A post at Joinourloop got me thinking about patron saints and cancer. It turns out that Saint Agatha is the patron saint of breast cancer, and her feast day was this past week.
I wondered about her story, so I took to the web and discovered she was tortured and her breasts cut off. She's often pictured holding her breasts on a plate. Pretty grim.
As a bc survivor, I was hoping for a saint who actually had the disease. Turns out that would be Saint Aldegundis, who is a "special intercessor" for cancer. She died of bc at the young age of 45. More importantly, she lived a vibrant life and is even said to have won an argument against the devil. Love that moxy!
Saint Peregrine is another saint who looks out for cancer patients.
Good to know there are a lot of folks both here and beyond in our corner.
Sunday, February 7, 2010
I Have a Life, but I'd Like a Job
I just finished up a rough draft of a cover letter for a job I'd like to get. I've spent several hours on it today and over the past few days.
Ironically, it's for a position teaching young adults how to improve their writing. The teacher in me thinks that's a really tough assignment--one I'll have to remember if I get the job.
Yeah, before I got bc, the big worry in my life was losing my job of eight years to a lack of funding. I guess you could say (and a lot of people have) that this was for the best since cancer treatment is tough.
I don't know--there's good and bad about everything, this included.
The bad is I'm still looking for a job that has something to do with writing--and that offers good enough pay and benefits.
I taught a little bit last semester, and I loved it. I see that now more than I did as I was slogging through the class for the first time. Mostly I think I'm just ready to get back to some real work that isn't kid or cancer-related (even though I'll still have those jobs--the mom one happily).
I hope the letter sounds fairly good when I read it again tomorrow, so I can wrap this application up and move on to the next one.
Tough times out there for sure.
Ironically, it's for a position teaching young adults how to improve their writing. The teacher in me thinks that's a really tough assignment--one I'll have to remember if I get the job.
Yeah, before I got bc, the big worry in my life was losing my job of eight years to a lack of funding. I guess you could say (and a lot of people have) that this was for the best since cancer treatment is tough.
I don't know--there's good and bad about everything, this included.
The bad is I'm still looking for a job that has something to do with writing--and that offers good enough pay and benefits.
I taught a little bit last semester, and I loved it. I see that now more than I did as I was slogging through the class for the first time. Mostly I think I'm just ready to get back to some real work that isn't kid or cancer-related (even though I'll still have those jobs--the mom one happily).
I hope the letter sounds fairly good when I read it again tomorrow, so I can wrap this application up and move on to the next one.
Tough times out there for sure.
Saturday, February 6, 2010
Pregnancy, Breastfeeding, Cancer Link?
I'm interested in all news related to breast cancer and read a lot of it. One of my regular stops is Science Daily, where I try to understand the studies they report.
I'm particularly interested in news about research that has to do with breast cancer and pregnancy and breast feeding, since I personally think something about that combination can explain the spike of bc in women younger than 40.
This article talks about prolactin, which is produced during pregnancy and breastfeeding, as blocking the development of really aggressive cancer.
I had a large area of DCIS (Ductal Carcinoma in Situ--self-contained cancer that isn't messing with anything yet, so Stage 0), that became invasive, then another invasive tumor as well as other areas of concern in old girl.
So applying this article to my situation (something I regularly do), I'm thinking it might mean I had the DCIS growing in there for quite a while, or maybe pregnancy hormones kicked off the DCIS, but my breastfeeding for two years kept things at that stage. And maybe once I quit breastfeeding, the invasive nastiness happened.
Of course I might be totally misunderstanding the article; I'm not sure I entirely get it. But it would explain why I had an entirely clear clinical breast exam just two months after I stopped breastfeeding, and then big-time cancer seemed to just pop up five months later.
Interesting, at any rate.
I'm particularly interested in news about research that has to do with breast cancer and pregnancy and breast feeding, since I personally think something about that combination can explain the spike of bc in women younger than 40.
This article talks about prolactin, which is produced during pregnancy and breastfeeding, as blocking the development of really aggressive cancer.
I had a large area of DCIS (Ductal Carcinoma in Situ--self-contained cancer that isn't messing with anything yet, so Stage 0), that became invasive, then another invasive tumor as well as other areas of concern in old girl.
So applying this article to my situation (something I regularly do), I'm thinking it might mean I had the DCIS growing in there for quite a while, or maybe pregnancy hormones kicked off the DCIS, but my breastfeeding for two years kept things at that stage. And maybe once I quit breastfeeding, the invasive nastiness happened.
Of course I might be totally misunderstanding the article; I'm not sure I entirely get it. But it would explain why I had an entirely clear clinical breast exam just two months after I stopped breastfeeding, and then big-time cancer seemed to just pop up five months later.
Interesting, at any rate.
Thursday, February 4, 2010
Possibly Paranoid, Or Maybe on to Something
No news yet on the expedited appeal I've requested from my insurance company. I could be nice and wait until next week to check in on things, but then I might risk some other clock starting in the meantime. I think I will call tomorrow for an update. I've found that politeness doesn't buy you anything with insurance squabbles.
Right now I'm thinking about something I've been mulling over for a while: Just as bc treatment is and should be tailored to the many different expressions of the disease, so too should follow-up treatment, including scans, be.
Treatments vary depending upon what type of bc you get. The severity of it--how hard they hit you--also varies depening upon how aggressive your cancer is. In my case, I received "dose dense" chemo (every two weeks rather than the typical every three weeks) because I'm young and had an aggressive cancer.
But cut to after treatment, and pretty much everyone who isn't stage IV gets the same follow-up plan--bloodwork but no scans unless you have "symptoms." I put that in quotes because this is how I find it works: I report things I consider to be possible symptoms of recurrence, and the onc decides if it warrants being called a symptom and getting scanned. Yes, he's seen a lot more cases than I have, but he isn't omniscient. A scan gives me a lot more peace of mind than his best call at the moment.
So I think people who have been diagnosed with an aggressive cancer and treated for an aggressive cancer should get offered an aggressive followup. To me this means yearly PET/CT scans for the first two or three years (when the risk of recurrence is known to be greatest; since I'm Her 2 positive, I'm in the first three year group). Care after this should be tailored to the patient's needs. Naturally, people who don't like scans should be able to skip them, but those of us who want them should be offered them.
Honestly, I can't think what I have to do to get my onc to give me a PET/CT to followup on my chest aches and my bone pain.
I have an appt. with this onc tomorrow to try one more time to get a scan. I also have a backup appt with an onc at a NCI-designated cancer center in March in case, and possibly even if, tomorrow doesn't go well.
There's a lot of talk about doctors being scan and test happy, but as a post-treatment cancer patient, I haven't found that to be the case. In fact, I think it's harder for me to get a scan now than before I got the big C. Sometimes I ponder if this is because it's easier and much less expensive to not fight the second time.
Of course, everything in me resists that thinking!!!!!
Right now I'm thinking about something I've been mulling over for a while: Just as bc treatment is and should be tailored to the many different expressions of the disease, so too should follow-up treatment, including scans, be.
Treatments vary depending upon what type of bc you get. The severity of it--how hard they hit you--also varies depening upon how aggressive your cancer is. In my case, I received "dose dense" chemo (every two weeks rather than the typical every three weeks) because I'm young and had an aggressive cancer.
But cut to after treatment, and pretty much everyone who isn't stage IV gets the same follow-up plan--bloodwork but no scans unless you have "symptoms." I put that in quotes because this is how I find it works: I report things I consider to be possible symptoms of recurrence, and the onc decides if it warrants being called a symptom and getting scanned. Yes, he's seen a lot more cases than I have, but he isn't omniscient. A scan gives me a lot more peace of mind than his best call at the moment.
So I think people who have been diagnosed with an aggressive cancer and treated for an aggressive cancer should get offered an aggressive followup. To me this means yearly PET/CT scans for the first two or three years (when the risk of recurrence is known to be greatest; since I'm Her 2 positive, I'm in the first three year group). Care after this should be tailored to the patient's needs. Naturally, people who don't like scans should be able to skip them, but those of us who want them should be offered them.
Honestly, I can't think what I have to do to get my onc to give me a PET/CT to followup on my chest aches and my bone pain.
I have an appt. with this onc tomorrow to try one more time to get a scan. I also have a backup appt with an onc at a NCI-designated cancer center in March in case, and possibly even if, tomorrow doesn't go well.
There's a lot of talk about doctors being scan and test happy, but as a post-treatment cancer patient, I haven't found that to be the case. In fact, I think it's harder for me to get a scan now than before I got the big C. Sometimes I ponder if this is because it's easier and much less expensive to not fight the second time.
Of course, everything in me resists that thinking!!!!!
Friday, January 29, 2010
Never Give Up, Never Surrender!
It turns out I have quite a developed opinion regarding insurance. I think this is probably the case for most people who have encountered an expensive illness.
I thought I'd explain my philosophy so people might see why I'm so adamant about getting the in-network exception for the rest of my reconstruction reinstated.
There is only one number I care about in regards to my health insurance--the maximum out of pocket my family has to spend. It's a sure bet we'll meet it this year, as we have every year since I've gotten the bc diagnosis.
This amount is several thousand dollars--roughly the cost of a Hawaiian vacation for my husband and me.
We're happy to have coverage and happy to pay what we owe on time. But I will not pay one dime more.
In appealling this latest goofiness, I have heard too many times that I can just use our out of network benefits to finish up the work. This would trigger a whole new limit, and would mean we would pay 20% instead of 10% and there would be no caps for reasonable and customary charges--so basically, sky's the limit in addition to the in-network maximum that we will still meet.
There is no way I am going to have my family pay for two tropical vacations in one year that we will never take.
If there is not a local doctor who performs the service, our insurance allows for using a doctor who does the work and will cover that at the in-network benefit level even if they are not in-network.
Almost all plastic surgeons who do a lot of DIEPs don't contract with insurance companies as a general rule, and there is no local doctor who can do a DIEP, so getting an in-network exception is the way I have to go.
And I won't give up.
I thought I'd explain my philosophy so people might see why I'm so adamant about getting the in-network exception for the rest of my reconstruction reinstated.
There is only one number I care about in regards to my health insurance--the maximum out of pocket my family has to spend. It's a sure bet we'll meet it this year, as we have every year since I've gotten the bc diagnosis.
This amount is several thousand dollars--roughly the cost of a Hawaiian vacation for my husband and me.
We're happy to have coverage and happy to pay what we owe on time. But I will not pay one dime more.
In appealling this latest goofiness, I have heard too many times that I can just use our out of network benefits to finish up the work. This would trigger a whole new limit, and would mean we would pay 20% instead of 10% and there would be no caps for reasonable and customary charges--so basically, sky's the limit in addition to the in-network maximum that we will still meet.
There is no way I am going to have my family pay for two tropical vacations in one year that we will never take.
If there is not a local doctor who performs the service, our insurance allows for using a doctor who does the work and will cover that at the in-network benefit level even if they are not in-network.
Almost all plastic surgeons who do a lot of DIEPs don't contract with insurance companies as a general rule, and there is no local doctor who can do a DIEP, so getting an in-network exception is the way I have to go.
And I won't give up.
Sunday, January 24, 2010
Having Troubles Getting to Second Stage
Remember when I said "peer to peer review" is the phrase you need to know if your insurance rejects your attempts for an in-network exception for DIEP reconstruction if it's not offered locally?
Well, you should also know insurance might try screwy things to keep you from getting this review, which involves their medical director chatting with your plastic surgeon.
Obviously, if that were allowed to happen I'd have a much higher chance of getting the decision overturned than if I and my dr's office wrote a letter, which the insurance co answers by letter in two weeks.
Having their medical director actually speak to my doctor seems imperative in this case, since the director thinks that I can get the second stage of a DIEP reconstruction in my town, which is simply not true. In my opinion, this person is in dire need of some education about the differences in breast reconstruction procedures after a mastectomy.
It's not like I'm asking for an elective boob job, after all.
Anyway, there are two issues that are bugging me about this.
1. When I call to get information about it, I'm told this is strictly between the dr's office and the insurance, though it affects me, the patient. They never let the patient speak with the medical director or any of that staff about the decisions. Apparently, they don't like to let the doctors speak to this person either.
2. The insurance company is saying my only line of appeal now is the letters because there is a 10-day window for asking for a peer to peer review. I have documentation that shows we did this, but they are saying that the window starts from when they made the decision--8 days before they put the decision into a letter and mailed it (a couple more days) to my dr's office. Naturally, my question is "How many, if any, peer to peer reviews do they even grant if this is their procedure?"
Now I'm left with appealling the craziness of their peer to peer process on these two fronts. What's so frustrating about this is it should be a no-brainer for insurance to approve an extension of the earlier in-network exception I had for all three stages of the DIEP back when I started this process. Those agreements come with an expiration date for some not reflective of real life reason, and that's why my doctor applied for the extension.
Trust me, I wanted to wrap up all three phases of this DIEP process as quickly as possible (usually that's first surgery, second surgery three months later and final office work two or three months after that). It would have been cheapest and I would have been even by now, but the reality of life dictated that I needed to wait to see if my new boob would soften up a little and fall a little so it would look more natural.
I hate to wait, but I waited. But I didn't know that when I was ready to move ahead again, I'd have this stupid problem.
I'll keep you posted.
Well, you should also know insurance might try screwy things to keep you from getting this review, which involves their medical director chatting with your plastic surgeon.
Obviously, if that were allowed to happen I'd have a much higher chance of getting the decision overturned than if I and my dr's office wrote a letter, which the insurance co answers by letter in two weeks.
Having their medical director actually speak to my doctor seems imperative in this case, since the director thinks that I can get the second stage of a DIEP reconstruction in my town, which is simply not true. In my opinion, this person is in dire need of some education about the differences in breast reconstruction procedures after a mastectomy.
It's not like I'm asking for an elective boob job, after all.
Anyway, there are two issues that are bugging me about this.
1. When I call to get information about it, I'm told this is strictly between the dr's office and the insurance, though it affects me, the patient. They never let the patient speak with the medical director or any of that staff about the decisions. Apparently, they don't like to let the doctors speak to this person either.
2. The insurance company is saying my only line of appeal now is the letters because there is a 10-day window for asking for a peer to peer review. I have documentation that shows we did this, but they are saying that the window starts from when they made the decision--8 days before they put the decision into a letter and mailed it (a couple more days) to my dr's office. Naturally, my question is "How many, if any, peer to peer reviews do they even grant if this is their procedure?"
Now I'm left with appealling the craziness of their peer to peer process on these two fronts. What's so frustrating about this is it should be a no-brainer for insurance to approve an extension of the earlier in-network exception I had for all three stages of the DIEP back when I started this process. Those agreements come with an expiration date for some not reflective of real life reason, and that's why my doctor applied for the extension.
Trust me, I wanted to wrap up all three phases of this DIEP process as quickly as possible (usually that's first surgery, second surgery three months later and final office work two or three months after that). It would have been cheapest and I would have been even by now, but the reality of life dictated that I needed to wait to see if my new boob would soften up a little and fall a little so it would look more natural.
I hate to wait, but I waited. But I didn't know that when I was ready to move ahead again, I'd have this stupid problem.
I'll keep you posted.
Thursday, January 21, 2010
Anniversaries
This month I celebrate being cancer free for three years. This past August, my husband and I celebrated 10 years of marriage.
Each is an accomplishment, and taken together, they are a sign that my little corner of the world is doing pretty well.
Getting a big disease like cancer can wreak havoc on a marriage. A statistic I saw recently said spouses are eight times more likely to leave if this brick comes through the window.
It's a big deal, no doubt, and I see now why it's included in traditional marriage vows.
I'm just very happy we've defied the odds. I think it helps that we were friends for many, many years before we got married. Honestly, I have trouble remembering a time before L. was in my life. Just as it seems like I've been a mom to S. forever.
Cancer has come, and hopefully gone, but it has changed our lives forever. Sometimes I think it's moved us ahead on the continuum of coupledom. It's like we're much older than we actually are and have covered so much more ground than we actually have. I feel we're like my grandparents and older than my parents in some ways.
It's a weird feeling, but a good one in that I know L. gets it. He gets that we will always have to worry about having insurance for the family. He gets that I am not crazy when I wonder aloud about ailments I've noticed. And he'll push me to get things checked out, because he wants me around for the family as much as I want to be around for them.
This all brings me to having my wedding ring redone recently--the original didn't fit after I gained weight from cancer treatment.
I could look at this new ring as just fixing more of the collateral damage, but I've decided to see it as a marker of what we've been through and a promise of many more beautiful miles to explore--together, as a family.
Each is an accomplishment, and taken together, they are a sign that my little corner of the world is doing pretty well.
Getting a big disease like cancer can wreak havoc on a marriage. A statistic I saw recently said spouses are eight times more likely to leave if this brick comes through the window.
It's a big deal, no doubt, and I see now why it's included in traditional marriage vows.
I'm just very happy we've defied the odds. I think it helps that we were friends for many, many years before we got married. Honestly, I have trouble remembering a time before L. was in my life. Just as it seems like I've been a mom to S. forever.
Cancer has come, and hopefully gone, but it has changed our lives forever. Sometimes I think it's moved us ahead on the continuum of coupledom. It's like we're much older than we actually are and have covered so much more ground than we actually have. I feel we're like my grandparents and older than my parents in some ways.
It's a weird feeling, but a good one in that I know L. gets it. He gets that we will always have to worry about having insurance for the family. He gets that I am not crazy when I wonder aloud about ailments I've noticed. And he'll push me to get things checked out, because he wants me around for the family as much as I want to be around for them.
This all brings me to having my wedding ring redone recently--the original didn't fit after I gained weight from cancer treatment.
I could look at this new ring as just fixing more of the collateral damage, but I've decided to see it as a marker of what we've been through and a promise of many more beautiful miles to explore--together, as a family.
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