Friday, February 28, 2014

we'll just pretend that never happened, then

Various calls to insurance companies and doctor's offices finally resulted in a call back telling me that I should have an answer by February 24, but that it was likely to be no.  February 24 came and went and I still have no news.

The suits at the insurance company are unlikely to approve my PET scan because I have not had a negative RAI whole body scan in several years.  It doesn't matter to them that my WBS are always negative unless I get a treatment (much, much larger) dose, and that my tumor marker is already half of what it was when I had my recurrence.

So I'm just going on the assumption that they'll refuse it, and when December rolls around again, I'll have the WBS (which will be negative) so they'll approve the PET scan.  Next year.  This is, after all, a slow-growing, die-with-not-die-from (usually) kind of cancer I'm dealing with.

I would feel a lot more relaxed about this if I didn't have an on-and-off pain by my collar bone, right by my scar.  It's probably an adhesion but it hurts, when it hurts, and it's different.  Still,  pain has nothing to do with metastases.  Usually.

In other news,  I am completely buried in work because we are in the midst of the science fair, which looks amazing -- the entire school's projects set up in the gym.  So much work on display, and much to be proud of (and quite a bit to inspire all the students who were lacking in motivation this year, for next year.)  On top of that, student-led conferences kept me at school until 7PM tonight, but DH grilled steaks for dinner so the evening was actually delightful.

Tomorrow DS1 heads down to Tuscon with his class for a field trip to U of A; he has to be at school at 6:30AM.  Last night was his performance in Antigone, a truly stellar production by his drama class. Sometime I'll find time to grade the 160-odd display boards and reports my students have turned in... spring break is only a week away and God knows I don't want to spend my entire break grading.

At the rate I'm losing time, I won't even notice until it's half over.

Sunday, February 16, 2014

adventures in health insurance

When I got my new job in July, I got new insurance.  For the first time in my adult life, I am not covered by Blue Cross/Blue Shield.  While I know a few people who have had major problems with BC/BS, they never hassled me, even when I went to M. D. Anderson Cancer Center in Houston for treatment of my first recurrence.

But now I don't have BC/BS anymore, and I'm finding out what life is like under Cigna.  Up until now, there haven't been any issues.  Thursday afternoon I got a call from AZ Molecular Imaging, the facility where I'm supposed to get my PET/CT scan, telling me that my pre-certification for the scan was denied.

Friday I spent about an hour on the phone, first with Cigna proper, who had no record of any request. Then back to AZMI, who told me that Cigna contracts out these approvals to a company called Med Solutions.  So then I had to call Med Solutions to find out why the authorization was denied. That's 3 sentences, but it took about 45 minutes.

Med Solutions has a checklist for cases like mine, and since the "negative RAI whole body scan" box could not be checked, they denied the authorization.  They don't know my history of perpetually negative scans, even when I had my recurrence in 2006, even though my doctor included her notes on my case.   My endo doesn't order WBS for me anymore since they are expensive and disruptive, requiring 2 weeks on the low-iodine diet, and if they're always going to be negative anyway, what would be the point? 

The next step is, my endo's office will appeal.  The insurance company has 30 days to respond, which I fully expect them to take, so I'll have this scan pending for another month, at least. If I'm lucky, I'll be able to make some plans for the short-term future by mid-April.

So, for now, I'm just trying to keep this whole "rising tumor marker, need a scan, can't get a scan yet" situation compartmentalized so it doesn't make me crazy.  Some days I'm more successful at that than others.

Tuesday, February 04, 2014

recurrence, again, eventually

I had my endo appointment last week.  As I feared, my Tg (tumor marker) went up again,  to 5.5.  That persistent node in my right cervical chain is still persisting, but doesn't look suspicious.  I think it's basically the last functioning node in my right cervical chain, so it gets enlarged trying to do the job of all the nodes that were removed in earlier surgeries.  It is, in a sense, a superhero node working permanent overtime.  Of course, it could also be a cancerous node, but even after all these years it doesn't ever present as one.

The tech also imaged a new, totally innocent looking smaller node on my left side.  Weird.

Since I had an MRI last year, we're going with a PET scan this year.  I intensely dislike these annual reminders that I have cancer, but we can't find it.  Nothing we can do, just have to wait and see if it ever gets big enough to treat.

I am slightly depressed over this.  I want to stay in bed and do nothing, but that's really not an option, so I end up not doing some things and choosing to do other, more random tasks, and just being extremely grumpy all the time, which is exhausting.

I don't like not knowing what's going to happen, and for now, I don't even know when the PET scan will be, so I don't know when I'll know what's going on with me.  I feel fine, mostly, just a little congested and chronically tired, but both are mostly caused by lack of sleep.

Here's the thing: there is literally nothing I can do about this.  I  dislike having so little control. I fully expect a negative scan, and to keep on getting negative scans, for at least another 10 years or so.  Eventually, something may light up and we'll have to go cut it out, but I don't see that happening any time soon. 

And on that happy note, it's off to bed.