Tom

 

Age: 51

Hometown: Galloway, NJ

BT Doctor: Dr. Kartik Shenoy, Temple University Hospital

Referring Doctor: Dr. Gerard Criner, Temple University Hospital

Insurance: Horizon Blue Cross Blue Shield

BT Procedure Date: Summer 2012

Tom

Husband, Proud Father of Two, and Mortgage Loan Officer

"Medically, BT was the best thing I ever had in my life! I have asthma but it is not a major concern in my life anymore. I don't often think about it."

My Life Prior to BT:

I was diagnosed with allergic asthma at age 15 and it grew worse as I grew older. There were years I would do okay with managing it, but other times it became extreme. We had to allergy proof the house. We couldn't have any pets and had to keep the dust out. When my asthma would flare up, I lived in fear of the attacks. I used my rescue inhaler non-stop. I would ask for samples so I would have extra inhalers. It was a part of me, like a money clip or glasses; I had to have one with me at all times.

When my asthma was controlled, I was a very active person. I enjoyed running, cycling, and being outdoors. But as my asthma grew more severe, my ability to be active was hindered dramatically. I would only workout indoors at the gym because even a one mile run outside could make me have an attack. I couldn't even cut my own grass! It's a man thing, but do you know how hard it is to watch someone else cut your grass?

I had a nebulizer at home and would be on that for weeks at a time and then would get off for short periods when my asthma calmed down a bit. We tried many medications including Advair™, Singulair™, albuterol, and of course, prednisone. At one point I was on 100mg of prednisone per day for 4 months straight and the side effects alone made life very difficult. I missed work, had difficulty sleeping and often got the shakes from the medications. I also suffered with cataracts and osteoporosis issues including a painful spinal fracture.

Even with all the medications, I would still end up at the hospital. In 2001 I even went by ambulance. At the end of 2009 I got pneumonia and ended up in the hospital for much of the early part of 2010. It was over 28 days total in the hospital during that time. I missed work and family events; my quality of life was very low. 

My brother in law, who works in the medical field, did some research and found information on BT and doctors doing this at Temple University. I actually went to Temple unannounced. I was discharged after an attack from a hospital in New Jersey and my wife just drove me straight to Temple. At that point we were desperate for other options. I met with Dr. Criner that day and he said I had two options; Xolair™ shots or Bronchial Thermoplasty. We decided to go with the Xolair™ shots first because at that point BT was not approved by the FDA yet and I knew insurance would not cover it. 

The Xolair™ shot did work for a while but I continued to have serious side effects from the medication including tendon ruptures. At that point I knew it was time to push for Bronchial Thermoplasty. The Alair System had been approved by the FDA by that point, but my insurance company immediately denied it as "experimental."

I was denied several times and I fought it at every level and they still declined it. We did a conference call with my doctor, 2 nurses, and the insurance people. They listened to my case and then still declined it. I asked for a case manager. I wanted to able to call someone and not wait on hold each time. After a few months even she said "there is nothing else we can do for you to get this approved." I remember it so clearly, I was driving on the highway, and when she told me that, my anger and determination only increased. That same day I went home and googled who I could file a complaint with against the insurance company. According to everything I read, the place to complain to was the New Jersey Department of Banking and Insurance which is actually run by Governor Chris Christie himself. He had recently visited my small town of Galloway for a town hall meeting and said he would help us if we needed him. Well, I called him right then and there. It took a few people but I actually got him on the phone. He has asthma as well. After a short conversation he said I would be hearing from his office shortly. The next week, a woman from his office called and asked for all my documentation. About 10 days later, my insurance approved my BT!

My Life Today:

I would say that BT improved my quality of life by 100%! I don't have to worry constantly anymore about being outside, about exercising, or about where my inhaler is at every moment. Since BT, I've had no ER trips or hospitalizations because of my asthma.

I no longer miss work or social events because of my asthma. Before BT I was a hermit. I missed my kids' sports and events regularly. I just had to let my wife handle the kids' stuff because I was worried that going out would trigger an asthma attack. Now I don't miss anything! 

I was devastated when I heard that only 6 people had had BT at Temple after me. I know it is the insurance barriers that are keeping other patients from accessing this life changing treatment. That's why I am happy to share my story here because I want to encourage asthma sufferers not to give up on their fight to get BT covered. Fight every denial and don't be afraid to reach out to your state government to help you win!

Results from case studies are not necessarily predictive of results in other cases. Results in other cases may vary.

Brief Statement of Relevant Indications for Use, Contraindications, Warnings, and Adverse Events: The Alair™ Bronchial Thermoplasty System is indicated for the treatment of severe persistent asthma in patients 18 years and older whose asthma is not well controlled with inhaled corticosteroids and long-acting beta-agonists. The Alair System is not for use in patients with an active implantable electronic device or known sensitivity to medications used in bronchoscopy. Previously treated airways of the lung should not be retreated with the Alair System. Patients should be stable and suitable to undergo bronchoscopy. The most common side effect of BT is an expected transient increase in the frequency and worsening of respiratory-related symptoms. ENDO-551804-AA

As with any procedure, there are risks, and individual results may vary. The most common adverse event of BT is a temporary worsening of respiratory-related symptoms. These events typically occur within one day of the BT procedure and usually resolve within a week with standard care. There is a small risk (3.4% per procedure) that symptoms may require hospitalization.1

Reference

  1. Castro M, et al, for the AIR2 Trial Study Group. Am J Respir Crit Care Med. 2010;181:116-124.
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