Guest guest Posted October 18, 2003 Report Share Posted October 18, 2003 In a message dated 10/18/2003 4:12:07 PM Eastern Daylight Time, ehall@... writes: Last year My PCP did contact my HMO about seeing Dr. Sutherland, in MN and they said that the Auto Eyelet Transplant and Total Pancreatectomy(SP?) are not cover by my insurance. They said that they are consider experimental. Hi Louie, my insurance company also said that the pancreatectomy and islet cell transplant is experimental but it isn't. They say that either because they don't undertsand the surgery or because they don't want to pay for it. We didn't give up trying to get approval and proved to the ins company that the surgery isn't experimental. It took a couple of months and after being denied at first they finally approved my surgery. I would think having the pancreatectomy without the islet cell transplant would not be the right thing to do. If you had the pancreatectomy without the islet cell transplant you would become a brittle diabetic. You need to make an appointment with a surgeon at University Hospital or another hospital and talk with them about you being a candidate for the TP/ICT since you are a diabetic. I do think if the doctors think it is ok then you can convince your insurance to approve the surgery. Shirley Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 18, 2003 Report Share Posted October 18, 2003 Hi Bert, It's Louie again, with just a few more questions, if you don't mind me being too noisy? Do you live in Ohio? I think I read somewhere that you did, but my mind isn't what it used to be. so I not sure I'm think of the right person or not. Did you have any problem with your insurance, going to UC? I do live in Wheeling, WV--- 2 hours east of Columbus, OH if you stay on I-70. I do have a local HMO and can only go to OSU in Columbus, where I had my Whipple done in 94 and Cleveland Clinic, where I have surgery in 92 and been there 3 times without results. Last year My PCP did contact my HMO about seeing Dr. Sutherland, in MN and they said that the Auto Eyelet Transplant and Total Pancreatectomy(SP?) are not cover by my insurance. They said that they are consider experimental. Well, just a brief history of what I have tried. Now back to more questions. Does the UC ever do just Total Pancreactectomy(SP?), without the Auto Eyelet Transplant? Because I'm already a Type 2 Diabetic and Have been since 90, thanks to the Whipple and CP. My diabetes is control with Glucotrol 10mg.XL and Metroformin ( Generic Glucophage) and my diet seems to keep it under control. I was thinking that without the Auto Eyelet Transplant, my insurance might consider the Total Pancreactectomy(SP?). I would not think that they should consider this experimental, since all they do is remover the pancreas and not transplant. I did ask my doctor at OSU that last time I saw him in 98 about just removing all the pancreas and he told me I would become a brittle diabetic and it would become too had to control. This was a long time before I ever heard about that they are doing the Total Pancreatectomy(SP?). This past spring from May 9 to July 1st, I was in and out of the hospital 3 times for a total of 32 days with pancreatitis, that would not go away. The in July I changed my PCP, and he great and he understand my pain. He suggested that they put me on a long acting Morphine- MS-Contin, which I take 2 30mg. a day and just the first of this month he gave me fast acting morphine 10mg. which I can take up to 4 a day for breakthrough pain. I also have a implanted pain pump that I get dulidid constantly thru, but I on a small dose of it. This is my second pain pump and I have had one in since 98. I was on morphine and in May they changed it to Dulidid and it does seems that most of the time it helps. But what I'm really saying, I so tired of living in constant pain of some sort daily. I have had pancreas since problems since Jan 90. 13 very long years. I know what you mean about planning anything. Some days it just takes all my energy to get out of bed, take a shower and get dressed. I haven't been able to work since 98. Are you able to work and how long have you had CP? Sorry that this turned out to be so long. I really very happy for you that you are doing so well and I hope that it continues forever. How long were you in the hospital when you did have your surgery? When you did decide to have it, how long did you have to wait to have it? Well, thanks for answer my first e-mail to you and all the best to you. Thanks, Take Care, Louie in WV Quote Link to comment Share on other sites More sharing options...
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