Wednesday, July 23, 2008

Sunday! Sunday! SUNDAY!!! er... WEDNESDAY!

Just five dollars gets you the whole seat but you'll only need the eeeeedge!

I was a little anxious yesterday afternoon heading for Dr. Lee's office. Was the CT scan good enough? Should I be expecting a fight with Kaiser over getting a PET scan? It's been five weeks... am I going back on chemo? Can I go back to work?

Yes, these questions and more were all answered on this week's episode of As Sco's World Turns.

In order, yes the CT scan was good enough. The report was a whopping two pages instead of two paragraphs and had many good things to say. There was nothing to see in the lymph nodes of my chest. The diseased spots in my right lung had shrunken more still compared to April and August of last year. The spot on my liver had also diminished down to less than an eighth of an inch in diameter; even smaller than when Dr. Grasso spied it when I had surgery. He said then that it was too small to go after then, even while I was already konked out. My spleen is enlarged, but that is most likely due to the chemo making things hard on my immune system and it is (was) pumped up now that the chemo has been off for a while. There is also a good deal of inflammation in the soft tissue 'down there' which is only a worry if I'd not been through radiation.

No, Dr. Lee does not need me to suit up for battle with Kaiser. She was a little sly when she said she would save her admonition for the denial for another time. There is something to be said for being owed one when someone goofs something up for you. ;)

Yes, I am going back on chemo.

Yeah, I needed a moment to let that sink in too. I tried to bargain right away because it's going to be the Xeloda again (pills) instead of a drip. I'm trying to keep an open mind here and hoping the side effects will be similar to last year's experience but without the sunburn from the inside. I'm going to need more willpower this time. Dr. Lee made it plain though that we need to do this and it needs to be for a few months to make sure all of the work I've done so far is not wasted by cutting things off too early. That would suck. Big time. I need to remember that to avoid the temptation of 'forgetting' to take the stuff.

Yeesh. You'd think a day to accept the news would be enough. :\

Can I go back to work? Sure. But Dr. Lee cautioned me to give the Xeloda a try and judge how the full dose hits me (the does I took last year was only 50% because I was getting microwaved at the same time). I agreed that would probably be a good idea and I shared that with my section manager at work today. Meanwhile, Dr. Lee is ready to write me anything I need to rejoin the wage-earning population. Just plain interacting with people again is going to make me feel good. :)

Wednesday, July 16, 2008

what a tangled web we type

Sure enough, I got my little five page letter from Kaiser explaining to me why they turned down the procedure my doctor had not requested. Right there in black and white they spelled out that I don't need a full body PET scan, not the thoracic scan we're trying to get. On the one hand, they got it right. If we'd asked for a full body scan, it shouldn't be approved because it's not needed. But on the other hand, they should have corrected the typo when Dr. Lee called in to explain that what was denied was not what she'd requested. Literally, someone goofed and checked the wrong box.

But no. The reviewing physician at Kaiser (whose name, address, and phone number are in the denial letter!) apparently understood Dr. Lee's request and that a clerical error had been made but still turned down the procedure... the correct procedure.


Denise's advice is to go ahead and start the appeal process. I'm not quite sure how I'm going to convince the Kaiser doctor if he has already heard Dr. Lee and still said no. But I'll try, I guess. At the minimum, the CT scan I just had done will probably come back inconclusive giving Dr. Lee another reason to ask for a PET scan. A thoracic PET scan. My very first CT scan was not revealing and that was while the tumor and mets were untreated. Seriously, Kaiser... duh, much?

So I'll do that today. And I'll ping Dr. Lee to see if she'll write me a letter for Lockheed to take me back on the payroll. And I'll call some tree guys after my county environmental guy visited on Monday. And I'll take a whack at cutting the grass; slowly so I don't keel over. And I'll whittle off some lighting fixes for the house. And when it gets hot, I'll retreat to the air conditioning and fight with Mom's dying laptop to rescue her pictures. And I'll have to work in a trip today to make sure we have dog food. Ahhh... tedium... ;)

Sunday, July 13, 2008

biding my time

Tomorrow morning (Monday) I'll be headed in for a CT scan. Fun. Two hours of lounging in a darkened room sipping day old strawberry milkshake. That's what the barium contrast stuff tastes like. I've learned to drink it without thinking about how gross it tastes. ;P

You may be asking why a CT scan and not a PET scan? Or maybe not. Well, thanks to a clerical error and some apparently paperwork shy doctors at Kaiser, the referral for a PET scan was turned down. The Kasier person who received the original request put it in wrong as if Dr. Lee had sent in a full body scan request; which I do not need and should have been turned down if that was really what had been requested. But we asked for a thoracic scan, just like the first two. Dr. Lee called in last Friday to correct the error and still got turned down.

Now, this is something I need to have done. Dr. Lee needs to see the same kind of scan as the first two to judge how well the chemo has done. Apples and apples, ya know?

So, while I wait tomorrow morning, I will call Denise (my case manager) and ask her if we can't get this approved somehow. I won't be surprised if she agrees with her standin (Denise was on vacation last week) and tells me it may be easier to have Dr. Lee call in another one but to make sure it is received correctly.

No biggie though it's not like I need any extra crap in my life right now.

I'm trying not to get my hopes up, but I may get an assignment to work in a few weeks. I don't have many specifics but one of my strengths has always been an ability to adapt to new jobs.