October Greetings,🍁

After consulting with the MGH oncologists yesterday, I can definitively report that the radiation treatment seems to be working.  Cancer activity has been downgraded from “high intensity” to “moderate intensity” on the Petscan, and the CT showed that the cancerous lymph node is still slowly shrinking at 9mm.  Also, no cancer lit up anywhere else on the scan.

So, radiation will hopefully keep shrinking the lymph node.   All good news.

Ofcourse there’s always something, so a few hours after my conversation with Drs Hong and Walsh, I opened up an envelope from BCBS dated 10/17—the day AFTER my scan.  They denied authorization for the Petscan.  It’s pretty common—they deny it because I already have a cancer diagnosis, and in the outsourced medical healthspeak- look at codes, not situations-world, a Petscan is only a diagnostic tool if you don’t have cancer already.  If you know you have cancer, you don’t need to find out you have cancer.  Which is ridiculous for many reasons—the main one is Petscans also measure the level of cancer activity to see if a treatment is actually working. But even if it was just for diagnostic, it would also show if cancer was anywhere else in my body more definitively than a CT or MRI, which, since CC has a habit of jumping to other organ areas, is equally important.  I’m firmly convinced that AI alone answers the first authorization requests.    Usually hospitals will not do procedures without authorization, and usually insurance companies also deny authorization before a procedure, not a day afterwards—and not just by mail (they also sent the letter to my oncologist which means we both got it on the 23^rd).  Then, the ordering physician then requests a peer to peer review where they explain to the insurance md why the procedure is necessary.  This case is a retrofit.  My oncologist will be explaining why it was necessary and if that doesn’t work I’ll be appealing the decision forever.  I’ll also be giving MGH Billing a signed note stating that I do not want to see any out of network physicians or have any unauthorized procedures without my consent.  Mt Sinai had me do that to cover myself after something similar happened that was resolved by an extendedly tedious appeals process.  And it’s something I should have done with MGH and Dartmouth, but forgot about.  I tell you all now, because probably everyone should have a letter on file with their hospital that says this.  Having one covers you if the facility forgets to authorize something big, or sticks you with an MD out of network without telling you.  Some insurance will pay if you have no choice (as in that’s the only MD on call that day), but it’s still a pain to go through the appeals.

Ok, health insurance class recessed!

It’s been a multi-eventful summer and fall.  We broke ground for the new house addition at the end of August, Birdie sightings started flooding in from neighbors (more about that) and I finally began to feel energetic enough to start hiking a bit again (each month I realize how much less energy I really had the month before).  There’s been a sort of dead, no sense of will or purpose feeling every morning that I struggle through in order to get out of bed.  But I am working towards the day of waking up with energy and excitement about the day again.  That’s the goal.

Cosmo has been doing better—after a few months of curling up on the bed with little interest in the world, he has blossomed into a solo cat.  During the day he naps over his bed kingdom.  In the evening he runs around meowing at doors and demanding to be let outside (he’s never been outside at night).  And he is getting interested in the new sunroom space.  Hopefully the screened in porch will happen in November so he’ll get a chance to truly hang outside at night for as long as he wants.

In September, I joined my sisters and 6 family friends on a Backroads culinary tour of Provence.  First we spent a week in Paris, walking around by ourselves, and then eating our way through part of Provence—some walking, lots of eating, no regrets.

While I was away, Birdie, who had moved into a very kind neighbor’s woodshed up the road on Black Mountain, was busy bonding with her chosen humans.  There’s something special about a skittish cat deciding to trust you, I think.  She started coming out when the family called her, rubbing up against them to be petted, and following them into their garage.  So, she is with them now, while they see if she and their dog will get along and if she can acclimate to being a completely indoor cat at their house.  If that doesn’t work, I will take her-- either way, this is a happier ending without her having to be trapped again (which seems traumatic for her), and she will have a good life.  But I didn’t see the need to take her away, yet again, from another family she has chosen, if they also like her. 

So good news all around…

My next scan will be in January, and hopefully there will not be much else to report till then!  I have dreams of getting to the ADKS once more before major snowstorms, or at least various Greens and Whites …autumn always reminds me how to breathe, the treasure of being alive.

The world is holding tight to broken hearts — I wish you love and support, whatever you are doing and wherever you are❤️

May there be more peaceful & hopeful times ahead.