Hi Mike,
I had a great trip to Salt Lake a few weeks ago to see Dr. Vitale. The John A Moran Eye Center was state of the art and everyone treated me with great care. They were thorough in taking my history and assessment. Dr. Vitale is quite impressive. After discussing my history he considered the fact that in a stepladder appoach to care I had never been treated with the NSAID approach before starting the DMARDS. So, it was decided that instead of proceeding to using Humira, with its toxicity and side effects, that we will try Celebrex. Humira is an option but, we will hold that out after trying the NSAID approach.
I felt very reassured after meeting with a doctor who knew EXACTLY how to treat iritis. The rest of my autoimmune issues remain a puzzle to be put together... but will remain vigilant in putting the puzzle together.
After returning home, I contacted my rheumatologist to let him know that Dr. Vitale had suggested a different treatment plan and he is NOT in agreement!?! He told me that there is no evidence suggesting that Celebrex has any effect on iritis. I called Dr. Vitale's office on Monday and they faxed my rheumatologist a note as well as had Dr. Vitale call him. They are so great to work with me from another state!
I received a call from my rheumatologist's assistant yesterday, they want me to come and meet with him Thursday. The assistant said that he had talked to Dr. Vitale and reviewed his note. I asked them what his response was to the treatment plan and she could not tell me!?!? I wonder if he is going to try to talk me out of it at my appointment? In that case I guess there are other rheumatologists...
I just wanted to THANK YOU for helping me find Dr. Vitale! The support you offer through this site is appreciated beyond words!
Tammie
post Dr. Vitale visit update
Moderators: Mike Bartolatz, kwork
post Dr. Vitale visit update
Tammie in Arizona
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Mike Bartolatz
- Posts: 6595
- Joined: Fri Feb 06, 2004 9:58 pm
Re: post Dr. Vitale visit update
Tammie,
it really amazes me how crazy some of the responses by doctors are toward one another. I do hope that you can find a team that will help you locally get MODERN treatment for this stuff and to enable you to get to durable remission.
the biological meds alone cannot get you to remission, just control of uveitis. they lose their effectivness over time in many people as well. the can work along with other meds to get one to remission.
it seems so strange that something as simple as use of an NSAID to treat autoimmune uveitis which has shown to be very effective in between 60 to 70 % of patients carefully selected by the ocular immunologist is fought by some others without the experience to really comment on effectiveness in this group of patients. they can't even see into the eye for the effect as they don't have a slit lamp since they aren't opthalmologists. many even use the meds at too low of dose to even give them a chance.
sorry for the rant,
mike
it really amazes me how crazy some of the responses by doctors are toward one another. I do hope that you can find a team that will help you locally get MODERN treatment for this stuff and to enable you to get to durable remission.
the biological meds alone cannot get you to remission, just control of uveitis. they lose their effectivness over time in many people as well. the can work along with other meds to get one to remission.
it seems so strange that something as simple as use of an NSAID to treat autoimmune uveitis which has shown to be very effective in between 60 to 70 % of patients carefully selected by the ocular immunologist is fought by some others without the experience to really comment on effectiveness in this group of patients. they can't even see into the eye for the effect as they don't have a slit lamp since they aren't opthalmologists. many even use the meds at too low of dose to even give them a chance.
sorry for the rant,
mike
Mike Bartolatz
Moderator
Moderator
Re: post Dr. Vitale visit update
Hi Mike,
I guess I just wanted to take my turn to rant... It's been almost a month now since my visit with Dr. Vitale and I have still not started the suggested treatment!! I met with my rheumatologist, who after receiving a telephone call and letter from Dr. Vitale agreed to oversee the Celebrex treatment as suggested. I have since been waiting for "pre-authorization." I didn't know if it was the doc's office, pharmacy, or insurance company that was holding things up. I spoke to each in succession, trying to get the ball moving - all to find last Friday that the rx was denied!!!! HOW CAN THEY DO THIS!!!! I spend money out of my pocket to fly to another state to seek medical care that is the best for my condition, I receive the advice from an expert, and then I bring the plan to my local docs and get them on board... all to have some paper pusher somewhere tell me that they have DENIED the sound, medically based treatment plan of a physician. Why do we have doctors?? I have just been transferred to 3 different people at AETNA to be disconnected! Just thought I'd get online and see if you had any suggestion for appealing this claim??
Thanks again!
Tammie
I guess I just wanted to take my turn to rant... It's been almost a month now since my visit with Dr. Vitale and I have still not started the suggested treatment!! I met with my rheumatologist, who after receiving a telephone call and letter from Dr. Vitale agreed to oversee the Celebrex treatment as suggested. I have since been waiting for "pre-authorization." I didn't know if it was the doc's office, pharmacy, or insurance company that was holding things up. I spoke to each in succession, trying to get the ball moving - all to find last Friday that the rx was denied!!!! HOW CAN THEY DO THIS!!!! I spend money out of my pocket to fly to another state to seek medical care that is the best for my condition, I receive the advice from an expert, and then I bring the plan to my local docs and get them on board... all to have some paper pusher somewhere tell me that they have DENIED the sound, medically based treatment plan of a physician. Why do we have doctors?? I have just been transferred to 3 different people at AETNA to be disconnected! Just thought I'd get online and see if you had any suggestion for appealing this claim??
Thanks again!
Tammie
Tammie in Arizona
-
Mike Bartolatz
- Posts: 6595
- Joined: Fri Feb 06, 2004 9:58 pm
Re: post Dr. Vitale visit update
GGet your doctors involved in this appeal. in the mean time ask if you can take Difusinal a Cox 1 inhibitor/NSAID that seems to work in some people quite well.
Celebrex is expensive and insurance companies don't want to pay for it. ask your pharmacist if it is in the drugs listed by the insurance company. often one can get it approved on appeal. you could also go to your state insurance commissioner and file a grievance against the insurance company for not allowing this drug which is needed as it has the best track record against uveitis and is allot cheaper than the biological meds such as Remicade and humira at over 2,000 bucks a month.
Rant anytime, thats why we are here.
wish you the best,
Mike
Celebrex is expensive and insurance companies don't want to pay for it. ask your pharmacist if it is in the drugs listed by the insurance company. often one can get it approved on appeal. you could also go to your state insurance commissioner and file a grievance against the insurance company for not allowing this drug which is needed as it has the best track record against uveitis and is allot cheaper than the biological meds such as Remicade and humira at over 2,000 bucks a month.
Rant anytime, thats why we are here.
wish you the best,
Mike
Mike Bartolatz
Moderator
Moderator