As many of you know, I have been in a battle with a cyst in the left foot for two years that brings about pain with; very much standing, long stretch of walking, stepping odd angles, uneven surfaces, sudden change of direction, climbing stairs, rotation of ankle. I've had two arthroscopic surgeries that did not have success (37% failure rate) and so the following procedure had been decided on and as a last resort it was planned for Nov 17. Cartilage cells were removed from knee at the time of the last ankle surgery in March and are in Texas facility waiting insurance approval to be cultured (2 week time frame).
Today a letter came from my ankle surgeon Dr. Richard Ferkel, kind of a standard letter to explain what/why might be the "delay" in the surgery date originally planned for Nov. 17 to remove the cyst from the Talus Dome in my foot. I have been determined to be a candidate for the "Autologous Chondrocyte Implantation (ACI) of Carticel (cultured Chondrocytes) into the ankle. Carticel is frequently implanted into the ankle in other countries, it has not been done with a tremendous frequency in the United States. This is partially due to the elongated process the FDA takes to approve products for particular services. Carticel is FDA approved for implantation into the knee, but not into the ankle. Therefore insurance companies consider this service experimental. This doctor has had success in overturning the experimental ruling with some carriers along with the lack of any viable solutions for my problem and has done this procedure numerous times. They are working hard on my behalf to resolve this positively.
So I am asking those who have received this to please pray on my behalf this; that the letter drafted and submitted to the Aetna Insurance Transplant dept, will be approved the first time when they receive it and the surgery can be performed before the end of this fiscal year 2008 as planned. The cost of this surgery is quite high, and that I have met my out of pocket maximum for the year is best scenario for us financially, the financial implications of a delay or rejection of insurance benefits would be a big blow. The letter was dictated yesterday hopefully, and so should be sent soon to Aetna whether by mail or Fax...... grateful thanks
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