Radiation Prayers Needed!

Dear Family and Friends,

Today we found out that our insurance has refused approval for the type of radiation that has been prescribed for Zac.  He has been ordered IMRT (Intensity Modulated Radiation Therapy), which is the newest type of radiation.  What makes the technology novel is that this radiation can essentially be given in a 3-D manner.  Technicians are able to focus the radiation photons to the shape of the specific tumor, thus minimizing the radiation”run off” to the surrounding tissues and organs.  Since Zac’s area of radiation will be very large (over 12 inches), and he is so young in age, and because his spinal cord will be involved in the radiation area, this type of radiation is his safest option for short and long term side effects.  

Our insurance company does not see it this way.  They are calling IMRT in relation to treatment of ependymomas “investigatory.”  They went so far as to say there is no evidence that IMRT is more effective than traditional radiation for treatment of his type of tumor.  While that might be true, it’s not the effectiveness of the radiation we are worried about…it’s the side effects.  His radiation oncologist already appealed the denial, which our insurance company denied again.  The second step was sending Zac’s case to the the insurance company’s peer review board.  They also denied approval.  So, we’ve filed a formal grievance, which unfortunately could take 30-60 days to get a response.  Our doctors here and at UCLA are doing their best to get information to the insurance company, hoping to persuade them into approving the treatment.  We get one chance to try to change their minds.  

So I’m asking for prayers that the insurance company would be moved to approve the treatment.  Zac is so young to be enduring radiation and this therapy will give him the best chance of continued health in the long term.  I’d also like prayers for their decision to be hasty, as Zac cannot return to work until four weeks after radiation is complete, so time spent waiting now is time keeping him out of work later.  This is very frustrating for him.  It is equally frustrating to have people with little medical knowledge, who are often focusing on a bottom line, determining the health and well being of our family.  Of course to us, none of this is new.  We fought the same battles with Everett.  Fortunately, we are experienced in what to say and how to say it.  We understand how the system works and how to make it work for us.  But all this requires energy, which we find in precious little supply just now.  I know with your prayers, we can get this accomplished!  It wouldn’t be the first time they’ve moved mountains :-)

Love,

The Bollinger Family