Auntie Mame [Everyone Should Have One]

My love of old Hollywood movies stems from a childhood tradition of watching them on TV with my mom on lazy weekend afternoons. She was particularly enamored of those that were made in the 1940's and 50's. Auntie Mame was a certain favorite in our house. She was bigger than life, independent, confident, eccentric, and wise. I've always wanted my own Auntie Mame.

She came to me, at last, in the person of Barb S., the director of the Women's Health Center at the hospital. With her deep and smoky voice on the phone, she pretty much gave me no choice but to meet with her prior to my first chemo session. It was imperative, according to her. No if's, but's, or maybe's. "Because," she insisted in that cordial Auntie Mame sort of way "all that you will need to know about chemo, I will tell you. You need to know what to expect so that you are prepared. That's my job." So, I eeked in an hour to see her prior to my first chemo session on March 11, 2009.

I was nervous and sort of out of body on my first chemo day. I did not know what to expect, except all that I read from the literature my oncologist gave me, plus the hours upon hours of research I did on the internet. My head was stuffed with too much information I couldn't process anymore. All I could remember was that I was at once not looking forward to the chemo and being impatient for it to commence. Altogether, it was going to be an awful experience. Period. So, in that state, I walked into Barb's well-appointed office -- so warm and inviting, peppered with health books, mementos and dog pictures -- everywhere!

It was uncanny how Barb oozed Auntie Mame (save the cigarette holder of course). She greeted me not with a handshake but with a big bear hug. Being in her presence was like being immersed in warm bath water with bath salts. She was soothing and assuring -- and bubbly. Barb has some heavy-duty creds to back up that genial hug. She's a licensed nurse practitioner specializing in women's health issues and has been in the business of aiding women with cancer for the past 20 years! So, the information she had for me was both practical and academic.

My one-hour meeting with her was the most informative meeting I'd had to date, considering I'd been meeting with doctors, nurses, and all other kinds of health care professionals for weeks. She was chock full of practical information, all of which (in retrospect) was spot on -- from which day I was going to feel bad after chemo, to how many weeks after chemo I will feel normal again, or to when my hair was going to start falling off (how? etc.), and when I was going to lose my eyebrows, and more!

But that's not all. More importantly, she addressed an issue that I was too crazed to even think about: how chemo was going to affect my appearance in the next few months. Yup! What do you do when your hair starts falling out? Or, how about when your eyebrows disappear? Wig? Or scarves? What about your skin? Will you break out? To the naked eye, it may just be about vanity. But, as Barb put it, when you look good, you feel good. And when you feel good, you get better. Simple. Yes. But very much taken for granted. She said that I may not have at that point thought it was of import. But it will be. So, she enrolled me in a make-over class and set up me up with a wig consultant, complete with free wig of my choosing. Bless her.

Barb stood out because of her unique was her approach and attitude. Although all of it was serious stuff, she had a certain lightness about it all -- much like Auntie Mame. "This is not the end, honey. This is but a detour. Give it all your energy so that you can go on with your life in a little bit" she said with a smile that could light up a whole room. In what then was sometimes a gray and cold existence, Auntie [Barb] Mame came and gave it light and color.

"Life is a banquet--and some poor suckers are starving to death."

Guess Who Ended Up in the Driver's Seat Anyway?

The phone conversation with the insurance lady left me feeling like that plastic bag in "American Beauty." But, I did not find any "beauty" in my particular wind dance. I was angry, sad, defeated, incredulous, tired, at a loss, and depleted. Like that plastic bag, I was windblown and empty. So, I put my hands up in the air once more, said "whatever" and succumbed to Ambien.

I was still in that Ambien haze when Dr. T greeted me the next morning. But, that soon cleared up when he escorted me into his office with that bright smile and hearty handshake. After we sat down, he showed me a luminous outline of a woman's body with glowing dots on his computer screen. They looked like little constellations. It was my PET scan. "It's ovarian cancer," he said as he pointed to the dots around the cervical area. "And as you can see, it has metastesized to your chest cavity," he continued, while tracing the dots up to the area in the midst of my lungs and heart. How ironic that an image so pretty could be an indicator of something so deadly.

Maybe it's because I'd been through the "cancer news" grindstone once that I didn't feel the sting or the blow of the news that it was Stage 4 Ovarian Cancer. Or maybe it was because I was numb from my phone call with the insurance lady. But, it was probably mostly because, the news came from Dr. T. It was actually a relief that he had solved the cancer mystery. Strange.

Because of its advanced stage, Dr. T was going to be very aggressive in treatment: Carboplatin and Taxol chemotherapy for at least 8 sessions, once every three weeks. "This is not going to be easy. But it's treatable," he said. "Are you ready to do this with me?" was his battlecry. Yes! Of course! I'm ready! Where do I sign up? When do we start? Let's do this!!

Oh wait...there's "small" matter of insurance coverage....

I took a deep breath, squared up and told Dr. T that I was ready and willing, but may not be able to fight the fight with him. A brief synopsis of my conversation with the insurance company followed. Without hesitation, Dr. T said "Well, you won't have to see another doctor. We're doing this together. Let's have you meet with my finance office now and we'll sort it out. You need not be bothered with this. I need you strong and prepared for chemo."

Dr. T handed me off to Suzanne, who headed up his finance office. After she heard my story, she immediately told me to leave all the financial details to her. She was going to talk to the insurance company and find out what's going on. "Don't worry. Your job is to get well. My job is to deal with the insurance folks. OK?" [I think at this point I may have seen the heavens open and heard a choir of angels sing "Ode to Joy."]

Yes! Dr. T [and his crew] had taken the wheel again! Take that, insurance company! His office ended up entering into a unique contract with my insurance company, agreeing to a very low pay scale (apropos to my POS plan) in order to continue with my treatment. No, I didn't get treated for free. But it cost me much less than what the claims rep had quoted me (it's about 5% of the total cost of treatment), . It will take me a while to pay off what I owe Dr. T. but I'm glad to pay for it. It means tightening the belt all the more, but I have my life! I am grateful, beyond words to the efforts Dr. T's group put into sorting everything out with the insurance company. Not only did Dr. T save my life, but he also agreed to save it for a huge discount.

So here's to the man who took the wheel back from the insurance company and saved the day(nay, my life) with a big smile and an even bigger heart. I will follow him whereever he tells me to go. And I hope my Christian friends will forgive me as I fondly refer to him as my lord and savior, Dr. T.

Oh! But They Wanted Someone Else to Drive!

On the eve of my first office visit with Dr. T, to find out what cancer I had and the appropriate treatment regimen thereof, a claims representative from my health insurance company gave a call. She was calling to inform me that Dr. T was not an approved oncologist on my POS network, although he is listed in the PPO network -- which I did not have! Therefore, the insurance company would not approve any treatment I would receive from Dr. T.

WHACK!

After taking a deep breath and counting to 10, I reasoned with her, telling her that I had no choice in the matter. The Internist assigned to manage my care at the hospital picked Dr. T to be my oncologist. Presumably, the hospital had cleared Dr. T with the insurance company before he met with me. And because of that, I went ahead and consulted with him and subsequently decided (with great relief) that he was the man for the job.

The claims representative apparently heard none of what I just said. Her robotic reply to my impassioned plea for Dr. T was "I'm sorry mam, he's not in network. So you're gonna have to pick one who is. There are plenty of good choices on there." Just like that? "Choices?" Just pick another oncologist from the list? Would this be just like picking a lunch special from a deli sandwich board? Or a new lipstick shade at a cosmetic counter? Choices? I mean, some people even have a hard time picking a new hairstylist, nevermind someone who's going to save their life! Just pick another oncologist from the list?

How would I do that? How would I start over again? How would I tear myself away from Dr. T, to whom I had just entrusted my life, and go on to interview a new group of oncologists? I couldn't fathom it! Dr. T was the first doctor who had steadied me since my ordeal began. And now, they've gone and pulled that very foundation from underneath my sanity. How would I interview a whole new group of oncologists, when deep in my being I knew I had found mine? My brain was in shambles once more. I had that crazy-scary ride feeling again! And I was panicked because time was of the essence. Cancer was eating away at me and they wanted me to go back to first base again. Did she not read the file and notice that I had Stage 4 cancer? What in the world were these people thinking? Or were they?

Over and over, I insisted that I could not change oncologists mid-stream. Dr. T. was well on his way to diagnosing my cancer and coming up with the treatment regimen. "OK," the rep said. "I'm afraid that if you insist on an out-of-network specialist, you'll be liable for a $5,000 deductible. And then, we will only pay for 80% of your medical costs."

WHACK!
[Thanks very much for your kind generosity, oh mighty insurance company! How about I reciprocate that with not paying premiums up to $5,000 and then pay only 80% of my premiums thereafter? Fair?]

I'm a single mother who works for a non-profit organization. Non-profit workers do not make a lot of money. But hey, it's a lifestyle choice and I don't expect anyone to feel sorry for me. I'm glad to be working for a cause and away from the corporate grind. But since the pay is not high, financial sacrifices are made. One of them is paying over $200 a month for my health care insurance because I wanted to be prepared for times such as these. Even though these premiums (among other living costs) made it difficult to make ends meet every month, they were necessary costs. So, to be liable for a $5,000 deductible plus 20% of what would be a huge medical cost was a something I couldn't do. No way! I don't have a mortgage against which to borrow nor any other assets to throw into this looming debt. I am a member of a the growing class of the working poor.

Desperately, I appealed to the better side of the claims representative and "begged, pleaded, borrowed." I did everything but walk on bended knees to the insurance headquarters whilst flogging my back raw to present them my first-born. But to no avail. She said rules were rules. Either I pay out of pocket for Dr. T or pick another oncologist from the list.

SLAM!

Now what?

[Mine was a minor situation of the millions of other more egregious reasons why we need Health Care Reform. Health insurance companies cannot be keep preying on the weak and the sick and keep gouging their insureds. They have to be regulated! This abuse cannot continue. I am but a mere drop in the bucket. Sadly, health insurance does not ensure health care.]

The Man Who Took The Wheel

Dr. T introduced himself with a big handshake accompanied by a luminescent smile that lit up his apple cheeks. Even more fetching was his very bold and colorful shirt and tie combination which paled his white coat all the more. I don't know what oncologists are supposed to look like or seem to be, but, "bright and smiley" were not words I would immediately associate with them. Beneath his shiny veneer, Dr. T is a well-credentialed and experienced oncologist and hematologist. (Wow! Two birds with one stone. Begone! pesky blood clots!). Naturally, because of his good reputation, he had a busy practice. And it was apparently difficult to get an appointment to see him. "He's one of the best. You're blessed," said the Chaplain to me.

Yes, his credentials and reputation were certainly important. But, I knew that I wanted him as my oncologist when I shook his hands and looked into his eyes. Dr. T exuded confidence, but not ego. He was professional, yet cordial. He was also very forthright, assuring and compassionate as he delivered the news that he couldn't tell what cancer it was. Were he another doctor, I probably would have fallen apart. Instead, I appreciated that he wanted to have more tests done, including further examination of the biopsy by the pathologist. Without my asking for it, Dr. T was going for the "second opinion."

Even though he had no answers by the time we said "goodbye" at the hospital, Dr. T sent me home with this comfort: Whatever type of cancer he found, it was going to be treatable and "We might even be able to make it go away." Again, said with THAT smile. What a great big dollop of hope! And what a lot of boost, as I set to left the cocoon the hospital to face the world. At least at that juncture "Now what?" had an answer. Unequivocally, that answer was to put my life in this man's hands. Altough very sad and scared, I felt assured that Dr. T had taken control of the wheel of the most out-of-control and scary ride of my life. After that, I was prepared to ride that car where ever Dr. T took it; because I knew that he had mapped it to go to a place called "Treatable."

A week from my hospital releas, I was going to meet with Dr. T so he could tell me what kind of cancer I had and we could start treatment. It would still be a scary ride. But, I had confidence in the driver. I knew he had it under control.

Even Boxing is a Team Sport

Though the good Chaplain's advice about my ensuing bout with cancer resonated, and I believed that if I were to beat cancer, it would have to be up to me, that was just the start. Waisn't it? Something this big could not have been borne by one person alone -- no matter how prepared or strong (which I wasn't, thank you very much). Even with the Chaplain's "boxer" analogy, we all know that any boxer in a boxing ring did not get there by himself. And altough he is seemingly alone in that ring, he has a team behind him. There are his trainers and sparring partners, his doctors, nutritionists, coaches, managers, agents, the person who brings him water, all working with the boxer toward one common goal -- to beat the other boxer. AND, he even has at least half the crowd (amongst whom are his loved ones) rooting him on. All of that that, including the boxer, has to do with whether he wins or loses the fight. It is not a sport of one. Though the victory or defeat of a boxer may seem to be theirs alone, it is indeed shared and carried by many. No one does it alone. Thank goodness for that!

I certainly couldn't have done it alone, no matter how high or intense my resolve was. And I will always be grateful for the team I had (and still do!). There were the health care professionals who diagnosed, planned, monitored and executed my course of treatment. Then my were my friends and family who, prayed for me, cheered me on, cooked for me, schlepped me around, showered me with presents and good cheer, held me, made me laugh and just plain loved me through it all. My phenomeal colleagues at work covered for me, asked no questions, but offered everything else, most important of all, they were fierce guards of my privacy at work. No one patronized me nor condescended to me. Everyone supported what I was going through and was always (in a drop of a pin) ready to help. All I needed to do was ask -- and sometimes, not even. This was my fuel!

What is that saying? There go I, but for the grace of [insert everyone's name here].

The next series of posts will mostly comprise the telling of those people and events that have held me up and helped me through my illness. Consider it my "Oscar speech" (in the spirit of the upcoming Oscars). Because I do feel like a winner, standing where I am. BUT, only because I have these wonderful people to thank, whom you will next meet in no order of importance.

(...and now, what gown to wear?) :-)

Perhaps It's That Simple

The other night, I was having a huge existential crisis. Since entering remission, I've felt my life in flux with serious lack of direction and purpose. Why did I survive cancer this bad, only to be brought to this place? Why? There's got to be a reason. I was crying for one.

Then, I was given wise counsel: "Maybe it's just as simple as having an excellent oncologist and you wanting to live."

It's very Zen.

But it may be that simple.

And Now, a Brief Moment of Silly Puffery

(Portrait of an Artiste as a Cancer Patient)

My posts have been oh-so-heavy, haven't they? So, I thought I'd indulge in a moment of silliness. I found this little drawing while I was reading my journals from last year. It was a poor attempt to occupy my time (distract my panicked brain, actually) while I was waiting to be wheeled to the next test. The other choice for distraction was reading the latest issue of "OK Magazine" that my daughter had left behind that day. But, for some reason, the prospect of reading "whose whomin' who" in Prada and Jimmy Choo's was giving me a serious case of nausea.

So, with a suddenly sense of "inspiration" (or was it delusion?) I decided to draw instead. Quickly, I arranged my glasses, watch and medicine cup on to the tray in front of me, et voila!

Now I can strike "take painting lessons" from my bucket list. :-)

Happy Friday!