Is Nothing Really Ever As Easy As It Seems?

Four days after my last round of chemo on March 7th, I received a $1,500 bill from the physicians’ billing department at my treatment center.  In the fall, I had applied for, and received, full financial assistance for covering my out of pocket expenses for a year from the time of my cancer diagnosis.  I was eligible because, since leaving my job of 20 years in 2007, my income has been substantially reduced and I have a high deductible health insurance plan. 

I was certain that the bill was sent by mistake. When I was originally approved for assistance, I was told to call the billing department if I received any bills and they would take care of it. So, on Friday morning the 11th, I called the financial office, only to be told that the one thing they don't cover completely through financial aid are the chemo drugs.  A minor detail!  The chemo drugs cost about $8,000 per round, and, apparently, the physician's assistance program only covers 40% of that cost.  I am responsible for the other 60% until I meet my annual deductible, which is $5,000. This was news to me.

Well, after six rounds of chemo, and being pretty much an emotional rock from my diagnosis through surgery and chemo, that was enough to tip me over the edge. I had a bit of a meltdown after I got off the phone. The financial assistance supervisor said I should speak to the oncology social worker, but I was too wrought to speak to anyone intelligently about the issue that day. I finally made some calls the following Tuesday, and discovered that because it's after the fact there is only one foundation that will take a "look back" at previously incurred expenses. (Gee, if they had let me know this before the fact, I might have applied for additional help up front, and it wouldn't be after the fact!) To complicate matters, this particular foundation only opens the application process on the first of every month at 11:00 a.m. Eastern Standard Time -- standard, not daylight, not moonlight, not eclipse -- no matter what time of year it is. The phones are open until they run out of the allotted funding for the month.  So, on April 1st, I will be among the many people sitting by the phone, waiting for the stroke of 11 EST, to call and apply for additional assistance to cover the gap in my 100% financial aid!

Despite my initial shock upon learning that I am responsible for this bill, I do know how very fortunate I am to get the aid I'm receiving and I don't want to sound ungrateful. My treatment has spanned two calendar years, and could have cost me $10,000 out of pocket, so $1,500 is a relatively low price to pay. I just can't quite get over the irony that here I was sailing along, so relieved not to have to worry about the fiscal implications of cancer, and then five days after my last round of chemo the "other shoe" dropped. In this case it was a good sized financial one!  This begs the question – is nothing ever as easy as it seems?

P.S.  For those of you who might now be inclined to reach for your checkbooks, please know that if I don’t get the foundation funding I have other options, including an extended interest free payment plan. So put your checkbooks away, or write a check to NPR or the Red Cross’ effort in Japan instead, since I don’t have as much to give them at the moment as I would like.

Monday Monday

Monday again, and here I am back at the hospital.  However, with chemo now over, today is the end of one regimen and next week will be the start of another.  Today was my last weekly herceptin infusion.  I am scheduled to go back next Monday and have a three-week infusion, meaning that I will get a triple dose of this anti-clonal antibody.  Then, I will only come in once every three weeks after that for hour long herceptin infusions.  This routine will continue into November, until I've had a year's worth of treatments.  It will be a welcome change from having to turn up at the hospital every Monday.

I have been coming to the hospital for treatment for the past 19 Mondays. Each week I have carried my pocket-sized camera in my pack, with the intention of photographing the Gateway Arch from the treatment floor every week. The Arch is located just about three miles east of the hospital. Today, March 14th, an unexpected thick wet snow has obliterated any hope of seeing that monument let alone photographing it.  Oddly, this is in keeping with most of the Mondays I’ve been here. Not that we’ve had snow every week, but there has been a preponderance of gray, cloudy Mondays, which have made the Arch a dull subject.  As I look back on the days I did shoot the structure, I see that we had at least one beautiful clear sunny day – on Monday, February 14th.  Here are a few of the images I’ve captured of the varied moods of the Arch.

This last one was taken from the 14th floor of the hospital -- not the 7th where the treatment center is located. The 14th floor provides an amazing view and a very different perspective of the area. With at least a dozen more visits to the treatment center between now and November, perhaps I'll have some better opportunities to capture the St. Louis icon under better light through the seasons. It would certainly be a great venue for viewing the fireworks on July 4th!

Chemo: Round 6, Take 2!

I'm happy, and a bit surprised, to report that I am sitting in a lounge chair in treatment pod 7, hooked up and nearly ready for my 6th and final chemo treatment.  I certainly didn't expect to pass the platelet or hemoglobin tests this week, and was mentally prepared not to receive chemo.  In fact, I was almost sent home to wait another week. My hemoglobin is awfully close to the point where I should get another transfusion, and, although my platelets rebounded from an all time low of 34,000 to 78,000 per micro liter of blood, that was still only a mere 3,000 over the no chemo zone. But after consulting with the study coordinator and the fabulous Nurse Shannon, the doctor agreed to give me the taxotere and carboplatin at slightly reduced levels, so we can get through this, without having my platelets won't fall off the chart.

When I came into the pod of 4 recliners and 2 beds, the place was full.  One nurse had to leave -- she'd lost two teeth, or rather a bridge with her front two, and needed to get to the dentist. It was 2:30. The other poor nurse was left alone with 6 study patients to monitor, which makes a slow process even slower.  I started to get the infusion at 3:30, and before I knew it the benadryl had knocked me out.  Every time I opened my eyes at least one person had left and been replaced by another patient.  When I awoke again at 6:30 I was the only person in the pod, finishing up my cocktail.  It is now a bit after 7:00 and I'm having a final saline flush, before they pack me up and send me off.  My last chemo was, in the end, very anticlimactic, but I'm happy to have it done, nonetheless!