[conductr]

My wife’s hair thinned a bit too with chemo and she never got her eyebrows back. She been drawing them on for almost 10 years now.

I first felt the tiny lump in her breast and then she couldn’t find it. I had to nag her for a few months to go get it looked at. She just waited for her routine appointment which was 4-6 months after I nagged her. In hindsight, I wish I was more insistent as I think it could have been removed without needing chemo earlier on. She was early 30s, and at that age at least, she’s of the opinion the double mastectomy and reconstructive surgeries were a breeze compared to chemo.

I knew it was not good when I felt it the first time (in college I worked in a pathology lab, have handled a lot of cancers and I knew she had brca genetics) Who knows really if chemo could have been avoided but my point and learning was, you are with this person more than anyone, if you notice something and are concerned for them you need voice it and create action.

[linsomniac]

Glad your wife's treatment seemed to work out well.

I'm sure it was hard to watch your wife wait out the next Dr appointment. I have a friend and they decided to "pray the cancer away", and didn't seek medical treatment until there were skin lesions visible. The nurse at that appointment had to leave the room to vomit it was so bad. They went through surgery+chemo+rad and she's been in remission for a number of years now. So, even in fairly bad cases of waiting it out, there can still be good outcomes.

Definitely don't wait though. In my wife's case, they were confident that surgery would resolve it. But when they got in there, it was "acting weird"; it had grown much, much faster than it should have over that time. Initial diagnosis was stage 1, after surgery they called it stage 3+.

I had to do battle with the insurance company, because our company was changing insurance, with the new insurance becoming active 4 days before her scheduled surgery. We have a "benefits advisor" that always says "if you have any questions, ask us and we'll take care of you", but they've been fairly useless. In this case, they were telling us that we needed to wait until we had the new insurance cards, which would happen sometime within a few weeks after the new policy became active, then we'd have to submit for pre-approval, which could take another few weeks. And the specialized surgeon was scheduling like 6 weeks out...

We eventually found that we could personally guarantee payment, and the doctor was confident that insurance basically never denies coverage in situations like ours, so we went ahead with this course and got everything paid for. Which was good, because as I said, the cancer was "acting weird" and in the 2 weeks between initial location of the growth and the surgery that we were lucky enough to be able to get in due to someone else needing to reschedule, the growth doubled in size. Another 4-8 weeks very likely could have resulted in spread to the lymph nodes and much worse outcome.

Another moral of the story: Don't let the insurance company push you around. With cancer, time is always of the essence.

[conductr]

Glad you wife’s outcome was good as well.

When it’s cancer, you have to move quick. I knew that from my experience in the clinical setting. That was over 20 years ago now but I still remember when a biopsy or specimen tested positive they’d want to know STAT and would then be calling the patient back in to discuss options immediately. The OR schedule would change to accommodate new cases and such. Outside the ER and Code events, most things in the hospital seemed to move slow especially the outpatient stuff. But as soon as C was involved doctors everyone wanted everything done yesterday.

It’s a good point on insurance as that’s the most common delay/blocker from how doctors would want to proceed. My wife’s young age (denser breast tissue) required a special type of imaging to detect. Insurance didn’t want to pay for it and it was something like 20x more expensive than the normal type. We went ahead and paid, thankfully we could, and her oncologist fought with the insurance a bit about why he justified it. Eventually we got reimbursed. The doctors apparently used her case to help build a new insurance-approved standard for imaging of young high risk patients, which is pretty cool byproduct of our stress.

It was a similar scary high growth type cancer, between the time the imaging was confirmed and a week or two later when it was surgically removed it had growth from 1.8mm to 3.5mm diameter. Which was still considered extremely early detection from what we were told. If she was not already aware of her brca risk and seeing an oncologist annually, it might have been much larger and likely metastasized possibly in the lymph nodes by the time it was discovered. Scary stuff, you guys did the right thing acting quickly for sure. I spent a good portion of my career in healthcare finance, and see how decisions are made regarding capitalistic agendas and have experience the patient side of these decisions as well, needless to say I’m strongly in favor of socializing healthcare and even removing the profit motive entirely. Some things shouldn’t be investments. It bothers me that all those against it are just ignorant to the existence of these kinds of issues and have been fear mongering. I think we have current resources to “do it right” if we put the proper thought and execution into it.

[linsomniac]

The proposal of making smaller healthcare groups so that healthy people aren't paying for sick people to make it more fair is exactly the wrong direction to go as a society, IMHO. And I say that as a person who has spent fairly small amounts over my life. We can basically guarantee that with the exception of early, cheap deaths, that everyone is going to need healthcare. Spreading it out among everyone just makes sense to me.

[conductr]

I'm of similar opinion. Tying it to employer makes no sense in our current world. People change jobs all the time. And I've seen boardroom decisions where we decide not to cover a drug on insurance because only 1 person takes it and it is very expensive and we only employ 100 people. Meanwhile, we all know damn well exactly who that one person is. It's Pam down in Accounting, she's open with her battle with MS/Cancer/etc. And, that's not insurance! The fact that it's done by CIGNA/United/etc who has millions to spread it across and the risk should have been baked into the rates we already were paying. It's just maddening.

I had to get out of Healthcare altogether after COVID and the Boardroom conversations I was a part of. The worst was we wanted to close ICU's because uptick in nursing labor was making profit margins lower than usual, never mind the fact we had a ton of cash on the balance sheet the government had given us for emergency funds - I luckily was able to win that battle and we remained open - but yeah, hedge fund owned ICU's during a pandemic...

[linsomniac]

Plot twist, my wife is an RN and she dropped out of nursing a bit before COVID because of similar shenanigans from the boardrooms: too many patients per nurse, not enough CNAs per nurse. Add to that patient families being jerks.