Playing Hardball

As Dr. Kuan said yesterday, "If they (ABMG) want to play hardball, we'll play hardball."

True to her word, Dr. Champion tried valiantly to contact Dr. Wong on Monday (and yesterday) to schedule a biopsy. He moves from imaging facility to imaging facility and so he was difficult to track down but she finally got his cell phone number (they're not supposed to do that, but she can be very charming and persistent) and got him to approve a biopsy for next Tuesday morning.

Of course, she left me this message while I was meeting with Dr. Kuan yesterday, and I didn't retrieve the message until Dr. Kuan left the examination room to try to track down Dr. Wong to get him to approve a biopsy. :-) It's all very symmetrical, isn't it?

Dr. Kuan said that Alta Bates Medical Group takes an egregiously long time to approve *anything* and that Hill Physicians is much better. Unfortunately, my primary care physician is not with Hill Physicians, so, unless I have another tumor, I'll stay with the awful ABMG.

So anyway, I have an appointment next Tuesday morning, and then I'll see Dr. Champion that Friday, and Dr. Kuan again the following Tuesday. And we'll know where we stand.

Meanwhile, Dr. Kuan says the mass (or hard area, or thick skin, or whatever you want to call it) has not grown in the four weeks since she felt it. She still suspects it's scar tissue, but given the distance from the surgery site, it's better to know what it is. (And if the MRI was inconclusive, we'd have to do a biopsy anyway, so....)

It feels good to have a plan of action again, rather than just waiting (and waiting and waiting).

Oh! and our office is almost done. I took pics last night of the job halfway done. They're at our house right now, finishing up. And then we shall start emptying our garage of the multitude of boxes. I'll post pics this weekend, when everything is in its place.

Still No MRI (but I love my radiation oncologist)

The surgeon's scheduler called yesterday morning to say that though ABMG is telling us five to seven days, it's been their (the surgeon's office) experience that it takes them 15 to 20 days. She also said they had a patient who was even more clearly indicated for an MRI than I and it had been refused. They got it sorted out with the help of the insurance commission, but still. Given that Dr. Kuan felt this hard mass almost a month ago (1/15), that kind of delay is heart-breaking.

My lawyer was at home when this call came, and after taking this news from the scheduler asked me if it was time for a letter. I wholeheartedly concurred and we cranked out a letter yesterday to: the CA insurance commission, Blue Shield, Alta Bates Medical Group (the gatekeeper*), and the surgeon's office. The upshot of the letter was that this delay is unconscionable given that the surgeon, the oncologist, and the radiologist all agree it's indicated. And that if my cancer moves from a stage 2B/3A to a stage 4, and it's determined that ABMG's delay had anything to do with such an "upgrade", this letter is our stake in the ground. It's wearying, really. Conflict is not fun, but neither is letting bullies push you around, so here we are.

Meanwhile, my radiation oncologist, aptly named Dr. Champion, is frustrated and thinks that this is terrible (yay! for validation). She's going to contact Dr. Wong (the radiologist who recommended the MRI in the first place) to see if he can't just do a biopsy. And that would be lovely. So we'll see.

So, there we are. Once again, I'm weary of talking about this. As Frank noted, I am the Worst-Case Scenario Girl, and since the worst case is pretty icky here, I prefer just not to go there at all. Thank you for your continued grace and patience with me as I go about my "let's not talk about this until we know what we're talking about" stance.

*A brief explanation for those not enjoying my type of insurance. My insurance company is Blue Shield. I've had absolutely no complaints about them. They've been wonderful throughout. Likewise, my doctors--all absolutely wonderful. The problem has been the intermediary--Alta Bates Medical Group. Basically, Blue Shield pays the bills, but does not review all my claims, ABMG does. So, in a typical situation, the doctor prescribes a course of treatment, ABMG reviews and approves (or denies) it, and Blue Shield pays the bill. I'm assuming that this middle man gets some sort of cut, or gets some sort of compensation, and that expensive treatments take a bite out of their profits, and so.... something like an MRI (which is somewhat expensive) is dissuaded. My lawyer husband calls this "institutional delay" and it's not something they should be doing. But I think we all know that it's about the bottom line, and whatever a company--any company--can get away with, they will. Unfortunately, we're talking about someone's health here, which makes that posture even less palatable than ever.

Hair Today....

Some peachy fuzz-like stuff starting growing on my head right around the time of my last chemo treatment, which means it was starting to grow even while I my body was processing the Taxol. Of course, to balance this out, I've lost most of my eyebrows and eyelashes... (it's all about the yin and the yang of life, right?)

Dennis took a photo of me to post here. At first, Frank and I were hoping I would be a lovely sophisticated silver or white, but it's looking very salt & pepper, so I'm thinking I might dye it in late spring/early summer, when the hair is around an inch long.... The hair is just long enough that some folks (who don't know me) are assuming the look is intentional. Ahem. Well, that's okay, too.

MRI Update: I called ABMG yesterday to follow up on the request for authorization and was told that it would be another five to seven days. Also, the person there indicated that the request was for MRI on both breasts. This strikes me as a mistake and what might be slowing down the process. I called the surgeon's office and left a message that I wanted to ask that he resubmit this request and make it "urgent". I've not heard back from him, so I don't know if he did it and didn't call, or if it's "in their system" or what. Anyway.

My radiation oncologist, meanwhile, had me give my info to her nurse, Donna. She felt that it was very possible that the request for both breasts might slow things down. In any case, they are pursuing the approval from their camp, so maybe between the surgeon's office and the radiation oncology office....? I mean, really. It's been three weeks since Dr. Kuan felt the lump. And I'm waiting for a #*&#$ approval. Ergh. More news when I have it....

(Have you noticed the preponderance of ellipses in this entry? Reflective of my current mood, I'm sure. Just waiting.....)

It Could Be Nothing....

So, the ultrasound yielded more ambiguity. So they did a mammogram, which was similarly non-conclusive.

Dr. Wong tried to get hold of my oncologist, Dr. Kuan, but was unsuccessful. He wants to do an MRI to see if that tells us anything.

Basically, he says, the mass does not look like what he would typically think of as a cancerous mass. But he can't tell what it is and so says we need to do an MRI to see if anything has metastisized. If the MRI indicates it's not something good, or is--like everything else so far--inconclusive, then we'll do a biopsy.

Frank would prefer we just do the biopsy and cut to the chase. Me? I'm just tired.

So, we'll wait to hear from Dr. Kuan and then do the MRI. Meanwhile, I still can't talk about this. It's too frustrating and it makes me weep. And I'm so weary of weeping.