Yearly Archives: 2009

Most individuals have a primary care physician. Many have a dentist. Many women have an OB/GYN for women’s health.  There are a variety of specialists’ that one may have: Internists, Ear/Nose & Throat (ENT), Ophthalmologists, Rheumatologists, and more.

When you are being treated for any form of pemphigus or pemphigoid (P/P) and are on any of the various treatments it is best to keep all of your doctors in the loop.  Each one should know of your present condition and the medications that you are taking as this can affect your diagnosis with each specialty examination.

If you will be considering an invasive surgical procedure of any kind, (including dental work) both your surgeon (and dentist) and your dermatologist need to be in touch.  Usually, your P/P medications can be increased for a few days prior and a few days afterwards to prevent any flare-ups.

Also advise your dental hygienist when you are having your teeth cleaned, so that he/she can be extra gentle with your gums.  (Many Hygienists are just now learning about P/P through the IPPF Awareness Campaign!)

When you are a new patient at a doctor’s office and filling out the information sheet, be sure to list all the medications you are taking for your P/P condition.  Your new doctor will then ask you about them and be aware of your situation.

Remember, when you need us we will be in your corner!

The IPPF strives to do many things for the pemphigus and pemphigoid community, but our three biggest goals are to raise awareness, create a support network, and to increase education. One of the biggest tools that we have at our disposal to accomplish those goals is social media.

Todd Kuh and Marc Yale

On September 26th Todd Kuh and Mariah Lowinske, two patient advocates with Pemphigus Vulgaris, and I attended the American Academy of Dermatology Legislative Conference in Washington DC. As a member of the Coalition of Skin Diseases, the IPPF sends advocates to this conference annually so we can learn about the latest initiatives prior to lobbying Congress for support for treatment and research.

In a previous Coaches Corner I have given prednisone tips. It is a good time now for an update as there are new patients who are diagnosed and who are leery of the side effects that can come from taking a steroid treatment.

No one chooses to take prednisone as a medication.  However, it is used frequently for a variety of medical conditions, like pemphigus and pemphigoid (P/P). Prednisone is often used as the first line of defense against P/P. It works rather quickly and is effective in diminishing disease activity.

To learn more about prednisone, how it is used, what precautions to take before taking it, dietary suggestions, and side effects please go to this link from the U.S. Library of Medicine: http://www.nlm.nih.gov/medlineplus/druginfo/meds/a601102.html

A few of the side effects from taking prednisone can be:

Headache, dizziness, difficulty, falling asleep or staying asleep, extreme changes in mood, changes in the way fat is spread around the body, extreme tiredness, weak muscles, and more.

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

vision problems, eye pain, redness, or tearing, sore throat, fever, chills, cough, or other signs of infection, depression, upset stomach, lightheadedness, shortness of breath(especially during the night), swelling of the eyes, face, lips, tongue, throat, arms, hands, feet, ankles, or lower legs, difficulty breathing or swallowing.

Please note that not everyone experiences every side effect and that even taking treatments like aspirin can come with side effects.  Everyone has his or her own unique physiological makeup. Therefore, while experiences with prednisone may be similar, they are not exactly alike.

Remember, when you need us we are in your corner!

As a Patient Educator for the IPPF, I have the fantastic opportunity to travel around the country to different dental schools and give lectures on my journey with pemphigus vulgaris (PV). It’s an empowering experience to have a hundred people listen to my story at once. But it’s also important that the audience relates to me. I’m a person, not just a patient.

The IPPF has maintained a “News and Information” section for many years. The launch of PemPress signals a new era in how we share information with our community. Our overarching goal is to increase public knowledge of the IPPF and our programs and services while providing P/P patients with information that improves their quality of life.

After months of uncertainty waiting for a diagnosis and finally finding a physician who can treat your rare skin disease, you return from the mailbox with a denial letter from your insurance company. After the shock and frustration has subsided you are now faced with the decision of whether it is worth appealing this insurance determination or should you start back at “square one”.

Chances are that the insurance company is counting on you not appealing but according to the U.S. Government Accountability Office, one report revealed that in the four states that tracked such data, 39 to 59 percent of private health insurance appeals resulted in reversal. Those are pretty good odds!

Here are some tips on how to appeal:

1.      Read the denial letter carefully. Make sure that you learn about your insurer’s appeals process. In the coverage documents and summary of benefits, insurance companies are required to give all the tools needed to properly make an appeal. There are often deadlines to meet, so act quickly and send it to them as soon as possible.

2.      Ask for help from your doctor. Check the medical policy and ask your doctor to review it to prepare something called a letter of medical necessity to support your case. If your doctor is not able to help, be prepared to handle it yourself. You are your best advocate!

3.      Contact the IPPF. The foundation can help provide you with resources about the disease and publications citing the use of treatments used for your condition. These documents can help support your case to the insurance company.

4.      Write a testimonial letter. You have a rare disease and it is likely that the person making the decision knows nothing about your disease. A letter with pictures detailing your story and exactly what happened will make it personal. Tell them that you are seeking approval for treatment, note any supporting science, clinical evidence, expected benefits, etc. Be clear, firm and concise. Make it clear that you plan to pursue the appeal until it is resolved and is approved.

5.      Follow up. Many appeals take weeks, even months, so call often to check the status and take notes of each call. When you speak to the insurance company, write down the time and date, length of the call, the name and title of the person you speak with and all the details of the conversation. Make note of any follow-up activities and next steps to be taken.

Remember, many insurance companies have a tiered appeals process. The first level is processed by the company’s appeals staff or medical director responsible for the denial. Second-level appeals are reviewed by a medical director not involved in the original claim. The third level involves an independent, third-party reviewer. If your insurance company continues to deny the claim; you can then take the appeal to your state’s insurance department, state insurance commissioner or even your local legislators who have staff to assist you.

This process may seem overwhelming but it is worth it. Your health and the health of other pemphigus and pemphigoid patients may be impacted by the awareness you create with the insurance claim.

If you need assistance, just “Ask a Coach!” Remember, when you need us, we are in your corner!