To Treat or Not to Treat?

You may recall my treatment was canceled in February because they could not get the preauthorization from insurance in time. (They eventually did get it a few days later; I was told by Cigna it’s good for a year.)

So, today is six weeks since my last treatment. This requires a reload, meaning double the dose and a lengthier infusion. Plus I’m getting Zometa today for the bones, so an even lengthier day in the chemo room.

That’s all well and good. Yay, I’m getting treatment…or not??

BUT THEN… I get a call this morning from Dr. K’s nurse and she said I need to have an echocardiogram before I can get treatment, “I’ve scheduled one for you today, downtown at 11:00.” What?? I can’t just drop everything and go downtown. (Have I told you how much I detest going downtown? 😤😤) I have to work up to that trip. In addition, we have meetings this morning and I couldn’t get there in time anyway, as well as get back in time for chemo.

Besides, I already have an echocardiogram scheduled for March 30th. My cardiologist said I’ve “graduated,” and he gave me six months before I needed another one. The last one was in September.

“Yes, but it was September 4th. It’s been more than six months.”

So this started a series of “what if” questions, a flurry of phone calls, self-talk, and stress over whether I would be able to get treatment today. This may not seem like a big deal. At least to me it didn’t. Just go ahead and treat! But apparently it is a big deal.

Then my oncologist (Dr. K) gets on the phone. “What if you just come in tomorrow?” he presses.

Does that really do anything for us? What if I don’t get the echo in time? What if my cardiologist doesn’t clear me for treatment? Why did they wait until the day of treatment to tell me this? Why didn’t they have the preauthorization last time, until after treatment?

If I don’t get it today, this disrupts our entire year of planning. We have identified the days I will have chemo, when we can travel, and when we will be at home. It’s not like I’m dying for crying out loud (or am I? 🙄).

I asked, “If I can’t get it today, can’t I just keep my echo appointment on March 30th and keep the chemo scheduled on April 6th?”

“Absolutely not. We don’t want to do that. We can’t wait that long.” There was an urgency in his voice. He continued with a discussion of the importance of this treatment, and how we should be careful not set any of our plans in stone. Always be prepared for something to come up, and be flexible with those treatment dates.

Try telling my hubby that 😔😔.

Dr. K. said he would try to get in touch with my cardiologist (Dr. I.) to see if it’s okay to go ahead with treatment today. He is concerned about my safety, and he wouldn’t want to jeopardize my heart. I was praying he could get in touch with him, because when I called my cardiologist they said he was not in today–probably doing some type of procedure.

Happily, Dr. K has Dr. I’s cell phone. Within an hour he was able to get a positive response. As long as I’m asymptomatic, continue to take my heart pills every day, and no swelling, Dr. I doesn’t see any reason I can’t get treatment today.

All kidding aside, I do appreciate my doctor’s diligence to keep me safe, as well as treat me for this awful disease. This did serve as a reminder that I’m not merely taking an aspirin each day. These are very heavy doses of immunotherapy (#chemonotchemo) that can be hard on the heart. So far I have been tolerating it well, but you never know what could happen in the long run. They have to be cautious. It’s also a reality check that without it, the cancer could rear its ugly head. We certainly don’t want that. 😳

I’ve also come to the realization that I need to be my own case manager. When it’s almost time for a preauthorization, it will be in my calendar so I don’t miss another treatment. When it’s time for an echo, I’ll make sure my appointment is at least 6 months minus a couple of weeks, so we don’t echo this problem again. (See what I did there?)

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À la prochaine…until next time!