Chemo Round 5 and More Fun with Insurance

Best shirt ever.

I had my fifth round of chemo on Monday, January 30. It was similar to the other rounds but they gave me some additional anti-nausea medication since I was pretty nauseous after the last round. Dr. Coluzzi didn't do an exam this time so no new news on the tumors. He said he would do one before my last round of chemo. I feel like my tumors are continuing to shrink but I guess the MRI I get after the next round will be the real judge.

This round made me so tired. I slept most of the day on Wednesday. On Thursday I worked and I definitely did not feel very well. I left at 3 and was asleep on the lazy boy by 3:30. I slept until 5 when I woke up and ate dinner. I think I was awake until 7, when I went to bed and slept until 6 am. Other than the sleeping, I'd say that I am having most of the same side effects as last round but they are a little worse. As I've been told, chemo has a cumulative effect.

The effexor has not been effective in helping with the hot flashes and night sweats. Dr. Coluzzi doubled my dose to see if that would help. I'm writing this about five days after doubling the dose and if anything, the hot flashes are worse. I'm not sure what can be done at this point. Dr. Coluzzi said I had about a 50-50 chance of ever having a period again. They'll eventually go away, right? Eventually?

I walked on Tuesday and Wednesday. I try to do two laps around the perimeter of our apartment complex (1 lap = 1 mile) and then I walk across the street to get coffee or something to eat. It's probably about three miles total. I walked a small amount on Thursday and Friday. On Saturday morning, I went to CrossFit. I kept getting light headed so I took it very easy. I would run 200 m and then I would rest a bit and then jump rope. Box step-ups, rest, push ups, rest, dumbbell clusters, rest. Goblet squats, rest. Dumbbell snatches, rest. Done. I'm hoping to be able to do a little more in the coming week but I'll listen to my body and see where I'm at. I feel much more wiped out than I have with the other rounds.

The CrossFit open is coming up. Seth is encouraging me to enter. The open is five workouts; one is done each week. It is announced on Thursday and then you have until Monday to do the workout and post a score. It is the start of the competition that you see on ESPN. Everyone starts with the open. I did it last year. The problem with this year is that the first workout is three days after my last chemo and the last workout is after I have my mastectomy. It's not a big deal if I can't do it or take a no score for a workout so I probably will register.

Insurance
Things had taken a turn for the worst regarding insurance between rounds 4 and 5 of chemo. My plea to have Dr. Z, my plastic surgeon, accepted by my insurance was denied. (My appeal was based on the high-risk nature of my surgery and the lack of a qualified professional to do it within 30 miles of my home.) Apparently they found one other doctor in Orange in a completely different hospital system who does the surgery I need. Then Aetna came back and said that Dr. Lin, my radiation oncologist, was also out of network. This was after saying that they thought he was in network and me going to an appointment with him.

I pleaded with my nurse navigator/case manager at Aetna. She said she would take it to her supervisor but I had no confidence anything would happen. So I called my benefits person at my company. I can't say what I hoped to accomplish when I called her but I was so frustrated at that point, I think I just needed to vent. WHY IS THIS SO HARD??

In law school, when they teach you how to write a brief or try a case, they insist that you come up with your "theory of the case." This is the story you tell and the theme around which you make your arguments. At some point during my call with my benefits person, I came up with my theory of the case. To successfully navigate cancer treatment, I have to have four different doctors. Aetna and my company cannot expect me to be getting the best care if they insist I use doctors who do not work in the same hospital system or have an effective way to communicate. Also, the benefits person began to see that I need to focus on fighting cancer, not fighting Aetna. She was worried that I was too stressed out. (I may have said something like, what's $5,000 when you're talking about dying?) So, the benefits person decided that she would take care of business. Within 24 hours, she had gotten Dr. Lin and Dr. Z to agree to be "in-network" through July. Seriously. Less than 24 hours later. This doesn't solve all of my problems as Dr. Z will need to do work after July but it will get me through radiation. To say that this is a relief is a very serious understatement.

Thanks again to everyone for all your love and support!