Peace and Perspective

I'm feeling so much more peace now. I'm thankful to have family and friends praying for me.

Of course I'm sad and anxious that our little cat, Sasha, is missing and I hope she's not gone for good. I brought her home a year ago from a shelter. She has seemed so at home with us spending her evenings sitting in my husband's lap, waking us up early in the morning for breakfast, rubbing her little head against our hands, purring endlessly. We've treated her for ear infections and bought expensive special food for her because of her digestive problems. But she's probably over ten years old and who knows how many other families she's lived with or how much of her life has been spent fending for herself? Two days ago she went out the dog door, which she started doing months ago. I had intended for her to be an indoor cat, but she figured out the dog door and seemed to enjoy just puttering around the back yard and sitting in the sun. About a week ago I noticed her go through a hole under the fence, but she came back pretty quickly and  I realized she might have done that before. I know lots of pet cats are outdoor cats and do just fine. Being a cat mom is still relatively new to me. Some of  my friends have told me their cats take off for days at a time and always come home, but I still I find myself worrying about Sasha and praying that she'll be alright.

But mostly I'm feeling more peaceful than I was yesterday. I still don't know what's going to happen with my FMLA claim. We faxed paperwork to the doctor's office again and are hoping it's the right paperwork this time and that they fill it out to the insurance company's satisfaction. I probably won't even know if it's approved until after surgery, but I'm determined not to worry about it anymore.

Either way, I am going to have surgery on Wednesday, I have health insurance to pay for it, my cancer was caught early, I have over 200 hours accrued sick time, don't expect to need anywhere near that much and even if the FMLA doesn't come through, I'm sure I wouldn't lose my job for taking time off for cancer surgery. I just don't want to fret about it anymore.

After my surgery I'll come back to a comfortable home and a loving husband and son. I hope Sasha will be here, but there will be at least four other furry friends to welcome me home.

I am reminded once again of my many blessings.

I was reading about how people in underdeveloped nations have such higher death rates and suffer so much more from all types of cancer, because it's seldom caught when it's treatable and there aren't many treatment options available to them anyway. That helped give me some much needed perspective.

God's Got This

Today, I, a customer service representative, make that a senior level customer service officer who takes escalated calls from other reps, yelled at a customer service representative of the insurance company who handles FMLA for my employer. I lost it and I'm not proud of that. I was immediately sorry and wanted to apologize, but I didn't get a chance to. Apparently she was not trained to take rude, yelling customers in stride like I have to in my job. She started lecturing and threatening to disconnect my call if I yelled again, which I hadn't planned on doing, so I just hung up in shame and frustration. Then I did something I haven't done since I was diagnosed with breast cancer three weeks ago. I cried. For a long time.

Bear with me as I backtrack over what led up to this and I know I'm being redundant here. A blog is a great outlet for venting selfishly and I'm afraid you've stopped in on my pity party. My employer changed medical insurance carriers for 2013. I had opted for a more expensive (to me) but lower deductible plan knowing that my husband needed hernia surgery, but having no idea that I would be diagnosed with breast cancer on January 2. For the first week and a half of the new year, insurance company H had no record of us in their system, not when we called, not when our doctors offices called to try to verify coverage. Needless to say, this resulted in much frustration and wasted time on the telephone. That was finally resolved, Thank God, no really, I do thank God for that.

While that was going on, my supervisor encouraged me to call insurance company A, who handles Family and Medical Leave Act claims for our company. He knew as well as I did that regardless of how much sick time I had accrued, I would need to have my absence for surgery and recovery certified for FMLA in order for the absences to be "job protected." So I called insurance company A and told them I thought I'd need "Intermittent FMLA" since I knew I'd miss time for surgery, recovery, followup appointments, pre-op appointments, radiation treatments, etc. I got the paperwork from them, filled out my part of it and took it to my surgeon's office. When I talked to them a few days later, they told me that all they could certify was the day of surgery and continous time for recovery afterward, not intermittent absences. Fair enough.

I called insurance company A back and told them I had been wrong, I didn't need intermittent FMLA; I needed about two weeks for surgery and recovery. Brenda, the rep I talked to that day told me that what I needed was short term disability and that she would cancel my FMLA. (Today I found out that this is where the real problems began. She was wrong. All I needed was continuous FMLA. I don't even have coverage for short term disability nor do I need it.) Brenda transferred me to Frank, who kept me on the phone for about 20 minutes taking information that I had already given previously for the FMLA, but that didn't seem too unreasonable. Then I called my surgeon's office back to tell them to shred the paperwork I had given them and that I'd get the new paperwork to them when I had it.

Then I waited for the new forms to arrive by mail or email or for a new claim to show up on insurance company A's website. I sent several secure messages that seemed to go into a black hole. Finally I called back two days ago to find that nothing had been done on their end. Over the past 48 hours I've talked to at least a half dozen of their representatives, received and printed out three sets of forms, two of which were the wrong ones, and spent hours working on this. As of last night I thought maybe this was finally going to be resolved.

Then this morning, just as I began my work day, I got a cell phone call that went to voice mail. It was "Sean" an A insurance company rep calling to talk to me about my claim for...completely wrong dates. Anyone who has ever worked a call center job knows that every minute spent off the phone has to be documented and explained and I've had to document lots of minutes like that recently. This is Thursday and my surgeon's office only fills out this paperwork on one day a week: Friday. Tomorrow is the last Friday before my surgery. I got off my work phone, emailed my supervisor to tell him why, checked my cell phone voice mail and tried to call Sean back.

When I finally got through the automated system to a live rep, I told her that I was returning a call from someone named Sean. She was not Sean, but asked for my name, date of birth and claim number and then proceeded to tell me that they had a helpful website that could be used for most concerns people might call about. That's when I yelled. They have told me this on every one of the countless phone calls I've made  trying to resolve an increasingly more convoluted situation that the website offered no help for. So this time, when the representative started off by telling me that again, I lost it and yelled, "PLEASE, don't go there!" .

I get yelled at multiple times a day in my job, sometimes cursed at and called names, but I don't ever want to treat anyone else that way. That insurance company representative was not personally responsible for the mistakes others have made and she didn't deserve to have me take out my frustration on her. It still pains me to think about it, but I've asked God's forgiveness, not only for raising my voice, but for the attitude that led me to do it.

After that phone call and after I spent some time crying and praying, I was calm on my next phone call with yet another representative, but they never did get things sorted out. Two emails, one more secure message and another set of forms later, I finally called my HR department. They intervened and they think the problems are resolved. I'd like to think that the paperwork Rick faxed to the doctor's office for me yet again today will result in my FMLA being finally approved so that I can use two weeks of my own accrued sick time for surgery and recovery. I wish I could tell you that when I go to bed tonight I'll be confident that the issue is resolved. But I'm not counting on Brenda, Frank, Colleen, Jessica, Ken, Laura or Sean from the insurance company or my HR department or my doctor's office staff to make this happen.

As my niece, Grace, often says, "God's got this." At some point today I finally remembered that.

Now one of our cats has gone missing. I'm praying that God's got her too and will bring her home to us safe and sound. If you are a praying person, I'd appreciate it if you'd pray for Sasha too.

Weary Wednesday

More phone calls today, more secure messages, faxes and emails sent and receipts copied. More time after work documenting the few absences I've had so far. It's amazing how much time and effort it takes to actually be able to use accrued sick time and employer sponsored benefits like health insurance, short term disability, flexible spending accounts for medical expenses. Of course I'm working full time so this is all being done after work or on breaks.

I'm weary and feeling overwhelmed now at the end of the day. I can't imagine how exhausting and stressful this would be for anyone who was actually feeling the effects of their illness, which I am not. I know I've been dealing with stress by eating too much junk food.

Of course I've also been taking care of Zoe after her orthopedic surgery last week

and trying to prevent Rick from needing to lift anything over ten pounds in the aftermath of his surgery not quite two weeks ago.

I'm still glad they were both able to have their surgeries and be well on the road to recovery before mine.

My surgery is a week away and today a nurse from my surgeon's office called and spent a long time with me going over information about what will happen the day of surgery and afterward. She was very kind and helpful.

I'm still hoping that sometime before surgery I'll have time to get the house cleaned.

Sweating the Small Stuff

If there's anything that irritates me more than breast cancer it's dealing with insurance. Don't get me wrong, I'm truly thankful that I have it. It just takes a lot of work to take advantage of it sometimes.
 
It started with our medical insurance company having absolutely no record of us right when my surgeon, Rick's surgeon and the radiology practice where I was supposed to have an MRI were all calling to verify coverage. My employer had changed insurance companies as of Jan. 1. I was diagnosed on Jan. 2. Rick was scheduled for hernia repair on Jan.10. The new insurance carrier apparently had some kind of mix-up in loading my employer's records. So they deleted us all and it was days, I honestly don't know how many days, until they reloaded our records correctly. In the interim it appeared that we simply didn't have any insurance, except dental, which is not a lot of help when you're dealing with hernias and breast cancer.

That necessitated lots of time spent on the phone getting nothing but frustrated. Finally that issue was resolved the day before Rick's surgery, much to our relief.

Then it was time to certify for my time off of work for my surgery and recovery. Yes I have sick time, but to use more than a few days here or there, you have to get it certified as FMLA or Short Term Disability so that the absences are "job protected." I don't know if this is as critical for salaried employees, but I am hourly and work for a call center where any time off is closely scrutinized. Whether it's FMLA or short term disability, you have to deal with, once again, an insurance company.

So I started by calling to open an FMLA claim, then found out that this was not what I needed. I needed short term disability. So after getting my FMLA paperwork, filling out and signing my part of it and getting that to my surgeon's office, I had to call them back, ask them to shred it and told them I'd be getting the new paperwork to them.  This misunderstanding was probably my fault as much as it was anyone else's.

Then the real frustration began. Last week I called the insurance company that handles both FMLA and short term disability, told them I needed to cancel the FMLA claim and open a new claim for short term disability. A nice lady named Brenda said she had cancelled the FMLA, then she transferred my call to a friendly fellow named Frank (OK, I admit it, I love alliteration) who spent about fifteen minutes on the phone with me taking lots of information for my short term disability claim. I got off the phone feeling that I was at least now making some progress after my initial setback and loss of time.

There was only one problem. Neither Brenda nor Frank did what they told me they had done. I waited in vain for my new short term disability claim to appear on the website when I logged in. I waited for paperwork to arrive in the mail. Finally today I called back and was told that the FMLA claim could only be cancelled if I requested it in writing, a little detail Brenda failed to mention. And there was no short term disability claim pending. So once again I started over from scratch, I think. Surgery is just a week away.

Lord, please give me grace for the little things. 

More Blessed Than Brave

Port Aransas, TX

I'm feeling a little sheepish about all the sweet comments I've had from dear friends and family telling me how brave or strong I am in dealing with this breast cancer diagnosis. Yes, I am trusting in the Lord and I sense that He's giving me His peace. And, yes, I have been pretty calm about this so far, but that really isn't because I'm brave. I know this is not predictable, but come what may, I have it much easier than many women and I want to respect those women as I talk about my own experience.

My children are all grown up. I did not face a breast cancer diagnosis before having children, before experiencing breastfeeding a baby, or while raising my family. Many women are diagnosed younger in life and that would have been so much harder.

My cancer was caught at stage one, well maybe bordering on stage two based on the latest info from the MRI, but it's still very early. And it is not inflammatory, which is the very aggressive, truly scary type of breast cancer.

I have a loving, steadfast husband to walk through this experience with me, providing emotional and practical support. My son is in town and willing to help in any way that he can. My daughters, although they live out of town, are loving, supportive and faithful about keeping in touch with me and praying for me. I am aware that not every breast cancer patient has these kinds of loving family relationships.

I have wonderful friends who have been through breast cancer and are open with sharing information and their own stories with me. I have a loving extended family and a loving, supportive, praying church family.

I am well established in my job, have sick time accrued, coverage for short term disability or FMLA if I need it, plus good employer sponsored health insurance.

I'm not exactly looking forward to lumpectomy, radiation treatments or taking estrogen suppressing drugs with all that entails, but I am going into this experience with countless blessings and advantages. God forbid that I would take those blessings for granted and fail to thank Him, the Giver of every good gift. I pray that I will be faithful to trust Him who has shown Himself to be trustworthy in every other trial I've faced in life. 

And I pray that I can talk about my experience with breast cancer in a way that respects and honors women who've had it so much harder than I probably will.

Wires, Brackets, MRI and a Timely Email

Three days before my scheduled MRI, I was sitting in the recovery room of the ambulatory surgical center with my husband who had just had hernia repair. (Hard to believe that was just last Friday.) We were having a good time joking around with his nurse, a hearty woman a few years older than us with a great sense of humor. I pulled out my smart phone to check my email, burst out laughing and handed her my phone to share what I had just read.

"Boy, I'm sure glad she prepared me for that," I said. 

The email was from a friend who is a nurse who's had breast cancer:

 "I thought I would give you a heads-up on the MRI if no one has. You are lying face down on the table with your breasts hanging down through a hole in the table...I won't go into the jokes that my co-workers thought of... "

I had that MRI this past Monday, and had a hard time keeping a straight face when the male technician rather sheepishly directed me to the table.

Yesterday, which was Wednesday, I started the day by going with Rick to drop our dog Zoe off for her orthopedic surgery before my work day started. On my lunch break I got a call from my surgeon's office. The scheduling nurse told me that the MRI showed no additional cancer so I would be able to have lumpectomy, huge relief there. Then she went on to tell me that the MRI also showed that the tumor we did know about is larger than the mammograms and ultrasound had revealed. That was not a relief, but it does make me very thankful for the MRI, because that information will help my surgeon to be much better prepared. The nurse went on to talk about wires and brackets and "localization" and the need to schedule a radiologist for the surgery. She said that the surgeon has a particular radiologist he prefers to work with, so she'll check his schedule and call me back with possible surgery dates. I should hear from her again today.

About ten minutes later I got another call from a lady who gave the name of the medical testing lab she works for, rattled off the name of a test and asked if it sounded familiar to me. It didn't. She said my surgeon had ordered it if I consented and if my insurance covered it. She had already determined that it would be covered at 100%. She said the test was to predict the likelihood of my cancer recurring within the next ten years. Maybe some people don't want to think about that, but I saw no reason not to consent. I guess this test will be part of the pathology testing that will done on the tumor after the surgery.

I did a little research into the wire and bracket thing. This is from the Susan G. Komen website:

Breast cancers found by mammography or other imaging may be hard to feel in the breast. If the tumor is nonpalpable (cannot be felt), a procedure called wire-localization or needle-localization will be done before surgery. A radiologist uses a mammogram, ultrasound or MRI as a guide and inserts a very thin wire into the breast in the area of the cancer. The surgeon then uses this wire as a guide to find and remove the tumor during surgery.

 From the Yale University School of Medicine website:

If the cancer cannot be felt, a needle (or wire) localization with numbing medication will be done by one of our radiologists just prior to your operation to help guide the surgeon directly to your cancer. Occasionally several wires may need to be placed in your breast to “bracket” an entire area of concern for excision (removal). 

I think the nurse said at least two wires will be used for my procedure, but in the words of Scarlett O'Hara,

"I'll think about that tomorrow."

Today, I'm off from work and hope to hear from the veterinary surgeon that we can go pick Zoe up soon. That poor puppy is going to need a lot of TLC. One of my friends suggested that I need a good distraction during this time and I've got no lack of those. 

Hernias and Hip Dysplasia and Cancer, Oh My!

One of the greatest blessings God has given me since I was diagnosed with breast cancer ten days ago is the perspective of dear friends who've been through this experience.

Some of the most helpful advice I've received was,

"Take your time with asking questions and doing research. It's important. I know that after you get the diagnosis you feel you need to get on with the surgery yesterday, but really you have time." 

 "I think you are wise to get Rick's and the dog's surgeries out of the way. You have time to get your ducks in a row."

Although I don't think I'll ever have my ducks in a row, this was very reassuring advice. Before I got my diagnosis, we were already planning for Rick to have a long overdue hernia repair and had also scheduled surgery for one of our dogs.

I had enrolled in a lower deductible medical plan for 2013, mainly because Rick needed surgery, so we had scheduled his consultation with the surgeon early in the new year. Because he is self employed, he is covered under my employer's medical plan. When we got my diagnosis, his first inclination was to put his surgery on a back burner, but I thought we had already delayed it longer than we should have.

So Thursday of this past week, he went with me for the consultation with my surgeon and Friday I took him for his hernia surgery. It seems to have gone very well and he is resting at home. 

This Monday, I will have my MRI and then wait for results which will tell me whether I'm a candidate for lumpectomy or will need mastectomy. Wednesday, we plan to go ahead with Zoe's surgery.

I'll probably schedule mine the following week if it's lumpectomy, maybe the week after if it's going to be mastectomy with reconstruction. That way Rick will have had ten days or more to recover and we will be able to take good care of Zoe for at least her first week after surgery. Of course none of this is very predictable, but that's our tentative plan.

I already feel more peace knowing that Rick has had his much needed hernia repair. And although factoring a dog's medical needs into all this might sound crazy, people who've ever loved a pet might understand. Once I'm dealing with my own surgery and recovery, it would make me feel so much worse to be watching my sweet dog suffering and falling on the floor when her legs collapse under her. I think it will help my frame of mind to know that we've started the process that we hope is going to extend her life beyond her seven years and improve her quality of life. After all, a breast cancer patient needs her therapy dog(s)

 
And speaking of getting my ducks in a row, sometime before I go in for surgery, I hope to make time to clean the house!