After pleading for seizure-stopping brain surgery, Cara Pressman has blunt words for the the insurance company that denied her.
“Screw you,” she said.
15-year-old Pressman was reportedly wept after her parents informed her that Aetna, her parent’s insurance company, would not be approving her claim for a surgery that would put an end to her years-long struggle with seizures, reports Fox 4.
“When my parents told me, I went kind of blank and started crying,” she said. “I cried for like an hour.”
During a weekend of birthday celebrations for her 90-year-old grandparents, Pressman experienced several complex partial seizures, which could be triggered by nearly anything including joy or stress.
“It’s like having a nightmare but while you’re awake,” she shared.
She’d hoped soon after her suffering would come to an end but she soon had to text her friends they couldn’t visit her in the hospital — because her surgery was off.
According to Aetna, this particular laser ablation surgery is “experimental and investigational for the treatment of epilepsy because the effectiveness of this approach has not been established.”
“Clinical studies have not proven that this procedures effective for treatment of the member’s condition,” Aetna wrote in its rejection letter. The insurance company, on the other hand, approved Pressman to have an open brain surgery — temporal lobectomy — which her medical team never appliedfor
Dr. Jamie Van Gompel, a Mayo Clinic neurosurgeon not involved in Pressman’s care, believes Aetna has the wrong idea, reports Fox 4.
“I would not call it experimental at all,” said Dr. Van Gompel, who is heading a clinical trial on the surgery. “It’s definitely not an experimental procedure. There’ve been thousands of patients treated with it. It’s FDA-approved. There’s a lot of data out there to suggest it’s effective for epilepsy.”
According to Dr. Van Gompel, an open brain surgery is a far greater risk for complications or even death.
Pressman is reportedly not the only seizure sufferer being denied this minimally invasive procedure by Aetna. 44-year-old mom Jennifer Rittereiser told CNN that the insurer wouldn’t pay for her to have the similar surgery.
Rittereiser had to stop driving for over a year to avoid another car accident attributed to her seizures. She, too, slammed the company for preventing her from affording her planed surgery.
“It’s just not right,” Rittereiser said. “Everything in their core values is not being shown in the way I’m being treated. They’re talking about promoting wellness and health and ‘being by your side.’ … [It’s] the most ridiculous thing, because they are the biggest barrier to my success and my well-being going forward.”
Julie and Robert Pressman don’t know how they’ll pull $300,000 out of pocket to cover the cost of Cara’s procedure, but they don’t plan to give up.
“Cara is worth every penny, but man,” said Cara’s mom. “‘Screw Aetna,’ indeed, to quote my kid.”