PT, Insurance, Stem Cell Transplant...

If this blog seems to have lost some momentum lately, there are some pretty good reasons for that. Not much of note has been happening, really. I continue to take all the usual pills, and (mostly) do the usual physical therapy exercises. I do a little work for my team at JDA, whenever they have something they think they can farm out to me without much risk of being blocked if I'm too slow. My transition from the walker to the cane is complete, and I even mostly walk completely unaided when at home.

I wouldn't dare try that trick in the outside world, though. My problems with balance and proprioception are still too significant to allow me to do that with any safety. And the home physical therapist thinks she has done all she can do for me in these areas. So she has discharged me, so that I can continue my therapy as an outpatient at a facility that has the right kind of equipment to work them. Today I visited such a facility that is not too far away from home; so now I just have to get the prescription and the insurance authorizations rounded up, to get started there.

Speaking of insurance, today we also mailed off my completed COBRA election form, accompanied by the associated scary-looking check. We'll have to write similar checks every month, as long as I remain on long-term disability. Actually, I am technically not yet on LTD, since the insurance company has not yet received the oncologist's completed forms; so I have to call the oncologist's office to badger those responsible for doing this....gah.

Yet another insurance-related issue is the fact that I can't do anything related to stem cell transplant at Christiana Hospital, since that hospital is not in the insurance plan's provider network for this therapy. The closest in-network facilities for stem cell transplant are the cancer centers associated with the University of Pennsylvania in Philadelphia, and with Johns Hopkins University in Baltimore. Since I am now well into my third cycle of induction therapy, we decided that it was time to begin making some contacts at these centers, in case there is anything I should be doing now, in preparation for becoming their patient at some point. We got some names and phone numbers at both centers from the oncologist, and began making some tentative probes of their outer defenses today. Initial impressions: Penn seems substantially less bureaucratic than does Hopkins. With Penn, I got right through to the assistant of the director of the stem cell transplant program, who agreed to arrange the transfer of my records from Christiana and then call back to arrange an appointment. With Hopkins, on the other hand, I had to navigate an automated telephone menu tree, finally winding up with a person who offered to do nothing for me. I must round up my records myself, fax them to a number there, and then call again to find out what to do next. Well, it's not like they need my business, being the third-highest-rated cancer center in the country (according to US News and World Report); whereas Penn is ranked fourteenth. Hopkins is also more distant, thus less convenient. But this is just the beginning of this phase of the game; many things will bear on the final selection of a facility for stem cell transplant, when the time comes.