The fight of his life
Jun. 23rd, 2003 02:12 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
yaksha42The fight of his life
The Community Hospital nurse has a rare form of cancer and is banking on a new treatment.
Kurt Patterson couldn’t get cancer. There’s just no way.
He lifts weights, eats right, doesn’t touch tobacco, and rarely has a drink. He’s a registered nurse, and has seen close up the results of neglecting your body.
And every May, for as long as he can remember; he’s walked in the American Cancer Society’s Relay For Life which begins at 6 tonight at the Hoquiam High School track.
“Cancer never happens to a 44-year-old man in perfect health,” the lifelong Harborite says. “But I learned it does.”
Now battling the Big C for a third time, Patterson’s prognosis is not good if his one shot at hope – a $40,000 “gamma knife” treatment – doesn’t work.
“With this treatment, it’s more than likely I’ll live for many years,” said the personable man with salt-and-pepper hair and warm brown eyes.
“But without it, I’ll die within … a year. There are no other treatment options available to me.”
Treatment coverage was initially denied by Trusteed Plans, a Tacoma company that administers the health insurance plan for employees in Grays Harbor Community Hospital in Aberdeen.
Julie Feller; director of Human Resources for the hospital, said Harborview Medical Center, where the procedure was to be done, called Trusteed Plans May 20, three days before the procedure, and wanted “pre-authorization” immediately.
She said Trusteed Plans needed more information and “had no option but to say, ‘If you want a yes or no right this minute, it has to be no.’”
“At no point did Trusteed Plans or the hospital say, ‘You have to cancel this procedure.’ It’s my understanding that Harborview advised him that if he went ahead and said he would pay for it himself, the insurance company would never agree to pay for it. That’s not how our plan works. It may be how other plans work.”
In any case, thinking he was almost out of options, Patterson turned to friends and co-workers. They had started to organize a campaign to lobby the insurance company and planned to raise the money privately, if it came to that.
Wednesday, after countless calls from co-workers on behalf of Patterson, as well as an interview with The Daily World, Trusteed Plans agreed to pay for the procedure.
Patterson’s odyssey with cancer began six years ago, with what the Hoquiam High grad believed was “just a cold sore” on the roof of his mouth. “But when it didn’t go away after six weeks, I knew something was wrong.”
Patterson has worked at Community Hospital for the last 29 years – 15 of them in the Critical Care Unit.
A biopsy revealed the sore was an adenoid cystic carcinoma, a rare, slow-growing form of cancer that account for 1 to 2 percent of all head and neck cancers.
Three months of neutron-beam radiation blasted the tumor away.
But in 1999, it came back.
Patterson’s diseased hard palate was cut away, and a “real gross” artificial “plug” was inserted in the roof of his mouth, he said.
For the next three months, Patterson traveled to Seattle for daily hyperbaric chamber treatments, in which he breathed pure oxygen for hours on end.
And when he thought his health was improving, a seizure indicated the radiation caused part of his brain to die.
“I kind of blacked out, didn’t know the names of my children, who the president of the United States was,” he said.
Patterson, no 50, continued working at Community Hospital, “except when I was too physically ill,” he said.
But his life had been altered.
Huge medical bills forced the single father of five to file for bankruptcy and move from his lovely five-bedroom “house on the hill” in Hoquiam to a two-bedroom rambler in Aberdeen which he rents.
“If I sold everything I have, I could get perhaps $7,000,” he said. “And that’s after working my entire life. Pretty sad.”
And when Patterson noticed it was becoming difficult to open and close his mouth two months ago, he returned to his doctors.
The news was like being socked in the guy: The cancer was back.
It was in his jaw muscle, too close to the carotid artery to operate.
A group of specialists, including the University of Washington’s Head and Neck Tumor Board, agreed that gamma knife radiation is his only choice.
The procedure – a misnomer; as it doesn’t involve a knife but instead 200 beams of gamma radiation aimed at a tumor – was scheduled for May 23.
The day before, Patterson’s bags were packed, and his 72-year old mother, who also lives in Hoquiam, was waiting for him at the Harborview Medical Center in Seattle.
“I was leaving after work (May 22) to go to the hospital when (Harborview) called me at 2:30 p.m.,” he said. “My insurance company would not authorize or pay for this treatment.
He was beyond angry.
“I’ve known for the last seven weeks that my cancer is back and have gone through a number of things to reach this point, thinking it would be eradicated,” he said. “It never occurred to me any insurance benefits would be an issue at the last minute.”
Patterson and his co-workers scrambled to figure out a payment plan. Donations, bake sales – anything to make some cash to save his life.
“What I find somewhat aggravating and frustrating and upsetting is that we take care of homeless patients, welfare patients, illegal immigrants and prisoners at the hospital without any questions being asked,” Patterson said Tuesday afternoon. “But someone who’s worked and paid taxes for 33 years is left dangling while the insurance company fiddle farts around and the tumor continues to grow? At some point, it’s going to be too late.”
Patterson even joked that if he wasn’t granted for approval for the treatment within a month, he “go out and rob a bank and be sent to prison. They’re always treated.”
In an interview with The Daily World just hours before accepting Patterson’s claim, Trusteed Plans President Bob Ewan and Executive Vice President Peter Hamilton said their company’s decision to deny to coverage was just temporary.
“The business itself is very complex,” Hamilton said. “The way it appears to you, you give (the doctor’s office) your card, and a co-pay and everything goes away.”
But behind the scenes, it’s a commingling of diagnoses, new methods of treatment and “technology that people are trying to get covered,” the vice president emphasized.
That’s why companies like Trusteed Plans rely on several sources for information to decide whether to pay a claim.
It’s not “just an arbitrary, subjective decision,” Hamilton said. “If we were ever audited, the question would be, ‘why did you pay this the way you did?’” he said. “We’re always under the microscope that way.”
And though Patterson’s appointment had to be canceled because of Trusteed Funds’ “pending” decision, Hamilton said the phone calls his company received on the nurse’s behalf weren’t warranted.
“If people would let it run its course and keep the emotion out of it and keep from printing stuff in the newspaper; that would be preferable,” he said.
Ewan said the company hadn’t issued a “formal denial,” but initially turned down the claim because it didn’t have enough information.
Ewan was clearly concerned with the prospect of having his company portrayed as uncaring and cold.
“Is the big, bad insurance company going to watch this guy die? It’s not the case at all.” Ewan said.
Now that Patterson’s treatment has been approved, the man who’s taken care of others his entire profession life will become a patient again on June 8.
“It was upsetting going through this … but everybody has been extremely supportive.” Patterson said about his co-workers. “From the Chief Executive Officer on down. I’ve got nothing but admiration and good things to say. They’ve been phenomenal.”
The Community Hospital nurse has a rare form of cancer and is banking on a new treatment.
Kurt Patterson couldn’t get cancer. There’s just no way.
He lifts weights, eats right, doesn’t touch tobacco, and rarely has a drink. He’s a registered nurse, and has seen close up the results of neglecting your body.
And every May, for as long as he can remember; he’s walked in the American Cancer Society’s Relay For Life which begins at 6 tonight at the Hoquiam High School track.
“Cancer never happens to a 44-year-old man in perfect health,” the lifelong Harborite says. “But I learned it does.”
Now battling the Big C for a third time, Patterson’s prognosis is not good if his one shot at hope – a $40,000 “gamma knife” treatment – doesn’t work.
“With this treatment, it’s more than likely I’ll live for many years,” said the personable man with salt-and-pepper hair and warm brown eyes.
“But without it, I’ll die within … a year. There are no other treatment options available to me.”
Treatment coverage was initially denied by Trusteed Plans, a Tacoma company that administers the health insurance plan for employees in Grays Harbor Community Hospital in Aberdeen.
Julie Feller; director of Human Resources for the hospital, said Harborview Medical Center, where the procedure was to be done, called Trusteed Plans May 20, three days before the procedure, and wanted “pre-authorization” immediately.
She said Trusteed Plans needed more information and “had no option but to say, ‘If you want a yes or no right this minute, it has to be no.’”
“At no point did Trusteed Plans or the hospital say, ‘You have to cancel this procedure.’ It’s my understanding that Harborview advised him that if he went ahead and said he would pay for it himself, the insurance company would never agree to pay for it. That’s not how our plan works. It may be how other plans work.”
In any case, thinking he was almost out of options, Patterson turned to friends and co-workers. They had started to organize a campaign to lobby the insurance company and planned to raise the money privately, if it came to that.
Wednesday, after countless calls from co-workers on behalf of Patterson, as well as an interview with The Daily World, Trusteed Plans agreed to pay for the procedure.
Patterson’s odyssey with cancer began six years ago, with what the Hoquiam High grad believed was “just a cold sore” on the roof of his mouth. “But when it didn’t go away after six weeks, I knew something was wrong.”
Patterson has worked at Community Hospital for the last 29 years – 15 of them in the Critical Care Unit.
A biopsy revealed the sore was an adenoid cystic carcinoma, a rare, slow-growing form of cancer that account for 1 to 2 percent of all head and neck cancers.
Three months of neutron-beam radiation blasted the tumor away.
But in 1999, it came back.
Patterson’s diseased hard palate was cut away, and a “real gross” artificial “plug” was inserted in the roof of his mouth, he said.
For the next three months, Patterson traveled to Seattle for daily hyperbaric chamber treatments, in which he breathed pure oxygen for hours on end.
And when he thought his health was improving, a seizure indicated the radiation caused part of his brain to die.
“I kind of blacked out, didn’t know the names of my children, who the president of the United States was,” he said.
Patterson, no 50, continued working at Community Hospital, “except when I was too physically ill,” he said.
But his life had been altered.
Huge medical bills forced the single father of five to file for bankruptcy and move from his lovely five-bedroom “house on the hill” in Hoquiam to a two-bedroom rambler in Aberdeen which he rents.
“If I sold everything I have, I could get perhaps $7,000,” he said. “And that’s after working my entire life. Pretty sad.”
And when Patterson noticed it was becoming difficult to open and close his mouth two months ago, he returned to his doctors.
The news was like being socked in the guy: The cancer was back.
It was in his jaw muscle, too close to the carotid artery to operate.
A group of specialists, including the University of Washington’s Head and Neck Tumor Board, agreed that gamma knife radiation is his only choice.
The procedure – a misnomer; as it doesn’t involve a knife but instead 200 beams of gamma radiation aimed at a tumor – was scheduled for May 23.
The day before, Patterson’s bags were packed, and his 72-year old mother, who also lives in Hoquiam, was waiting for him at the Harborview Medical Center in Seattle.
“I was leaving after work (May 22) to go to the hospital when (Harborview) called me at 2:30 p.m.,” he said. “My insurance company would not authorize or pay for this treatment.
He was beyond angry.
“I’ve known for the last seven weeks that my cancer is back and have gone through a number of things to reach this point, thinking it would be eradicated,” he said. “It never occurred to me any insurance benefits would be an issue at the last minute.”
Patterson and his co-workers scrambled to figure out a payment plan. Donations, bake sales – anything to make some cash to save his life.
“What I find somewhat aggravating and frustrating and upsetting is that we take care of homeless patients, welfare patients, illegal immigrants and prisoners at the hospital without any questions being asked,” Patterson said Tuesday afternoon. “But someone who’s worked and paid taxes for 33 years is left dangling while the insurance company fiddle farts around and the tumor continues to grow? At some point, it’s going to be too late.”
Patterson even joked that if he wasn’t granted for approval for the treatment within a month, he “go out and rob a bank and be sent to prison. They’re always treated.”
In an interview with The Daily World just hours before accepting Patterson’s claim, Trusteed Plans President Bob Ewan and Executive Vice President Peter Hamilton said their company’s decision to deny to coverage was just temporary.
“The business itself is very complex,” Hamilton said. “The way it appears to you, you give (the doctor’s office) your card, and a co-pay and everything goes away.”
But behind the scenes, it’s a commingling of diagnoses, new methods of treatment and “technology that people are trying to get covered,” the vice president emphasized.
That’s why companies like Trusteed Plans rely on several sources for information to decide whether to pay a claim.
It’s not “just an arbitrary, subjective decision,” Hamilton said. “If we were ever audited, the question would be, ‘why did you pay this the way you did?’” he said. “We’re always under the microscope that way.”
And though Patterson’s appointment had to be canceled because of Trusteed Funds’ “pending” decision, Hamilton said the phone calls his company received on the nurse’s behalf weren’t warranted.
“If people would let it run its course and keep the emotion out of it and keep from printing stuff in the newspaper; that would be preferable,” he said.
Ewan said the company hadn’t issued a “formal denial,” but initially turned down the claim because it didn’t have enough information.
Ewan was clearly concerned with the prospect of having his company portrayed as uncaring and cold.
“Is the big, bad insurance company going to watch this guy die? It’s not the case at all.” Ewan said.
Now that Patterson’s treatment has been approved, the man who’s taken care of others his entire profession life will become a patient again on June 8.
“It was upsetting going through this … but everybody has been extremely supportive.” Patterson said about his co-workers. “From the Chief Executive Officer on down. I’ve got nothing but admiration and good things to say. They’ve been phenomenal.”
