Did April Fool’s Day Come Early This Year?

Last month, I spent a night in the hospital after a liver embolization.  I stayed in a very small double room with a roommate.  Recently, I got an explanation of benefits from United Healthcare, my secondary insurance (see below).  Note that the amount billed for one night at Memorial Sloan Kettering Hospital is $55,746.78!  Who bills that amount for a one night hospital stay? 

Do you think this is a typo?  I know NYC rents are rising fast but this is ridiculous!

Second Time for Bland Liver Embolization

Wow! It’s been a while since I wrote a blog post!  Since my last post in August, I had another CT scan in November that showed that the group of tumors in the left side of my liver had grown from an area of 6.8 x 1.7 cm to 8.3 x 2.2 cm.  This was not one tumor but a group of about 10 smaller tumors.  My doctors said I should do another liver embolization - on my left side this time. This procedure was set for December 5^th.

I knew this was coming and was glad to have had about 5 months between embolizations. The procedure was similar to the one I had on July 15^th but I spent less time in the hospital.  The pain was worse from the recent embolization, probably because the tumors in my left side were much more concentrated in one area.  That’s my theory, anyway.  I felt better in about 3 weeks and was reasonably healthy for Christmas and the New Year. 

My January 7^th post-embolization CT scan showed that the tumors on the left side of my liver had shrunk and were mostly dead (“necrotic”). There was a tumor in the middle/right segment of my liver that was embolized in July but still had some living (“viable”) tumor showing on a CT scan.  My interventional radiologist revisited that tumor in my recent surgery to embolize the areas that were not being fed by the hepatic artery.  Unfortunately, he was not able to completely “kill” that tumor and that’s why there is still some viable tumor there.  Overall, my doctors (interventional radiologist and oncologist) were very pleased with the results of the procedure.

My “syndrome” which had consisted of very occasional flushing has completely disappeared.  I stopped taking Sandostatin LAR in January 2016, prior to my PRRT clinical trial and have not resumed since.  My doctor and I have discussed whether I should stay on a somatostatin analogue since I don’t have syndrome and my tumors have already progressed while on Sandostatin LAR. These are the issues that came up:

• Patients who don’t take Sandostatin LAR have a higher incidence of carcinoid heart problems.  My doctor ran an echocardiogram and found that I have no evidence of any heart problems
•  My tumors started progressing in late 2015 so I’m not sure whether Sandostatin is still helping them grow “less fast” or not. My doctor doesn’t know either.
• I do not have “carcinoid syndrome” at all right now
•  Sandostatin LAR has always caused me icky side effects – mostly gastrointestinal - that make my life miserable

After reviewing the above, we both agreed that is was ok for me not to take Sandostatin LAR. 

At this point, my tumor load is quite low with only smaller tumors located in inoperable places.  I am in “watch and wait” mode for 3 months until I have another scan. I hope 2017 brings me more stability and fewer medical procedures!