Making a Plan and Sticking To It

Today I met with the liver surgeon. This was surgeon number two. Right off the bat, I got a good feeling at the office. Turns out that his medical assistant is a woman who worked for me 20 years ago. She had moved on to California for new horizons and had returned to care for her ailing mother during the last year. I recognized her immediately. I had bought an art print from her when she was moving that I still have displayed in the laboratory. We had lots to talk about, and it is reassuring to have an old friend on the inside to give me the inside scoop. She thinks my surgeon is a pretty good guy so that is good too.

As far as the prognosis goes, he is planning a two stage surgery. First the other guy goes after the colon cancer. After I recover from that for a few weeks, he goes in an does a combo surgery on the liver where the cut out the worst of the lesions and microwave the remaining masses to death. Second good news here. All of the equipment he needs is at my hospital, so I can have all of my surgeries at Genesys. That makes me feel good too. It is nice to know all of my friends from all of my years at the hospital will be looking out for me.

So, we have a plan. It involves a whole lot of stuff for me and that can be scary, but I would rather have a plan to anticipate than not knowing what comes next.

The games afoot!

That and Ten Dollars Will Get You a Cup of Coffee

Well, the drug deals are done. In the end, I managed to get my prescription filled and it cost me half of what I had been paying.

Go figure.

And they gave me 16 refills on it.

Go figure again.

I guess preserverance paid off this time.

Drug Deals

Today I experienced what I am sure many others have experienced; prescription denial. It was my first time. I was shocked. The anti nausea drug that my oncologist had prescribed for me, which I might add, I had successfully filled five times previously, was summarily denied by my prescription drug insurance company for some reason. The clinic had warned me initially that the drug was very expensive and they might deny it, but that they could usually get an authorization if needed.

I didn't need it.

Five times.

Now nothing.

Since I was getting my chemo treatment today and I had plenty of time, I called the insurance company myself. After going through a couple of menus and a couple of different people, I finally ended up with someone who could help me. It turns out that the brand name drug is covered, but the pharmacy had submitted the generic. This seemed odd, but who am I to argue. We ended up with me agreeing to ask the pharmacy to try it under the brand name. OK. I called the pharmacy, explained the situation and had them try again. Sure enough this time it went through. So everything is OK right?

Wrong!

It went through all right. At six times the copay as before. I told the pharmacy not to fill it because I certainly wasn't going to pay $120 for six pills. Not without more investigation. I can really feel the pain of people without insurance. If I had nothing, the cost would have been over $400. For six pills. You should see my monthly benefits statements for the chemotherapy. Thousands and thousands of dollars. I am very thankful to have relatively good health insurance. I can't imagine the impact on noninsured people. It must make their diseases that much harder to bear. I really think healthcare should be the top issue in this election year. Something has to be done to make sure that people get the care they need without going broke or worse, not getting the care they need.

In the meantime, its back to the phones to try and figure out my prescription. At least I have someone to call.

Getting To The High Ground

Good news today! I got my cat scan results back and all of the lesions, both in the liver and the colon have shrunk significantly. My chemical markers have also dropped even further. My oncologist is very happy with my progress. So am I. Thanks to everyone for all the good thoughts, prayers and positive vibes!

CAT Scan Fever

This week I had my second cat scan. The "cat" stands for computed axial tomography. Basically, you drink a bunch of nasty stuff and they take pictures of you as you slowly are pushed through a big donut shaped device. My first cat scan had gone off without a hitch so I expected no surprises. I even drove myself to the procedure, confident that I didn't need anyone to ride shotgun this time around.

I was mistaken.

The procedure was a little different this time. The procedure was scheduled for 1pm, so at 11am, I had to drink a whole bottle of vanilla flavored barium contrast media. This helps provide a clear definition to the gastric tract so they can get a good clear image. After two hours, this should have made it all the way through you. When I got to the cat scan place at 12:45pm, they gave me another bottle of the stuff. "Drink half of it and save the rest" was my new instruction. I had to drink it all at once last time. After waiting an hour (they seemed to be very busy) I was finally called back for the procedure. Put on the gown, walk over to the machine and now chug the rest of the contrast media. Believe me, I was getting sick of this stuff, but trouper that I am, I dutifully drank it down. Having the images taken is really no big deal, no claustrophobia or anything, it's just a donut about 2 feet deep. It's not even dark. I kept my eyes open this time. After taking five or six pictures, the technician informed me that I was going to require delayed images this time. "What does that mean?" I inquired. It means we need to wait 60-90 minutes and take the images over. "Why?" I replied. "Because the barium had not made it all the way down to the end (you know what I mean) yet. "Does this happen often?" I asked. "More often than we like. Everyone is different" she replied. Ok, I'm a trouper. I would take a nap in the car, no sense going back to work or home for an hour. I redressed, and headed out to the car and listened to classical music while I dozed. An hour later I trouped back in, waited 20 more minutes and went back to repeat the procedure. Same drill, put on the gown, climb back onto the machine, take some pictures. All Ok. Right?

I was mistaken again.

Apparently, my system was not cooperating. The stuff still hadn't "advanced" to the end yet. With this, the technician laid out my options. Go with what we have, try it again another day, or the third option. I was in no mood to go through this again and I didn't want to go with an imcomplete scan. I wanted the best pictures possible. So I remained a trouper and chose the third option. They would insert the barium from the bottom up. Yes, you are getting the picture. A barium enema. It has been some time since I experienced this procedure. I may have been a small child. I certainly didn't remember the sensations. It worked. Nuff said.

With my procedure completed, I was free to go. I couldn't wait. What had promised to be an hour or so procedure had taken the entire afternoon. I was tired and ironically, once I was free of the facility, the barium decided to complete its journey through my system all at once. I had to stop twice on the 25 minute drive home. Nuff said. Not a stellar day and I was glad it was over.

The next day it was back to chemo. As you might expect, I was not feeling my best after the previous days' adventure. During chemo we got a call from my family doctors' office manger. The doctor wanted me to come in today to discuss my cat scan. Could I come at 4:30pm? Of course I could come! Are you kidding. I just had the procedure yesterday and they already want to see me. Now, I work in healthcare. I know the final report is not done yet. My mind went wild. It had to be bad news. They don't call you to discuss good news, they wait till the next scheduled appointment. And I had 4 hours to think about it. At different times I was convinced they found more lesions, found nothing, found something completely new, aaaah! By the time 4:30 rolled around, I was a nervous wreck. Of course we had to wait once we got there, aaaaah! I tried deep breathing and had just about calmed down when the doctor walked into the room. Of course, he is completely casual about the whole thing. "The radiologist noticed you may have a little diverticulosis and called me about it. I want to put you on antibiotics to ward off any infections."

All of the air left my lungs.

Is that all! Thank god in heaven. I had been having pains in my side intermittantly and here was the proof that it wasn't something awful. It wasn't the bad, bad news I was expecting. If I hadn't been so relieved I might have hugged him. It cost me $75 to get this news, but I would have paid more.

So we went home relieved and grateful that the worst hadn't happened. I should have suggested to the doctor that if a cancer patient needs to see him urgently and unexpectedly they should at least let you know whether it is serious or not. If I had needed to wait until next week to see him I might have lost my mind.

But I'm a trouper. I have to be. Lost mind or not.