Saturday, May 31, 2014

NETest Results

Last week I got my NETest results from Nancy Texiera.  My results were a level 3, which is in the low activity range of 1-4.  She explained that this a typical result for someone who has residual disease after surgery.  I have not seen the report yet but Nancy said she would send it when it is done.  She encouraged me and my fellow NY noids to come back up for our second test and she would have lunch for us.  If we do this at around the 90 day mark, that would be mid-end of July.  I wasn't sure what to expect from this test but the 3 makes sense to me given my situation.

Friday, May 30, 2014

The Cost of the Emergency Room

When I was in the emergency room at New York Presbyterian on April 15th -16th, I saw a few doctors, one of which was a surgeon named Dr. Kumar (not his real name). This doctor was the boss of all those pesky surgical residents who were so anxious to operate on my bowel.  I saw him just before he discharged me. On April 17th, there was a bill in my mailbox from Dr. Kumar for $550.  I threw it away thinking that this would be submitted to my insurance since he saw me in the emergency room.  Aetna, my medical insurance provider paid the following amounts for my overnight stay in the emergency room hallway on April 15th:

New York Presbyterian Hospital:  $13,095
Dr. Yong Ho Auh, radiologist:       $181
Dr. Elisa Aponte, ER physician:    $165

Total payments:                            $13,441

For whatever reason, Dr. Kumar's bill was sent to me separately.  I received another bill today in the mail stating that my account is past due and to avoid further collection activities, to remit payment in full.  Not to be a b*tch, but if a doctor sees a patient in the emergency room, shouldn’t his payment be part of that overall bill?  If not, shouldn’t he have asked me for my insurance information - like any other doctor would before he saw me?  Why should my credit be at risk for this obnoxious doctor behavior?  The only way for me to take care of this is to call their toll free billing number and sit on hold to get it straightened out.  Grrrr….like I have time to fight with the doctor over the bill while I am working 50+ hours a week and battling cancer! 

I probably should not have been, but I was shocked by the cost of this emergency room visit.  Considering that I did not even have a room, IV pole, nurse call button, privacy curtain, TV, pillow or bathroom, I find this kind of pricey.  On top of that wonderful experience, I now have to deal with Dr. Kumar’s billing issues.

Sunday, May 18, 2014

Updates and Interesting Article

Follow Up on Bowel Obstruction

I haven’t posted for almost a month.  I’ve been quite busy at work and with other non-cancer related activities.  I had an appointment last week with Nina, my nurse practitioner at Dana Farber, who explained what was happening with the bowel obstruction and what I might do about it.  The bowel obstruction occurred where the small intestine was resected during my surgery. The medical term is ileal anastomosis. She explained that ileal anastomosis is the area where the bowel was sewn together after the 100 cm was removed.  This area of the bowel is narrower than the rest of my small intestine because of the fusing together of the two pieces. There could also be some scar tissue or adhesions.  She said that this was not bowel ischemia or small intestinal bowel overgrowth.  The problem is due to the bowel resection surgery.  Nina suggested smaller meals, soft foods and chewing thoroughly.  I asked about determining when I need to go to the emergency room versus waiting it out. She said that it is ok to wait for perhaps 4-5 hours at home if I am not vomiting.  I should not eat or drink anything until it clears.  If it hasn’t cleared in that time, I should go to the emergency room to get intravenous fluids to avoid dehydration.  I asked about taking fish oil or massaging the abdominal area to help avoid another obstruction. Nina said that these things have not been proven to help but they won’t do any harm so go ahead if I want to try it.  The only way to “fix” this is to have another open surgery to resect the bowel again which will/might cause more scar tissue/adhesions.  That definitely does not sound like a good solution and I would only go that route if it were a life or death situation.  I’m hoping that it doesn’t happen again.
No Update on NETest

I have not received my NETest results yet.  I surveyed my fellow New York noids who went with me to get the test and one of them has received the results.  I’m guessing that they are ready and I will have an update next week after Nancy Texeira contacts me and sends the test results.
Two Year Anniversary of Beth’s Adventures with Cancer

This week is the two year anniversary of this blog.  Last year I hit 10,000 pageviews exactly on my one year anniversary.  Now I have close to 60,000 pageviews but I think some of them are spam.  I started getting spam comments right around the time of the winter Olympics. Many  of the spam posts came from the UK and France, not a usual source of my readers who are mostly US based. I don’t have a clue as to any Olympic connection. These seem to have lessened now and I think most viewers are people who are actually reading the blog. 
Since last year, I had the big bowel resection surgery and have had a rough recovery.  Eight months out from surgery I am definitely not back to normal.  I am at a new normal with a completely different metabolism and many gastrointestinal problems.  From an oncological standpoint, I am better with lower tumor markers and less tumor bulk but my quality of life has taken a big hit.  I haven’t decided if I am better off or not.

Interesting Article in “The Atlantic”
Finally, there is an interesting article in The Atlantic magazine called “Cancer Treatment as Comic Book”:  “Matt Freedman scrawled the pages of Relatively Indolent but Relentless as he underwent radiation therapy, with engrossing, surprisingly funny results.”  I have not read this book which is a journal with hand drawn comics about his cancer treatment.  It sounds interesting and I could relate to some of the comics that were in The Atlantic article. The link to the article is below along with two of the comics that I liked:


I can relate to both of these, particularly “two good years” comic.  I’ll have to read this book when I get some time. 
That’s it from me for now.  I think I’ll go outside and enjoy the nice sunny weather!