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Old 08-07-2012, 02:09 PM #1
StephC StephC is offline
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Originally Posted by restorativepose View Post
That's weird.

My neuro recently ordered MuSK and even though I have insurance, Athena called me right away and said "we will be covered as out of network with your insurance (coverage at 65%) so you'll need to enroll in our patient protection plan".

Straight out of pocket was going to be $1300 (est). Through my out of network coverage it would have been $450-some. Through their patient protection plan it was like $260.

... and of course in the end it came back negative.

Must know I am a lawyer! Lol

who knows why they told me $2500 but I was ale to get all but the anti striational test done by quest
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Old 08-26-2012, 11:25 AM #2
Anacrusis Anacrusis is offline
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Must know I am a lawyer! Lol

who knows why they told me $2500 but I was ale to get all but the anti striational test done by quest
Oh MY! I do feel bad now! I complained because where I live in Europe I had to pay 77 dollars via a private doctor.
Had my normal doctor agreed to refer me it would have been free!
But then again I did have to spend money on hotels and flights to another country to see a neuromuscular specialist who knew how to test fatigable weakness in the office!!!

This week I´m going to remain grateful for most things, regardless!
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Old 09-07-2012, 04:07 PM #3
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I had this test done, and it was worth it for me, because they found I was positive for MuSK. Mestinon did NOT work for me, both times I've tried it. I got the impression from my Dr though that he wasn't surprised when he saw I was MuSK positive and the medication not really working.

I thought it was more like $1,500 but I remember when my mother called she had a hard time with Athena getting a straight answer about payment, what was covered/not covered and all that. Anyway, it is very expensive, but it may help you with an answer. Good luck
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Old 09-08-2012, 03:57 AM #4
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This thread sadly proves again that MuSK myasthenia is one of the most neglected diseases.

Patients with Musk are "expected" to be like a very different and much more common illness, with a similar name-AchR+ myasthenia.

Until 10 years ago, this disease didn't exist at all. (which means that patients with MuSK MG were not ill and had a psychiatric illness which made them think they were ill, even when they were hospitalized in the ICU and required respiratory support, as has been bravely depicted in Chloe Atkins' book). Even now, many neurologists still doubt its existence and don't routinely check for it.

Patients with MuSK are more likely to have normal test results (including SFEMG), are less likely to have a positive tensilon test or respond to mestinon. So, many do not comply with the criteria for MG. I don't know (and don't know how to find this information) how many of them are told that there is nothing physically wrong with them.

They are also less likely to respond to the commonly used treatments for MG (as those treatments were studied on patients with AchR+ MG which is a different disease in its mechanism and clinical manifestations).

Patients with MuSK are more likely to have muscle related side-effects of steroids, they are more likely to have severe exacerbations and crises even on treatment.

Yet, there are no clinical trials in MuSK MG looking for better management approaches. There are also no efforts I am aware of being done to improve the ability to diagnose this illness.

I find it hard to believe that even a simple serological test (which probably doesn't detect all the patient with MuSK) is not yet done routinely and paid for by insurance.

But, this is not surprising when in the official site of the MGFA clinical overview it is written:

Quote:
Elevated serum concentrations of AChR binding and probably MuSK antibodies virtually assures the diagnosis of myasthenia gravis.

Antibodies to muscle-specific receptor tyrosine kinase (MuSK), a surface membrane component essential in the development of the neuromuscular junction, have recently (a decade ago-my comment) been identified and are found in up to 50% of MG patients who are seronegative for AChR antibodies. Emerging data suggests that the patterns of weakness and response to certain treatments may be different from those with AChR "positive" MG.
And then the future of MG treatment-

Quote:
The future of Myasthenia Gravis lies in the elucidation of the molecular immunology of the anti-acetylcholine receptor response with the goal of developing a rational treatment for the illness that will cure the abnormality in the immune system that results in the AChR immune response. To this end, six broad categories of theoretical treatment strategies need to be explored...
Or in other words-MuSK MG-who said this illness really exist and even if it does why should we care about it. Why should it concern us that there is "emerging data" (for more than 10 years) showing that this a different illness than AchR+ MG which requires a different diagnostic and management strategy? Isn't it much easier to " stick" those patients into a diagnostic category that we know, and if they don't fit send them to seek their fate elsewhere?

And as this is the official site of a patient organization, I assume that MG patients don't care either.
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Old 09-08-2012, 12:50 PM #5
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And as this is the official site of a patient organization, I assume that MG patients don't care either.
I was devastated when my Musk test did not turn out positive. I was sure it would. I was equally as cross with the medical system where I live that I had to pay for the AchR as well as pay for the MuSK.

In Europe I pay around 3,000 dollars a month in taxes that are supposed to cover such tests. It was the principle of paying for these tests with a private doctor when my regular physician didn´t believe me and that is what I disagreed with. Again on principle I refused disability payments that would have been based purely on psychosomatic grounds and instead asked my employer for reduced employment each year over a 4 year period.

The MuSK test was the last straw in a chain of events from a context involving doctor and patient butting their heads together (I must admit!!) It wasn´t about the MuSK it was about us.

The few blood tests we know of in MG are like small pieces from a bigger MG jigsaw puzzle. It is thanks to you and others Alice that we know these pieces are not enough to make the whole picture. It is also thanks to you Alice that a lot of us are able to manage with seronegative myasthenia or even without a diagnosis. I will be disappointed if my SFEMG turns out negative and disturbed by all its negative implications as a result – however, I will remain empowered rather than helpless precisely because of your extensive research, knowledge and diligent open minded approach that will eventually reach out to many more in the future.

I´m continuing doing my little bit over here by trying to educate doctors I come across that a negative AchR and negative MuSK do not necessarily form the basis for a psychiatric diagnosis!!! If it takes a trip, a test, a speech, a letter, a demonstration (at the insurance companies!), a new way of thinking, anything that would help - then count me in - I´m there, whatever the cost.......

Last edited by Anacrusis; 09-08-2012 at 01:35 PM.
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