Tuesday, April 28, 2009

Once you've had cancer, it's always looming

The first entry in this blog goes into some detail about my experiences and emotions around the time of my first breast cancer diagnosis and the surgeries that followed. Those things are much easier for me to write about than the financial hit that takes even longer to recover from. For me personally, there are a lot of intense feelings surrounding my ability to take care of my responsibilities.
Coming off the pain medication after those surgeries felt like swimming up from deep murky water, the light got brighter and reality became sharper. When I saw the medical bills piling up, I really wanted to dive back down into those comfortable Percocet depths.

I have a great deal of fear and shame around not being able to pay my own way in the world. I’ve always had immense pride about my credit rating, always paid bills as soon as they landed in my mailbox. I never wanted to depend on anyone else to help me make ends meet, more the opposite, I was proud to be able to give a hand up to someone else who might need it.
Of all the things I had to confront in facing my cancer (my mortality, the disfiguring surgery) the hardest by far was facing the fact that I would have to reach out for help financially. I had to admit to myself and then to the world that I was not capable of taking care of my own medical responsibilities. This is still very challenging for me to admit, it has taken me about an hour, four espressos, and a couple of procrastination breaks to write this down.

At the time of my diagnosis, my husband and I were planning our wedding and had been saving toward a down payment on a house. Saving money is something I like to do and something I have always been good at. Saving toward what is likely the single biggest purchase of one’s life takes time, but I am patient.

I had to put my plans on hold and turn my attention to driving to Cedars Sinai for doctor visits, around town for consultations, phone calls to my insurance company to verify coverage and I also wrote a living will. I did what needed to be done to remove the cancer, and I felt proactive, involved and positive for the most part.
I am a control oriented person and I felt within my comfort zone after lots of research, I felt I knew more than I ever wanted to about breast cancer and the treatment options. I found excellent doctors, and I was feeling optimistic about the potential outcome.
Until the medical bills were more than I could pay with what my husband and I had in our checking accounts, more than what we had left over after household bills, until we had to look at each other and decide to use our savings, until even that was not enough. I hadn’t thought death would be an easier choice until I saw how incredibly quickly all of our money was spent. Death looked like a real option when I had to pay for groceries on a credit card because there was no money left in our checking account. I felt like a burden on my husband and friends and I felt ashamed and like I was somehow not good enough because I didn’t have the money to pay for my medical treatment. I felt like I was foolish for choosing medical care beyond my means, as if truly excellent care is a privilege that I did not deserve.

Six years later, I am glad to have made the choices in care that I did, happy to be well and so immeasurably grateful to have had the support network that I do. Still, six years later, my husband and I have not recovered from the financial hit. Our savings remains depleted and I have come to terms with the fact that we may never own a house.
Time has passed, my life has gone on and while I am happier than ever, a dark cloud looms in the distance of my consciousness. Until I had a cancer diagnosis, my yearly check ups were a routine. Now, I wait with a knot in my gut for a call a week after the checkup. The call where the nurse tells me that I have to come in to discuss the test results. They will never tell you over the phone that some thing looks suspicious, but they might as well. Being told that you have to come in to talk about the results is never a good sign.

Last night I attended a dinner at my husband’s restaurant, five courses paired with five outstanding wines from the Barnett Vineyards in Napa. I slept only about four hours because this afternoon I will go to Dr. Kristi Funk’s new Pink Lotus Breast Center for a needle biopsy on a new lump in my reconstructed left breast. The familiar nervous feeling in my stomach will likely be with me until next week when all the test results are in.

Life looks more beautiful, wine tastes more delicious, and love feels more precious from my perspective. I am well aware of the tenuous nature of life. I am one positive biopsy, one strange new lump, one mutated cell away from plunging back in to the deep murky waters of surgeries, pain meds and medical bills. Cancer often comes back.

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