Cognitive Side Effects

Today the chemo is having it's effect on Pace's higher cognitive functions.

In her own words "I'm having a bad day. My face was all "numm" and my lips this morning accompagnied by daisy spells. I'm feeling better now but not 100%. I'm going to bed one more time."

I've never seen her make as many mistakes in English before. For the moment I am chalking it up to fatigue and the medecine.

By the afternoon she was feeling better but not 100%. So she went back to bed one more time.

Sleep heals.

Carcinoeconomics

Regardless of Canada's socialized health insurance plans’ getting sick has a major implication on family revenue and expenses. I've discovered that there are a whole lot of instances where the provincial health insurance plan doesn't cover the costs of health care, especially if cancer drugs or special treatment considered expensive.

As its tax season consider this, whichever is lower, either $1,844 or 3% of net income is the minimum possible claim for medical expenses and you max out at $10,000. I don't feel gratified considering that people who've traveled this road before us had a maximum deductible of $5,000 until 2005.

Current and projected expenses include: Drug costs outside the hospital are the responsibility of the patients; entrepreneurs and those without private insurance must cover these costs out of pocket.

Here's why I think the medical deduction is flawed. To start, Bone Marrow Growth Factor Hormones (GCSF) which Pace will require to boost her white blood cell counts later in chemotherapy are not covered if the drug is administered outside of a hospital; these treatments can easily cost over $2,000/month out of pocket.

Also the benefit doesn't allow carry over if expenses started in late November. In addition, any medical equipment costs for at home care must be prescribed or they're mine alone, then again I can resell home medical equipment on eBay later...

Private nursing adds up fast and it is not covered by all provincial health plans. Pace won't be able to lift anything or use her right arm for a month following breast surgery and removal of lymph nodes in her underarm.

Physical rehabilitation expenses are fully my responsibility. However some of those will accumulate for tax time next year.

Life insurance, if they'll even consider Pace as a policy holder will be at a prohibitively very high cost. Then on the revenue side of the equation... There’s lost income for me and other family and friends that act as caregivers and need to take time off work to help Pace.

Career plans are on hold for 12 to 18 months, for the both of us. Then there are the lost work opportunities due to scheduling for family health care commitments. If I go full time, I won't be able keep Pace's condition a secret for long. Promotions are probably out of the question.

Pace will face workplace discrimination on health issues, regardless of what the law says. One of the reasons for making this blog anonymous is to keep her and my potential clients or employers from knowing my family's medical situation. A friend in HR has told me I will be passed over in the hiring process due to the risk of additional insurance costs on the benefit health plan that my family could incur.

Then there are the incidental costs: parking is a $12.00 to $16.00 daily rate at the Hospital; multiply that over several weeks of daily and weekly visits, add to that family travel and accommodation costs to and from the city for treatment are over $1,000 per month. They're non-deductible too unless Pace is declared incapable of traveling alone.

The best solution is to stay healthy.

Set the clippers to # 2

You can let cancer rule your life or you can make pre-emptive decisions. Today Pace had her hair trimmed down to a GI Jane length.

Better to cut off your own hair than have to go through the trauma of watching it come out in clumps every time you touch it.

Pace has such great facial bone features that she will be a looker without hair too.

We'll see if the old Frech-Canadian folklore of making your baby sleep on it's right side one night, and the left side the next really does make for shaping a round head ;)

Treatment 4 and a Theory about Pace’s TIAs

Last week they dropped Pace’s dose of Abraxane from 149mg to 119mg due to the ongoing vertigo, which is not a normal treatment side effect.

The nurse also commented on the spike of platelets in Pace’s blood. It’s unusual; as I understand it chemo lowers the level of platelets. The higher the level of platelets in the blood the thicker the blood is, potentially causing clotting and overworking the heart. The average person scores between the numbers of 140 – 450 on the level of platelets in the blood. Her platelet level was 264 on Jan 26th, 449 on Feb. 9th and 490 on the 17th.

She thought that Pace should take it up with the Doctor and suggested that it might be something genetic and that she get tested.

Pace’s arms were bruised as it took four tries to get a vein. We’ve still got another 2 months of weekly treatments and blood work; they may have to switch arms or use the veins in her legs.

RAZRs and Breast Cancer Research

We got to bed late last night. My train pulled in at 7:30 pm and by the time we got home, put the wee one to sleep and we sat down for supper it was going on 9:00 pm.

After dessert Pace and I sat in front of a pleasantly warm fire, and got caught up. I gave Pace her Valentines Day present. A V3 Motorola RAZR phone, it’s very slim and stylish like Pace and it’s a bright anodized pink aluminum.

She loves it!

And I get the satisfaction of as the sales representative told me Rogers is giving 50$ from each sale of that phone model to breast cancer research.

Good News from the Meeting the Doctor

Last weekend I felt the tumor for the first time in three weeks. I was sure it was smaller but I thought it was better to wait for the doctor to confirm that before releasing any information.

First thing Pace does every week is get her blood-work done, then she sees the doctor. The results of the tests are available at treatment time the next day,

Pace saw the Oncology Surgeon on Thursday and he was happy with the progress. The good news is she is responding well to the Abraxane, and the mass has reduced in size by about 20 to 25%.

Personally, I’m glad Abraxane is punching out the cancer because it’s also taking a toll on her energy levels; they’re unfortunately, but predictably, reducing with each treatment.

Happy Valentine's Day Pace!

Pace,

On this Valentine's Day, I've been asked by many people to send you their love and best wishes for a complete recovery.

And to you, my charming, spirited and vivacious love, I'm so blessed to be your best-friend, lover, and husband.

All of my heart,

Robert

Virgin Cancer Care

Richard Branson, my entrepreneural hero, has launched Virgin Cancer Care.

The financial health magaizines have published artcles examining it and found that while good it pays to shop around for a health insurance policy.

We're at treatment 3 and here's a health update

Pace's secondary effects continue to be dominated by chemotherapy induced neuropathy that seems to have localized in her cheeks and lips. Last week it manifested itself as numb lips that adds to the other symptom of a constantly runny nose. She thinks it's a cold she can't shake, I'm of another school of thought.

Other side effects are the off taste that food has now. It manifests itself as both an unwillingness to eat at times and nausea at others.

She's been having dizzy spells again, the doctors are not sure if it is, or is not related to the TIA episode we had back in October. So the neurosurgeons are recommending more tests, (here we go again...) to eliminate possibilities of underlying conditions. The recommendations are:

A transesophageal echocardiogram to determine if there are any congenital defects of the heart. Specifically defects in the heart walls allowing abnormal mixing of oxygenated and unoxygenated blood between the right and left sides of the heart.

Then there's an MRI of the Brain Stem to look for potential brain tumors, I thought they would have done that with the other Brain MRI that she had in October.

There's also the "Bubble Test," where an ultrasound is done in combination with an injection of saline solution into the circulatory system to look for places were arteries may be pumping blood directly into veins. By all accounts it's painful.

Lastly the doctors are ordering a genetic blood test for coagulation disorder. This is a test that the good doctors at Mount Sinai were about to perform before the breast cancer diagnosis.

Pace is being so brave and all I can do is observe.

Treatment 2

Once again it is a wonder the Abraxane has so few side effects given it's power and history as a poison. On Saturday Pace felt numbness in the extremities of her arms and legs. She's also tired and can't seem to shake a cold.

In short, Abraxane is a part of the drug family known as Taxanes, these powerful drugs can stop cancer cells from repairing themselves and from dividing to create new cancer cells. The origin of taxanes is the European Yew tree

However, it has serious potential side effects:

• neutropenia, low counts of white blood cells that prevent infection


• neuropathy, pain and numbness, including symmetric polyneuropathy


• weakness


• infection, due to the neutropenia

So far there's been no sign of skin sensitivity, which is another side effect, albeit less serious, that can make taxanes difficult to take.

(Image Source: sanofi aventis)