Help for Treating Thyroid Eye Disease

Thyroid eye disease—also known as TED, Graves’ eye disease, Graves’ ophthalmopathy, and Graves’ orbitopathy—is an autoimmune disease that can damage the tissue around the eyes. It results from thyroid complications, with symptoms occurring from either an overactive or underactive thyroid. Treating thyroid eye disease is crucial to minimize this inflammatory response.

 

Thyroid eye disease and other symptoms

Signs and symptoms can vary from person to person, but redness, irritation, and discomfort are a few of the more common symptoms of TED. Some people also experience pain when moving their eyes, eyelid retraction, or have a gritty feeling behind the eyelids.

The most noticeable symptom of thyroid eye disease is bulging of the eyes, called proptosis, which can make people look like they are constantly staring. This swelling can lead to additional complications, such as headaches, corneal erosion, and even vision loss. People may also have difficulty closing their eyelids due to the increased size of their eyes, often leading to dryness that can also require treatment. In advanced cases, double vision and light sensitivity sometimes occur, which may be debilitating.

Thyroid eye disease is progressive, meaning symptoms can increase over time, but it usually stops advancing after six months to two years. However, the symptoms can persist beyond disease progression. Treating thryoid eye disease can prevent disease progression and reduce symptoms.

FlexCare has the highest approval rate of second-course Tepezza referrals. Contact us if your second course of treatment was previously denied.

Treating Thyroid Eye Disease

Until recently, those seeking thyroid eye disease medicine didn’t have any specific treatment options for their disease. Eye drops, artificial tears, and ointments can help relieve dryness and discomfort. Dark sunglasses may help with light sensitivity. Specialized lenses or eyepatches can help correct double vision.

Sometimes in more severe cases that involve loss of vision and chronic pain, patients may need to undergo orbital decompression surgery. During this procedure, a surgeon creates additional space near the bones surrounding the eye, allowing the eye to sit in a more natural position.

Another therapy, Orbital radiation therapy, is sometimes used to treat TED by reducing inflammation around the eyes. This usually takes around 6-8 weeks to take effect.

While these methods are still used in some cases, now there’s a more targeted option.

In 2020, the U.S. Food and Drug Administration approved Tepezza (teprotumumab-trbw), an infusion for thyroid eye disease treatment in adults.

Tepezza infusion treatment involves a series of therapy sessions over the course of approximately five months. Patients spend 60 to 90 minutes receiving infusions, and typically receive medicine every three weeks. Of course, this can vary between patients depending on the prescribing doctor’s orders.

In clinical studies, over 70 percent of patients receiving the Tepezza infusion for thyroid eye disease experienced a greater than two-millimeter reduction in proptosis, or bulging of the eyes, a significant improvement.

Seeking treatment for thyroid eye disease

FlexCare Infusion Centers have a higher approval rate for Tepezza infusion treatment referrals than other leading infusion centers. If you have thyroid eye disease or are seeking an infusion for thyroid eye disease  after your previous referral was denied, contact a FlexCare team member. Our medical writers are industry leaders in seeking successful Tepezza referral appeals.

Although rare, thyroid eye disease is a chronic autoimmune disorder that can be serious, sometimes resulting in vision loss. Talk with your doctor about treating thyroid eye disease with Tepezza, and ask them to complete and fax or email a Tepezza referral form to FlexCare. We know that seeking treatment can be difficult, and we’re here to help you find relief.

Cecilia Wilborn, Operations

Derrick Swetlishoff

VP of Managed Care & Contracting

Derrick Swetlishoff joined FlexCare in December 2023 and is thrilled to be part of this talented and innovative team. Derrick comes to FlexCare with over 15 years in the home infusion and specialty pharmacy contracting space. Derrick obtained his bachelor’s degree from the University of British Columbia and his master’s degree in health administration from the University of Missouri.

Derrick and his wife, high school son, and pet rabbit live in Phoenix, Arizona. While home life today is driving back and forth to high school varsity and club swim practices to support his son’s competitive swim ambitions, Derrick finds time to run, play golf, and is blessed to enjoy travel off the beaten path with family. Derrick stays involved in the community with Church and Brophy College Preparatory.

FlexCare is not currently accepting referrals for Benlysta due to a national backorder issued by the manufacturer (GSK). Our team is currently unable to determine the duration of this shortage and is recommending steps be taken by patients and providers to transition to an alternative therapy. Please close this box to view referral forms or possible alternative therapies. If you would still like to access the Benlysta referral form please click here. 

Cecilia Wilborn, Operations

Cecilia Wilborn

Operations Director

Cecilia Wilborn joined FlexCare in early 2022 as Operations Manager and assisted in the achievement of the organization’s accreditation before assuming the role of Operations Director in 2023.

Cecilia earned her bachelor’s and master’s degrees from the University of Kansas – Rock Chalk Jayhawk! She brought to FlexCare 10 years of experience in infusion therapy operations, specializing in data organization and analysis, quality assurance for clinical documentation, and editing and proofing of publications.

Cecilia currently resides in Kansas with her husband, son, and spoiled pets. In her spare time, she loves trail running, baking, and traveling. She and her husband love traveling so much that in 2021 they lived in a small travel trailer with their cat and dog for six months, visiting 47 states and 41 national parks.

Aaron Smith, CEO & Co-Founder

Aaron Smith

CEO, Co-Founder

Aaron Smith partnered with Callie Turk to start FlexCare Infusion Centers after learning firsthand the profound impact specialty infusion can have on patients and the challenges they often encounter on the journey to effective treatment. There is an unprecedented opportunity to improve access, delivery, and outcomes through better communication, technology, and operations. At FlexCare Infusion Centers, his team works hard to make the changes the patients deserve to see.

Aaron joined the healthcare sector 25 years ago when he co-founded a disease management software company focused on patient outcomes collection and ambulatory clinic accreditation. He entered population health through an acquisition of Healthways and later entered specialty medications with Briova – an Optum company. His FlexCare team routinely makes the impossible possible through expertise, good process, cutting edge technology, data-driven decision making, and a lot of listening.

Makenna Lang, Director

Makenna Lang

Director of Clinical Services

Makenna Lang joined FlexCare in 2021 as the Managing Nurse Practitioner in Birmingham. In 2023, she assumed the role of National Director of Clinical Services. Makenna oversees protocol optimization, patient safety, and clinical procedures.

Makenna holds an MSN and FNP-C certification from Samford University. Previously, Makenna worked as an ENT nurse before earning her certification from the American Academy of Nurse Practitioners (AANP) in 2018.

Makenna is married to Wes, and together they have two cats, Ralphie and Beans. She enjoys going to concerts, trying new restaurants, playing trivia and board games with friends, and has recently taken up skateboarding as a hobby.

Heather Randel, Director

Heather Randel

Director of Revenue Cycle Management

Heather Randel joined FlexCare in 2020 and led the development of the Intake team before taking over Revenue Cycle Management in 2022. Heather has 10 years of medical RCM experience in ambulatory, specialty pharmacy, and home infusion. Previously, Heather was the Assistance Director of RCM in Intake for a Specialty Pharmacy and Home Infusion service in Kansas.

Currently, Heather oversees RCM for FlexCare’s ambulatory infusion services and specialty pharmacy. She lives in Olathe, KS with her husband and two children.

Rebekkah Jackman, Director

Rebekkah Jackman

Director of Patient Access

Rebekkah Jackman joined FlexCare Infusion Centers in 2019 as a Managing Nurse Practitioner and Specialty Biologics Clinical Reviewer before assuming the role of Director of Patient Access in 2022. Rebekkah heads FlexCare’s industry-leading Intake team and ensures FlexCare patients experience the shortest time to treatment.

Rebekkah graduated from the University of Oklahoma Health Sciences Center where she earned her Master of Science Degree in Nursing with a Family Nurse Practitioner emphasis. She has over 16 years of experience in patient care and is passionate about infusion therapy and best serving our patients.

Rebekkah lives in Oklahoma City with her 3 kids and her dog. When she’s not keeping busy with her kids, you can find her in her craft room.

Matthew Holden, VP Operations

Matthew Holden

Vice President of Operations

Matt Holden is an acute care Nurse Practitioner with over a decade of committed service to the patients in his community. Matt joined FlexCare in 2021 as a Managing Nurse Practitioner and led the launch of the first FlexCare location in Alabama before assuming the role of Vice President of Operations in 2023.

Matt received his BSN from Auburn University before earning his MSN from Vanderbilt University. His experience includes Intensive Care, Transplant Medicine, Cardiothoracic Surgery, and Outpatient Care. Prior to joining FlexCare, Matt developed and launched two new service lines for an outpatient cardiology group in Alabama.

Matt and his wife Rachel reside in Birmingham, AL with their two pets, Addie and Jenkins.

Austin Wickersham, VP of Technology

Austin Wickersham

Vice President of Technology

Austin Wickersham joined FlexCare in 2020 as a software consultant before assuming the role of Vice President of Technology in 2021. He led the initiative to build a custom-developed enterprise software solution that supports and enhances FlexCare’s vital Intake team, and later led the projects to create data and reporting systems to support all departments. He oversees FlexCare’s software, data, IT, and communications projects.

Austin graduated from the University of Oklahoma with a degree in mechanical engineering. His focus on electromechanical systems quickly led to a passion for automation and building software and data solutions. After gaining experience as a software and applications engineer, he started a software consulting company and has launched several enterprise web, desktop, and mobile applications.

Austin lives in Oklahoma City with his wife, Skye, and two kids. In his free time, you can find him on the running trail, golf course, or playing games and sports with his family and friends.

Rick Yerondopoulos, Executive VP

Rick Yerondopoulos

Executive Vice President, Pharmacy

Rick Yerondopoulos professional trajectory took him into leadership just 3 years after obtaining his Doctor of Pharmacy (Pharm.D.) from the University of Arizona. His desire to be a business leader in the world of pharmaceuticals and operations drove him to complete two post-graduate residencies in Milwaukee, WI, with a heavy concentration on administration leadership.  Rick was selected to represent the state of Wisconsin in a joint venture with the state of Iowa at the 2007 Young Pharmacy Leaders Conference.

After a successful launch to his career in Milwaukee, WI, Rick returned to Arizona to be closer to his extended family.  In Arizona, he oversaw all pharmaceutical operations of the hospital-based outpatient clinics at HonorHealth, where he met his future business partner, Mark Kharoufeh.  Rick and Mark co-founded InfuseAble Care in Scottsdale, AZ, in 2020.  When FlexCare acquired InfuseAble Care in 2021, Rick transitioned to EVP of Pharmacy, leading the supply chain and procurement initiatives across the enterprise.  With the recent acquisition of a specialty pharmacy, Rick extended his purview to include oversight of this valuable service line.

Rick currently resides in Scottsdale, AZ with his wife.  His son attends Northern Arizona University in Flagstaff, AZ.

Mark Kharoufeh, Executive VP

Mark Kharoufeh

Executive Vice President, Business Development and Expansion

Mark Kharoufeh began his journey in healthcare almost 30 years ago as a pediatric oncology nurse at Los Angeles Children’s Hospital. His evolution in healthcare through various clinical, leadership, and executive roles and a passion for customer service led him down a successful path of business operations. In 2012, Mark was a finalist for AZ Business Magazine’s “Healthcare Professional of the Year” for his leadership in an all-inclusive care under one roof ambulatory healthcare service model. Mark obtained his MBA from Grand Canyon University in 2015 and completed the University of Arizona Eller Executive Leadership Program in 2019.

Mark’s dedication to enhancing access to healthcare and a model that always places the patients and their caregivers at the center of every visit was the impetus for teaming up with Rick Yerondopoulos and establishing InfuseAble Care in November 2020. Through Mark and Rick’s reputation in Arizona for reliable and service-oriented healthcare, InfuseAble Care’s brand quickly became the trusted ambulatory infusion center for physicians to refer their patients to around the state. Mark and Ricks’s goals of scaling InfuseAble Care nationally came to fruition upon meeting Aaron Smith, Callie Turk, and Adam Midkiff of FlexCare and RC Capital and ultimately joined FlexCare Infusion via acquisition in December 2021.

Since uniting with FlexCare to provide a reimagined infusion experience across the country, FlexCare has grown to 30 ambulatory centers across three states.

Mark currently resides in Litchfield Park, AZ with his wife, two sons, daughter, and labradoodle Eevee.

Adam Midkiff, CSO

Adam Midkiff

Chief Strategy Officer

Adam Midkiff joined FlexCare in 2023, though he has been involved with the organization from the early stages. He is excited by FlexCare’s mission to provide better access and high-quality care to patients in cost appropriate settings. Prior to joining FlexCare, Adam was a private equity investor with RC Capital, and he helped architect the partnership between FlexCare and RC. Prior to Adam’s experience in healthcare private equity, he was an investment banker in New York City and involved in numerous M&A and capital raising transactions.

Adam currently resides in Cincinnati, OH with his wife and two kids. He serves on the board of the Cincinnati Healthcare Professionals Network, a group of healthcare leaders with a common goal to advance healthcare innovation within the Cincinnati ecosystem. He graduated from the University of Kentucky with a degree in finance. In his spare time, Adam can be found on a soccer field or a golf course.

Jack Weston, CFO

Jack Weston

CFO

Jack Weston joined FlexCare in 2023, after most recently serving as CFO and COO of Lighthouse Behavioral Health Solutions in Central Ohio. Lighthouse focuses on improving the lives of those suffering from substance abuse disorder by combining a suite of services in an outpatient setting along with recovery housing. Prior to Lighthouse, Jack had stints in corporate accounting and finance roles at PricewaterhouseCoopers, Omnicare, and Procter & Gamble. Additionally, he embarked on an entrepreneurial journey over the last decade, beginning with a hospitality business that has grown from a single, urban sports bar to 8 bar, restaurant, and brewery locations opened in 10 years. He also opened and sold a boutique fitness studio.

Jack graduated from Miami University with bachelor’s and master’s degrees in accounting. He resides in Cincinnati, OH, where he can often be found on the golf course or trying to stay active by chasing around his young kids with his wife, Anna.