Medical Update -- Xeloda vs. Taxotere

I tried to bypass the trip to Tel Aviv.

I emailed the oncologist and received an answer from her. She recommends Xeloda and Herceptin.

Because Moshe wanted an uninfluenced opinion, I sent her the minimal amount of information necessary to form an independent opinion. But now I had more specific questions.

I emailed her again, but did not receive an answer. So I called her with several follow up questions.

She was in the middle of seeing patients, so she was not available for a lengthy discussion. I managed to ask about Taxotere, and she repeated her recommendation to switch to Xeloda.

I wanted to ask her more questions, but she did not have the time or the patience. I asked if there was another time that I could call her. She was noncommital.

That is the only thing that I do not like about this doctor. The only way to consult with her is to come in person. It seems to me that we should be able to have a short phone consultation for relatively simple questions or, at least, a short correspondence via email.

It is clear that the only way we are going to receive satisfactory answers to all our (read: Moshe's) questions is to go in for a consult.

Moshe really wants to do this. I really do not want to. This is so ironic. I am going for him, and he is going for me.

Either way, we are both going to Tel Aviv tonight.

All I want to do is sleep. I forced myself to stay awake to call the oncologist when the secretaries said to call. (Then I had to argue with the secretary until she put me through, and then the doctor did not even really have time to talk with me!)

Now I can't sleep because I have to get ready to go see the doctor, because she did not have time to answer my questions over the phone, and she would not commit to talking with me later.

Oh, yeah, and did I mention that we had an appointment for 8:30 pm, but they moved us up to 7:30, which is NOT a good time for us?!?! (I hope I can sleep in the car!)

I am really trying to stay focussed on how important this is to Moshe.

I wish my two doctors would just talk directly with each other.

I am really inclined to take the Taxotere, for all the reasons I wrote in my previous post.

Moshe asked that I do not decide anything until I speak with the other oncologist. I am trying, but it is difficult.

Now, in addition to not wanting to spend the time or money getting this second opinion, I am worried that it will cause even more strife if Moshe and I do not agree on the next course of treatment.

...as if I did not already have enough stress in my life!

I HATE having cancer!



Please daven (or send happy, healing thoughts) for RivkA bat Teirtzel.

With love and optimism,
RivkA

Anonymous Angels

Tomorrow, I start Taxol.

I am anxious about the side affects. But there is no way to know how I will react.

I am trying to remain open-minded and relaxed. Easier said than done.

Nevertheless, what will be, will be.

I will also be receiving Herceptin. Tomorrow is the latest that I can continue taking Herceptin, without needing a "loading dose." My health fund, Maccabi, denied our initial request for coverage.

I am putting together an appeal, which we will send to the ombudsmen of Maccabi and the Health Ministry.

Meanwhile, some anonymous angels are taking care of me, and making sure that I get what I need.

My regular dose is 570 mg, and Herceptin comes in 440 mg bottles. So I need two bottles tomorrow. Leftover Herceptin can be used for up to 4 weeks. So, in three weeks, I will need only one more bottle. Essentially, I need 3 bottles, for every 2 treatments. Each bottle costs 11,221.85 NIS (approx $2,805). (Herceptin costs even more at this government approved pharmacy, which sells drugs that are not covered by the health funds)

Several years ago, when I had the opportunity to purchase private insurance covering medications, I decided to forego that added expense. After all, I thought, how expensive can medications be?

Little did I know....



Please daven (or send happy, healing thoughts) for RivkA bat Teirtzel.

With love and optimism,
RivkA

Chemo Day

On Tuesday, Sept 22, I came late to chemo. My friend had a son, and the brit was that morning.

I called in advance, and both my doctor and the head nurse approved the late arrival.

We agreed that I would arrive by 11:00 am, and that I would call earlier in the morning, to remind them to prepare my prescription.

I forgot.

Well, I remembered at 7:30 (too early to call), and forgot at 9:00 (the right time to call).

It happens.

So, they ordered my prescription when I arrived, at a quarter to 11:00.

The delay might not have made a difference. That day, there were several prescriptions which were delayed for unknown reasons.

Unfortunately for me, the delay would have significant repurcussions. I was scheduled to get all three drugs that day: Herceptin, Navalbine, and Zomera/Denosumab.

I was also scheduled to get a full-body x-ray for the bone drug study, but that was not such a big deal. I was able to get the x-ray while I was hooked up to the Herceptin IV.

The Herceptin took a long time. If the drip is too fast, I have an allergic reaction (pain in my chest, as if someone is squeezing my sternum).

At 3:30, one of the nurses informed that if I did not finish by 4:00, I would have to return the following day, for the remainder of my treatments.

On several occasions, over the past few months, I finished receiving my treatments around 5:00 pm. So I did not understand why she insisted I return, when I would be finished by 4:15 or 4:30.

The doctor on duty approached me, and explained (rather harshly) that it was her responsibility to be there while patients received their treatments, and she had to leave by 4:00 (since she had a clinic across town).

I was quite taken aback by the hostile way she spoke to me.

Though I was not the only patient still receiving treatment, she scolded me, saying "because of you, I cannot leave, and all the patients at my clinic will be treated late!"

I understood her time constraints, and appreciated the fact that she did not want to keep her patients waiting.

Still, she could have said "I understand that it is disappointing, and inconvenient. I am sorry, but there really is no other choice."

She was completely insensitive and unsympathetic.

The nurse on duty saw that I was distressed, and offered to leave my port open, so that I could come to the hospital in the morning, get hooked up right away, and finish quickly.

I appreciated her attentiveness and consideration.

The next day, I discovered that there were further consequences from the delay.

I would not be able to have my next treatment the following Sunday, before Rosh HaShanah, as originally planned.

I dreaded the thought of coming in on the Thursday after Rosh HaShanah. I knew the ward would be swamped after being closed for three days. Moreover, I would be anxious about finishing in time to teach swimming. And, I did not know if I would be able to teach, since I am extremely tired and worn out by the time I get home from chemo.

My doctor, and the head nurse, agreed that I could come in on Sunday (today) for the next treatment.

Well, if I thought the ward would be any less crowded, I was sorely mistaken!

This time, I was instructed to arrive late. I was only getting Navalbine, so it would not take that long.

Hah!

I arrived around 10:30 (instead of the usual 9:00).

It was a madhouse!

It took almost three hours for the pharmacy to deliver the drugs and for the nurses to hook me up. It usually takes one hour; on rare occasions, an hour and a half. But never THREE hours!

By the time I finished, I was completely finished!

I really wanted to go straight to sleep when I got home, but Moshe had to work late, and I had to be around for the kids.

It ended up being a late night for all sorts of reasons....

At 10:00 pm, my phone rang.

"Why are you up?" asked the caller.

I was not certain how to answer him, since I was exhausted and wondering the same thing myself!

My doctor, God bless him, was calling to check up on me.

He had sent me, via email, a referral for a bone scan, and he wanted to be certain I received it.

10:00 pm and he was still working!

Have I mentioned recently that I really appreciate my doctor?

Anyway, now, finally, at 11:30 pm, the house is quiet and I can go to bed.

I am nauseous and itchy, thanks to the chemo. Hopefully, that will pass.

Meanwhile, I am not looking forward to my next chemo day... next Sunday.

As one of the nurses said "days like today make one wonder if the chagim (holidays) are worth it!"



Please daven (or send happy, healing thoughts) for RivkA bat Teirtzel.

With love and optimism,
RivkA