Hey...I Benefited from the Health Care Bill !

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Over the last few weeks, I had been bantering with my Preferred PPO Health Care Plan about payment for my upcoming Breast MRI. I had been told that in order for the PPO to pay, they needed a current inconclusive mammogram. (I won't rehash the idiocy of the logic, in light of my present diagnosis and determinative tests that were needed to confirm same a year ago. For those gory details, refer to blog entry dated September 23, 2010.)

As we parried and thrusted on the issue of coverage, the Health Care Reform Bill took effect. Voila! This past Monday I was on the phone again for round four with the insurance company (the MRI was scheduled for the next day). Before I could get my vocal chords warmed up I was met with: "Ms. TC, we were just going to call you. We have looked into this matter and of course since it is medically/diagnostically necessary in light of your condition we will most certainly be covering the MRI. We are insurance administrators, it is not for us to determine what is medically necessary for you. If your oncologist has determined that the MRI is a medical necessity, then all she needs to do is put in the correct diagnostic code and it will be covered. Our apologies if there has been any confusion on this issue. Again, medical necessity is determined by your physician, not us."

WOW!!!! No kidding, no sarcasm...the above narrative is as true a retelling I can provide without a court reporter!  The only "change" or intervention that had occurred between my September 20 conversations with Blue Cross/Blue Shield and my September 27 conversation was the implementation of the Health Care Reform Bill. Yes, I had been doing my best B.O.W.* impersonation. I do not flatter myself with having been the cause of their change of heart (or profit ledger).

So there you go. Now if only they would have taken the blasted test for me it would have been a truly wonderful thing!

* B.O.W. = bitch on wheels

Her Friend...

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Dear "Her Friend." Please forgive me for my impulsive presumption to share your expressions on my blog. They are so honest. One of the more honest things I have heard or read from an involved spectator. So much so that I felt compelled to memorialize them as part of my personal (public) journal. Your honesty empowers me. Thank you!

Her Friend...we just found out yesterday that it is HER2 invasive ductal carcinoma. I say "we" because she is such a huge part of my heart and life that I really feel like this is happening to both of us. I'm angry about so many things.

I'm angry that she has to go through the worst part, when it should be me. She, like you, has always been the healthy one...organic, vegetarian, non-smoker, nature lover, etc. while I always do everything "wrong". I only quit smoking a year ago (except during the breeding years) when I was forced to in order to donate. For years and years she has been nagging me about all the things that are bad for me.

I'm angry that I can't be there with her for every doctor appointment and treatment, etc. because she now lives 2 hrs away and I have to work a job I hate for a man I hate even more.

I'm angry this disease is threatening to take my best friend away from me and there is no other person in the world who knows me like she does.

I'm angry about things I can't even articulate. I'm just angry.

And then I feel guilty because it feels so selfish to be angry. After all, it's not my body, it's her body. It's not my life being threatened, it's her life.

And now I feel guilty for ranting to you, when you are having to live with this fight every day.

This sucks!

=============

TC...Cancer sucks chica -- for everyone. Be angry. Be confused. But do not indulge in guilt. Feel. Face and embrace all those emotions and own them. Have a glass of wine. Have a smoke, if you need. Then get off your arse, get empowered, and let your BFF know that you are there in any way she may need -- which may include giving her some distance.

I truly believe that cancer sucks more for those whom we love that are the spectators. I found a bizarre...surreal, actually, clarity in being forced to confront my immortality. It is stifling and liberating at the same time. Help each other find that clarity.

The Dichotomy of the Cancer Industry...the ongoing saga..................?

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Dichotomy – splitting into two polarized groups; opposed by contradiction; differentiated between practice & theory

It is that time for me to get the full work up and see where I have been. The breast MRI. It gives the ONC a hindsight snapshot, allowing her to peer into what my boobies have been up to this past year.

The breast MRI is the annual gig. The PetScan is done bi-annually to see if those bugger cancer cells have decided to nest anywhere else in my ample frame (I am 5'1" ...almost; and 103 ...on a good day).

Here's the issue. I am being told (and by no means am I willing to take this as the definitive last word) is that my private PPO health care plan will most likely not pick up the tab on the MRI unless a mammogram demonstrates its indicated. That in itself would not be unreasonable ...except... (and yes, here it comes) IT HAS BEEN AND STILL IS MEDICALLY RECOGNIZED THAT MY CANCER (ILC) CANNOT BE DIAGNOSED WITH A MAMMOGRAM!

To add insult to the idiocy, a mammogram would unnecessarily expose me to radiation (and radiation is bad). The form pushers at the PPO, however, are saying that they need the "inconclusive" mammogram (again) prior to authorizing the MRI (note, this thinking does not take into consideration what I, as the patient, needs). The inanity (I am so liking the "i" words today) is that the MRI facility says that this is not uncommon (the paper pusher garbage that is) and they typically schedule the mammogram 1/2 hour before the MRI and then there is no delay, both are paid for, and I can be on my merry way...having been exposed to an unwarranted dose of radiation (that may ultimately result in...?) and costing the insurance company more $$$...all so the proverbial boxes can be checked.

If I cannot win this current pissing match regarding my OWN health care? Well, it appears that by insisting on doing what is medically required, and no more --- i.e., outside the parameters of protocol, the price tag for my independence would be $1800.00 out of pocket.

Random Thoughts from the Heart

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You know I can't let you slide through my hands

Wild horses couldn't drag me away
Wild, wild horses, couldn't drag me away

I watched you suffer a dull aching pain
Now you've decided to show me the same
But no sweet, vain exits or offstage lines
Could make me feel bitter or treat you unkind

Wild horses couldn't drag me away
Wild, wild horses, couldn't drag me away

I know I dreamed you a sin and a lie
I have my freedom, but I don't have much time
Faith has been broken, tears must be cried
Let's do some living after love dies

Rolling Stones

Kindly...STOP Waving the Pink Ribbon in My Face!

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Dichotomy – splitting into two polarized groups; opposed by contradiction; differentiated between practice & theory

As I was pulling into the home driveway yesterday evening I got a call on my personal cell displaying an unfamiliar phone number. It had already been a confusing day. I had just arrived 10 hours prior from an emotionally charged 5-days in New England, and had spent the day dealing with myriad of “high octane” feelings. I thought when you “left your heart” in a distant geographical location the sensation would be that of a gaping hole in your chest wall. For me, since Sunday and my departure from N.E., my chest wall is exploding! I can’t catch my breath. Indeed, I almost feel like if I were able to I would erupt on the exhale.

But I digress. Back to the unexpected call and the unwitting caller...

A very chipper voice on the line greets me with “Hi Tamera! This is Janice. Janice? I am so excited to share with you that we will be shortly getting in our Pink-Ribbon Breast Cancer Survivor Bracelets and we are taking pre-orders. I didn’t want you to miss out!” Well OMG my arse! “Janice, darling (I have a BFF who uses “darling” to refer to nearly everyone. As a slang-word junkie I thought I would try it out myself in discreet situations – like when it would not be appropriate to verbally rip someone a new one). . .Janice. as a SURVIVOR let me tell you that although I so appreciate your thoughtfulness, not to mention your exuberance, I would not order, pre-order, purchase, gracefully accept, adorn myself or even consider giving as a gift to my nemesis a ghastly pink-ribbon doo-dad. If I wanted to broadcast my status, I would sew a yellow star to my clothes; embroider a scarlet C on my chest; or indulge in word-vomit all over a self-published blog. Obviously I have chosen the latter. Thank you very much." Janice came up with at least 17 different ways to sputter out an apology. Poor darling – I probably was a tad harsh.

For those of you who have traversed my path through the maze that is breast cancer, you may recall my vehement disdain for the Pink Ribbon Industry that has capitalized on raising awareness (like who has not heard of it) of breast cancer by merchandising, packaging, and marketing breast cancer as PINK & FLUFFY!!!!!!

It is not.

Realistic adjectives for breast cancer are: slice, dice, slash, burn, disfiguring, painful . . . in short not a heck of a lot of fun.

So, as the retail market enters their nauseating month of pink satiny ribbons, fluffy pink beanie babies, shiny bracelets and sport hats & Ts that color Breast Cancer Awareness Month, please remember “THINK BEFORE YOUR PINK” and check out bca.org

Something to Ponder ... and to Take Action About

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The following was forwarded to me by an informed & educated individual. My visceral reaction was: environmentally induced early puberty could very like result in development of breast cancer...and in our younger daughters !!!!! ???????? What the hell is our species thinking??? or not thinking about ????

A new study shows that early puberty in girls is on the rise. Our children deserve better!

Tell your members of Congress to co-sponsor an update to the Toxic Substances Control Act (TSCA)!

Take Action - http://action.momrising.org

I had to do a double take last month when I read an article about new research in the Journal of Pediatrics showing that more than one in ten girls are starting to develop breasts by age seven, with even higher rates in some communities. [1]

Seven year old girls should be able to focus on playing with friends and learning to read, not having to deal with the complex physical and mental effects of puberty.

Tell Congress to protect the healthy childhoods of America's children by co-sponsoring an update to the Toxic Substances Control Act (TSCA)

What does updating the Toxic Substances Control Act (TSCA) have to do with preventing early onset of puberty?

One of the many contributing factors to the rise in early puberty is that young children are exposed to dozens of potentially toxic chemicals on a daily basis. In fact, endocrine disruptors, which are chemicals that mimic and interfere with hormones, show up in a wide variety of everyday items including: household cleaners, air fresheners, cosmetics, canned foods, and school supplies. These endocrine disruptors can cause the early onset of puberty. [2]

Updating the Toxic Substances Control Act (TSCA) is crucial to the health of our kids because, currently TSCA lacks a requirement that chemicals be tested to assess their ability to disrupt hormones. This means that many of the chemicals we encounter every day have never been tested for safety. In fact, since the passage of TSCA in 1976, the EPA has required testing of less than 1 percent of the chemicals in commerce!
The TSCA update would require chemical manufacturers to provide basic health and safety information for all chemicals as a condition for staying in or entering the marketplace. It would also, for the first time, make that information public. [3]

It's time for us to take action and support updating TSCA. Our daughters deserve better! The physical and mental ramifications of early puberty are substantial. Girls who begin puberty at an early age are more likely to experience low self esteem, poor body image, and depression. Physical side effects include an increased risk for breast cancer, endometrial cancer, and elevated blood pressure.

This September, our children need more than just new school supplies:
They need new toxics legislation to protect their growing bodies.

Tell your members of Congress to co-sponsor an update to the Toxic Substances Control Act (TSCA)!

Early puberty is just one of the many frightening health effects which can be caused by exposure to toxic chemicals. Our broken chemical screening system also puts our families at risk for cancer, learning disabilities, infertility, and more.

We can't protect our kids and families from toxics without updating legislation like the Toxic Substances Control Act (TSCA).

Please forward this email message on to your friends and families so they can take action too.

Here's that action link again so you have it handy:
http://action.momsrising.org/go/NewTSCA1/360?akid=2306.214299.hZRBv8&t=6

Together we are a powerful force for families,

Kristin, Claire, Joan, Anita, Mary, and the whole MomsRising Team

[1] "Some girls' puberty age still falling, study
suggests": http://action.momsrising.org/go/361?akid=2306.214299.hZRBv8&t=8
[2] "Pubertal Assessment Method and Baseline Characteristics in a Mixed Longitudinal Study of
Girls": http://action.momsrising.org/go/362?akid=2306.214299.hZRBv8&t=10
[3] "Recent Findings on Early Puberty in Girls Highlight Urgent Need for New Chemicals Policy":
http://action.momsrising.org/go/363?akid=2306.214299.hZRBv8&t=12

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