I.O.U.

 

The oval shaped lump below my incision scar in the picture above is my port. This port protects me from the chemo drugs. For reasons I don’t fully understand, veins can tolerate the chemicals used, but some tissues cannot. If you access a vein directly, then each time the needle is inserted and removed, there is the potential for small amounts of the chemo drugs to “drip” out between the vein and the skin (or directly on the skin) and cause damage. That, along with the fact that I have notoriously hard to tap veins, is why I have my port. A special needle enters directly into the port (which is clearly visible and extremely easy to access) and this set up protects me and makes the whole process easier.

Accessing the port takes a few seconds, and is not painful. The needle just has to go through a small amount of skin. (I know it looks huge, but the whole needle is contained in the port. Again, I barely feel it.) The process looks like this, and all they have to do is poke that needle somewhere in the large, oval shaped lump in my skin. I could practically do it myself. A really good dart player could hit it from across the room… 2 of the 6 times, college students have done it!

The reason I’m telling you all of this is because this part of my lab work- this literal one second act of poking the needle into the port is considered… (wait for it….)

….CARDIOVASCULAR SURGERY  (at least on this particular insurance claim) and it costs $475 (!!!).

 The actual labs and testing of the blood have separate fees. Some weeks it’s called something different, but the $475 charge happens every time. Granted, the port access does require putting on sterile gloves, wiping off my skin with alcohol, flushing the port with saline, and putting a band-aid on after, but $475 “cardiovascular surgery” is really quite a stretch, in my opinion. 

If we didn’t have insurance- or have the discount agreement that our insurance agency has worked out with IU health, we would pay $950 every two weeks (for 14 weeks) *just* for the needle to get stuck into the port on lab and chemo days.

But that is nothing, because this is what it costs for just 1 (ONE!!!) chemo infusion day:

Yep, that’s right, it’s nearly $42,000.

I complained a while back about our out-of-pocket costs, and I still firmly stand by the fact that it sucks. But I fully recognize the people I know who are underinsured (or uninsured)- restaurant staff, artists, home healthcare workers/nurses, people who are self-employed… the list goes on and on. Do you know anyone who could afford to pay $42,000 for 1 day of chemo? I do not. What if their insurance pays 50%, and it’s only $21,000? Or 75%, and it’s only $10,500? Still no? Same here. And if they have no insurance, no deductible, no out-of-pocket max, they would incur that cost EIGHT times.

IU health has recently been in the news for its somewhat secretive $416 million donation to the IU School of Medicine, and their higher than average billing practices, so maybe my charges are “more than average”, but a medical crisis is outrageously expensive even in the “cheapest” of healthcare networks. This can be truly devastating, and our healthcare system is really, really messed up. 

Anyway, my labs came back ok. My liver enzymes are still elevated, but the number is only half as high as last week, so that’s good. My white blood cells are still high from the neulasta injections, but they are less high with every round. Hopefully they will hang on through my last 2 rounds.

My red blood cells, along with my hemoglobin and hematocrit counts are all low, and getting lower each cycle. They have not reached dangerous levels, though, so I assume everything is good to go for tomorrow. Also, I learned that people who have bone metastasis often have their cancer areas calcify during chemo, which makes their blood calcium levels go up. Mine have stayed consistent, which is not a guarantee of no bone mets, but it’s a good sign.

I have had a concerning cough off and on since my last infusion. My oncologist was worried, but an X-ray showed no pneumonia, pleural effusion, or masses of any kind! So that’s also good news. 

I think that’s all I’ve got.

6 down, 2 to go!