Sunday, April 27, 2014

Insurance nightmares...


I found out Friday after I left chemo that insurance has DENIED my radio-embolization procedure. This week Dr. Friedman will be having a Peer-to-peer discussion with the MD at the insurance company to attempt to reverse the decision. (By the way, this happened before when I tried to get in-home physical therapy approved for Leo's cerebral palsy; they had some random MD of internal medicine making a judgement about something specific regarding cerebral palsy..how does that make sense?!?!) Dr. Friedman is also armed with information from the Siri-spheres company and Cedars Sinai. I will see if Philomena can put in a letter of support as well. I will also be calling the insurance company to find out WHY in all their wisdom (*cough, cough) they have decided to deny the procedure. Just how BAD do the liver tumors have to be in order for them to approve the procedure? What brilliant life saving method do they suggest I try instead of the latest cutting edge procedure that is minimally invasive? Surely it can't be a financial decision, right? I have to say that ever since Obamacare has been shoved into existence, and its been good on the one hand because people who are close to me are able to get (however I didn't say *afford) health insurance, the private insurance companies are giving previously insured, current policy holders a run for their money. Nothing is easy anymore. Nothing is approved anymore. Everything requires push-back, follow-up, extensive investigation, filing and re-filing, changing code numbers, etc. etc. A stressful paperwork fight is EXACTLY what people who are facing serious illnesses need, am I right? This next week will be an anxious one for me. I have a birthday on Thursday, perhaps I can pray that good news from the insurance company will be my present that day. Fingers and toes crossed.

Friday, April 25, 2014

The canvas

Sitting here at Tower getting my infusion…I had a scare today about an hour ago while getting the Abraxane that freaked me the f*ck out but more on that later… I opened up this blog and the editor told me that I had a post from last week that I never finished so I'll start with that first.

First of all, I want to give a special thank you and "shout out" to my beautiful friend Nandi. I haven't seen her in forever and out of the blue she asks me for my address….a few days later I got the special PEACE mug for my tea that I was so crazy about in Hawaii. I was so touched I started to cry. It was just so thoughtful and really made my day. I guess I'm not writing this blog for nothing! See, I get free gifts. Ca-ching!! Thank you Nandi.

So how are you? Everything good? Have you been watching Cosmos? Neil Degrasse Tyson is my hero. I love science. I forgot how much I love biology, physics, and chemistry; school was so much fun. So how am I? I am all over the place lately. Generally, I'm feeling run down. The fact that I fasted last week, got chemo, plus haven't been able to get back to a rigorous work out regimen don't help the overall picture. I need this ankle to heal so that I can get back to ballet and back to building muscle. I tried yoga last week the day AFTER I bumped up my melatonin to three tablets per night and it was a pointless session. I basically couldn't do much more than ujjayi breathing, stretching and lying down (emphasis on the lying down part). I was having terrible bone pain the past two weeks. I thought it was related to the ankle but since it was both legs it really couldn't have been. When I went for chemo last week my nurse practitioner Paige said is was related to the Abraxane. Apparently, bone pain can be a common side effect. This week, however, I am having less bone pain. I think the bone pain is related to the Xgeva shots. It's always very achy after I get that shot and then it dissipates over the month until I have to get another shot. I have been able to walk my neighborhood, starting out with shorter walks and building my way back up to the full distance with short stops along the way. Exercise is supposed to help the joint and bone aches so I'm trying to keep it up. I'm also trying to build up my stamina and endurance because I've signed up for the LOVE foundation annual walk!

Walk with Love 2014 for a Future Without Breast Cancer. May 18th at 10AM, right in my very own neighborhood in the Pacific Palisades. I hope we walk by my house. I did this walk two years ago and remember walking by our future house and admiring it. How fun it will be to walk by it now!!

I was trying to explain to someone the other day what being a cancer patient was like. Basically you just do what you have to do. I don't like it but I still do it because let's be frank - there isn't another option. Just like you feel when you know you're going to get a shot or the doctor is going to prod at an injury to check for sprains or breaks - you flinch, you feel dread, your fight or flight response kicks in and you hope there is some way to get out of it or away from the pain. When you realize you can't you just take a deep breath, suck it up and get it over with. That's how this feels. I still feel the way you would and do at the doctor's office. I still feel that absolute dread when I see the Chemo nurses taking out their packets with the huber needles, sterilization materials, dressings etc. I constantly take deep breaths, look away, try to trick my mind that the pain will be over soon. That soon I'll be back home and away from this place.

Fasting has become harder for me. This last one was really difficult. I think it was most difficult because it was emotionally hard. I kind of could care less about the food plus I was pretty nauseous last week too. I was losing faith that the fasting was having an impact. Looking at my blood work though it appears to be working. My blood work has remained stable despite how terrible I may feel at times. When I really think about what was bothering me the most, it is the balance of doing everything I can when I don't really know what is working. I'm trying so hard to be perfect all the time with supplements, fasting, exercise, diet, doctor appointments and follow ups. It's exhausting. Good thing I can remember that I am human. That I am NOT perfect. I am attempting to shift my type A personality. I know that I can take a beat. That I can slip up. Have an off day. Forget pills. Skip a work out. Miss an appointment. Take a nap instead. And feel OK about it. This is what I have been focusing on. Doing less. Doing only the things I feel I really want to or can do.

I had my Y-90 radio-embolization consultation for Dr. Marc Friedman at Cedars. He is very impressive and certainly put me at ease about this process. It will be a series of three procedures once they get done fighting it out with the insurance company for approval. They started two weeks ago with the authorization process. Once we get the go ahead I will have an angiogram to map out the path through my femoral artery to the hepatic artery where they will release the radiation to zap out of the liver tumors. They will start with the left side. Then they will take a four week break before they check out my blood counts, etc. etc. and then do the right side (which I'm curious about since the Abraxane is shrinking them)…

Today during my infusion I started feeling super cold on my right side and was having difficulty breathing. All of a sudden I felt super nauseous, couldn't take a deep breath and started having a panic attack. My nurse had to stop the Abraxane and take a break. 20 minutes later she started again with a slower rate and had to give me the steroids. Apparently, sudden on-set chest pain and issues are par for the course with Abraxane. It is likely that I will need the steroids again next week (which will be the last infusion for this cycle, yay).  It felt like someone was sitting on my chest, while sucking in liquid oxygen at a high altitude. I was very scared. I did not feel well and I did NOT like it. I'm going to get a chest x-ray next week. I want to make sure it was just the infusion and not an issue with my lungs.

Can I say it…FUCK cancer. OK, there I said it.

I saw my therapist Pam recently and communicated my emotional roller coaster and how very afraid I am of continuing treatment, how it has been increasingly difficult to recover after each infusion, and how the upcoming procedure scares me. I do my best to not let the feelings over take me but I still have to acknowledge that they are there and that they are very real. She explained that those dark feelings and emotions can be there and that they are a small part on a larger emotional canvas.
Our emotional canvas is a detailed and changing painting. There will be some dark spots but we can't let it over take the whole canvas. Recognize it is there and that it can grow and diminish depending on the day. Stay in the present moment. Like that lame movie I forced myself to finish watching with Will Smith and his kid, After Earth. The best part of that movie was the message that there is no fear in the very present moment. Fear is in the future or of not letting go of the past.

My fascination with death is becoming less of one with fear and one of acceptance. Yes, I know we are all going to die, blah blah blah. (I'm a little tired of hearing that from people who aren't dealing with a serious illness). And no I'm not saying I am anywhere near that point. I have faith that things are going to turn around for me. I'm saying that understanding and accepting death is a process. A true process that has to happen to achieve peace before you go. You start to see that when people who are close to you die, who may or may not be in similar circumstance to you. Were they ready? Were they scared? Were they in pain and ready to be free? This is a dark spot on my emotional canvas at the moment that I am working through. But I have 100 times more bright spots on my canvas to think about…

I took the kids to Disneyland on Wednesday kind of spur of the moment. Abby had a random day off and Leo is still on his spring break (their spring breaks don't overlap). It was a really fabulous day. Very exhausting but totally worth it. There was this one point after the dumbo ride and hat shopping at the Mad Hatter that Abby turned around in the busy plaza and took Leo's hand to walk with him over to the restaurant for lunch. I whipped out my phone and started snapping away because it was one of those moments that makes your heart swoon and fill with pride. I love them so much!!!

It's time for my last cold cap of the day for this infusion so I'm going to wrap it up. Fingers crossed that I hear from Dr. Freidman's office and can get started this week or next for the radio-embolization!!

Thank you for listening.
Love,
Jess




Tuesday, April 8, 2014

Doing fine

I've been too busy (in a good way) to post and that is a good thing. It's spring break!! I'm a girl gone wild!! Woo hoo...



I just returned from an amazing 10 day trip to Hawaii for Spring Break, and I swam, ran, yoga'd,  played with the kids every day. Unfortunately on the evening of the second to last day I went for a run (hard core by my standards and was running full force like some kind of athlete, I may have been influenced by the lava man triathlon the previous day but I digress) and fell, twisting and spraining my ankle and getting some nasty cuts in the process. I was running on a back street of the hotel property and just lost my footing, I think on some finely ground lava rocks. The next day was David's birthday celebration and I wanted to do all kinds of things for that but there went those plans, along with plans to swim in the ocean one or two more times before we left. Bummer, dude.

 

After I woke up from a nap on the fourth day or our trip I checked my phone and saw a flurry of activity in a message board I was tagged in. My friend and fellow Stage IV cancer warrior Martha Mata died. She had an exploratory surgery for a biopsy that Friday but I had heard she got through it. I was shocked and rattled to hear such bad news. I wanted (and selfishly needed) for her to be okay and get through her treatments. I know how hard she yearned for things to be back to normal for her. She was a year younger than me in school but we really knew each other through our conversations as adults and as cancer survivors. Her death is so tragic. It really struck me hard. I know how much she enjoyed First Descents and going on adventures. For those of you who don't know, I am pretty petrified of the ocean. It feels like a monstrous beast that you don't mess with. I made sure to do things that she liked to do. I stand up paddle boarded, dove into the ocean, body surfed waves (one of which Abby saw me get go under and she flipped out but I came right back up with a thumbs up), ran, walked, enjoyed the sunsets, the wind, the water, the air and all because she no longer can. I tried talking to her while I did these things. I asked her when I was floating on the ocean if it was easier for her now. My heart told me that she was at peace. I decided to take my anger and grief and fuel it into an appreciation for my own life and my own fight. To keep fighting in her name. Fuck you cancer.  Fuck you for robbing Martha of life during her prime years. She fought you bravely with her whole heart. You are a conniving, ugly, manipulative, horrible, and heartless disease. We are going to figure out how to beat you.

Have you read this? Anti-CD47 cancer therapy clinical trials

I started fasting the last day, our travel day which made it easier since there isn't anything remotely healthy to eat at airports or on the airplane so I had nuts, tea and water all day. It sure was hard to wake up with the time change, losing three hours of sleep, but woke up and drove myself to chemo. Back to reality. Everything was fine. I was very worried my counts would be down since I exercised like a mad person and did have two nights of wine drinking and dessert eating. I indulged, it's vacation! The rest of the time was fish, salads, fruits, rice, no gluten, etc. OKAY?! (I'm really telling myself that). My blood counts were good. Up from two weeks ago. They took tumor markers again but at this point I am just not that interested. They go up and they go down. I'm focusing on what the scans say. I did the cold caps, drank tea, water and some soup. Biggest let down was that I was due for my two injections. Big f'ing bummer, dude. They really knock me out. Lupron and Xgeva. I save them for the end when I'm not hooked up or freezing my scalp to get the two gnarly pricks. Then I drove home to the kiddos! The following days over the weekend I spent recovering from the ankle issue, chemo issue, and injections.



My good friend Daniel forwarded some very relevant articles to me over the break. This was one of the trials I was looking to get into BUT I'm not actually post-menopausal so I didn't qualify. Forced chemical menopause is not the same.... These new trials are being managed by Dr. Dennis Slamon at UCLA (among others) who I had talked to at my initial diagnosis. He and his team are the researchers who developed Herceptin for Her2 positive types of tumors...nonetheless these new trials are important and interesting to me because they target estrogen receptor positive, her2 negative types of tumors.

Pfizer breast cancer drug results impressive

Breast Cancer drug shows groundbreaking results

Pfizer drug double time to breast cancer tumor growth in trial

Oh yeah, coming up on Thursday I have my consultation with Dr. Mark Friedman regarding the Radioembolization. I haven't started researching this yet. Not sure I should. He plans to walk me through the outpatient procedures (with an S) at the first appointment. Here is one interesting article about the procedure, if it in fact is one in the same: Y-90 Radioembalization

Enough cancer talk. I loved this mug I used while in Hawaii. It took everything within me not to pack it into my suitcase. I need to remember this on a daily basis. No matter what life throws your way, you can take some deep breaths and work to find peace in your heart and mind. I am thankful to my husband and family for being able to take such an amazing vacation. To have time away from reality. To have time to heal and relax and recenter.


Lately I've been listening to audible books for my book clubs, the first was The Flamethrowers by Rachel Kushner (good but not my favorite),  next was We Are All Completely Beside Ourselves by Karen Fowler (very well done) and my favorite was A Tale for the Time Being by Ruth Ozeki. I loved this book. It had me laughing, crying and engrossed until the end. I am loving all these books because they let me escape to different lives, periods, and places. Books are the most wonderful form of distraction. I am especially becoming addicted to the audio books. And anything else portable which leads me to my next point....

I am really loving (and yes, laugh if you will since I am very behind the times of all you techno-savvy peeps) are the TED talks. There's an iphone and ipad app and you can watch or listen (depending on how much memory you want to use) to the talks while on the go. There are two that my therapist recommended I watch, both by Dr. Brene Brown. Please look them up -  the first is on VULNERABILITY and the second is on SHAME. They are only about 20 minutes or less each and they are pretty powerful. Another one I enjoyed was by a comedian with cerebral palsy. We all have our own struggles and paths, it's all about the journey, right?

I am worthy of LOVE and BELONGING.

I have the courage to be IMPERFECT.

I have the COMPASSION to be kind to myself first and then to others.

I fully embrace VULNERABILITY.

I let myself be SEEN and be HEARD.

I LOVE with my whole heart.

I STRUGGLE.

I am UNCERTAIN.

I practice GRATITUDE and lean into JOY.

I AM ENOUGH.

I AM ENOUGH.

I AM ENOUGH.

I AM ENOUGH.

I AM ENOUGH.

Why does typing that last sentence make me cry and shrink down? Three little words that are so powerful. Each day I am learning to embrace that concept. I am enough. I am strong. I am healthy. I am happy. I am at ease. I am peace.

May you be well.
XOXO