My Growth Hormone/Humatrope Treatment Has Been Approved!!!!!! Yeah!!!! Yeah!!!!

Okay, I just received a letter from Aetna that my Humatrope treatment for my Growth Hormone Deficiency has been approved!  Yeah!! Finally!!!  They have approved me for one year.  so I will probably have to go through this again next year.    Now I can really start to feel better physically and emotionally.  This drug is so important for my well being.  The main problem now, is coming up with the money for my co-pay.  I have to pay about $300.00 a month for my treatments.  So who should I thank for helping me?  Aetna??  Eli Lilly??  The Humatrope Reimbursement Center??   Ha ha I think not!!! 

Absolutely no thanks is due to the HRC.  They just made the process longer, added unnecessary paperwork, gave wrong information to the insurance company, badgered my doctor’s office for unnecessary forms and information, and were the reason for the denial I first received!  Once I received the denial, they closed my case early and told me that they could not help me.  My advice to anyone with Growth Hormone Deficiency, is to NOT WORK with the HRC!!!!

I really do want to thank my doctors office!  They worked with me, the insurance company, and the HRC.    Dr. Miklius’s nurse sent the information again and again to the HRC and insurance company.  They sent the letters and requests.  They spent the time to help me straighten this mess out.    Dr. Miklius tolerated my emotional outburst when I broke into tears at her office about the whole mess.  She is truly a great doctor.  At their office, you do have to wait a long time, they often run late, but it is worth it!  She listens to her patients.  She understands her patients!  If you need an Endocrinologist, and you live in the Dallas area, I recommend Dr. Audrey Miklius!  She is the doctor that finally helped me find out what was wrong with me. 

Early Thursday Thirteen

Thirteen Things about Health Insurance Companies 1. They only care about money 2. They do not want people to get better. 3. They over-rule your Doctors recommendations 4. They give crappy customer service 5. They live for fucking people’s lives up 6. They make money off of the sick and dying 7. They discriminate 8. They demoralize 9. They are unorganized 10. They bring shame onto this country. ( See the movie Sicko!!!! People in France, England, Canada and even Cuba were amazed at how bad our health care system is thanks to Health Insurance Company Greed.) 11. I HATE THEM!!!! 12. greed, Greed, GREED GREED GREED GREED GREED GREED GREED GREED $$$$$$$$$$$$$$$$$$ $$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$ $$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$ 13. They would rather people stay sick or die, then get the treatment they need.

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I Still Hate Insurance Companies and Drug Companies (Escpecially Eli Lilly)

I just thought I would give you all an update about my Humatrope.  Since receiving the letter from Aetna Denying my Humatrope, my doctor has submitted an exception request, and then an appeal.  The lack of customer service at Aetna is incomprehensible!  The lack of assistance that I am getting from Eli lilly is even more ridiculous!!!!! 

Eli Lilly has an organization created to assist the patients, The Humatrope Reimbursement Center (HRC).  I have to say they are wasting their money with this one!!!  I have been working with this group since last year, and it is like smashing your car into a brick wall while driving 100 miles an hour. 

I have called this place and called this place and called this place to no avail.  The person assigned to my case, is this chick named Vanessa.  The woman never returns my calls, and rarely answers her own phone.  When she does call me, she mixes my case up with others, asks questions she has asked before, and makes promises she never keeps, and then blames her mistakes on my doctor’s office.  

The Humatrope Reimbursement Center (HRC) is supposed to help patients with:

• Obtaining a description of the benefits provided through their insurance plans.
• Understanding their insurance coverage and what options are available.
• Coordinating and submitting claim forms and documentation required by their insurers.
• Appealing any denials of coverage from their insurers, whenever possible.
• Exploring other sources of coverage and reimbursement.
• Working with their doctors’ offices to make sure all necessary information is promptly supplied to each patient’s insurer.

I know this is a free service they are providing, so I hate bitching about it, but I am telling you they seem to be more of a hindrance then a help.  They wasted my doctors office time by having them fill out the same paperwork 5 times.  It was so bad that the drug rep and her boss had to go to my doctors office to finally complete the paperwork.  My doctors office kept blaming the HRC, and the HRC kept blaming my doctors office.  This process literally took months.  If the list above is what they are supposed to be doing, I can tell you that from my experience, they have not helped me with any of those issues.  I had to hound them to help me, I gave them information about my insurance company, I have had my doctors office fax, call and mail them information.  They open and close my case with no rhyme or reason, and Vanessa from the HRC told me that she could not help me with the exception or the appeal.  Once again, Elli Lilly states that the HRC is supposed to assist with this.  I could go on and on about the problems I am still having with this group!

Now, let me talk about Aetna.  My doctor’s office, the Humatrope Reimbursement Center, and I, have faxed, called and mailed information to Aetna.  We have sent test results, lab results, and the letter of Medical Necesity to them over a million times.  Every time I call Aetna to get a status update, they tell me they have not received any of this information!!!!!!!!!!!!!  Okay now, WHO IS LYING??????  Is it Aetna?  Is it my doctor’s office?  Is it the Humatrope Reimbursement Center?  Is it me?  If I am not already crazy, I think I shall be soon.  Why is this so complicated?  I have an illness, Adult Growth Hormone Deficiency.  My doctor tested me for it.  My doctor prescribed medication for it.  You would think it would not be so f*%@$g difficult to get the medicine I need to live a normal life!!!!!!!!  I am truly about to just give up.

I Hate Health Insurance Companies!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

I received a letter on Saturday from my health insurance company.  They have decided  not to approve my Humatrope.  This is a drug that is very important to me, because I have Adult Growth Hormone Deficiency.  The letter was signed by some dude named Mark Rubino, R.Ph, M.H.A..  He is the Chief Pharmacy Officer with Aetna Pharmacy Management.  Why can a pharmacist override the decisions and directions of a doctor?????????????  My doctor thinks I need the medicine!  My doctor went to Medical School.  Then she completed specialty training in endocrinology.  Did Mr. Rubino?  No, I think not!  I also went through a 4 hour L-dopa/Arginine test that proved that my body does not produce growth hormone.  I did not sit there for 4 hours having substances I.V.ed into my body, and having my blood drawn every 30 minutes for the fun of it!!!  @#!*%$#@  I did not undergo closed MRIs that lasted what seemed like forever to just entertain myself!  *&^%$#*@ Who are these people that make these arbitrary decisions about my health????? 

 I am sure they will get their bonuses for turning down patients who need help!  Michael Moore’s movie Sicko was right on target.  If you have not seen it, I highly recommend it. 

I feel right now that I am in a battle for my life.  I want to live a better quality of life, a normal life.  It has taken seven years to find answers to the problems causing the deterioration of my mental and physical health.  Now that I have a big part of that equation solved, I can’t get the medication anymore that was helping me work towards obtaining the life I once had, and the life I dreamed about.  The medication I need is Human Growth Hormone, and now with baseball players, and possibly other athletes misusing the drug, it is going to make it harder for people like me to obtain it.

I have a somewhat rare disorder called Adult Growth Hormone Deficiency.  What this means is that my pituitary gland does not produce Growth Hormone.  In adults, Growth Hormone Deficiency can cause the following list of problems:

• weakened heart muscle contraction and heart rate
• increased arterial plaque and blood pressure
• elevated lipids or fats in the blood:
 - cholesterol 
 - low density lipoproteins (LDL)
 - triglycerides
• decreased exercise capacity due to decreased cardiac output
• decreased energy due to decreased metabolic rate
• abnormal body composition:
 - increased abdominal obesity (waist to hip ratio)
 - decreased bone density due to decreased synthesis of bone
 - increase in fractures and osteoporosis
 - decreased muscle strength and muscle size
 - decreased lean body mass
 - increased fat mass
• low blood sugar:
 - dizziness or fainting
 - weakness or tiredness
 - headaches
 - poor concentration or memory
Physical Symptoms
 - lack of energy or fatigue
 - decreased sexual desire
 - muscle weakness
 - sleep problems
 - weight gain
Psychological Symptoms
 - shyness
 - withdrawal from others
 - nervousness or anxiety
 - problem with sleep quality
 - decreased social contact
 - sadness or depression
 - feelings of hopelessness
My Adult Growth Hormone Deficiency was caused either from some sort of head trauma (I had a very physically and sexually abusive childhood,) or from a prolactinoma or small pituitary tumor that has damaged my pituitary gland.  This has also reeked havoc with my hormones causing me to lactate (produce breast milk), and problems like having my period every two weeks.  It also might have caused my Hypothyroidism as well.  According to the Pituitary Network Association, 1 in 5 people have pituitary tumors.  In most cases they go undiagnosed unless a person develops some of the symptoms, and like in my case, once they start producing symptoms they can go misdiagnosed for years.

I went over 7 years battling the symptoms, going from specialist to specialist, and each doctor telling me to “just exercise and lose some weight,” which is hard for people with this disease to do because it causes enlargement of the heart, physical exertion intolerance, and causes your body to convert muscle to fat faster.  Doctors also told me that my symptoms were related to the sexual abuse I received as a child, or because I was on anti-depressants.  Depression, isolating behaviors, and apathy syndrome are also symptoms of my illness.  One endocrinologist, rated as one of the top in the Dallas area by D Magazine, without any testing looked at me, listened to my symptoms and simply told me quote “you are just too fat.  Exercise, lose some weight, or have a gastric bypass.” Endocrinologists are the specialists that are supposed to diagnose this problem!  All the while both my physical and mental health were declining.

It started for me at the peak of my professional career.  I had been working in Telcom/Technology for eight years, was making more then $80,000 dollars a year, and was looking forward to hopefully one day also having a family in addition to my career.  Back then I never dreamed I would be where I am now, alone, fighting a mental and physical illness that has destroyed my life and my body.  Without Humatrope, the Growth Hormone that I have been on, my life is not worth living!  I have been on the medication for about a year and a half and the improvement in my physical health has been tremendous!  I can now exercise, walk my dog, and even walk into the grocery store from a far parking spot without collapsing in exhaustion, all of which I used to not be able to do.

Now my new insurance carrier does not want to cover the drug, and even if they do the percentage I will have to pay will go up significantly.  Since this is a costly drug, it will be a struggle for me to afford it.  It is a catch 22 situation.  I want to have my life back, and the main drug that will help me to do this, I can not get!  I am at a loss for what to do, please help!