Not All Sugar Plums & Fairytales

Jumping for joy, for real. Taylor Sherrill photography. 

Today is my last chemo treatment before surgery, and I should be celebrating. After six months of toxic cocktails, my tumors have shrunk enough to make surgery possible. But I’m not celebrating. I’m crying and it’s pissing me off.

My plan was to be the happiness you want to see in the world. If I don't feel happy, I fake it. Cancer doesn’t like happy. Cancer likes stress. Besides, no one likes a sour puss.  But there’s a glitch in my happiness groove, and it’s spelled H-M-O.  I’m in a battle with them for a specific surgeon and it’s not going well. I’ve been denied by the HMO, and Blue Shield. The case is now being reviewed by the state.

All I want is a breast cancer specialist surgeon. Is that too much to ask? Apparently, yes.

The surgeon they’ve assigned me is a General Surgeon, not a specialist. He’s not even board certified in Surgical Oncology. During my consult with him, he didn’t look at my latest test results, which was weird because how can he decide what surgery I should have if he hasn’t checked my latest tests? Well, he doesn’t need no stinkin’ tests to determine what surgery I should have! That’s how good he is! He’s recommending a “simple” mastectomy. He also said there would be no need for any additional testing before the surgery. That seems weird, too. 

I can’t help but think, am I being punk’d?  Here's the kicker. The HMO and Blue Shield denied my request for a third consult because they said the two surgeons I already consulted with are recommending the same thing. But they’re not! So the denials are based on inaccurate information, which for a journalist who deals with fact checking everyday is a mighty frustrating situation. Accuracy? The case reviewers don’t need no stinkin’ truth to deny, deny, deny.

I ended up paying out of pocket for the third consultation with a local breast cancer specialist. Pending further testing, she is recommending a more extensive surgery than the general surgeon that includes intricate and select lymph node dissection, similar to what the second surgeon is recommending. The second and third surgeons also said they would want an additional test or two prior to the surgery to be fully informed and prepared. That makes sense to me. To the HMO, no. To the General Surgeon, no.

I’m in the infusion room. My oncologist just came by and told me the exact opposite of what the HMO told me about a particular part of the appeal process. Ugh. Another catch-22. 

I'm running out of time. It's important to have the surgery before I'm too far out from my last chemo, before the tumors start growing again.  

This hard ass, cynical news desk maestro is trying to hold back tears. It’s not the chemo, it’s not even the cancer. It's the HMO. A nurse tells me everything will be okay. I so want to believe her.

Insert fake smile here.