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Author Topic: I'M APPROVED!!! Woo-hoo!  (Read 2333 times)

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Offline nikkiluv

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I'M APPROVED!!! Woo-hoo!
« on: March 26, 2009, 09:57:22 PM »
Hi everyone,

I can't even believe how wonderful of a day today has been. A lady that I have been dealing with my case at US Bioservices (with Genzyme) called me today to let me know that my insurance has approved my ACI!! I'm absolutely on cloud 9 right now. The lady called me last Friday to let me know that she needed additional information from me. I sent it to her on Monday, and when I called to verify she received it on Tuesday, she told me that I had a couple things going against me. For one, I had not had microfracture before, which many insurance companies prefer you have prior to ACI because it's apparently "more conservative." My defect is on my tibial plateau, which is an "off-policy" area for ACI, which meant they may or may not cover it. However, when I called my doctor's office the administrative assistant believed I had a really good chance for approval. Also, my case is a little bit different because I'll also be having a distal femoral osteotomy along with my ACI. None the less both my doctor's office and Genzyme sent everything they could to my insurance company along with their fingers crossed.

Well I've been hoping and praying every day for my insurance company to approve the surgery ever since I had my biopsy, and things came through today!! I still can't believe how quickly everything happened. I had my biopsy on March 13th, and I heard back today that I was approved...less than 2 weeks! Now I'm just waiting for all of the papers to go through and my doctor's office to contact me to start scheduling everything (along with my cells to finish growing).

I felt like I just had to share the news with people who can relate how wonderful it is to hear such fantastic news!!! I can't thank everyone that I've dealt with enough...everyone at Dr. Minas' office, Jann at US Bioservices, and Aetna for approving my surgery. I finally feel like things are finally happening and I can start planning things and begin on the road to recovery and hopefully having my life back! :)
03/25/05 - RK debridement
12/22/05 - RK medial meniscal repair
10/31/08 - RK partial lateral menisectomy
03/13/09 - RK ACI biopsy
05/18/09 - RK ACI/DFVO
01/06/11 - ACI failure confirmed
*Currently awaiting call for fresh Osteoarticular Allograft Transplant cadaver match & removal of femoral hardware

Offline Penny W

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Re: I'M APPROVED!!! Woo-hoo!
« Reply #1 on: March 26, 2009, 10:00:38 PM »
Sometimes it is worth the extra effort and patience and we can't give up on ourself.I hope this fixes everything hope to hear the date soon.Take care
June 2003 L knee scope with the holes for tissue regeneration
Sept 2003 R knee scope
March 2005 L foot cyst removed
June 2006 Broke L ankle 2 plates 18 screws
Feb 2007 L ankle scar tissue removal
Nov 2007 Plate broke in ankle removed and replaced with bone putty
Dec 2008 R knee TKR w/lat rel.

dileigh

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Re: I'M APPROVED!!! Woo-hoo!
« Reply #2 on: March 26, 2009, 10:47:39 PM »
Congrats on making it over the insurance hurdle!   Keep us posted on the schedule.

Now you can do all the stuff you need to do to keep you occupied and comfortable (as much as possible) afterwards.


Diana

Offline momhanaway

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Re: I'M APPROVED!!! Woo-hoo!
« Reply #3 on: March 26, 2009, 11:39:50 PM »
YAY!  Daughter and I both cried the day we found out that she was approved.  Understand completely.

Offline nikkiluv

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Re: I'M APPROVED!!! Woo-hoo!
« Reply #4 on: March 27, 2009, 05:33:32 AM »
Thank you, Penny W, dileigh, and momhanaway for such encouraging words. I can honestly say this board is such a great support system and has truely been a blessing to come across.

momhanaway,

I was actually with my dad and he was driving around with me and we were running errands. I originally forgot to bring my cell phone and was upset because I've been glued to that thing on pins and needles waiting for an approval. We ended up stopping home really quick before going out of state, and low and behold not even 5 minutes after getting my cell phone I got the call saying I was approved. I did completely lose it to be honest and just started bawling and I was shaking (good thing he was driving). I seriously confirmed it with the lady like 5 times stating, "so you said I'm approved, I'm approved right?" I got off the phone and could barely get the words out to tell my dad, and then called my mom at work. When I got a hold of her I started to cry and she thought something was seriously wrong, but once I got the words out she said I better stop crying because she was going to cry too. I was in shock and don't think I believed things went so well, especially after hearing some horror stories on here. I guess just keeping the faith and a positive attitude that things would work for the best really helped.

Thank you all again. I look forward to sharing a date with everyone, and then hopefully starting my own pre-op/post-op recovery diary. I've learned so much from everyone else on here that I would like to try and do the same for someone else who may be in the same situation as me and can learn something from my experience.
03/25/05 - RK debridement
12/22/05 - RK medial meniscal repair
10/31/08 - RK partial lateral menisectomy
03/13/09 - RK ACI biopsy
05/18/09 - RK ACI/DFVO
01/06/11 - ACI failure confirmed
*Currently awaiting call for fresh Osteoarticular Allograft Transplant cadaver match & removal of femoral hardware

Offline courtem10

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Re: I'M APPROVED!!! Woo-hoo!
« Reply #5 on: March 27, 2009, 01:51:43 PM »
i can totally relate to you as well, nikkiluv. it was such a bittersweet moment to hear the approval. soo happy that the ordeal would soon be in the past,  but also nervous & scared what the next 2 years would be like. nevertheless, congratulations and let us know how everything turns out

courtney
7/08 Left knee microfracture
12/08 Left knee ACI biopsy
4/09 Left knee ACI/AMZ

Offline nikkiluv

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Re: I'M APPROVED!!! Woo-hoo!
« Reply #6 on: March 27, 2009, 03:02:30 PM »
Hi Courtney,

Thank you and good luck on your upcoming surgery. Is yours in early April? I look forward to reading about your recovery and how everything turns out for you as well.

Nicole
03/25/05 - RK debridement
12/22/05 - RK medial meniscal repair
10/31/08 - RK partial lateral menisectomy
03/13/09 - RK ACI biopsy
05/18/09 - RK ACI/DFVO
01/06/11 - ACI failure confirmed
*Currently awaiting call for fresh Osteoarticular Allograft Transplant cadaver match & removal of femoral hardware

Offline courtem10

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Re: I'M APPROVED!!! Woo-hoo!
« Reply #7 on: March 27, 2009, 03:11:58 PM »
Yeah mine is wednesday, April 1st. So 5 days left until the big ordeal. Where is your cartilage damage?? I am having patellar ACI with an AMZ/Fulkerson osteotomy in Connecticut.

Courtney
7/08 Left knee microfracture
12/08 Left knee ACI biopsy
4/09 Left knee ACI/AMZ

Offline Room 101

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Re: I'M APPROVED!!! Woo-hoo!
« Reply #8 on: March 27, 2009, 04:24:41 PM »
Congrats on the approval!  It is bittersweet, but just think about how great it's gonna be!

Room 101
February 1 2008 - left knee AMZ/LR/Debridement/ACI biopsy
December 2 2008 - left knee ACI - Patela
May 25 2011 - Left knee mfx - trochlea  (ACI growth looked "pristine"), Right knee ACI biopsy
September 5, 2012 - Right knee AMZ/ACI - patella

Offline nikkiluv

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Re: I'M APPROVED!!! Woo-hoo!
« Reply #9 on: March 27, 2009, 04:36:59 PM »
Thanks, Room 101. I know it is so bittersweet and it's so hard to share such excitement with people that don't understand how big of a hurdle insurance approval is, as well as the chance to have a painfree/working knee after so many years of pain.


Courtney,

Wow, yours is getting so close! I bet you're feeling such a large range of emotions right now.

Well originally I've only thought my damage was on my lateral tibial plateau. However, I guess I'm starting to develop a small defect on my medial femoral condyle as well. The one on my lateral tibial plateau is grade 4 and is about the size of a quarter (20mm x 25 mm), and I guess the one on my medial femoral condyle is grade 2 and about the size of a dime (10mm x 10mm). My doctor, Dr. Tom Minas at the Cartilage Repair Center in Boston, MA, said that he's not nearly as concerned about the femoral condyle defect as he is about my tibial plateau one. He said if when he goes in if he thinks the femoral condyle needs to be fixed then he'll do the ACI there as well, but he may even do OATS there because it's so small and not that bad.

I'll be having a distal femoral osteotomy along with my tibial plateau ACI. I've had 4 scopes over 4 years (debridement, medial meniscal repair, partial lateral menisectomy, and ACI biopsy), but the first 3 were done by my first OS and every time he went in the cartilage damage was worse and worse. My last scope this past Oct. it was all the way to the bone so he referred me to Dr. Minas. My doctor is so in demand that it's about a 6 month wait before you can even get in for a consult, so when I called in November they were telling me April for a consult. However, after I registered at the hospital and called back again they had just had a cancellation for February so I took it immediately. I can't believe how fast things are moving along, however I am grateful for that so it hasn't been giving me much time to sit and think about the awful part of the surgery/rehab and with all the positive things that have been happening I've just been thinking about how great it would be to have a working/pain free knee.

Do you know what type of pain management you'll have following surgery? How long will you be in the hospital? I'll be having an epidural and I'm approved for a 3 day stay and my doctor says I'll be there for 2-3 days. I'll have a CPM immediately following surgery and will be on coumadin for 3 weeks. I find it interesting all of the subtle differences between doctors.
03/25/05 - RK debridement
12/22/05 - RK medial meniscal repair
10/31/08 - RK partial lateral menisectomy
03/13/09 - RK ACI biopsy
05/18/09 - RK ACI/DFVO
01/06/11 - ACI failure confirmed
*Currently awaiting call for fresh Osteoarticular Allograft Transplant cadaver match & removal of femoral hardware

Offline nikkiluv

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Re: I'M APPROVED!!! Woo-hoo!
« Reply #10 on: March 31, 2009, 05:27:55 AM »
I'm sorry if you've already read this since I've posted it on like 3 other boards, but I'm not sure who follows what and I just want to make sure all the people who wanted to stay informed are, haha.

So there's a bit of good and bad news for the day. The bad news: I didn't end up getting my brace  Turns out I drove a half hour to change into my shorts to get fitted only for them to tell me they ordered the wrong brace. I was pretty upset as I was looking forward to getting it, especially since today and Wednesday are my days off so I was hoping to wear it the most on those days to wean myself into it. They're putting a rush on it so they'll have it Thursday and they said no matter what they'll fit me in that day as well. I'm just frusterated because they called me Thursday to make my appointment to get it...I would've figured 3 days would've been enough time for SOMEONE to have figured out it wasn't the right brace! Oh well, like my mom said if that's the "worst thing" that's happened so far along this journey then things overall things are still going really really well. She's right, I can't complain too much.

However, the good news: I have a surgery date!!!  Offically 7 weeks from today...May 18th. I wanted it to be the first week of May, but both the first week and second week are already booked so the first available date in May was the 18th. She said I could've done it April 20/21 or April 27/28, but my parents are going on vacation the week of April 25th-May 2nd so clearly neither of those days would've worked. It's okay anyways though because the more I thought about things the better it is for me because I'll have more time to physically prepare myself (gotta build up all the muscles I can, hopefully lose a few more pounds), and hopefully take some vacation time (at my work vacation time is based on your hire date, and my hire date is the end of May so I have to use at least one week's work of vaca so I don't lose it before my surgery!!).
03/25/05 - RK debridement
12/22/05 - RK medial meniscal repair
10/31/08 - RK partial lateral menisectomy
03/13/09 - RK ACI biopsy
05/18/09 - RK ACI/DFVO
01/06/11 - ACI failure confirmed
*Currently awaiting call for fresh Osteoarticular Allograft Transplant cadaver match & removal of femoral hardware

Offline Room 101

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Re: I'M APPROVED!!! Woo-hoo!
« Reply #11 on: March 31, 2009, 04:33:13 PM »
Glad to hear things are progressing for you... It probably feels good to have that date and now begin to plan for it :)
February 1 2008 - left knee AMZ/LR/Debridement/ACI biopsy
December 2 2008 - left knee ACI - Patela
May 25 2011 - Left knee mfx - trochlea  (ACI growth looked "pristine"), Right knee ACI biopsy
September 5, 2012 - Right knee AMZ/ACI - patella

Offline courtem10

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Re: I'M APPROVED!!! Woo-hoo!
« Reply #12 on: March 31, 2009, 05:36:50 PM »
sorry to hear about the setback with the brace, but congrats on the approval!!

courtney
7/08 Left knee microfracture
12/08 Left knee ACI biopsy
4/09 Left knee ACI/AMZ