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24 Jan 2010 14:32
  • tacmom
  • tacmom
My work went under a new insurance plan this month. Do you know if most insurance companies would consider Rituxan a "medically necessary" treatment? I was trying to look through my insurance book and prescription book and I don't see any of the conventional therapies for ITP listed except for Prednisone and Imuran. Does your dr usually make the call to get Rituxan preauthorized or do you have to do it? I am trying to get the process started so we can get this infusion started for Caitlin.
24 Jan 2010 16:41
  • alisonp
  • alisonp
I am not sure that there will be a good answer to this, but I've decided to ask the question anyway.

Dougie has just got out of the shower. He has loads of petichiae on his legs and feet, and fewer over the rest of his body. He only used to get petichiae and bruising at counts under 10 or so, but then in October, he started getting bleeding under his skin (like a graze without the broken skin) from scratching or knocking himself at relatively high counts (20 to 30). I've just looked at his legs now, and although he hasn't got any of the raised bruises, a lot of his legs just look dirty. I thought he was still covered in mud from football and I unsuccessfully sent him back into the shower to try again with the soap, lol! But when I look closely, it is like bruising, but a long way under his skin.

I am losing confidence in my ability to work out what his count is, and therefore to decide what he should or shouldn't be doing at any point in time. This is becoming particularly difficult because his count has been all over the place in the past couple of months (between 33 and 123, but possibly lower at the moment). Today, for example, we let him play footie for his team today. Lots of hard tackles, although we've banned him from heading the ball ever since he got ITP. Now I am wondering whether we should have not let him do so because the consultant said he should'nt be playing competitively with a count under 30 - in my defence I didn't think it was anywhere near that bad until I saw him fresh from the shower!

So what I want to know is

a) whether ITP symptoms are consistent over time with your kids or do they change from month to month, and

b) if their symptoms are not consistent, how on earth do you decide what activities should be restricted or not at any point in time.

He is going for a blood test tomorrow anyway. I don't work Mondays so if he needs to go, I always try to arrange it then. But if his count continues to yo-yo like it has done recently, I need a better way of reading the symptoms because this continual testing just makes me paranoid!

Thanks for reading this stupidly long post,

Ali
24 Jan 2010 16:56
  • alisonp
  • alisonp
Hi Pauline

Your posts about insurance make me feel grateful for the NHS - thank you!

Having said that , there are also a lot of drugs that we would find it difficult to get on the NHS, either because they haven't been approved by NICE (national drugs approval body) or because the local health authority hasn't got sufficient funds. So for example, my dad has a form of bone marrow cancer called myeloma. He gets treatment with a new and very expensive drug that seems to work really effectively for him, but a friend of his who lives about 100 miles away from him can't get that drug because his local health authority won't pay for it! So this is probably just as much of a lottery in the UK.

Hope it isn't too difficult for you to get Caitlin's treatment approved anyway and that she has some improvement from it.

Ali
24 Jan 2010 18:26
  • snowgoose
  • snowgoose
That is the first step in the battle won! Thank you God for answered prayers. Praying that you will continue making steps towards a full recovery Steve.

Love and prayers to you and your family

Vanessa :)

Thank you so much for passing on this good news Sandi.
Category: Social Chat
24 Jan 2010 18:45
  • Sandi
  • Sandi
Pauline:

It all depends on the insurance company and the type of policy you have. I had Health Assurance and was denied...they wouldn't change their minds. Then I got switched to BC/BS and they denied at first, but approved after appeal.

I would think that you could appeal and win based on the fact that Caitlin has gone through most treatments with little result.
24 Jan 2010 20:08
  • tofer
  • tofer
Steve will be again in my prayers tonight & everyday. Until he can respond and tell us he's praying for us. <giggle>
Hang in there Steve.
Category: Social Chat
25 Jan 2010 01:01
  • liam12
  • liam12
hi,my mane is Jenny,my son Liam is 4 years old and was diagnosed with itp in April last year
his platelet levels were 7 .He has had all the other tests to rule out any other nasties,in the last 10 months he has had steroids ,wich are fine if you dont take into account the side effects or that the last time he was on them for one week his levels only went up to 40. Without the steroids his levels are consistently at around 20-25 give or take.Liam is due to start school this weekand i am more worried than ever about wether he will be ok,mid you he can hold his own as he has 2 older btothers.Liam is beig seen//treated at The Royal Childrens Hospital in Melbourne,Australia,his heamatologist reasures us he will be fine,I am absolutely petrified as i wont be with him to constantly remind him to slow down,stop climbing etc.. We have tried naturapaths and other herbs ,all to no avail.For some unknown reason i expected his levels to go up just before he started school,and when they didnt the dissapointment was nearly as bad as hearing it for the first time.Its been great to let off some steam and emotion.Thankyou,it would be great to hear from anyone,Jenny
25 Jan 2010 01:14
  • liam12
  • liam12
hi , my name is Jenny,my son Liam is 4 and a half,he has had itp for at least 10 months ,Liam gets purplish circles under his eyes and gets quite pale and tired along with a couple of extra bruising for good measure! his doctor says these symptoms are not typical of itp but every time he gets like this and even if his bruising has not gotten worst yet i am normally spot on that his levels have gone down. Jenny
25 Jan 2010 03:32
  • Angel85
  • Angel85
Thats Great Cindy, hopefully they stay around the same level, i'm still having weekly counts at the moment
25 Jan 2010 03:39
  • Angel85
  • Angel85
I used to think so, but now i'm not so sure. My last platelet count was 76 last week and i have about 4 or 5 bruises on my legs and heaps of petichiae, more then what i had when they were at say 20, unless they have suddenly gone down, which i am hoping not cause i am still on 40mg of pred a day. I had another count done today, so i'll guess i will know in a day or two if they have gone up or down again.
25 Jan 2010 04:04
  • Angel85
  • Angel85
Hi Jenny,

Sorry you have had to find this forum, but it is a great resource for ITP and has wonderful helpful members. I am also from Australia, I live in Newcastle in NSW and I am 24 and have been dealing with low platelets all my life, so i can understand what Liam would be going through and that at his age he wouldn't be able to understand much of what his happening to him.

I am currently on prednisone at the moment and i hate it too, so i feel sorry for him having to have that at such a young age. I wouldn't let him stay on it for a long period of time, I had it for quite a long time when i was younger and i hated what it did to me and my mum also hated to see what it was doing to me too.

It is scary thinking about what could happen, but platelets at 20 and over, you can function normally and do most every day activities, so try not to worry too much and just let him enjoy being at school with the other kids and i'm sure his teachers will watch over him as well if you explain to them what he has. I have to admit even now at my age, my mother still worries about me when my platelets are really low and always says before i leave be careful, i think it is just a mother's job to worry about her kids.

I feel dissapointed every time my counts come back low, it feels like you have to start all over again.
25 Jan 2010 06:07
  • CindyL
  • CindyL
Tamar, I go to the IV Day Hospital, which is a specialty clinic; there is also a blood lab that is strictly for regular blood tests.

I started going on Sundays because I don't like to drive in the winter and Steven doesn't work Sunday's, so he drives me.
25 Jan 2010 06:09
  • CindyL
  • CindyL
25 Jan 2010 06:20
  • alisonp
  • alisonp
Angel85

Thats just exactly like I think with Dougie - for the first 6 months, I knew what symptoms went with what counts, but now I am "not so sure". Its helpful to know that petichiae can show at higher numbers though, because he has only got them before at quite low numbers.

Dougie had a count of 60 a fortnight ago, and I really hope its still somewhere near there. Just got back from a blood test, so we should know this afternoon anyway.

Thanks for the reply

Ali
25 Jan 2010 07:49
  • xray001
  • xray001
Ali - I hope that Dougie has a good count, but unfortunately, I dread that it will not be.

Isn't that just the thing that really sucks about this -- you can never really know from one day to the next.

Danica was 118 on Friday (which is normal for four days after IVIg), but her white cell count was low, meaning that she has a viral infection. She has been super tired all week, and now I know why.

She went water sliding on the weekend (friend's birthday party) and had fun, but was tired. I am wondering if she will bruise from the sliding. She bruised when she went tobogganing a couple of weeks ago. Nothing serious, but did bruise all the same.

Anxious to hear your results today.

Michelle
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