September-19-2007

13 days and still swinging

Hello to everyone!!!

Fall is in the air in Virginia and it is getting cooler! I can't wait for the leaves to change, to go apple picking, and enjoy the seasons changing. A LOT has changed in the last week, so I figured I would update everyone! First of all, I want to thank every person that has taken time out of your week and called me and/or written very thoughtful emails. I apologize that I ha-vent been able to write and call back right away, but I plan to! I am overwhelmed by the amazing support and words of encouragement, thank you!

The most important thing to mention before sharing my "road blocks" with you is to express how amazing it has been to watch God take control of this situation. Yes, the news is unfortunate. But ever since Sept 6th, it seems like great things have been happening in my defense...getting the best of the best doctors every place I go, the fertility doctor waiving his fees yesterday, the stories I am hearing from others who have been in my shoes in their life, etc. So first things first...Thanks to God! I am realizing my potential to impact others' lives and that brings me so much joy.

To catch you up on my treatment options, I went to see a surgeon at Anne Arundel Medical Center (Dr. Tafra, chief of breast surgery), who Sloan Kettering referred me to. I was hoping to be reassured about the treatment plan of mastectomy first followed by chemotherapy. However, when I got there, Dr. Tafra had a very strong counter plan. She suggests chemo first. The reason is that tumors react to different chemo agents better than others. If I leave the tumor in for the time being, the doctors could judge how effective the drugs are based on the tumors response. If the tumor shrinks, good drugs. If not, they can switch agents before causing toxicity in order to get a better response. If the tumor was removed first, they could not judge the effectiveness of the drugs and it would be a guessing game. This is very important at my age because if there was a spread of cells somewhere, using the right drug is crucial for recurrence rates. This method is called "neoadjuvant chemotherapy" and is all over the research lately. MD Anderson in Texas has been doing it successfully for 30 years. The problem is that now I am confused! Do I believe the #1 place for cancer, Sloan Kettering. Or do I go with the stronger sounding argument? Please pray about this for me and offer any knowledge any of you might have on the topic! I believe God will open a door for me clearly, but it is still a hard decision!

The most frustrating thing so far has been my battle with insurance. I have Kaiser insurance and they have only treated 3 people my age in 30 some years. Because of that (and the fact that their plan makes absolutely no sense compared to these two), I decided to try and get approved to go out of network. Everything has been out of pocket, but Dr. Tafra does take Kaiser. If I could convince Kaiser that the treatment I need is over their head, and get a referral approved, then I could get treated elsewhere with 50-70% coverage (compared to 0%)...good old HMOs!!! My primary care wrote a referral in my defense and it was denied. Then I did an expedited appeal, which was also denied. Now I am at the state level, trying to file a second appeal. Please pray that Kaiser sees the need for me to be treated at an academic institution and grants my referral!

My plan for the next few days to a week includes a bone scan, a PET CT scan, seeing an oncologist (hopefully at Johns Hopkins), fighting with insurance, working with the fertility doctor to see my options, and having fun! Pray for me please during all of these steps!

I know that this update has a lot more prayer needs, yet I believe in the power of prayer and God has shown me how great He is so far! Other than this whole cancer thing (hah), I feel great! I switched to a completely organic diet and have been exercising more to get strong for my big fight! The weather has been beautiful so I have been fortunate to play football, horse shoes, grill out, etc with all of my friends and Ben. Thanks again to everyone for the incredible support! I am one lucky girl!

Jami :)