b'Consideringatreatmentthatrequiresup. I told them I wasnt going to be able to wiping out your immune system is a verycommit to that [chance to be randomized out serious decision. During his appointment,of the trial], but that I still wanted to pursue Dr. Cohen asked DeWayne why he was sothe treatment. Dr. Cohen thanked him for his certain HSCT was the treatment he wanted.honesty and said that, down the line if the Aftersharinghisstoryuptothatpoint,treatment became more widely available, he DeWayne boiled his hopes down to theirwould let him know. essence. I told him I wanted HSCT because,Before long, Dr. Cohen reached out to as far as I can tell, there is no medication outDeWayne again. Both he and the transplant there that will prevent me from being disabled.coordinator felt DeWayne was a good candidate At least with HSCT, not only do I have a chancefor HSCT. They decided to reach out to to halt the progression of MS, but I might beDeWaynes insurance company to see if it was oneofthosefewpeoplethatexperiencespossible to move forward with the pretreatment some healing from it too. testing. In little more than a week, his insurance Dr. Cohen was sympathetic, but explainedcompany approved the preliminary evaluations.that DeWayne would not qualify for the trial,The process of getting cleared for HSCT because it was evaluating the treatment oninvolved a thorough evaluationbone marrow, people who had not been helped by standardcardiac, and blood testing among themto MS treatment with medication. Having neverbe certain DeWayne was healthy enough to tried traditional treatments, DeWayne wouldendure the process of wiping out his immune not meet the criteria. Dr. Cohen and DeWaynesystem and transplanting a new one. His test agreed that DeWayne should try one medicationresults looked good and soon he was approved and be evaluated later to see if it was helping.by the doctors to receive HSCT.At his follow-up appointment several months later, DeWaynes MRI still showed active MSThe next step was getting approval through lesions, the signal that the medication hadthe insurance company for the immune not helped. Dr. Cohen agreed they couldablation treatment and transplant. I was pre-proceed to see if DeWayne would qualify forpared for a denial, said DeWayne. He knew the trial. fromengagingwithonlineHSCTpatient Only then, as he began the preliminarygroups that many people have been ghting process of speaking with the trial coordinator,for years to get coverage. But to his surprise, did DeWayne come to understand that trialhe soon got the call and he was cleared to participants didnt necessarily receive HSCT.proceed. He acknowledges his employer has It was a randomized trial, so only some of thethe Cadillac of insurance plans and that people wound up in the HSCT arm. Therehes very fortunate. August the 4th of 2020 were no guarantees as to which arm DeWayneat4:55p.m.IgotthecallfromCleveland wouldbeassigned.ThetrialcoordinatorClinic, hey, youre approved for HSCT. Im asked DeWayne if he could commit to stayingstill, to this day, Im still in shock. in the trial if he wound up in the control group.On Sept. 11, 2020, DeWayne signed the After some serious soul-searching, DeWaynepaperwork that would make him the first realized his answer was no. Hed been ghtingpatient at Cleveland Clinic to receive HSCT long and hard for what he believed was theoutside of the clinical trial. A few days later, best treatment available, and he wasnt givinghe was back at the hospital to have a port 13 msfocusmagazine.org'