covered in slime

I hate ultrasounds.

It's not just the unpleasantness of lying in a chilly room, covered in cold, goopy, gel.

It's not just the ugly robe and mind-numbing boredom of lying first on my back and then my sides, as I silently obey commands to, "Breathe in. Hold it. Breathe out."

What really gets to me is the fact that there is a screen right in front of me that I cannot interpret. A screen that has the answers to whether the tumours in my liver have grown larger. Or if they have started to invade elsewhere.

I hate that the ultrasound technician, a stranger, can interpret the images yet can tell me nothing.

I really hate ultrasounds.

I see the oncologist on Friday. I hope to have results by then.

$87,973.90

Or $78,812 in US dollars. That's how much Jeanne, of the Assertive Cancer Patient (really good blog, check it out) has calculated that her insurance company pays for Herceptin in a year.

Drug companies are evil.

Thank goodness, once again, for socialized medicine.

And, boy, it costs a lot to keep me alive.

heartbreaker

An older woman (she was at least six) said to my four year old son, this evening, "You've stolen my heart."

They had known each other for approximately twenty minutes, as we waited for a big enough table to be ready at Swiss Chalet. She was the manager's daughter and they had been chasing each other around the restaurant foyer.

After we were seated, she came to our table and said, "I wish I could sit beside him."

This kind of thing happens everywhere we go with D. I shudder to think what the future brings. Let's just hope he uses his charisma wisely.

the many faces of four

My baby turned four on Sunday.

Smart, sweet, confident, challenging D.

We watched video of him as a baby today. Even then, he sparkled, a child who knows he is beautiful and loved.

D. is opinionated, tyrannical, loving, adventurous and funny.

I can't believe he's already four.

The Carnival of Risk # 24 is Up

The Carnival of Risk is up over at "The Digerati Life:""Welcome to the Carnival of Risk #24, where we showcase articles that discuss risk in all its forms, particularly touching on the subjects of risk management, insurance, investing and other articles on business and financial risk...read the rest.

Humana Caps Annual Increases on Consumer-Driven Plans--Too Bad it Isn't a Real Guarantee

Humana says it will cap annual increases on self-insured consumer-driven plans for three years.Two problems:Humana is capping the costs of its "SmartResults" self-insured plans and only putting 40% of their fees at risk. If they were really putting their money where their mouth is they would be capping the cost of fully insured plans--and if they are so confident on their self-insured product,

whiskers on kittens

I came up with this list this morning:

runners' legs

dog snoring

my coffee mug

the smell of lilacs

sunflowers

dark chocolate dipped in coffee

soft, beautiful yarn made from natural fibers

greg brown's voice

the back of my sons' necks

What would be on your list?

The Medicare Fee-For-Service Product is a Kamikaze Flight for Health Insurers--But Are the LBO Guys Interested in Humana Anyway?

There is plenty of speculation over just what the Congress will do about Medicare Advantage payments to health plans.I have posted on this many times before.To summarize, I believe:Medicare Advantage payments to health plans will not be cut by the Congress for 2008. But health plans will suffer some relative Medicare Advantage payment decreases in 2008 because the average 3.5% increase the plans

sieve

Today, I went to an appointment with my naturopath.

I was early.

Three days early.

Chemo is eating my brain.

ending better than it started

Monday:
Found out someone used my credit card number and forged my signature on a Visa cheque for almost two thousand dollars. The cheque was returned as NSF. Thank goodness we've been spending beyond our means or the fraud might have been successful. As it is, we've had to cancel our credit card and wait for a new one to be sent to us.

Tuesday:
Chemo.

Wednesday:
Appointment with my radiation oncologist.

I was first examined by a medical student, who asked, sounding alarmed, "How long have you had this lump?" I panicked for a moment, then realized she was referring to my Portacath (shouldn't she have known what it was?).

As for the doctor, should a man who is uncomfortable with the words 'bra' and 'prosthesis' really be working as a radiation oncologist with breast cancer patients? He seemed disbelieving when I told him that the treated area on my chest and back is still extremely tender and had no suggestions as to what I could do to ease this discomfort. When I told him that it hurts too much to wear a prosthesis, he said, "Well, you have to wear something in public."

This is the same doctor that objected to the fact that I do not have the same last name as my spouse.

Thank goodness this same spouse was once again in attendance. It was one of those appointments when it was really good to have someone there who knows me well, if only to say afterwards, "You are not crazy."

Thursday:
Booked my plane ticket to Chicago to attend BlogHer '07, thanks to air miles donated by my wonderful brother-in-law.

Nothing contributes to a sense of optimism like making plans a few months in advance. And just thinking about spending a week end with other women bloggers makes my heart beat a little faster.

Friday:
Spring has sprung. I feel quite a bit better. And I finished this:



It's the little blanket that grew, my 'log cabin' from Mason-Dixon Knitting.

It is the most beautiful thing that I have ever made and it makes me happy just to look at it. It's been almost finished for weeks (since our return from the Florida trip where I worked on it in the car, both ways). And it smells good too, since I washed the potato chip smell out of it this afternoon (did I mention that I worked on it on a long car trip?).

Things are definitely looking up.

Medicare Drug Negotiation Bill Fails in the Senate

Democrats fell short of the required 60-votes to pass a bill that would have allowed the Secretary of HHS the power to negotiate Medicare Part D drug prices. Democrats did get 55 votes while 42 Senators opposed the bill. The vote generally followed party lines.The Medicare Part D drug negotiation bill was little more than a political charade anyway since the bill would not give HHS any leverage

this made me laugh

Too tired to write tonight.

I thought this was very funny, though.

Cat In Dog Bed | Send To Friends | Funny Flash Cartoons at JibJab

And this, too (my dog is this smart):



The Hole - video powered by Metacafe

Latest "Health Wonk Review" is Up

Health Wonk Review is a biweekly compendium of the best of the health policy blogs. More than two dozen health policy, infrastructure, insurance, technology, and managed care bloggers participate by contributing their best recent blog postings to a roving digest, with each issue hosted at a different participant's blog. For participants, it's a way to network and share ideas, and for those

Hillary Clinton Doesn't Like Health Insurance Companies and Never Has--But Demonizing Them Again Won't Get Us Health Care Reform

At a recent health care forum attended by Democratic presidential candidates, New York Sen. Hillary Rodham Clinton observed, "The insurance companies make money by spending a lot of money employing a lot of people to try to avoid insuring you, and then if you're insured, to try to avoid paying for the health care you received... ." (Newsday 4/14/07)I'm sorry to hear her say that.Health care is

so damned tired

I am bordering on neutropenic again, which could explain why I have been feeling so rundown (and why the cold hit me so hard). My white blood count was very low on Tuesday, not low enough to cancel chemo but getting there.

I have an ultrasound scheduled for April 30 (and will get results at an appointment on May 4).

Meanwhile, I know the following:

• My liver is swollen, but not terribly so (and nowhere near where it was in November).
• My liver functions in two of the categories they test are normal. A third area was high but it is also the one the doctors worry about the least, as it can be indicative of other things going on with the body.
• It is not a good sign that I have been experiencing discomfort but my most constant stitch is nowhere near my liver (I really need to learn more about my own anatomy).
• The swelling and the fatigue could also be the result of my cold and my battered immune system.

I am feeling less stressed than I was on the week end (which isn't saying much, given that I was a wreck on the week end) and reassured enough that my worries are no longer top of mind.

So keep your fingers crossed for me.

And stay away from me if you are sick.

And for goodness sakes, wash your hands after you go to the bathroom (this is for the guy my spouse almost confronted at the cancer centre today, and who I'm sure isn't reading this).

Tomorrow, I will tell you about today's appointment with my radiation oncologist, another laugh or cry experience (I chose to laugh). My spouse has decided that I need to get one of these t-shirts and wear them to all future appointments.

I think he's right.

Democratic Presidential Candidate Bill Richardson Supports the Employer Mandate as a Way to Provide Health Insurance

Democratic Presidential Candidate Bill Richardson has weighed in on the health care debate with comments about what he would do on the issue:"You know, every time a Democrat, it seems, we propose a new [health care] plan, it's more spending or more taxes. I'm not that way...I would have a mandate. I would say every employer...has to have a health care plan. That's how you pay for it."Well

too stoned to blog

Still stoned from the Demerol. I'll write more tomorrow but wanted to let you all know that I had a fairly reassuring chat with the doctor on call today, during chemo.

I also have an ultrasound scheduled for April 30.

Update: This should really be a picture of a poppy but since I only have pictures of sunflowers (and tulips) this will have to do.

The Imus Fiasco and the Virginia Tech Massacre—What They Have in Common

Why is it that these campus massacres seem to be a unique American phenomenon?Last week the country struggled to understand why the Imus fiasco hit such a raw nerve.This week, a 23-year-old Northern Virginia kid took some kind of rage out on dozens of innocent people at Virginia Tech.Could it be that the two share some kind of common thread?I believe they do.In my mind that thread has to do with

Senate Developments on Medicare Advantage Payments to Health Plans and the State Children's Health Insurance Program (S-CHIP) Reauthorization

The Senate is back to work and two important developments occurred last week in the debate over Medicare Advantage payments to health plans and the reauthorization of the State Children's Health Insurance Program (S-CHIP).First, the Senate Finance Committee held a hearing where its chair, Senator Max Baucus (D-MT) and ranking Republican, Chuck Grassley (R-IA), both expressed concern about the

More Than 10 Million Are Now Using Consumer-Driven Health Care Accounts--We Will Soon Have Enough Data to Know How Well HSAs and HRAs Work

Consumer Driven Market Report (CDMR) has issued a report on the success of consumer-driven care in the marketplace.CDMR reports that over 6 million people are participating in health plans that have a health savings account (HSA) as part of their plan—that is an increase of 2.85 million in the last year.Similar health reimbursement accounts (HRAs) now total 4.1 million and are growing at a rate

life and death

I have a stitch in my right side tonight. It's probably nothing but since my liver functions are also a little elevated, my doctor is ordering another ultrasound.

Suddenly, 'stable' is looking pretty good.

I try not to dwell on my fears. There are, however, times when the dark thoughts that nibble at the edge of my consciousness threaten to swallow me whole.

I want to live longer than the friend of a friend (and mother of young children) who died from liver mets within two years of her diagnosis.

I want to outlive the prognosis of "years not decades" that was gently delivered by my oncologist.

I want to be a living, breathing medical miracle.

I want to live.

Another Victory Declared in Massachusetts--The Connector Exempts 20% of Uninsured State Residents From the Requirement to Buy a Health Plan

The only place there are more victories being declared than in Iraq these days is in Massachusetts.The Massachusetts Health Plan regulator, "The Commonwealth Connector," has issued new rules that will exempt an estimated 20% of the uninsured from a state legal requirement to purchase health insurance.Since the health plan bids came in last month, it has been clear the prices would not make it

know any good jokes?

I met with a naturopathic doctor today. I liked her quite a bit, she was very compassionate, has treated patients with cancer before and believes strongly in the mind-body connection.

To that end, she recommended laughter. A good belly laugh every day is apparently worth a mountain of medicines.

So, does anyone have any funny stories to share? Books or movies that will make my face hurt from laughing so hard?

I'll get the ball rolling and recommend Bon Cop, Bad Cop. The humour may be a bit culturally specific but it did make me laugh. Hard.

What makes you laugh?

The Medicare Part D Drug Benefit: "The Ugliest Night I Have Ever Seen" - "60 Minutes" Report on How the Medicare Drug Benefit Became Law

As any any of you who know me, or who have regularly read this blog, know, I have great disdain for the Part D Medicare drug benefit--the way it was passed and the horrible health care policy it represents.I do believe seniors are entitled to coverage for their drugs. But instead of layering $8 trillion of unfunded liability (the whole of Social Security has a $4 trillion unfunded liability) on

A Bipartisan Bill to Ban Genetic Discrimination Continues to Move Through the Congress

The House continues to move toward approving a genetic discrimination bill that would prohibit health plans from collecting genetic information and from requesting, requiring, or purchasing such information for insurance underwriting purposes.Employers would be prohibited from using genetic information in the hiring process.The bill is now working its way through the committee process with

foul

I am in the worst mood.

My sinuses are killing me and my head is full of goo.

I had to cancel dinner with friends this evening.

D. has had a series of tantrums tonight.

I was really looking forward to that dinner (and know that it would have been good to fight my increasingly hermit-like tendencies).

Damn.

A Drug Reimportation Bill Continues to Receive Bipartisan Congressional Support

A drug reimportation bill that would enable consumers, drug retailers, and wholesalers to import cheaper foreign drugs from FDA-approved plants and warehouses continues to gain support. The CBO reported that the bill would generate $50 billion in savings for pharmaceutical purchasers over 10 years.While a floor vote has not yet been scheduled in either house, we continue to believe this, or a

more than the sum of my parts

A liver riddled with tumours.

A scar where my right breast used to be.

Lymphedema in my back and arm.

Frozen shoulder from radiation.

Radiation burns on my chest and back.

Assorted minor but annoying side effects from chemotherapy.

Fifteen pounds gained in 2007.

Panic every time I feel a stitch in my right side.

I think it is time I talk to someone who specializes in treating the whole person.

Anyone have any advice on finding a naturopathic doctor? What about some questions to ask when I schedule a consultation?

A Mental Health Parity Bill Still on Track for Passage

During the last few weeks we reported that it is likely a bipartisan mental health parity bill will emerge from this Congress after years of inaction on the issue.That prediction still holds today.In past years, the Republican Congressional leadership blocked the bill even though the votes were there for passage--with many Republicans behind it. With the Democrats now controlling the

sick in the head

I am all stuffed up.

I have what Sassymonkey had.

OK, so I probably didn't catch it through the internet but I do find it remarkably suspicious that I am sick and she is feeling better.

Or maybe I just caught the cold from my son, who routinely coughs in my face (or coughs in his hand and then puts it on my face).

Wouldn't it be interesting though, if we could catch stuff from the folks we visit regularly over the internet?

Clearly the cold dope has made me delirious.

a time for excess

Easter is the only day that I allow my children to have chocolate before/in lieu of breakfast.

We've all been eating like little piggies this week end (and eating piggies, as last night's dinner was comprised of both a Passover brisket and an Easter ham). I think when next week rolls around it will be time for a little detox.

But I'll think about all that tomorrow, for in the words of an immortal heroine, "Tomorrow is another day."

Spoken like a true lover of meat fried in oil and chocolate rabbits.

Oh, and for the record, it is not actually true that S., pictured above, has not had a bath in seven months. He just likes to embarrass his mother by telling people that.

new kind of cycle

So maybe I don't get PMS anymore but my moods are as tied to a cycle as they've ever been. My heart is lighter today and the sadness and fear I've been feeling seem to have evaporated.

I do not have chemo next week.

And that makes everything better.

The Health Wonk Review--A New and Improved U.S. Health Care System

Jane Hiebert-White host's this edition of Health Wonk Review over at the Health Affairs Blog. Health Wonk Review is a bi-weekly round-up of the best in health care policy blogging. This edition is loaded with commentary on how we might achieve universal coverage--or not.

the elephant at the table

Or the ostrich with its head in the sand?

I note that nowhere in this article do they mention environmental factors, such as pollutants and other toxins we absorb on a day to day basis.

From ctv.ca:

Cancer cases to double by 2030, agency says

Associated Press

Updated: Wed. Apr. 4 2007 8:06 AM ET

UNITED NATIONS — The number of diagnosed cancer cases will more than double between 2000 and 2030, primarily in poorer countries, the director of the International Agency for Research on Cancer said Tuesday.

Dr. Peter Boyle said the reasons for the increase include population growth, longer life expectancy, more people smoking in the developing world and a lack of health care in poor countries.

In 2000, the agency estimated 11 million new cases of diagnosed cancer worldwide, seven million deaths from cancer and 25 million people living with cancer.

"We currently estimate that between the year 2000 and 2030, there'll be a more than doubling of the numbers of cases of cancer diagnosed each year," Boyle said. "And the great majority of this increase is going to be in the low- and medium-resource countries."

The agency, part of the World Health Organization, expects that by the year 2030, there will be 27 million cases of cancer, 17 million deaths from cancer and 75 million people living with cancer.

"We've been concentrating on cancer in high-resource countries and until essentially AIDS came along, we haven't looked too closely at what's going on in low-resource countries," Boyle told a news conference.

But he said new research shows that as time has progressed, there has been an increasing shift of cancer to poor countries.

"What's going to happen between now and 2030 is that the population is going to increase from about 6.5 billion to 8 billion in 2030," Boyle said. "So even if the risks remain constant at each five-year age group, because we've got more people around, we're going to have more cases of cancer."

An increase in life expectancy in the majority of countries, with the exception of some AIDS-ravaged countries in Africa, also is leading to a rise in cancer cases, he said.

Both China and India have continual growth in the number of people reaching older ages, Boyle said. "So if you've got more old people in the population with the same risks as the younger people, you're going to have more cases of cancer in the older population," he said.

Boyle said one of the unfortunate successes for developed countries in the last 40 years has been their export of cancer risk factors, such as cigarette smoking and alcohol consumption, to poor countries.

"These three elements are going to come together and that is going to drive up the global cancer button over the next 30 years," Boyle said.

The Real Reason Health Care Reform is Hard—Hillary Clinton Leads the Presidential Candidates With $26 Million in First Quarter Campaign Contributions

Reading the press, it’s as though raising money for a presidential run is a sweepstakes to be won—like it’s something to be proud of.Just exactly what should we all be celebrating?Hillary Clinton leads the way with $26 million raised in the first three months of the year before the presidential election. Senator Obama is reportedly going to come in well over the $20 million figure and John

better than a treadmill