Life After Cancer: The Expensiveness of Life

I think I pay a pretty decent amount of money for health insurance and since it is required by law you would think that having insurance would be helpful to receive the care you need to live a healthy long life.  But that doesn't seem to be the case.  My medical bills are going to put me in the poor house.  I wish I was joking or being overly dramatic, but I am not.

For those who suffer from long term medical issues, health insurance and medical bills consume your life.  If you are not on the phone arguing with the insurance companies to pay for things they should then you are on the phone with the billing department of hospitals/clinics trying to organize a payment schedule and plan for the massive amounts of medical expenses that you have accrued throughout the year.

For me personally, I have a $750 deductible and a $3,500 out of pocket expense to reach before my insurance is really any help.  Who has that kind of money just laying around these days?!  I know I do not, not with student loans and life expenses.

It has been a rough year, financially.  But then again, every year has been this past decade.  Every year I keep thinking that this year will be different; I won't accrue anymore medical bills or spend my savings on an Emergency Room visit.  Yet, each year something happens and I watch as all that hard earned money that I had been trying to save up vanishes in a blink of an eye.

To make matters worse, when I looked into getting financial assistance with medical expenses I found out that on salary alone my husband and I made too much money, just barely over the maximum amount of income that qualifies for assistance.  This is heartbreaking news when you think that every year is going to be like this.  Every year I will be shoveling out over $4000 in medical bills.  That scares me, and that is just for in network expenses.

How is this affordable health care?  I should not be this terrified and stressed about medical expenses day in and day out.  I do not even want to open my mail anymore because I know that I will just stress over how to pay the new bill.   But I know that because of my health, and the permanent effects cancer and the treatment for cancer had on my body, that this is my life.  My life is unaffordable.  No one should ever have to feel this way.

I fought like hell to keep my life because I wanted to experience all it had to offer and I have truly enjoyed every day that I have had so far, in one way or another, and I look forward to the many more days to come, but to know that each year is going to possess a financial burden that will always be hard to overcome is honestly disheartening.

As some fellow people in my world have already pointed out, it could be worse.  Yes, I am well aware that the expenses could be worse if my insurance was different or I had no insurance at all, but if you factor in the rest of life expenses, $4,250 is still a lot of money to spend on an annual basis in addition to the amount that is already paid toward having insurance.  I know that it is a lot better than $20,000 or $100,000.  I really do not need to be reminded of this.  But not only is this an issue for me, but for many more all over.  If I could get by without having to go to the doctor, as most of my fiends and family know, I will do whatever I can to avoid going in, but there are many appointments that I cannot avoid.  Each one comes with a rather lengthly list of expensive tests.  If I knew this would not be an annual thing then I probably would not worry as much or mind, but it is not something that I cannot think about.

Being a very money conscious person the way it is I tend to not do a lot of extra things that cost money and out of respect some of my friends have excluded me from their activities because they do not want me to feel obligated to spend money.  That just makes me feel left out and lonely, two things that I have already spent too many years feeling while going through cancer treatment.  If you cannot afford to do anything and your life basically consists of going to work and coming home, is that really a life?  Are you really experiencing what life has to offer or are you just existing, barely?

Birthdays Are A Blessing

Some people freak out when they reach a certain age, more specifically for this post I am talking about turning 30.  I always wondered why.  Maybe they break down because they are not at the point in their life or they do not see themselves where they wanted to be when they turn a certain age.  I can not help but be reminded of the Friends episode when Rachael turns 30 and freaks out about it and starts thinking about where she wanted to be by the time she turned 30 and realizes that everything was going by quickly, or when Phoebe realized that she lost a whole year of her life because she thought her birth date was different than what she knew and she had not completed her list of things to do before turning 30.

As I am quickly approaching this age mark, August 29th (today, eek), I am not worried at all, nor do I worry that I am not at the point in my life in which I wanted to be by the time I turned 30.  

I have done a lot with my life before now and I have had a lot happen as well.  The one thing I think of right now is that reaching 30 is a blessing.

At the age of 19 I was diagnosed with Acute Myeloid Leukemia (AML) and during treatment I almost died multiple times.  It was scary and all I could think was that I was too young for this and there is so much more I want and need to do in and with my life.  My other thought was that I could not leave my family like this.  So, I fought hard every day and night.  I made it through several more difficult times and was in remission.

Slowly, I started getting my life together and was enjoying it once more and appreciating all of those small things that mostly go unnoticed.  I decided to travel abroad and as much as I could, carpe diem, so to speak.

However, after signing up and making my deposit to travel to Morocco to ride camels in the Sahara Dessert and explore the world, I found out that my leukemia relapsed.

I was angry.  Mostly because I knew that the relapse meant more intense chemo and a bone marrow transplant, which were still rather new at that time.  Also, I knew that finding a marrow match was extremely difficult because of all the markers they had to match for it to be successful.  At this point I was unaware of stem cell transplants and how they worked, etc.  What I knew was that the fight was going to be longer and more difficult than the previous.

This round of treatment was even more dangerous because every cell has to be killed, all the good and the bad, more so than with my first instance.  I needed full body radiation to help kill all the marrow in my bones so that the new marrow, or in my case stem cells, could be injected to create a whole new marrow production, so new that it can and will change your blood type to which ever donor’s cell blood type happened to be.

This was dangerous and scary because without platelets there is no way to stop the bleeding if it were to happen, which did happen the first time going through treatment and was one reason I almost died that first time.  Also, without and immune system there is no way to fight off an infection, which also almost killed me the first time around as well.  But this time was even more intense and dangerous since I would have even less of an immune system, even less platelets, less blood cells.

I made it through the second time after fighting death several more times and being diagnosed with severe osteoporosis and a very rare, and when I say rare I mean rare, as in at that time only 5 people in the world having the same diagnosis/disease.  Pulmonary Veno-Occlusive Disease (PVOD), which does not have a very cheery prognosis.  Most of the people diagnosed with PVOD, or rather all since it was such a small number, only lived up to 5 years after diagnosis.  This disease, if you could not tell by the name, affects the heart and lungs and makes the heart work harder to pump blood through a person’s body and reduce the amount of oxygen received in lunges and other organs.  It is progressive disease causing harm to organs over the years, which is why survival rate is low.

Considering all I have been through medically, and everything I have done since, graduating with an undergraduate degree in Psychology and Human Services and receiving a minor in French, as well as studying abroad in both France and Morocco, also visiting Canada a few times and London, and traveling within the U.S. to Seattle, Florida, New York, Illinois, Nebraska, and all the states between Minnesota and Florida on an awesome road trip with 2 amazing friends to vacation on the ocean for 2 weeks; I really cannot complain about where I am in my life.

Thus, I feel achieved and hope that on my 30^th birthday in a few days I will not freak out about my age.  I am sure that it will be like any other day and I will mostly be happy for just being alive 8 years after being diagnosed with a progressive disease that has only a 5-year life expectancy after diagnosis.

All this feels like reason enough to not be worried about turning 30, but I guess I will not know until the day comes.  I guess no one does, which is why they tend to freak on their day of birth.

Life After Cancer: The Impossibility and Yet Possibility of Having Children

Some people grow up knowing that they want to have kids when they get older and others don't think about it, or at the time believe that they do not want kids later in life. I grew up believing that I never wanted kids. I just never really saw myself as a mother. Later on I thought that if I did have kids I would like to adopt at least one of them because there are so many children looking for good homes. But lets face it, I was young and had so many things that I wanted to do before I would even consider having little ones running around. 

You never know how your mind will change throughout your life, so learning that I would never be able to have kids of my own physically at the age of 19 did not cause a great deal of turmoil at that time. In the moment I was more concerned with trying to stay alive than anything else. One of my next posts will talk more about why I can no longer have children but I need to at least briefly explain parts of the reasons with more details later. One of the reasons was during my consolidation therapy I had a major complication and had to be put into early menopause to prevent similar future complications. The second reason was due to total body radiation that I had to go through before I had my stem cell transplant, and the third reason has to do with a rare disease involving my heart and lungs, which I developed from a complication from graph vs. host disease after my stem cell transplant. All of these contribute to me not being able to have children of my own. 

Even though I did not think that I wanted children at that time in my life there was no way to know that at some point I would meet someone with whom I would want to have a family. Knowing that it was already impossible to bear children and constantly having a doctor, one with whom I have to see every six months repeat to me that it would be dangerous for me to get pregnant, makes it even harder now that I would like to have kids. It is frustrating to repeatedly have to tell a doctor that you see regularly that there is no biological way to become pregnant and having to explain why when they should already be aware of that makes the situation more difficult. 

Another tough part is that recently (September) I got married and everyone wants to know when we think we will start having children. I can't blame them, people are curious and a lot of them do not know my history and those that know do not know everything. But it is still hard to repeatedly respond to that question.

Just because it is impossible for me to have children physically it is still possible to have children through adoption. Recently my husband has been talking about wanting a baby and the topic comes up even more when we are with family and their kids or friends who have children as well. 

But it is still hard because there are so many things that you have to consider before starting the process and even more things that are taken into consideration before you can even begin the process of adoption. Instead of just deciding that you are ready to start trying for a baby you have to wait for someone that you do not know to decide that you are ready and financially stable to support a child. That is definitely a job that I would not want to have. To tell someone hey, I know you really want to start a family but not right now, of course in a more professional manner. Oh, that would be hard. 

So, this is what has been on my mind lately and I am sorry that it took such a long time to get this post up but having three jobs all start up at the same time made life super chaotic until I could get use to finally having to wake up at a specific time every morning. :) Oh adulthood, you are not as fun as I thought you were going to be when I was a child. :)  Hopefully I have finally gotten things on track so that posts will be more regular.  

My Cancer Story: Chemotherapy

There was always a feeling of uncertainty.  Uncertainty of what was to come, the things that could happen along the way, the outcome of every new thing that was thrown my way. Nothing can really prepare you for all that can happen after learning that you have cancer. Not only did I never know what to expect but I also had no idea what chemotherapy was. All I knew was that it was used to treat cancer. Chemo and cancer, what a heavy alliteration. Hearing one usually means hearing the other and can change a person's life either temporarily or permanently.

Not knowing anything about chemo meant that I had a lot to learn in a short amount of time. I always thought that chemo was one specific drug, but it actually refers to a cocktail of drugs that doctors feel will be the best combination for killing the cancer cells. Two of the drugs that I was given were Cytarabine (ara-C) and Idarubicin (Idamycin), which are common for AML treatment, or at least at that time.

For my type of cancer, Acute Myelogenous (Myeloid) Leukemia, there were different stages of chemotherapy. The first stage was the Induction Phase. The goal of this stage was to kill all of the leukemia cells from the blood and reduce the number of blast cells, which are immature cells, to a normal range and put the cancer into remission. This was a very intense stage because of the large doses of drugs that were administered. The weeks that followed were equally intense. Since chemo does not just target the bad cells, but instead kills all the cells in your body, including the ones that support your immune system, it is very important to protect yourself against germs. A simple infection, like a virus from someone visiting who may not even know they are sick, can lead to many complications and possible death since the immune system cannot fight off the infections. When people find this part out they tend not to visit to reduce the risk of unknowingly passing on a virus, which tends to lead to a lot of isolation and alone time. Understandable.

Fortunately for me the induction chemo put my cancer into remission. If remission does not occur with the induction phase, more chemo is given until remission is achieved.

So, I got to relax in a hospital room for the month while my blood counts regained strength in numbers with nurses coming in every 4 hours, day and night, to get my vital signs, a lab person coming in every morning around 4am and sometimes during the day to poke me for blood, a flock of doctors, interns, med students, etc. cramming into my room every morning around 7am to see how I was doing and to let me know about all the exciting things the day would contain. It was all very exciting. Plus there was that delightful and delicious hospital food. Just in case you could not make up your mind between the two decisions you had to choose from for each meal, it did not really matter because you had the next week to try the other option. Yup, every week had the same option for each day in that week.

Unfortunately the hospital food was not good, AT ALL. Breakfast was alright, you cannot really screw up cereal, right? I learned early on never to order anything that needed to be cooked if you actually wanted to eat that morning. Eggs always tasted like silly putty/rubber, toast was soggy by the time it made it to my room and pancakes were similar to eating cardboard. The oatmeal was alright once you added a few packets of sugar and luckily there was a kitchenette on the unit floor so that I could get toast, along with several other goodies whenever I wanted. Good thing there were several other restaurants around the area so that I could ask my mom to run down and get me something that was edible, at least when I was feeling up to eating.

Chemotherapy kind of ruins a person's appetite. Even if something actually tasted good, which was rare since chemo also wipes out your taste buds, it is never good coming back up. Medicine has come a long way in helping with the side effects of chemo, especially when it comes to treating the nausea. However, all the Zofran in the world can not keep some people from giving up their lunch. It was the best med that I received for helping reduce the nausea, but it did not always help. Sometimes it just gets bad enough where nothing can help settle the stomach, even if it doesn't have anything in it.

It definitely was not the best of times, but it also would not be the last time of feeling like I was hit by a mac truck. I still had 4 rounds of consolidation therapy ahead of me after I made it through the induction phase.

Consolidation phase is needed to kill the remaining cancer cells. Without this phase the leukemia is likely to return. I will give a brief description of this since there will be even more in the future about everything. This is the follow-up stage. After my counts rose and were back in the normal range I started my first out of four rounds. For a week I would be admitted to the hospital to receive a week of consolidation chemo. Once that week was up I was released and sent home to wait for my counts to drop. If at anytime during this point I developed a fever of 100.5 or above I had to get to the emergency room and back to the cities because the fever meant infection, which was life threatening. I usually wound up back in the hospital after a week of being home. With each round, it took even longer for my counts to rise back up to a range where it was safe enough to start the next round of consolidation chemo and each round was harder and harder to get through. Each round has a story of its' own, a story to be told in future posts. They are not light stories, but then again this is a rather heavy topic.

Lotza love!

Life After Cancer: Follow-up On Previous Post

One of my readers left a wonderful comment on my last post, which got me to think about things slightly differently.

Life is adventurous, and if I would not have had cancer I would not be where I am today and I wouldn't change that for the world. I have been blessed to be able to do some really awesome things, such as travel to Paris, London, see the beaches of Normandy, and I traveled all over Morocco. These were things I only dreamed of doing all those days I was stuck in a hospital room. Sure enough, after getting better I decided to make them a reality. I cannot honestly say that I would have ever gone overseas (except for Paris since I have wanted to go there since I was in high school) if it was not for cancer.

I guess it is all about how one looks at something. It is better to be optimistic and think of all the different things still available rather than focusing on the few things that are no longer possible. This is something that I have been really trying to focus on whenever I start to get upset or sad about not being able to participate in soccer events or join my mom on a horse ride, or even when I think about my future and not being able to be a nurse. However, sometimes you just need to be able to say that life sucks, as long as you let it only be true for a few moments at a time rather than allowing it to consume you.

I may not be able to be a nurse for a career anymore, but I am able to do something else that involves doing something that I live for everyday, helping other people in need. This I am able to do in a variety of ways, I just have to discover all those different opportunities. This is the adventure I am on now and who knows what path it will bring me down.

Shout out to g Vijayank for the wonderful comment on the last post. I hope you and everyone else continues to read and enjoy my blog.

As always, questions and  comments are always welcome.

Lotza love!

Life After Cancer: Losing A Part of Yourself

I read a blog today that got me thinking even more about something. The blog was about losing a body part to cancer and accepting that fact. It was really interesting. But it got me thinking about a different loss.

What if you lose something that makes you feel like yourself?

What could that be? What would it be for you, the reader?

One of the hardest things I have had to deal with after having cancer was changing a lot of the things that I did before cancer. These are the things that I felt contributed to who I was/am. Now, how is this more important that a body part? For starters, losing a body part and losing a part of what makes you feel like yourself area two different things in my mind. Of course it is terrible losing a leg or a breast to cancer, I am not saying that this is easy and I really wish no one had to worry about losing something, but medicine has come a long way in being able to reconstruct some of the parts that can be lost. The only body part I lost from cancer was my ability to have children because of all the radiation and chemotherapy that I endured, as well as being put into early menopause at the age of 19. I am not exactly sure why this happened, but for some reason the doctors did not think about the consequences of a female not having any platelets in her body to help prevent her from bleeding to death when her monthly cycle comes around. Due to that oversight, and me not knowing that could have ever happened and thus never thought about it, the doctors did everything they could to stop the bleeding and as a preventative measure decided that menopause was a good alternative. I would have to agree, but with menopause comes a bunch of other things that a 19 year old gal should not have to worry about. Luckily for me I was able to do hormone replacement therapy for a while to help with some of the heat and cold flashes. At the time I was not really worried about my prospects of having kids because I never wanted any. However, your mind changes when you get older and then get married. Now I wish I could have children, but even if I was able to still conceive children my body would not be able to handle the stress that comes with being pregnant. So, I am rather glad that I can save that money that would have otherwise been spent buying tampons on something that is so much more fun to buy. However, for all my lady friends that come over I generally keep a box on hand just for you just in case.  ;)

So what was it that I lost that made me feel myself?

There are a few things that I have done since I was really young. Riding horses, hiking, playing soccer, and bike riding. You may think these are weird things to have lost due to cancer but for me these are the things that I love and still love today, I just cannot enjoy them like before.

For those who do not know me and have not read other parts of my blog, I had a stem cell transplant in 2005 for Acute Myelogenous Leukemia. The transplant was a success, but it came with many complications. One of which was an attack from my new immune system on my heart and lungs leaving me with a very rare heart and lung disease called Pulmonary Veno-Occlusive Disease. This means that it is harder for my lungs to fill with oxygen and my heart has to work harder to pump oxygenated blood throughout my body. This makes any physical activity hard because I get short of breath easily. Because of that it is almost impossible for me to play soccer, the only sport I enjoy playing, and it is really hard for me to enjoy biking and hiking. Luckily I can still bike a little bit and hike small, semi flat areas, but I really enjoy long non-flat areas, and the same is with biking. It may be silly to miss these things and you may be thinking, well at least you can bike and hike a little bit, and you are right. But, these are things we did every day and all summer long while I was growing up so it is hard to let go of that (and I am not saying that this is harder than losing a leg or a breast or any other body part, this is just another take on losing something to cancer).  You would think after six years I would be over this and just accept that it is something that I just will not be able to do, but I cannot. I am hoping that at some point in time there will be an advancement in medicine that will make these things possible for me again. Is that too much to ask?

The other thing that I have not been able to do for several years now is ride horse. Apparently, after going through menopause your bone density decreases and makes your bones more brittle so they break easier. However, the amount of time between starting menopause and getting to the point where one's bones are weak enough to break easily was unknown. Thus, no one thought to put me on bone strengtheners to help prevent easy breaks. So, after my childhood horse passed away and I got on a new one who, for some reason, spoked at something unknown, I found out just how strong my bones were not. When my horse spoked and jumped I went about an inch up out of the saddle and when I hit the saddle again I broke my pubic bone, which caused a great deal of pain and caused the horse to spoke some more and I hit the saddle horn and broke another part of my pubic bone and then slide off the back side of her and onto the ground. Once I hit the ground I broke my elbow and another area of my pubic bone. Thus, ever since then no one, meaning my mom, will let me ride horse until my bones are strong enough and even then she is not sure she really wants to chance it. Riding horse was a connection that Mom and I had that I loved. Almost every weekend we would pack up the trailer and go camping and trail riding.

Now every summer when Mom packs up for a weekend or longer of trail riding I get very jealous and sad that I cannot go with her. As if losing my horse was not hard enough, I also lost being able to do my favorite thing in the world.

How do you get over giving up things like these that you spent your life doing before you had cancer? Does that feeling of loss ever go away? Should these things be a part of who I am? Am I crazy for letting them be me?

How would you feel if you were no longer able to do just one of your favorite things?

I may have the rest of my life to find something to fill the voids of these things I can no longer do and I am grateful for that, but I have yet to find anything to fill in the holes, yet. But, I am open to any new adventure that comes my way and thanks to the advancements done by research to treat cancer, I have that luxury at least.

Lotza Love!


  

Today is a very special day. 7 years ago today I had a stem cell transplant to rid my body of leukemia cancer cells, which fortunately for me, worked. It wasn't the easiest thing and complications from the procedure forced changes in my life forever. What were those changes you may ask? Well, I guess you will just have to stay tuned. That is how you keep people coming back right? Intrigue... Although it may not be enough for a majority of people.

I have always wanted to write a book about my experience with cancer. Not because I want people to know everything but because I think it could help some out, especially those who are going through similar situations. When I was sick I never knew what to expect or what was to come and that scared me more than having cancer. The uncertainty. The thing that helped me out the most was getting to know others who were going through the same/similar thing. There were some that had already gone through some of the procedures and had received the drugs so they knew some of the side effects and could tell me what they experienced and what could happen. This helped more than what the doctors told me since they made everything seem like it could happen but doesn’t happen to everyone.

A lot of things happened during my treatment and some of it I can’t remember but I often have flashbacks of those times showing me what I once had forgotten.

The thing is, I don’t know how I would start out my book. Maybe I should just start writing one day and go from there…  It would at least give me something and I can always arrange things as I see fit later.

I think what most deters me from writing is knowing that I could never write a perfect paper. I always had spelling and grammar mistakes. I would hate to write a whole bunch of stuff just to know how crappy my grammar is.

Maybe I am just too scared. Scared of writing it and finding out that no one actually cares to read it. I wonder if all writers have that initial fear? How do you work through it? Just do it and put it out there and see the results and reviews?

I think wanting to help people get through the difficult time of going through treatments for cancer is what led me to want to become a social worker. However, I really do not want to live in a big city. I just wish I would have transferred to a school where I could get my bachelors of social work instead of needing to go to grad school. I am scared to spend even more money on school loans. However, I feel that if I keep waiting to find a job with my current degree I will never have a career.

I keep letting fear stop me from doing what I want. That is silly. I just need to put my fear aside and go for it.