At 6:30 p.m., Gorman starts the process all over again.
She believes vancomycin is helping her recover from a case of chronic Lyme disease so debilitating that it left her too tired to work, too confused to make dinner or find her way home from the mall, too racked by pain and weakness to stand up straight or grasp a can of food in the grocery store. The antibiotic, she believes, is the only thing keeping her Lyme disease at bay. Her doctor, Jeffrey Darnall, an infectious disease specialist from Ridley Park, believes another month or two of therapy will help her.
But her insurance company, Keystone Health Plan East, disagrees. It began questioning Darnall's orders back in March and has refused to pay since June. Gary Owens, vice president of patient-care management for the company, said there was no scientific evidence that more than three months of IV treatment did any good.
Gorman, a pale, thin woman with short, dark hair, is so convinced she will relapse without the medicine that she is paying $105 a day from her own pocket. The 37-year-old widow who lives on Social Security benefits has used up her ready cash, sold furniture from her large Colonial house in Aston, and is running up thousands of dollars of credit-card bills to pay for the drug.
She also has retained a lawyer to fight Keystone's denial.
``If a person's ill,'' she said, ``they're going to do whatever they have to do to survive.''
Darnall said he had never before prescribed more than three months of IV therapy for a Lyme patient. He did so for Gorman because she seemed to be improving. Before they override doctors' orders, he said, insurance companies should understand that there is no standard of care when it comes to Lyme. Each doctor treats the disease differently.
``It's not an exact science,'' he said. ``It's an art form.''
