Plot Twist: Chemo Cycle 3 (of 6)

Here we are at cycle 3. I have to admit that I went into this round of chemo with a little more enthusiasm since the results of the PET scan were so positive. Knowing that I am getting the right treatment and that it is working makes going through the treatment a little easier.

There was one major hiccup this time around. I went in on Monday, bright and early to do all the lab work, meet with my doctor, get the Rituxan treatment. I had been scheduled for the Rituxan injection and the clinic had it ordered only to find out that the insurance had not authorized the injection. Weird. They cancelled the injection and ordered the infusion that was still authorized. Kind of a drag because the infusion took 2 hours once the medication arrived from the pharmacy instead of the 15 minutes for the injection. No real issue, just a little slower.

Or so I thought.

After the Rituxan I went to the hospital registration desk to check in so I could be admitted and start my week of chemo. I arrived at the registration desk and they had no record that I was to be admitted. Um… The desk called my doctor’s office and after some checking determined that no one had called the insurance company to request authorization for my chemo.  What????

They started the process, told me to wait, told me to wait some more. I contacted my doctor’s office and her nurse called me right away to explain the situation and tell me the issue would not be solved on Monday. I should go home. She would call me in the morning when everything was worked out.

I was not a happy camper, but I went home.

I am not complaining about my health insurance at all. You have to know that my health insurance is very good. Very, very good, approaching spectacular. They have approved every part of my treatment. My out of pocket expense is ridiculously low. As soon as I was diagnosed I was assigned a case manager to help me navigate all of this.

So I called my case manager. She could see when the doctor’s office called in the request and what was still missing. And she followed this until it was completely resolved the next day.

And It was. Everything was worked out and I was admitted on Tuesday and the chemo was started

The lesson learned is that even though the patient who is already dealing with a lot should not have to keep track of things like authorizations, the reality is they do. Going forward I will be calling my case manager the week prior to my chemo so she can help me check for the authorizations. Hopefully I can avoid this issue again.

Chemo was started Tuesday, a day late. This meant that I did not get to go home until Saturday. Other than that, there weren’t many changes to the hospital routine this time. My chemo dose was increased (I had level 3 this time around). The protocol was still the 20 hours, but this time the breaks between were shorter – just long enough for me to take a shower.

An interesting thing happens when you spend one week out of every three weeks in the hospital. The nurses get to know you, remember you and your likes and dislikes. Even the food and nutrition folks and the housekeepers remember you. There is relationship building whether it is intended or not. It is interesting to have nurses asking how your kids are and how is life on the boat. I had nurses assigned to other patients popping in just to say hello because they saw I was back. They do not feel like people who are that familiar, but in some very real ways they are becoming just that. I am starting to understand why the nurses and doctors tell patients they will miss them once treatment is complete.

On another note, I have become something of an ambassador for Mighty-Well, the company that makes the PICC line sleeve I use. After my blog post, I started talking with a couple of people from the company and they sent me some flyers to hand out. I have had other patients with new PICC lines approach me and ask for information, I have had many, many nurses ask for more information, and now the nurses are telling me about all the patients they have been able to give better information and options to. And the other patients see me in the clinic and say hello and thank me for the information. That feels like a really good thing. I am happy that I might have been able to help others.

Finally, my hospital stay was made so much better by visitors. A dear friend came and just hung out with me for two and half days. We had a very nice time just chatting and solving all the problems. I also had a surprise visit from two co-workers who brought me chocolates! Any day that involves chocolate is a good day. And my UltiHope mentor came to visit and brought me lunch. I always enjoy these visits because she has been through the same treatment I am going through (she even had the same doctor) so she can provide insights that very few other people can.

I continue to tolerate the chemo pretty well. And I continue to have relatively few and minor side effects. I obviously lost my hair, but I have not had any nausea and my appetite continues to be pretty good. It comes and goes, but I suspect I may be the only person to go through chemo and not lose any weight. I have the smallest bit of peripheral neuropathy (tingling and numbness) in the tips of my fingers. And this round of chemo ended with the start of a case of thrush (a fungal infection in my mouth). It is early so I do not have any pain or sores (apparently that is common) and treatment clears it up.

Hard to believe it, but this is the half way point. I am officially half way done with my chemotherapy. WooHoo!