Decision Day …



Today we met with Dr. Smith for the second time.  He needed a decision as to which treatment protocol I wished to follow.  We needed one more in-depth lesson on the protocols relevant to my choice. Today was definitely a “Come to Jesus Moment”.   I think you get my drift regardless of your spiritual heritage or personal belief structure.

I awoke this morning with these thoughts:

(1)  Once I start the pre-op drug infusion therapy I have to wait 30 days before any surgery.  I am able to stop this therapy mid-stream, but would seriously risk giving the cancer a breakaway moment while waiting for the drugs to leave my system.  Hopefully, in any case my auto-immune system would recover before introducing surgical trauma.

(2)  Going with immediate surgery and choosing no chemo means I can have no regrets (should my cancer have already seeded itself elsewhere in my body only to discover cancer is now a full body endeavor).  …Tic-Toc  …Tic-Toc.

(3)  Immediate surgery followed-up with chemo provides no assurances that the chemo is working and leaving any such conclusions to father time.  Another Tic-Toc life choice.

I chose Door #1, after asking the doctor more questions and hearing the down-and-dirty on each drug in my three drug protocol.

Why?  HER2 Positive Breast Cancer is mean.  It is extremely high risk at any stage.  The doctor agreed to start my treatments with the chemo drug at a reduced level and the two antibody drugs at full level.  He also stated that were I to be medically intolerant of the chemo drug he was allowed to eliminate it entirely and stay with the two antibody drugs only; these are Perjeta and Herceptin.  There is something about getting early confirmation that the cancerous tumors are shrinking away.  This should come somewhere around 9-weeks into an 18-week infusion protocol.  The implications for surgery and recovery thereafter are a no brainer –  I chose out-patient surgery over major surgery.

I spoke earlier about having a team of hands-on supporters with you.  Realizing the immediate implications of my decision, William went to work looking into the employment consequences and remedies.  His work history gave him insights most don’t have.  Cancer is not just a medical matter, it is just as equally a financial one too.  The facets of this illness are never-ending.  I have spent so much time talking here about the medical and family issues and so little about the financial implications.  I need to devote some time on this too.  A good beginning is to highlight my husband’s assistance in figuring out a disability plan that works for me and my company.  William is a retired businessman with ample experience in operating companies and in human resources.

William did good work.  He learned that California Employment Law provides for 12-week sick leave (called Family Medical Leave).  Even better, this leave must be approved by the employer as intermittent leave at the request of the employee and backed by medical necessity.  The key appears to be that I must return to work for periods no less than 2-weeks at a time.  My treatment plan fits into this program like a glove – one week off for infusion treatments and then two weeks working, which goes on for 6 cycles.  Then a month working while waiting for out-patient surgery with a one week to three week recovery period.  Thankful for the law. Hopeful this request will need be approved by my employer in a timely fashion as we look to the future to start the treatment protocol.  The last hurdle before finalizing treatment plans is getting Insurance Company authorization for the protocol which should be routine.  This endeavor is a medical provider effort and they are an AETNA approved medical provider specializing in this kind of care.  The doctors are great here at my medical provider and they are adamant that their prescription is best and FDA authorized as prescribed.



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