Mark