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For My Beautiful Migraine and Headache Family

Beautiful275Problem Migraines and Headaches can really bring us down, not only physically, but emotionally as well. They can sap our strength, our self-confidence, sense of self-worth, and our hope. These are issues we need to work on, and one very important reason we need to work on them is that our self-perception so strongly affects how other people perceive us.

Every human being is indeed beautiful, but Headaches and Migraines can make it harder for us to remember that and claim it for ourselves. Sometimes, we can use some help in this area. So, today, I want to share a video with you. In this video, Carole King performs a song that I fell in love with years ago.

Please view this video and listen to the song knowing that I care for you, and I know that you ARE INDEED beautiful. I listen to this song to start out each day. Maybe you'll want to bookmark this page so you can come back to it when you need a reminder that you're beautiful.

Live well,

PurpleRibbonTiny Teri1
 

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© Teri Robert, 2014
Last updated September 27, 2014.


Migraine Medications, Insurance Coverage, and Profits

ExPtThe recent issue with Aetna's coverage (or non-coverage) of Botox for Chronic Migraine made me think of the various problems I've had with my prescription medication coverage over the last several years. For many years, Medco Health was the pharmacy benefits manager who handled my prescription coverage. Then Express Scripts bought Medco, which made Express Scripts the largest pharmacy benefits manager company in the U.S.

Before any of the triptans came out in generic form, Medco wanted me to switch to Relpax. I didn't want to because at that point, Maxalt worked better for me. In fact, Relpax seldom worked at all. In looking at all of my options, I found something quite curious. We're always show what insurance pays as well as our co-pay. We can look up the various medications for a price quote as well. Guess what? Medco would have paid 27% more for a Relpax prescription than they would have for a Maxalt prescription with the same number of doses. I was astounded. My husband, on the other hand wasn't. His theory was that Medco was probably getting better prices on other meds, and that those better prices offset the higher prices they paid for some others. Did we have any proof of this? No, as I said, it was a theory.

Then came an episode where they stopped paying for a medication I'd been taking for about eight years - unless my doctor got a prior authorization. And, of course, they denied it. It took months to appeal, during which time we had to pay around $400 per month for it, or I had to do without it. The medication was Namenda, a medication developed for Alzheimer's disease, but now also prescribed off-label to keep glaucoma from progressing. Now, let's see. Did I want to pay for the Namenda, or did I want to risk complete blindness? What do you think? We paid for it. Now we have to go through the denial and appeal process every six months. How absurd is that?

I just read an interesting piece on the Wall Street Journal site, "Officials Probe Express Scripts's Ties With Drug Makers." During three consecutive months this year, Express Scripts has received three subpoenas:

  1. From the U.S. Department of Justice, District of Rhode Island, related to its contractual relationships with several makers of multiple sclerosis treatments.
  2. From the Attorney General of New Jersey, requesting information regarding the company's arrangements with AstraZeneca and its heartburn medication Nexium.
  3. From the U.S. Department of Labor, Employee Benefits Security Administration related to Express Scripts's client relationships from 2009 through the present.

Interesting, isn't it? Maybe there's something to my husband's theory. One thing is certain - we'll be watching closely for updates on this.

Overall, I'm SO beyond tired of Express Scripts essentially practicing medicine without a license, and that's exactly what they're doing when they refuse to cover a medication because it's prescribed off-label. If my doctors prescribe a medication, an insurance company or benefits manager has no business saying, "No." The same thing applies when they take a prescription for 24 triptan tablets for a 90-day supply and cut it down to nine tablets. They're circumventing my doctor's orders, changing his prescription, and they are not doctors. Even if they were, and even if they have doctors on a review panel, that only slightly changes things. In that case, those doctors are guilty of malpractice because they've changed my doctor's orders as expressed in his prescription when they have neither reviewed all of my medical records nor examined me. That's malpractice on the part of those doctors, and it's illegal.

If you have prescription medication coverage, how does it stack up? Does it meet your needs. Are your co-pays reasonable? Do you have trouble getting the medications you need? Please post a comment below and share your thoughts and experiences.

Live well,

PurpleRibbonTiny Teri1
 

Make a difference... Donate to the 36 Million Migraine Campaign!

 

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© Teri Robert, 2014
Last updated September 25 2014.


Aetna and Botox for Chronic Migraine - What a Farce!

StupidityIncompetenceHave I said that I'm thrilled not to have to depends on Aetna to cover my treatment for Chronic Migraine? No? Well, I am truly thrilled that my insurance coverage changed from Aetna to Cigna the first of the year. Back in December, I shared my frustration that Aetna had denied coverage on Botox treatment for me for Chronic Migraine? Why? Essentially, because it was working too well. Since Botox had reduced my Migraine and Headache days to fewer than 15 per month, they had cut off coverage. (See Aetna Denied Botox for my Migraines - What?!) In the end, they paid it, but by the time they did, I was honestly beginning to wonder if anything was worth all the arguing and stress.

Today, I'm writing about a pathetically sad situation another patient is in with dear old Aetna. First, they questioned if the patient met the part of the Chronic Migraine definition that says the Migraines and headaches last at least four hours per day. Mind you that the doctor had charted that the patient had "continuous" Migraine with no breaks. Do you think that means four hours or more? Duh!

Then the doctor and the Aetna rep came to an Aetna requirement for Botox. The patient must have failed at least one preventive from each of three different classifications of medications. She's tried antidepressants, and they failed to help. She's failed two anti-epileptic meds, and they failed. The woman is beyond chronic, and the doctor feels it's time to try Botox. But, oh, no! Aetna insists that she try anti-hypertensives first, regardless of the fact that several of them are contraindicated for her due to other health issues.

Now here's where I just want to scream, "Stupidity and incompetence should be illegal!" Enough is enough. This poor patient has tried preventive medication after preventive medication, but they want her to try more, MOST of which have a might higher potential side effects profile than Botox does.

Anyone who's being honest will admit what's going on here. It's about the $$. Aetna doesn't want to pay for the Botox treatment. SHAME ON THEM?! If they don't want to pay for Botox, they should simply put it in their contracts and not cover it. People whose Migraines are bad enough to need Botox treatment don't need all the useless, idiotic, asinine red-tape run-arounds.

Seriously?! I repeat, stupidity and incompetence should be illegal!

Live well,

PurpleRibbonTiny Teri1
 

Make a difference... Donate to the 36 Million Migraine Campaign!

 

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© Teri Robert, 2014
Last updated September 23, 2013.


How We Respond to Migraine & Headache Awareness Opportunities

Research funding for Migraine and other Headache Disorders is woefully lacking. That's nothing new. Advocates have been working on this for years now. Something else advocates have been doing is working to raise funding ourselves, then donating it to trusted organizations who fund research.

In the wake of the ALS Ice Bucket Challenge, Dr. David Watson wanted to come up with a challenge to raise money for Migraine and Headache research funding. Dr. Watson is a Migraineur himself. He's also the director of the West Virginia University Headache Center and an active advocate. Here's the challenge he came up with:

Dr. Watson has blogged about this challenge: Migraine and Headache Awareness - The Hot Wings for Headache Challenge, but the reception to it has been less than stellar in some quarters. This hasn't as much to do with the challenge itself as it has with the way it's been received by some people.

If you've ever organized anything directed toward a group of people, you know that not everyone is going to like it or be happy with it. It's that simple. You absolutely cannot please everyone, and really, there's nothing wrong with that. It's just the way it is because people are naturally different from one another.  If we were all alike, live would be horrendously boring!

Many of us have been tagged on Facebook or otherwise invited or challenged to participate in opportunities or events that we didn't particularly like. It's gonna happen! Let's assume that we've received one for a good cause, but really dislike it for some reason other than the cause, and that there's no harm in the even or opportunity. In fact, since it's so visible right now, let's use the ALS Ice Bucket Challenge for an example.

I was challenged to this ALS challenge. Obviously, it's for a good cause. I had two options - accept the challenge or not. But I have a personal problem with the challenge. Dumping a butcket of ice water over my head would almost certainly trigger one of my Migraines from hell. It simply wasn't worth getting a Migraine, so I accepted the challenge, but made a donation instead of dousing myself with ice water.

This is a reasonable way to accept an event or opportunity that we don't particularly like, and I hope it's something everyone will consider if they're challenged during the Hot Wings for Headache Challenge and when they come across it in blogs, social media, etc.

If you have Migraine or another Headache Disorder, or if you care about someone who does, we're all in this together. It's made me terribly sad to see some comments that went beyond negative and into nasty. That's just not necessary, and it's exceedingly counterproductive. It hurts the entire Migaine and Headache community, not to mention Dr. Watson, who worked hard to come up with this challenge.

So, will you join me? When you encounter awareness events and opportunities, will you look not only at whether you like them or not, but at why they were created and what they were designed to accomplish? Will you join me in being a positive force in the community? I sincerely hope you will.

Positive450

Live well,

PurpleRibbonTiny Teri1
 

Make a difference... Donate to the 36 Million Migraine Campaign!

 

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Page copy protected against web site content infringement by Copyscape

© Teri Robert, 2014
Last updated September 5, 2014.