Sunday, December 23, 2007

Way To Go, America!

as one of the uninsured with cancer, i'd have to say this is one great article.



ATLANTA, Georgia (AP) -- Uninsured cancer patients are nearly twice as likely to die within five years as those with private coverage, according to the first national study of its kind and one that sheds light on troubling health care obstacles.

People without health insurance are less likely to get recommended cancer screening tests, the study also found, confirming earlier research. And when these patients' condition is finally diagnosed, their cancer is likely to have spread.
The research by scientists with the American Cancer Society offers important context for the national discussion about health care reform, experts say -- even though the uninsured are believed to account for just a fraction of U.S. cancer deaths. An Associated Press analysis suggests it is around 4 percent.
Those dealing with cancer and inadequate insurance weren't surprised by the findings.

"I would just like for something to be done to help someone else, so they don't have to go through what we went through," said Peggy Hicks, a Florida woman whose husband died in August from colon cancer.
Edward Hicks was uninsured, and a patchwork health care system delayed him from getting chemotherapy that some argue might have extended his life.
"He was so ill. And you're trying to get him help and you can't, you can't," said his 67-year-old widow.
Facing hard facts
The new research is being published in CA: A Cancer Journal for Clinicians, a cancer society publication. In an accompanying editorial, the American Cancer Society's president repeated the organization's call for action to fix holes in the health care safety net.
"The truth is that our national reluctance to face these facts is condemning thousands of people to die from cancer each year," Dr. Elmer Huerta wrote.
Hard numbers linking insurance status and cancer deaths are scarce, in part because death certificates don't say whether those who died were insured.
An Associated Press estimate -- based on hospital cancer deaths in 2005 gathered by the U.S. Agency for Healthcare Research and Quality information and other data -- suggests that at least 20,000 of the nation's 560,000 annual cancer deaths are uninsured when they die. Experts said that estimate sounds reasonable.
That's around 4 percent of the total cancer death toll. One reason is that most fatal cancers occur in people 65 or older -- an age group covered by the federal Medicare program. Another is that more than 80 percent of adults under 65 have some form of coverage, including private insurance or the Medicaid program for the poor, according to various estimates.
Some are enrolled in Medicaid or other programs after diagnosis, when the condition worsens and their finances erode. But such 11th-hour coverage can be too late; early detection is the key to catching many cancers before they've grown beyond control, experts said. Dr. Sanjay Gupta explains the study
"Insurance makes a big difference in how early you are detecting disease," said Ken Thorpe, an Emory University health policy researcher.
In the new study, researchers analyzed information from 1,500 U.S. hospitals that provide cancer care. They focused on nearly 600,000 adults under age 65 who first appeared in the database in 1999 and 2000 and who had either no insurance, private insurance or Medicaid.
Researchers then checked records for those patients for the five years following. They found those who were uninsured were 1.6 times more likely to die in five years than those with private insurance.
More specifically, 35 percent of uninsured patients had died at the end of five years, compared with 23 percent of privately insured patients.

Differences in survival rates
Earlier studies have also shown differences in cancer survival rates of the uninsured and insured, but they were limited to specific cancers and certain geographic areas.
The new findings are consistent across different racial groups. However, the fact that whites have better survival rates cannot be explained by insurance status alone, said Elizabeth Ward, the study's lead author.
The researchers were not able to tell whether the numbers were influenced by patients' education levels, or by other illnesses.
Experts said the study also hints at problems with quality of care after diagnosis: such as whether the patient got the appropriate operation from a high-quality surgeon, whether the tumor was thoroughly evaluated by a high-quality pathologist, and whether there was access to needed chemotherapy and radiation.
"The differences that we see in outcomes after people are diagnosed, even among those with early stage disease, suggests that problems with quality of care may be an important reason," said Dr. John Ayanian, professor of medicine and health care policy at Harvard Medical School. He didn't participate in the cancer society study.
The study makes an even stronger statement about the role insurance plays in the timing of screenings and how that can raise the likelihood of a late-stage diagnosis, experts said.
A Kaiser Family Foundation survey last year of 930 households that dealt with cancer found that more than one in four uninsured patients delayed treatment -- or decided not to get it -- because of the cost.
Such was the case of Edward Hicks.

The retired laborer, had surgery for colorectal cancer in 2005 and was thought to be clear of the disease. Chemotherapy was suggested after the surgery, but he didn't get it.
In February of this year, his wife grew worried when he lost energy and appetite. In April, he told her he felt a lump in his stomach

Hicks, who lived in Fort Meade, Florida, couldn't get an appointment with a specialist, but a family doctor checked him into a hospital and specialists saw him in late May. They said that he was terminal but that chemotherapy might extend his life a little, his wife said.
She was able to get donated chemotherapy drugs from a pharmaceutical company, but it took time to arrange the treatments, which didn't start until mid-June. Meanwhile, her husband's health deteriorated. In July, after just a few treatments, he stopped the chemo, saying it was too hard. He died on August 21, at age 64.

Friends and family told Peggy they believe he would have lived longer had he got chemo earlier, when he was stronger. She doesn't agonize over that, she said, trusting in God's will.
But the devil's in her mailbox -- she is facing a $21,000 hospital bill and other costs from his death.

Not Done Yet!

ahhh. december 19th was supposed to be an independence day of sorts for me, but of course, life had other plans.

a couple of weeks before, i felt really violently ill after treatments. i was shivering so hard that the whole bed would shake. i couldn't get warm, my skin felt tight, and my entire body hurt.

after massive amounts of fun fun scans from my doctor, we found out that my body had started rejecting the treatment. my organs were enlarged, and if i chose to finish the treatment, i would most certainly end up in the ICU.

going into this, i told them that my number one goal was to avoid hospitals at all costs. they scare the bejeebus out of me. the only good things that happen in a hospital are:

1. they make jello. there is always good in jello. and gelatin, too.
2. babies are born. this is good because they are not mine.

so what we ended up doing was giving me a sabbatical of sorts from radiation. i'm currently off of treatments until january. i go back on january 2nd for more scans, and from there we'll decide my treatment schedule. and, instead of 2 full strength treatments, they're going to break it up into 4 half treatments, so it hopefully won't be such a shock to my system.

i'm not entirely sure how this is all working, and i'm not entirely sure i want to know. i really trust that my doctors are doing all that they can for me. it's nice to say, "hey, doctor dude, i don't want to end up in a hospital" and then 8 weeks later have them remember that for themselves and take it into account.

Tuesday, December 11, 2007

Tis The Season...

many hospitals say that the first thing a juvenile cancer patient asks for in the hospital is a movie. the problem is, there is often little to no funding to provide entertainment extras.

kidflicks is a terrific organization that provides a movie library of 100 dvd's per hospital. if you have kids and they have "outgrown" their dvd's, or if you're just in the holiday spirit and want to give, purchase a dvd and send it to:

Kid Flicks/Barta
11755 Wilshire Blvd.
Los Angeles, CA 90025 #1450

provide your name and return address so they can send you a thank you/receipt.

i know one of my greatest refuges during this time has been to plop down and forget everything in front of a movie. let's make the same opportunity available to some of our sick kiddos.

more info is available on their website, http://kidflicks.org

Thursday, December 6, 2007

Cancer Is Super Sexy

had my 6th treatment yesterday, which was pretty normal, as treatments go. i'm now one of the sick ones who can eat lunch while getting filled with radioactive fluid and blood. yay!

one of the yard supervisors at my work knows that i go directly to treatments on wednesdays, so she packed me a little lunch of lasagna (i love the school's lasagna, i swear) and a chinese chicken salad to take with me. so multicultural. and since they've been sticking my feet instead of my arms, i'm able to eat more easily.

the doctors also came in and talked to me a little bit. since i submit my food logs nightly via e-mail, they've had an up to date record of my nutrition, not to mention how often the food does NOT get digested.

most food i eat leaves my system from one end or another within an hour, so calorically and nutritionally, i am deficient. (i think mentally, too, but they said they weren't "THOSE" kinds of doctors. psh.)

so, despite my pleasantly plump appearance, and the fact that people see me eating pretty normally on a regular basis, i am malnourished. my anemia has not gotten any better, i'm getting two bags of blood a week. and i need to up the calories.

here is a clip of what the doctors sent me in an e-mail last night:

"Foods that might be good to eat are things like ice cream, instant breakfast, protein shakes, whole milk, peanut butter sandwiches, etc. These are things that pack the most calories for the punch, so you may absorb more calories before the food is purged. Also, iron rich foods such as dark leafy greens, lean red meat, and certain folate rich fruits (see attached list for more specifics.)"

they don't want me on an iron supplement because it may cause my digestive system to go the other way on me, and as much as i hate a constant running tap, i'd hate it even more if i were shut down.

also, they think that my body is rejecting the radiation treatment judging by how bad my shakes are getting. i guess it's good that my body recognizes that it's not normal to glow, but if it gets much worse, they may end my treatments early to avoid me ending up in the hospital. they're pretty confident that it wouldn't affect my overall status if they did that, so after next week's treatment we'll reconvene.

Thursday, November 29, 2007

Fun Quotes

I have heard there are troubles of more than one kind.
Some come from ahead and some come from behind.
But I've bought a big bat. I'm all ready you see.
Now my troubles are going to have troubles with me!
~Dr. Seuss


My veins are filled, once a week with a Neapolitan carpet cleaner distilled from the Adriatic and I am as bald as an egg. However I still get around and am mean to cats. ~John Cheever, letter to Philip Roth, 10 May 1982, published in The Letters of John Cheever, 1989, concerning his cancer and its treatment


Well even before she was diagnosed with the cancer, I would have said that she was a lot tougher than me and most guys would probably say that about their wives and it's probably true in most cases.
Brett Favre (tee hee, brettfavre.)

Everyone needs to be proactive and know the various warning signs of cancer. Early detection and research to make detection easier at earlier stages, along with the treatments needs, is still a must. I salute all those winning the battle.
Dennis Franz

It costs a lot of money to look this cheap.
Dolly Parton

I feel like I'm fighting a battle when I didn't start a war.
Dolly Parton


Insensitive

had my second transfusion yesterday, 2 bags of blood this time. i have one doctor who wants to put me on procrit, but the fda just came out with something saying that cancer related anemia drugs are more harm than good for a cancer patient.

i was told going into this that there would be a point where i would hit a wall. and i think i've hit it. not only physically, although i feel seasick nearly all of the time and a little over half of what i eat usually pays me back within an hour of consumption.

i'm also losing my hair, the bald patches are getting larger and it's all sort of...thinning.

if i thought i could afford a nice wig, i'd probably cut my hair and invest in one, but so far i've been able to get by with a collection of bandanas, scarves, and beanies.

the problem is, my coworkers can't seem to stop themselves from making fun of said headwear. now, i know i work at an elementary school and none of the staff really ever acts their age, but i don't appreciate being told that i look like a thug, or that dude from the simpsons, or whatever other pleasant metaphor they can dig up on a minutes notice. and they all laugh so snidely afterwards, congratulating themselves on their big joke.

the thing is, my cancer is (and has been) no secret. these people know what i'm going through. and though the fact that i'm an adult and should be able to ignore it has been brought up, it's not easy to be that thick skinned when i'm already going through so much.

i struggle with just how vain i am about my hair. i KNOW it's just hair. i KNOW it will grow back. but each time i look in the mirror and see what this disease has done to my body, i have a total "elephant man" moment and want to isolate myself.

i don't like having to cover my head whenever i go out. and it would be nice if some people could look into themselves and figure out a way to be supportive rather than insensitive.

Sunday, November 11, 2007

How Ya Doing?

i think one of the hardest questions to answer right now is "how are you doing". there are so many responses:

cancerful!
bald!
ever see the pepto bismol commercials?


and of course, the standard answer: tired.

i am very, very tired. all the time.



i began losing hair last week, and noticed it first when i saw a sinkful of this:





thanks, i was using that. TO COVER MY HEAD WITH. this week, i lost some more and i'm left with two bald patches, both in the same spot on the opposite sides of my head:



and to top it off, this week i caught a cold from the little boogers i teach, who have been passing around this virus literally all year long amongst themselves. it makes me a little cranky because, you know, i'm supposed to be taking care of my health and all, and this really sucks. not only am i tired from radiation, i'm tired from a cold.

that's it. i'm wiping all of them down with lysol wipes.


also, i am allergic to the adhesive on band aids and medical tape. it makes for some good times:



they had ghetto-rigged an ace bandage for me, but it bugged me so much i decided just to deal with the bandaid burns. my stepmom bought me some aloe vera gel to use on it, so it's not so bad.

my dad has been really good with checking in with me to see how i'm feeling, and he's noticing things on his own. such as the fact that my appetite comes and goes, or he'll see when i'm tired and suggest i go lay down. little things that aren't pushy, but suggestive.

it's not so bad, i have this long weekend (woooooot! veterans day!) to recover from this cold and then it'll be a short week with the kiddos. then a normal weekend, then an EXTREMELY short week with the kiddos and then it's thanksgiving, followed by the festival of rahnaukkah.

because, you know, instead of one day of presents, i have eight crazy nights.

sometimes i feel really alone as i go through things, because as well meaning as people are, they can still say some hurtful things or notice things that don't make me feel too pretty ("is that a new bald spot?").

but i do have a great support system.

Friday, November 2, 2007

A List of Sorts...

things that were in my purse before radiation:

-wallet
-keys
-checkbook
-extra chapstick
-glucose tablets
-hair thingies
-big ol' pile of spare change

things that are in my purse post-radiation:

-all of the above
-pepto tablets
-tums
-band aids for the iv spot
-wee little bottle of listerine
-crystallized ginger
-peppermint teabags

i need a larger handbag...

Wednesday, October 31, 2007

Radiation, Ho!

today was my first day of radiation!

it really wasn't any big deal, i had already toured the clinic and met up with the doctor. i'm now an official part of the "lunch crew." we're all patients who are nowhere close to being critical or needing very much medical help, so they kind of hook us up and go eat lunch. ;p it's a little weird, but it's also nice not to be hovered over and have someone jab and prod you.

i sat down and told them where they could tap a vein easily, and they laughed and proceeded to screw it up 4 times before they finally got it. riiiight where i said they could. silly them.

they had a laptop i could rent, so i went online for a bit. the other people there seemed nice, but i was the new kid in the room so no one talked much. it seemed okay, though, everyone had brought something to keep them occupied and some were dozing.

so so far, my arm hurts a little and i'm feeling sluggish, but otherwise okay. i had pizza for dinner, though i wasn't able to eat much (just one half slice.)

i'm really thirsty, and have a tiny bit of a sour stomach. so far, not too bad.

and of course, all my hair is still here for now.

and i got the OK to get a new tattoo! as long as i get it fairly soon, before the treatment really starts to build, i should be fine. i'm getting a hot pink lady bug to honor one of my best friends, sheri, who died of ovarian cancer last wednesday. she always wanted one, so i'm going to get it FOR her.

thanks to everybody for your good thoughts....send cookies!

Wednesday, October 24, 2007

For My Fellow Cancer Chronies...

Now Ain't That About A Bitch...

Cervicitis Overview

Cervicitis, a common infection of the lower genital tract, is the inflammation of the cervix (this is the neck and outlet of a woman's uterus).

Inflammation may be caused by infection from certain sexually transmitted diseases (STDs) or by injury to the cervix from a foreign object inserted in the vagina, from birth control devices such as the cervical cap or a diaphragm, or by cancer.

Many cases of cervicitis go untreated because women who have the infection do not know they do. Often there are no obvious symptoms.




You may have an allergy to contraceptive spermicides or to latex in condoms that leads to cervicitis.

uh, hi?? i'm allergic to nonoxynol-9!!

If untreated, cervicitis may lead to pelvic inflammatory disease, infertility, ectopic pregnancy, chronic pelvic pain, spontaneous abortion, cervical cancer, or other complications during the delivery of a baby.


okay. so, it's possible that since i tested negative for HPV, the cause of my cancer is chronic cervicitis, which i didn't even know i had. and the cause of the cervicitis could be nonoxynol-9.

just something that blew my mind a little.

Ketchup

...i like heinz.


i kid, i kid.

the harvesting last friday went really well! usually they get about 6 eggs total, but from beautiful, bountiful ME they got 20. ten from each side and could easily have gotten more.

the procedure itself wasn't that painful (except for my belly button). it was laproscopic, i was numbed with local shots and had a shield up so i couldn't see anything, and the whole shebang lasted about ten minutes. not bad!

i did have to pay through the nose for storage of my kidsicles. (i named one frosty.)

i've been really tired lately, i think having three procedures done in a matter of weeks has begun to catch up with me. i'm tired and achey and i'm tired of all the drama at work and with certain friends who feel i'm not contacting them enough.

sorry, i try my best, but i've got ENOUGH on my plate without having someone carry a running tally of how many text messages i've sent them. (this does not apply to erin or colleen, of course. :))

the follow up meeting was in fact with the butcher lady.

to start things off, she assured me that they had removed all the cancer and precancerous spots from my cervix. yay! *takes a brief moment to tear up a post it and use it as confetti.*

next, she confirmed that i would be needing radiation and that i would be meeting with that doctor right after her meeting.

finally, she APOLOGIZED. she did! she said she didn't realize that i had chronic cervicitis, and that therefore i was much more sensitive than the average woman.

i'm still insulted that she thought i was faking it originally, but i could tell that this was a woman who does not apologize easily. it doesn't make anything OKAY, by any standards, but i do appreciate the apology. i felt i was owed at LEAST that.

she explained that under normal circumstances, they would just reschedule me for a pap in a year's time. however, she explained that she's more conservative than most doctors and would like to see me again in april for a follow up pap, and again in october. if those come back normal, i can go back to yearly.

i'm going to be doing radiation at the fertility clinic that i am already familiar with, for an hour a week each wednesday. i begin on halloween and i am due to stop on december 19th.

Tuesday, October 16, 2007

Hey Cancer...


greetings to all!

as my appointment date nears, i get more and more nervous about it. it should be no big deal, but i guess this just confirms it and sets about a course of action that i know will be changing many aspects of my life.

and we all know how i just looooove change.

in the meantime, i'm trying to perfect a cancer mix cd that i can take with me to treatments and just generally annoy people with.

so far, i've got kanye west's "stronger" (n-that-that-that that don't kill me, will only make me stronger!). and helen reddy's "i am woman" because, hey, i am woman. and it's oddly and funnily empowering.

i also have donna summer's "macarthur park" because it's hilarious and it just keeps going forever, leaving me amused for at least 5 minutes.

i have yet to find any songs that say "cancer can suck it" or "cancer can lick balls." maybe i'm not looking hard enough...

Monday, October 15, 2007

For Those Who Want To Know...

and ESPECIALLY FOR THOSE WHO DON'T!


...my cervix itches. this is weird.


that's all.

I'm Almost Ripe For The Pickin'

last night around 8:30 i got a call from "the clinic" (okay, pretentious, i know you're planned parenthood, just say it!) and they said that with the way the tests are coming back, from the scrapings and the biopsies, it's looking more and more like i'm going to need radiation to knock those last few remaining cancer cells from my body and to make sure that it doesn't come back.

of course there's always the chance that it could.

anyhoo, so this morning, i jetted over to torrance memorial, and recieved a shot in the hip, filled with delicious hormones which will, in combination with my natural cycle, make me ever so fertile on friday.

after my meeting with the butcher, they'll go in laproscopically through my abdomen and...i dunno, steal some eggs? pick some eggs? put some eggs in the basket?

this way, SHOULD the radiation do wacky things to my cervix or any other part of my reproductive system, i'll still have the option of having my own kids.

and my mom and dad can have some grandsicles.

Friday, October 12, 2007

Update-arooni

so, i had my colposcopy a week ago and today is the first time i've felt i could sit and write about it. my wife colleen picked me up from my house at 8am, and we dashed on over to the planned parenthood. we shared a good laugh along the way, as a punked out young man in scrubs pulled up alongside us blasting carrie underwood's "before he cheats." he was then treated to the "wtf?!" stare from us, as well as a ginormous round of laughter resulting in snorting, more laughter, tears, and him getting really angry and zooming away to enjoy his underwood in peace.

we get to the planned parenthood, and because we're early, we catch up in the car a bit before we head in. once inside, they hand me paperwork to fill out. one is a form entitled, "request for surgery."

i would just like it noted that it wasn't ME who requested it.

i was called back fairly quickly (as opposed to my usual 1 hour + wait time.) and they brought me into an exam room. please note that during this procedure, there were several Moments of Escape Fantasies.

as i entered the room, i was greeted with Moment 1. The examining table had the oddest stirrups i had ever seen, and a snaking light attached to it. they were mining deep today, fellas.

i was told i could keep my top on, which was, for some odd reason, rather comforting. i sat there with my little paper hula skirt and stared at all the instruments they had. Moments Number 2-5, my friends.

the doctor came in and started discussing my chart with me, and i almost lost it right there because it was the same doctor who had administered the roughest pap smear i had ever had just a couple of weeks ago. she explained the procedure and had me lay down on the table. turns out, those weird stirrups aren't stirrups, they're leg slingers. you put your knees over them. and they hold your hips in a really awkward position.

they started trying out different sizes of speculums. mass discomfort ensued. when they finally found one that would allow the best view for the microscope (and let me just say, i didn't think they made them that big!) she had to really shove to get it in place. i cried out, and was told i was making a fuss. oh-kay...

so then i start cramping pretty good. she sprays me with a "vinegar/iodine-like solution" and i start to go apeshit. this stuff BURNS. and it caused my cervix to close up and try to run away into my uterus. i shifted, and The Butcher told me to stop shifting. i told her i would try, but she kept moving the speculum up higher or rotating it for a better view. she started scraping, and i started to cry. she got really skeptical and started asking me if things really hurt so bad, and if so, WHERE could it be hurting?

...

yeah.

i tried to stay as still as possible, but then it was time for the biopsies. this giant tool that looked like a dinosaur relative of needle nose pliers went in, and i began to shake and asked for a container to puke in. i was told i was not allowed to puke in this exam room.

....

uh huh.

at this point,i'll admit i was almost TRYING to puke just to give this lady something to actually bitch about. i was being a fairly good patient, but i was in a lot of pain and it was causing me to cry, sweat, shake, flinch, and gag. she asked, exasperated, "do you even WANT me to do this?!"

...let me think. do i actually want you to force things up my hoo-ha? did i even order this surgery? NO, BITCH. i don't believe i do.

at this point, the medical assistant jumped in, trying to soothe me the only way she knew how. "you should only feel some pressure..."

the doctor rolled her eyes. "this is ridiculous." she said. "let's just get this done." and she went at my cervix the way most men go after a good steak dinner.

she called out numbers. "2, 4, 6, 7, 9, 11, 12." i felt some pressure and release, in addition to the pain, like someone was hole-punching my cervix.

"we're done now. you can stop." said the butcher.

she removed the speculum sloooooowwwwwly. (i just wanted to rip it out.)

then, this maniacal butcher lady pretended to be nice and caring while she explained that i'd need to come back in two weeks, and not to worry, no exams then. she left, and i got dressed and approached the counter. a worker who had been fixing something in the hallway said he'd heard me crying, and did i need help out to my car?

it was sweet, but i just wanted to get the heck out of dodge.

i got my work excuse, and talked my wife (riding on a waaaave of adrenaline!) into taking me to work so i could pick my check up. we got there, and i casually told everyone i saw that i had cervical cancer. they were surprised that i was up and about, and i was just adrenalined out, happy not to have anything in my hoo-ha for a while.

the healing has been slow, i still feel some pain and my hips hurt from the weird stirrupy things. the constant cramping has made me feel nauseous most days, so i've become a tea and rice junkie.

i've also been sleeping a lot, and going to bed early, and small things wear me out pretty fast. i'm not allowed to lift much, so if i go shopping, i have to go with someone. other than that, it's business as usual and i'm back to work. blah. ;p

Thursday, October 4, 2007

Coming Out of the Cancer Closet

there's no great way to announce this, so i'm gonna go this route:

ding dang, y'all, i've got the hoo-ha cancer.

i've been diagnosed with stage 0 cervical cancer, and had a conization on monday and am not looking forward to a follow up colposcopy on friday. my wife is going with me, and i am tired of people sticking things in my cooter.

i possibly may have to have radiation, but i won't know anything until approximately 2 weeks after the colposcopy, when i meet with the clinician to discuss my options.

keep your fingers crossed!

also, if you believe in some sort of prayer or woo woo-ism, please send some healing thoughts to the people who love and support me. i think they'll need it more than i will.