The Cost of Cancer, updated

It has been one year since my post-surgery pain- & insomnia-induced rant about health insurance.  I continue to tabulate all my cancer-related expenses; it's been a good six months since my last financial update.  Since then, the Neulasta billing problem was remedied (finally), I finished chemo, I had radiation and a scan and a procedure, but I haven't seen that many benefit statements.  I haven't seen anything related to the radiation, and still only saw the one set of charges last fall that appeared to be for chemotherapy.  I won't pretend to understand how any of it works.

In support of continued transparency, here are the numbers as of the last EOB I received, as of 8/19/16:

Chemotherapy                  6,645.22
Chemotherapy-related  126,589.98 (Neulasta)
Clinic/Consultation          1,076.00
Emergency Room            1,949.00
Inpatient                           6,687.34
Labs/Scans                    31,457.00
Medical Supplies             2,059.57
Surgery                          16,516.50

TOTAL                        193,159.53

And an updated out-of-pocket breakdown:

Clothing/supplies          169.82
Copays- appts               275.00
Copays- scrips                41.47
Food                             418.57
Parking                         620.00

TOTAL OOP             1,524.86

Wicked-sobering grand total:     194,684.39

Notice that the Neulasta is a solid 65% of the grand total.  I found that especially striking in light of the recent controversy surrounding the Epipen price hike.  I'll bet a significant percentage of patients undergoing any chemotherapy regimen end up needing Neulasta to support their immune systems.  I'll bet a not significant percentage of those patients have the miraculous health insurance that I do.  It boggles the mind.

More walking - support my Jimmy Fund Walk!

I'm doing it again -- exercising and raising money for the fight against cancer!  This time I've registered for the Boston Marathon Jimmy Fund Walk.  I've upped my goal since the FitFest back in May.  Now I'm including an "allocation" for my two surgeries as well.  My new default goal is $2,000: $100 for each surgery (2), round of chemotherapy (12), and week of radiation therapy (6).  Please visit my fundraising page here:

http://www.jimmyfundwalk.org/2016/eemthomas

I opted for the half-marathon 13.1 mile route from Wellesley to Boston.  I've been doing a lot of walking since ending treatment at the end of April, but 26.2 miles felt like it would be too much all at once.  I'll work up to the full route next year... baby steps.

I am also trying to get back into a biking routine.  I did about 4 miles yesterday and that was plenty.  It was only my 2nd time back on the bike since diagnosis.  Hard to believe I used to ride 18 miles a day, 2-3 times a week, from May - October for my commute to work.  I'm still not sure I'll do a commute by bike this year.  I would like to, but I might talk myself out of it... the streets of downtown Boston will surely be as challenging as they ever were.

And next year, my goal is the Pan-Mass Challenge.  I've always wanted to do it and know many people who have done it multiple times.  We'll see - baby pedals!

Test results from afar

You might recall that way back in June I had my first post-treatment CT scan.  You may also recall that the results were excellent: no indication of any recurrence, anywhere.  That was a good day.

I have also been due for another diagnostic, a colonoscopy, which I finally had about a week ago.  I never had one when all the nonsense started.  They tried the day after I was first diagnosed, but the tumor made it impossible (early blog post on that, tons of fun).  I had a sigmoidoscopy but it was primarily to get a tumor sample for pathology.

And so, there I was, post-treatment, cancer-free, talking about when I could have surgery to get me back to normal anatomically, and lo and behold I've never had a colonoscopy!  So I had one.  They can do this via the ostomy and it's actually much simpler.  However I got really lucky and they checked me out from both directions.  I am now a master of conscious sedation, by which I mean no safe amount of "sleepy medicine" puts me to sleep anymore.  I was a bit out of it, but pretty aware of everything, for better or worse.

Thankfully everything was for the better.  My prep was good, everything looked fine, except for one slightly suspicious area in the hepatic flexure, where the ascending colon turns right and becomes the transverse colon (by the liver).  The surgeon doing my procedure took a sample but told me she wasn't overly concerned.

I wasn't overly concerned 17 months ago when my stomach issues started, so I wasn't all warm and fuzzy with this.  I wasn't overly anxious either but was leaving for vacation (where I am now), knowing I wouldn't get results for a few days, and it was hard not to think about it.  Here on vacation the wifi is spotty.  I can get email usually - and got the "you have a new test result" from the patient portal this morning - but websites and such are hit or miss.  We were busy vacationing all day so I didn't try logging into the portal until a few minutes ago, but it was a miss, over and over again.  Luckily the resort has one public computer for guest use and I was able to connect there.  The result:

"Colonic mucosa within normal limits."

Great big sigh of relief.  Back to vacation!