Major Medical

What would you do if you didn't (or don't!) have health insurance and all of a sudden you became "sick" or injured, your ailments falling into that category of "major medical?" And note that it does happen all of a sudden. In fact, all at once, you can become "sick" even when you feel "normal" and "healthy." That's how it happened for me last November when I was diagnosed. It's bat-shit scary, and that's before taking into account the potential financial hit.

I've taken a while to write about this only because I've had other things to say and simply haven't had the energy to get to it until now. But earlier this winter or spring, Craig was looking at statements and bills, and noted the cost of just one of my chemotherapy infusions from chemo course #1 (prior to surgery). This was when I received Taxol on a weekly basis and a cocktail of Taxol, Herceptin, and Perjeta every three weeks. The cost for one of these cocktails? About $50,000. We've all heard about the exorbitant costs of healthcare in the U.S., but seriously--$50,000 for one episode of chemo?

So what's going on here? That's actually a serious question, because I really don't know. I imagine it's partially the super-high price tag slapped onto new and innovative drugs like Perjeta (which, along with Herceptin, is made by Genentech), which has only been on the market for a year or two. But an article in Pharmacy Times lists the cost at just under $5,000 per dose (http://www.pharmacytimes.com/publications/health-system-edition/2012/August2012/Pertuzumab--Perjeta). And according to a Wikipedia article, Herceptin can cost about $70,000 for a full course of treatment (http://en.wikipedia.org/wiki/Trastuzumab). Even if we included Taxol, these numbers don't add up to $50,000 for one infusion of Taxol, Herceptin, and Perjeta. Sure, I would also get Benadryl, Zofran, and saline, but still...

According to an article in today's New York Times, the primary source of healthcare costs is not healthcare workers or physician's bills. Rather, it's executive salaries in the medical business world: http://www.nytimes.com/2014/05/18/sunday-review/doctors-salaries-are-not-the-big-cost.html?smid=fb-nytimes&WT.z_sma=OP_MTE_20140519&bicmp=AD&bicmlukp=WT.mc_id&bicmst=1388552400000&bicmet=1420088400000&_r=2. This includes CEOs of health insurance firms and hospital administrators, who make much more money than general physicians and nurses do. I'm thinking oncologists may make more than general physicians, but still--this article does an excellent job of pointing out where our "major medical" expenses are coming from, at least in part.

I would really love to know what those of you who work in the healthcare and biomedical industries know and think about all of this. Although I have no answers, I do know this: I am extremely fortunate not only to live in a place with quality healthcare, but also to be fully insured. I honestly cannot imagine what this whole experience would be like if I did not have that kind of security. And thus, I find it very very difficult to imagine why so many people would want to keep so many people from securing the same peace of mind. Obamacare ain't perfect, but neither are our bodies.

The Average Wholesale Price of pertuzumab (Perjeta) is $4890 per 420-mg vial. - See more at: http://www.pharmacytimes.com/publications/health-system-edition/2012/August2012/Pertuzumab--Perjeta#sthash.8451ACmy.dpuf

The Average Wholesale Price of pertuzumab (Perjeta) is $4890 per 420-mg vial. - See more at: http://www.pharmacytimes.com/publications/health-system-edition/2012/August2012/Pertuzumab--Perjeta#sthash.8451ACmy.dpuf

It's alright

Last night I had a dream that my mom and I were shopping for hats and earrings, lost track of time, and missed today's doctor's appointment and my last chemo. The feeling is a bit like those dreams that I (and many people) have of missing the school bus or a final exam. Hmmm... What does it all mean? Well, I'm not 100% sure what it all means, but here are a few thoughts. First of all, I must make public that my dreams have shifted from really scary things to milder turmoils; from "oh shit, I have cancer" to more mundane little fears like missing appointments and school buses.

And significantly, today is my last scheduled chemotherapy infusion. As usual, I'm not looking forward to it (sort of like I wouldn't look forward to a final exam), but I am at the same time thrilled to be able to put this behind me. While my other infusions have been accompanied by the knowledge that I would feel like hell for a week, then good for a week, and then like hell for another week, this time I get to look forward to constant improvement in how I feel; a gradual but continued emergence from the nausea, fogginess, and sluggishness. This is in addition to other side effects that have been taking hold as the chemicals build up in my system: Fingernails breaking like nobody's business, a greenish tinge to my complexion, dark circles under my eyes, continued hair loss, mild neuropathy in my fingertips, and exhaustion even beyond my post infusion week. (As I've said before, I think the EPA would shut me down if they knew what was flowing through my veins.) But after today I will be over the biggest hump in my treatment, and it should be smooth sailing from here on out, with a steady process of detox, until...

RADIATION! That should start on June 4th, but it's very localized with minimal side effects. I should feel more like a person, my hair will start growing back, etc. But in celebration of finishing up chemotherapy and in anticipation of the last major stage of my treatment, here's a song for you all: The Beatle's Here Comes the Sun. The video is admittedly over-flowing with hyper cute little baby animals, but on the other hand, meaningful milestones and awesome songs will do that to people. And the sun theme seems fitting given my upcoming radiation. :-) One of the things I appreciate about this song is the gradual move from sweet and quiet anticipation of good things over the horizon to an emphatic exclamation point of those good things to come, and the knowledge that while things have been difficult, it's alright. Present tense. Indeed, it's alright.

Grateful

Cleaning the garage

Taking care of the soccer carpooling

Feeding the pets

Emails and text messages from friends (even if I don’t respond, I read them all)

Load after load of laundry

Fixing the towel rack

Cleaning up dog barf

Dinner

Pulling weeds

“You have a nicely shaped head”

Fixing the kitchen chair

Doing the grocery shopping

Hats

Getting the tire on my car fixed

Running a meeting for me

Mowing the lawn

Chocolate

Going out for coffee with me

Walking the dog

Driving the kids when they have to get to school early

Offers to shave and polish my head

Filling the bird feeders

A new pair of sweats for my horizontal days

Helping me plant the garden

Little notes in my box at work

Making sushi with the kids

Thoughtful cards in the mail

Cleaning out a birdhouse

Hand sanitizer everywhere

FMLA

Doing the dishes

Getting gas for the mower or my car

More dinner

An origami bird in my box at work

Presenting a paper for me

Squeezing me in last minute at the doctor’s office

Co-teaching with me

Fixing the doorknob

A vacation for the kids

Nurses who know my name without having to look it up

More laundry loads

Taking me out to watch a soccer game

More dinner

Listening to me talk about cancer and chemo

Remembering that sometimes I like to talk about things other than cancer and chemo

A snuggly child

Cleaning the coffee maker

Helping a kid with their homework

A Facebook message

Letting the dog out first thing in the morning

Flowers

A new book

Scooping dog doo from the yard

Helping me understand my treatment

Driving me to physical therapy, doctors’ appointments, and chemo

Ordering and picking up take-out

Jump starting the battery

Going to the kids' games and cheering them on

Fixing a loose part on a table

More dinner

Phone calls

Getting a kid a meal on the run

Picking up a prescription

Hugs

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I could go on and on, but you get the picture. So many people giving me (and us) so much. Thank you, all.