“When the results of a colonoscopy showed nothing serious, I finally succumbed to the idea that I was going to have to see another OB and get another ultrasound to see what was going on with my fibroid. It had grown to 7 cm in size by then, and my new OB said that considering my anemia and other symptoms, it was time to take action. She suggested either Uterine Artery Embolization or a Myomectomy, two painful options I was not ready to consider. She also suggested a blood transfusion, as she said there was no way I could rebuild my iron from iron pills alone, considering how low my hemoglobin had gotten.

After receiving a blood transfusion, and cancelling a much anticipated vacation, due to using up all my vacation days for sick time, I started researching alternative fibroid treatments on the internet. I discovered an article about MRI Guided Focused Ultrasound (MRgFUS). It seemed like the answer to all my problems! When I mentioned it to my OB, she admitted to having heard of it, but seemed skeptical about it really working. She seemed supportive enough of my decision to at least investigate it as an option, so I made an appointment at UCLA’s radiology department, which was one of only two hospitals in California performing this procedure. After having an MRI with and without contrast, and meeting with their OB and two radiologists, I was told I was a perfect candidate for this completely non-invasive procedure, and that they thought they could shrink my fibroid significantly, to help alleviate my symptoms. They also informed me that contrary to what my first OB had told me, my fibroid was submucosal, living in the cavity of my uterus, and pressing into the endometrial lining, which meant that it was most likely the source of my bleeding and discomfort.

A week later, I received the devastating news that my insurance company, Anthem Blue Cross, would not cover the procedure. I appealed their decision, and was again denied coverage. They stated they felt not enough large number or long term studies had been done to show the effectiveness of MRgFUS, and that it was considered “investigational”. They recommended the “gold standard treatment of myomectomy or hysterectomy.” I couldn’t believe my insurance company was willing to pay for me to get a much more expensive and risky surgery than to risk a completely non-invasive and much more cost effective alternative. I was not giving up the fight. I could not afford to miss 2-6 weeks of work and face a painful and slow recovery. I had already cut down my gym workouts by half and used up all my vacation time. I submitted my paperwork to the Department of Managed Healthcare for a third-party appeal, where a panel of three outside experts would make a decision. I had my doctors sign the appropriate forms to have my appeal expedited, as my symptoms were still severe and were still causing me to miss work. My expedition was not granted, and the nurse in charge of reviewing my case informed me that even though she felt my case was a strong one for expedition, it did not meet their “standards of medical necessity.” Now the DMHC would have 45 days to make a decision! I did not have 45 days. I was not willing to get another transfusion and risk my health deteriorating further.”

Tune in next Thursday to find out where Erin went from here.