It's Not Cancer

The lumpy stuff was, indeed, fat necrosis along with something else (we'll get a copy of the pathology report tomorrow, I hope). Frank says he already knew it, he's just glad I know now. ;-)

So, sorry for freaking everyone out.

Now I can relax and look forward to seeing San Simeon with Emily and Robert next month. Whew. I don't know what else to say. Just "whew".

Boy I love the world right now.

Almost There

A brief aside: So many times in the past half year, I've felt like that guy at the end of Star Wars--the one who is tasked with dropping a charge into the chute that will cause the explosion and destruction of the Death Star. You know him--he's the guy who is focused on his targeting device and he keeps saying, "Almost there..... almost there.... almost there...."

So here we are again. Almost there.... :-)

The biopsy went just fine this morning, though I couldn't help but get weepy. The last time I did this the result was pretty awful and it's hard for my imagination to avoid that scary place. I've been a bit of a wreck for the past several days and I've been a little crazy/grouchy with my loved ones. My poor husband. His patience seems to know no bounds.

With the stress, it's been extremely difficult for me to fall asleep the past week or so, and last night as I was preparing for bed I thought, "Well, duh" and I took an Atavan. I feel asleep with nary a hitch. Thank heavens for medication.

Dr. Wong (Sue--for your chart--he's the doctor at the mammography and imaging center, and he did the biopsy this time, as well as last time) said it could be something called fat necrosis, and the samples floated in the solution in their little jar, so there's the bit of hope to which I currently cling.

We should have results by Thursday or Friday.

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.....)

Make Me Wanna Holler

To recap: My oncologist felt something hard in my left breast (the one currently being treated with radiation everyday for breast cancer) on January 15. I had an inconclusive ultrasound last Friday, January 25. The doctor on staff at the imaging center left a message for Dr. Kuan, recommending an MRI.

On Monday, my oncologist's nurse tried to get the authorization in for the MRI, but was told that my surgeon had to request the authorization. Why? I don't know why. But she was attentive to my needs and tried to pass it on to the surgeon's office and have them get the authorization.

Someone in that office told her that I needed to come in to the office before they could do that. I was somewhat outraged by that and called the surgeon's office, explaining that I had been in to see Dr. Broderick-Villa for a follow-up in December and I didn't see the point coming in to see them just to have them say, "okay, we'll request this authorization." Dr. Broderick called back that afternoon/evening and expressed his total agreement. He was very nice and said he'd get the request to the scheduler the next day (Tuesday).

Tuesday came and went.

At the end of yesterday (Wednesday), I called the surgeon's office and asked to speak to the scheduler. She didn't expressly state it, but it sounded like she did not get the request sent to Alta Bates Medical Group (my gatekeeper for Blue Shield) until that day (Wednesday). Furthermore, she said it typically takes ABMG 15 to 20 days (!) to approve MRIs. I expressed my surprise and she said that everything changed last summer and it just takes a really long time. And if they (the surgeon's office) mark it as urgent, to try to speed up the process, it gets stuck at the bottom of the pile and takes even longer.

Out of frustration, I called Blue Shield. I expressed my dismay and the woman agreed that, indeed, 15 to 20 days was an egregiously long time. She very nicely gave me the number to file a grievance, and suggested I talk to ABMG, to verify that they could/would/might take that long.

When I get this mad and/or frustrated, I cry. It's how I'm made and I don't like it, but there it is. So, weepy and mad, I called ABMG. The woman there was very nice (*you* try being mean to a woman with breast cancer who is crying at you on the phone--I dare you) and, while she wouldn't say it never taken that long, that was the exception and she would expect that, given my history, etc. I should have approval in three to five days. She told me that the request was not yet in the system and that I should call back the next day (today) to ensure that they had received the request.

And here we are. I called ABMG today and was told that the request was entered in to the system at 1:45 p.m. today. This is four days after the ultrasound, mind you. <sigh>. The kindly gentleman told me it could take up to five to seven business days for approval. (And then we get to try to schedule something. I wonder how long *that* will take?)

If I don't hear by Wednesday of next week, I'm calling to see where it is. And then, depending on how angry I am, I'll call Blue Shield or the surgeon's office or both. (I think the scheduler at the surgeon's office has too much to do, quite frankly. I think she could have turned this around a bit faster. Which is not to take any of the pressure off ABMG. But she really didn't need to scare me into thinking I wasn't getting an MRI for another month while obfuscating the fact that she had that request for a full day before she sent it in.) See how ticked off I am?

But honestly? For all you caring, wonderful people out there, who keep emailing me or trying to "not bother me" out of love and empathy--please know that for the most part, I'm somewhat Zen about this. It is what it is and I'll find out just what that is sooner or later (looking like later right now, isn't it?) And while I don't want to talk about this bit of the unknown, that doesn't mean I don't want to talk or that I'm fragile or anything. When we know something, be sure that I will let everyone know, right away.

In the meantime, life goes on and I have completed eight of 35 scheduled radiation treatments. Yay! I've written numbers 35 through 1 on my whiteboard at work and I'm crossing off each treatment. It's extremely gratifying. :-)

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.

Le Sigh

Well, I went for my post chemo check-up with Dr. Kuan and she did what should have been a routine breast exam, just to make sure everything is okay. Unfortunately, there is something hard on my left breast, a bit beyond where scar tissue should be, closer to the nipple.

I told her that I experienced some pain in the area last night, and she's confused. Since the incision site itself is nice and soft, it's even more confusing. *Sigh* So. I'm having an ultrasound on the 25th (I know. Ten whole days. Can you even believe it?) to see if it's scar tissue (her best guess) or something else (which is why you do an ultrasound, right?)

More than anything else, I'm weary. I'm so very, very tired of this. And now, at what should be almost the end, we've got a "what is that" question. Well. There it is.

Meanwhile, still planning to start radiation. Got my "dress rehearsal" on Friday, and then I think I'm starting next Tuesday.

This weekend? Tahoe with Deirdre B, Deirdre G, Carla, and our daughters. I plan to drink. :-)

P.S. I genuinely appreciate the kind thoughts and words, but I'm not really up for talking about this right now. I'm frustrated and feeling a bit futile because I dont' have an action plan. I can't have an action plan--either way--until I know what's what. And I won't know that until the ultrasound. So, please, just try to bear with me until the 25th. And in the meantime, thanks for your patience.