My neuro was worried that the insurance would balk at the IVIG, but I don't know if he had reason to be. As it turned out, I was admitted through the ER, because I was having trouble swallowing*, which is considered an emergency. If there are any insurance problems (which there may not be), it looks like it's easier to get the insurance company to agree in an emergency than just, you know, in order to treat your illness. "Trouble breathing" can also be considered an emergency, even if you don't feel like you're in any danger.

In other words, if your insurance company says they won't pay for routine IVIG, I bet they will pay for IVIG after you're admitted for trouble breathing.

My understanding is that IVIG is done by IV, but plasmapheresis often requires having a port put in. Ports are implanted surgically, under sedation and local anesthesia (but by "sedation" they mean you'll be asleep--you just won't be on a breathing machine). That's probably why IVIG is usually tried first.

*I found out that "trouble swallowing" can mean a lot of things! It didn't seem like an emergency to me. I was just having liquids go down the wrong pipe (a little coughing) about six times a day.

Abby