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Published June 05, 2010, 12:00 AM

Woman fights disease, bureaucracy

Cheree Schneider is battling severe autoimmune diseases including scleroderma and lupus that have robbed her of her strength and vitality.
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By: Patrick Springer, INFORUM

Cheree Schneider is battling severe autoimmune diseases including scleroderma and lupus that have robbed her of her strength and vitality.

She’s also had a few run-ins with North Dakota’s medical assistance program.

The 35-year-old Granville, N.D., woman has been pushing since November for surgery to repair a painful rectal prolapse, a condition in which the intestine protrudes from the body.

She wanted the surgery to be done at the University of Minnesota Medical Center, Fairview, where a team of specialists treat problems associated with scleroderma, which afflicts her skin and internal organs.

That request was denied because officials determined that North Dakota has colorectal surgeons who should have been capable of performing the surgery.

“We’ve been fighting for the prolapse for a year now,” Schneider said in an interview at MeritCare Hospital in Fargo, where she was admitted Monday.

On Thursday, the battle seemingly was decided in her favor. Following a request by doctors at MeritCare and inquiries about her case from The Forum, medical assistance approved medical consultations regarding the procedure and treatments for a leaky heart valve.

“We are sending Cheree out of state for services (a MeritCare doctor) indicates she needs at this time,” Maggie Anderson, director of medical services for the North Dakota Department of Human Services, said Thursday.

Doctors at the University of Minnesota will have to determine whether she can have the surgery. Schneider said doctors are concerned about whether her wounds would heal properly and whether her heart could withstand the anesthesia.

Multiple doctors in Bismarck and Fargo have agreed that the surgery and treatments should be done at the University of Minnesota because of the complexity of her case and the special expertise the center has in dealing with scleroderma, Schneider said.

The policy of the medical assistance program is to approve medical services out-of-state only when they are unavailable in North Dakota, or when a physician refers a case outside the state because of its complexity, Anderson said.

In recent weeks, Schneider has been in and out of hospitals in Bismarck and Fargo. She suffers from pulmonary hypertension, heart problems and other serious ailments as a result of her progressive autoimmune diseases, which have no cure.

Last week, a rheumatologist in Bismarck wrote to medical assistance officials pleading for experimental treatments at the University of Minnesota in the hope she will go into remission.

“Her disease is (so) severe that if she is going to survive there is an urgent need for experimental medication and special expertise from a tertiary care center,” unavailable in Bismarck’s St. Alexius Medical Center, wrote Dr. Nowarat Songsiridej.

That request still is being considered, Anderson said. Medical assistance officials must consult with medical experts to determine if the experimental drugs are eligible for payment under Medicaid guidelines.

“We do understand the urgency of it and are trying to address it quickly,” Anderson said.

Schneider and her mother, Brenda Martinson, said they fear that her condition has deteriorated more than it would otherwise because of denials for treatments by medical assistance.

Anderson said officials handle requests as quickly as they can and must follow guidelines and procedures.

Preparations were under way to transfer Schneider to the University of Minnesota Medical Center as early as Friday, pending final approvals, Schneider said.

But then word came that medical assistance wouldn’t cover a medical transfer and was only authorizing consultations with the Twin Cities specialists, Martinson said Friday.

“She’s just getting bounced from place to place, and she’s not getting any better because medical assistance keeps denying her treatments,” Martinson said, after her daughter was released from MeritCare Hospital Friday afternoon.

“This is such an ongoing thing for me,” Schneider said. “I didn’t know being sick would be so much work.”

Readers can reach Forum reporter Patrick Springer at (701) 241-5522