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The latest on the ALS Patient Insurance Fight

by Craig Cheatham

KMOV.com

Posted on March 4, 2010 at 12:57 PM

Updated Thursday, Feb 3 at 1:15 PM

On Tuesday, we reported on Danny Gottman's struggle to keep at-home nursing care. Gottman is in the final stages of ALS, commonly known as Lou Gehrig's Disease. He's completely paralyzed, breathes through a ventilator and eats through a tube. However, he is alert and can talk. Horizon Blue Cross and Blue Shield of New Jersey had threatened to cut off all nursing care for Mr. Gottman. After we got involved, BCBS dramatically reversed its position and agreed to pay for around the clock at-home care.

Ironically, the decision to pay for that coverage had an almost immediate impact on Danny Gottman's care. I got this email from his wife Judy:

"Yesterday’s nurse stayed to fill the evening time so there would be no gap.  I was upstairs about 7:30 when she called for me.   The inflate/deflate mechanism on his trach had failed. It is a little balloon like thing that surrounds the tube that goes in his trachea.   Deflating that is what allows him to talk but it can’t be left down very long. We had to do an emergency trach change.  That means pull the whole thing out and put in a new one. That process definitely takes two people and one needs to know what she is doing.
It has happened before and I had worried that it would happen again with no nurse here....whew! Without a nurse I would have to call for an ambulance and get him to the emergency room."

"That happening one day after full nursing hours being put in place....Wow!"

It goes without saying that the Gottmans are grateful the nursing care will no longer be an issue. BCBS has agreed to pay for 24/7 care for at least the next six months.

 

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