Wednesday, October 31, 2012

Hurricane Sandy

Wow, it was really damaging here.  I live below 40th Street on the East side of Manhattan and we have no power, cell phone, internet, or landline service.  They say we will not have anything until the weekend, maybe!  My office, however, in midtown has full power and services so I expect to be there a lot this week.

Below are some pictures:

Williamsburg Bridge between Brooklyn and Manhattan
  Unfortunately, I live on the Manhattan (dark) side of this bridge.  Brooklyn is all alight with power.

La Guardia Airport
 Above is La Guardia Airport - still flooded and not sure when it will reopen.  I'm glad I'm not flying this week.  They have not cancelled the New York marathon for Sunday but I'm guessing a lot of runners will not get here.

Downtown NYC Subway Station
The above photo is a subway station in downtown NYC.  They have not reopened the subway but I think tomorrow there will be service above 34th street in Manhattan. 

I'm happy to be safe but I think the no power thing could wear on me soon.  The only hospitals in Manhattan that are working well are NY Presbyterian and Mount Sinai.  Some of the big hospitals like Bellevue,  New York University Medical Center and Beth Israel were evacuated when the power went out and the generators were flooded. 

Many people are much worse off than I am - especially in NJ.

That's it from NYC!

Saturday, October 27, 2012

Insurance Woes -- and an update

Throughout my cancer experience my doctor or hospital system has submitted my insurance claims.  I am quite lucky that I have very good coverage through my employer. Owen also has good healthcare so I use his plan as my secondary coverage.  After my visit to Dr. Warner last week, I submitted the bill to my primary insurer, Aetna.  (Dr. Warner does not take any insurance).  Today I received a rejection of my claim. I’m not sure if it is because of the procedure code or an issue with my secondary coverage.  I called Aetna to ask but they are closed on weekends.  Now I have to call from work to figure out the problem. I usually work 50-70 hours a week so it is hard to find time to remember to deal with insurance issues.  I realize now how lucky I am that my doctors have been handling this for me.

I am scheduled to have a small bowel x-ray series on Monday morning.  Monday is also the day that we are supposed to be hit by hurricane Sandy.  I wonder if that is an omen about doing all these diagnostic tests!  I hope I can just get the test done - or if they are going to cancel the appointment, that they give me a few hours notice. 

That’s all I have to report this week.  I’m planning to go out and get some extra water and batteries in case we lose power.

Update as of Monday afternoon:  Last night, the radiology group called to cancel my small bowel x-rays in plenty of time, thank goodness.  I called Aetna and they said that they did not process the claim properly and will resubmit it and I should get payment within a week or so.  The hurricane still has not hit here in NYC but it is quite windy.  One of my friends in NJ had to be evacuated.  As of now, the power is still on and things are ok.  My office was closed today and will be tomorrow as well.  I'm hoping all goes well as the worst is yet to come. 

Thursday, October 18, 2012

More Medical Advice

“I do not despair of carcinoma being cured somewhere in the future, but this blessed achievement will, I believe, never be wrought by the knife of a surgeon” – Siddhartha Mukherjee - The Emperor of All Maladies

On Tuesday, I had an appointment with Dr. Warner to discuss my treatment options. Once again, he emphatically stated that I needed to have surgery.  His analogy (one of several he offered) was that ”I was sitting in the living room watching television while the house was on fire”.  Like  Dr. Liu, he said it was best to do the surgery while I was still healthy.   I still need to do some diagnostic testing before anyone will even begin to tell me exactly what the surgery will encompass. 

I was talking to one of my carcinoid buddies who is going through a similar situation in determining her need for surgery.  She went to a carcinoid specialist who told her she did not need an operation. That doc’s analogy was it would be “like killing the one cockroach you see in your kitchen but leaving the thousands of others to remain and continue to reproduce”. 

I guess doctors like to use analogies to articulate the rationale for their opinions. 

Dr. Warner asked why I had seen so many doctors. He stated that it would be easier if I settled on one so all the tests and procedures could be done in one place, in an integrated way.  I explained that my first doctor was entirely inappropriate, primarily due to his attitude. He was fine with Sandostatin and a “watch and wait” plan, but his arrogance and inability to communicate effectively with me ruined our working relationship.    I then went to Dr. Warner for an opinion and he sent me to Dr. Ratner, who works with him. I traveled to Tennessee to see Dr. Liu because that was where I could get the 68-Ga scan, which was unavailable locally. Dr. Liu also believed surgery was necessary.  Finally, I had a written opinion compiled entirely from my records.  This is from an organization called Best Doctors, offered as part of my healthcare benefits at work.  This particular opinion was from Dr. Edward Wolin in Los Angeles.  He did not think I needed surgery as long as I was stable on Sandostatin.   It’s not like I enjoy going to all these doctors but there seems to be some difference of opinion as to how I should be treated.  I told Dr. Warner that I need to gain some trust with a doctor before I do something as major as an exploratory surgery.  He seemed to understand that and said we should take this one step at a time. 

Personally, I have a fear of a big abdominal surgery due to the relatively recent death of a close relative from sepsis - 30 hours after a bowel resection for a non-life threatening condition.  

I will continue to work with Dr. Warner and Dr. Ratner on the diagnostics needed to determine the best treatment for me. The psychological issues and fear of death/collateral damage as consequences of an extensive abdominal surgery are big hurdles to overcome.  Stay tuned.

Tuesday, October 9, 2012


Wawona Sequoia Tree
El Capitan
Owen and I just spent the last eight days in Yosemite and Lake Tahoe, CA on vacation.  The weather and scenery was gorgeous and it was a nice respite from work and all these doctors and treatment thoughts.  As I’ve said before, getting away from the rat race, relaxing and enjoying our short time on earth is one of my favorite things to do. 

Half Dome
Yosemite was incredibly beautiful as we expected – crowds were low, probably due to its being off-season as well as the well publicized hantavirus that had killed a few tourists this summer.  Below are some pictures of the famous scenery there:  El Capitan, Half Dome and a Sequoia tree,  It’s hard to capture the size and scope of what we saw in these photographs.

We then went to Lake Tahoe and stayed in Stateline which is right on the California and Nevada border.  Lake Tahoe is gorgeous as it is a large lake surrounded by mountains.  The elevation here ranges from 6,000 – 8,000 feet.  This location is quite touristy as there are many hotels and restaurants on the California side and just up the block is the Nevada side that has a few casinos.  Close to Stateline is Emerald Bay, which is an offshoot of Lake Tahoe and several really nice beaches. 

Emerald Bay
Baldwin Beach
Tomorrow I am back to work and next week back to doctors to discuss if my current treatment of this disease needs to change.  I feel well rested and ready to face my current challenges.