So I still haven’t started radiation therapy yet. The CT
simulation has been authorized, however, UCLA is still working on
obtaining authorization for the brain MRI. The brain MRI is needed in
the brain mapping portion of the treatment. The issue is that additional
documents are needed beyond the norm because I just recently had an MRI
on 10/17 so my insurance needs additional information on why another
one is needed so soon. In speaking with the UCLA radiation oncology
office, I believe everything should be cleared up by this week. The good
news is that my CT simulation is set for this coming Thursday (11/17).
It would be great if the brain MRI is authorized and can be scheduled
for this date as well.
So if both scans can be done by the end of this coming week, the most
likely start date for my treatment would be November 28. It normally
takes 7 to 10 days for the treatment to be finalized by the
radiation-oncologist and neurosurgeon after the completion of the brain
mapping. Based on this start date, my treatment should end the first
week of January 2012.
A mini crisis also came up this past week. I received a letter from
UCLA informing me that their contract with my insurance will be
terminating January 1, 2012. It also further stated that both parties
are currently negotiated a new contract, but no agreement has been
reached as of yet and it is uncertain whether one will. This revelation
certainly brought some cause for concern because my treatment would run
so close to the date. I wasn’t sure how it would possibly affect my
treatment and whether it would be necessary to go elsewhere for
treatment. I sent an email to Dr. Selch and the very next day received a
call from his office. The person whom I spoke with was great. She
explained that in the circumstance that a new agreement cannot be
reached between UCLA and Blue Shield, that it should not be a problem to
continue receiving care at UCLA. There is a Blue Shield program called
Continuity of Care Services that would allow patients to continue to
receive care from their provider under in-network terms for a specified
amount of time in the event such as what I am facing now. The radiation
oncology office said that if needed, they would go ahead and fill out
the application for me and that in their experience, it should not be a
problem in getting approval from Blue Shield based on my specific
circumstances and the criteria used for approval. In speaking with a
Blue Shield nurse who I have been in contact with, she also stated the
same thing. Hearing this definitely made me feel better.
This past week I also met again with Dr. O’Bryan. The good news is
that the echocardiogram shows everything is okay with my heart. It is
structurally sound and functioning normally. Also, based on the
transmissions I sent, everything looked fine as well, therefore I no
longer have to wear the monitor. Dr. O’Bryan feels that my
off-centeredness may be a side effect of the Keppra I am taking due to
the fact that I am getting these random episodes even when I am sitting
as well. However, at this point, he recommended that I intake about 32
oz of electrolytes per day for the next couple of weeks just to see if
it helps. If it doesn’t, then he may prescribed me a medication to
increase my blood pressure, however, it’s something he is hesitant to do
and will consider it when the time comes.
Regarding the Keppra, I feel that it may have something to do with my
bouts now. Maybe it didn’t when the dizziness came back again at the
end of August, but it may now. This past Monday, Dr. Lai increased the
daily dosage from 2000 mg to 2500 mg. He felt it necessary because about
1.5 weeks ago, I had a couple episodes accompanied by some slight
disorientation and one bout accompanied by very slight weakness in my
legs although just literally for a fraction of a second. This was cause
for concern considering I’ve never had an episode with disorientation
even before I started Keppra back in June and I haven’t had weakness
since I first started having mini-partial seizures. The good news is
that I only had these two sensations that one day 1.5 weeks ago and
haven’t had them since. However, I do feel a bit more off-centered since
the increase in dosage and I do seem to be having more bouts while
seated and the bouts seem to be lasting longer or are prolonged whereas
before the increase in dosage, they would be relatively brief.
Well, I am hoping that the brain MRI will be resolved this week and
that I can get both the MRI and CT scans done by Thursday in order for
my treatment plan to be finalized.