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Prayers are answered ~~~
Prayers have been answered in more than 1 way, thanks to all of you!
As you recall, CVS/Caremark my BCBSIL pharmacy denied coverage for Tykerb.
My Oncologist appealed it and it was denied.
I contacted my husbands employer, as they are self insured and plead my case with them. They said my Dr. could appeal one more time. I knew she wouldnt, she was so upset at the insurance/Caremark.
Soooo, I filed my own appeal the other night, marked it urgent and included alot of documentation from all of you. I truly felt I didnt have a chance on this, but at least I would get my "day", and have the last word.
I started to fervently look in Indiana, ohio, Michiga, etc for a T-DM1 trial that I could qualify for...I spent 3 days non stop on the phone. I explained the urgency at getting in, as I am due to have herceptin Tuesday. I ffinally get an appt. in a week to see if I qualify, faxed them all my recent info and scans, filled out paperwork, and have to have another Brain MRI, Muga and Bone Scan....this trial is an open label with pertuzumab.
I decide i really should call my oncologist today and let her know what I am doing. She returns my call today and tells me she got a call from a Dr who oversees second appeals, he reviewed mine, and said he was overiding the previous decision and I am eligible for Tykerb as a solo agent with herceptin.
I am overwhelmed...my prayers are getting answered in multiples.....and now i need to make a decision on whether to go the Tykerb/Herceptin route, or see if i qualify (and I am almost positive I will) and do the T-DM1 / Pertuzumab Trial.
The way I look at it, if i progress on T-DM1, I can always go back to Tykerb, but if I progress on Tykerb, i will be to late for the T-Dm1 trial....
So i am calling a friend on this one (all of you)
...my oncologist says its up to me
What would you do......I need to have a plan in place by Monday of next week.....
Thank you for all the support, your teamwork has made this happen!!!!
__________________
"Be kinder than necessary, for everyone you meet is fighting some kind of battle."
Hugs & Blessings
Sheila
Diagnosed at age 49.99999 2/21/2002 via Mammography (Calcifications)
Core Biopsy 2/22/02
L. Mastectomy 2/25/2002
Stage 1, 0.7cm IDC, Node Neg from 19 nodes Her2+++ ER PR Neg
6/2003 Reconstruction W/ Tissue Expander, Silicone Implant
9/2003 Stage IV with Mets to Supraclavicular nodes
9/2003 Began Herceptin every 3 weeks
3/2006 Xeloda 2500mg/Herceptin for recurrence to neck nodes
3/2007 Added back the Xeloda with Herceptin for continued mets to nodes
5/2007 Taken Off Xeloda, no longer working
6/14/07 Taxol/Herceptin/Avastin
3/26 - 5/28/08 Taxol Holiday Whopeeeeeeeee
5/29 2008 Back on Taxol w Herceptin q 2 weeks
4/2009 Progression on Taxol & Paralyzed L Vocal Cord from Nodes Pressing on Nerve
5/2009 Begin Rx with Navelbine/Herceptin
11/09 Progression on Navelbine
Fought for and started Tykerb/Herceptin...nodes are melting!!!!!
2/2010 Back to Avastin/Herceptin
5/2010 Switched to Metronomic Chemo with Herceptin...Cytoxan and Methotrexate
Pericardial Window Surgery to Drain Pericardial Effusion
7/2010 Back to walking a mile a day...YEAH!!!!
9/2010 Nodes are back with a vengence in neck
Qualified for TDM-1 EAP
10/6/10 Begin my miracle drug, TDM-1
Mixed response, shrinking internal nodes, progression skin mets after 3 treatments
12/6/10 Started Halaven (Eribulen) /Herceptin excellent results in 2 treatments
2/2011 I CELEBRATE my 9 YEAR MARK!!!!!!!!!!!!!
7/5/11 begin Gemzar /Herceptin for node progression
2/8/2012 Gemzar stopped, Continue Herceptin
2/20/2012 Begin Tomo Radiation to Neck Nodes
2/21/2012 I CELEBRATE 10 YEARS
5/12/2012 BeganTaxotere/ Herceptin is my next miracle for new node progression
6/28/12 Stopped Taxotere due to pregression, Started Perjeta/Herceptin
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