I was admitted on 4/27.  It was the usual outpatient visit with Dr. Cripe and then upstairs to the 3rd floor for admission to the unit.  I was in A pod for the first time since December.  I like A pod.  My chemo started at 2pm that day and I received a dose every 12 hours, including Saturday at 2am.  At 5:30 am on Saturday I received 2 more quick doses of chemo and was ready to be discharged about 9a.  Besides there being a folding chair where a stool should have been, my room was in complete working order.  I guess there’s a first time for everything.

As I said, I was discharged around 9am on Saturday.  Lindsey picked me up and we headed home.  The next few days consisted of mostly me either being in bed, or just up enough to eat and see the kids a bit.  I didn’t have bad headaches (thankfully) and the nausea was manageable with phenergan.  Overall the biggest side effect was fatigue, which I’ll take all day long over some of the others.  Tuesday was still a rough day, but on Wednesday I started feeling better.  I wasn’t up to doing much, but I could at least be out of bed all day and I actually wore clothes instead of pajamas.  On Thursday and Friday I was able to work from home and during the weekend we hosted my family.  Today I am doing quite well and have been out of the house a few times.  I’m not walking any long distances or anything, but at least I can keep one foot in front of the other.

Late last week, Lindsey came to me and said she wasn’t feeling well.  It wasn’t the best timing since it was after chemo but it wasn’t bad timing because I was well enough to at least keep the kids fed and alive.  After a day or so of not feeling well, and not really sure why Lindsey said “If I didn’t know any better, I’d say I was pregnant.” SAY WHAT!  Now that will get you out of your chemo fog in a heartbeat.  It’s funny because no matter how impossible it would be for her to be pregnant, in the back of your mind you’re still thinking “oh holy hell”.  It’s pretty much impossible because A) The chemo has most likely killed off all my swimmers to the bottom of the testicle pool and B) Lindsey has an IUD and C) Well, in all honesty, with 3 kids and monthly chemo there ain’t much of anything going on here.  Still, we took a test just to be sure.  I was quite relived that it was negative.  And even more relieved when the 2nd and 3rd test were negative as well.  You can never be  too sure 😉

In December I joked about being an IU Health Employee, being treated by IU Health physicians, at an IU Health facility, with IU Health insurance.  What could possibly go wrong!  The latest example of billing woes is with my Neulasta shots.  These are the shots I get once a month after discharge to help boost my blood counts.  I’ve had a shot in January, February, March, and April.  Just recently my Jan and Feb shots made it through insurance, er well, didn’t make it through insurance.

Here’s the funny thing.  It’s the exact same shot, with the exact same bill code, and the IU Health insurance treated the Jan shot differently than the Feb shot.  The Jan shot was denied because I wasn’t pre-certified and the Feb shot was denied because I wasn’t pre-authorized. Now those two things sound quite similar, but they are apparently quite different.  You see, the charge not pre-authorized did not qualify for the insurance’s negotiated rate, so they say I owe $9,160.75 for that little shot.  While the charge that wasn’t pre-certified does get a discount, so I “only” owe $5,518.44 for that shot.  It amazes me that the exact same shot is being treated 2 different ways.  Not to mention, when I contacted my IU Health Physician’s office about my IU Health insurance woes, the IU Health Physicians office clearly had a confirmation number from my insruance company that my shot was pre-authorized, certified, and everything else that was needed.

Unfortunately said insurance didn’t have a record of that, so we had to do a retroactive pre-authorization/certification (I think time travel was involved).  I’m well on my way to having this cleared up, but imagine it will take a few more phone calls.  As IU Health transforms, we are supposed to be saving costs or increasing our revenue by 25%.  I think we could save a lot if our IU Health insurance trusted the decision of our IU Health doctors.  After all,aren’t 80% of US News & World Reports top doctors in Indiana practicing at IU Health?

My A cycle involved 4 days of steroids during the 2nd week of the cycle.  I’m taking those steroids right now and they are messing with me a bit.  Unfortunately I’m not pumping iron, so I don’t get any of the muscle building benefits.  Then there’s the important side effect of the winky dink shrink. I’m still doing ok there.  However the steroids are keeping me up something fierce.  I suppose it’s not too bad because I’m not tired during the day, but it’s just annoying not being able to go to sleep at night when you want to.  I’ve tried various combinations of the drugs at my disposal, but I think I’m just going to have to tough these four days out.  At least the winky dink won’t shrink.

Father God, thank you for feeling good.  Thank you for a positive outlook so that even if I feel bad, I try to see the good in it.  And when all else fails, thank you for holding me in your arms and comforting me.  Be with those that need you tonight.  Even those that don’t know they need you.  Thank you for another day.  Amen.

This last treatment has been pretty good to me.  I would say I’ve felt better this time around than any other.  Granted, that could be  because 2A was the worst I’ve felt after chemo so this time just seems better.  We’ll have to see if 2A was an anomaly, or if the A cycle just likes to beat me up.

With Apologies to IU Health

Apparently I upset someone with my last post about IUH owing me a dollar.  I say this because shortly after I wrote that, we received a collections notice for an IUH bill.  Now I may at times not pay an IUH bill the same month I receive it, but that is simply because I’m usually waiting for some charges to work themselves out.  I usually always pay by the 2nd time I receive a bill and I would most certainly pay attention to a final notice.  Try as I might, I just couldn’t track down the charge we were being taken to collections for.  I keep all my IUH bills and this particular charge wasn’t showing up on any of them.

Stymied by the lack of documentation on where I went wrong, I gave my good friends in billing services a call.  They are good friends because it seems I have to call them often to get things fixed.  Anywho after some typing and searching a very nice lady was able to track down the charge.  Here’s the rub though…IUH only ever sent me one bill (or so they say, I still can’t find this bill in my records).  They never sent a 2nd bill or even a final notice.  Just one bill and then off to collections the charge went.  The lady apologized, as this charge never should have gone to collections.  She ended up writing the charge off for me.  Unfortunately it was only a $150 physician visit and not the $90,000 hospital visit.

I get my labs drawn Mondays and Thursdays.  I’ve always gotten my labs drawn Mondays and Thursdays.  Ever since my original discharge, I’ve been told to get my labs drawn Mondays and Thursdays.  So I was a bit surprised when I had the following conversation with the lab last Thursday.

Me: I’m here to get my labs drawn

Tech: Hi Mr. Culross, let me get you set up

Me: Ok

Tech: Mr. Culross, you’re actually not supposed to have labs until Friday.

Me: Really?  I always get my labs done on Mondays and Thursdays

Tech:  Well the computer has you scheduled for Friday.

Me:  That’s weird, when did the schedule change?

Tech:  It’s always been scheduled for Friday, but we’ve drawn your blood on Thursdays because that’s when you show up.  We can’t do that anymore.

Me:  Oh, but my doctor told me to get blood drawn on Thursdays.

Tech:  Yes, but the computer says you should get it done on Fridays.

Me: Yes, but my doctor told me to do it on Thursdays.

Tech:  I know, but the computer automatically schedules your labs and it scheduled them for Friday.

Me:  But my doctor told me to get it done on Thursdays

Tech:  I know, but the computer has always had it scheduled for Friday.

Me: But my doctor is a person, and he wants it done on Thursdays

You can see the trend developing here.  Now I do want to say that the tech did a wonderful job helping me out.  She called her supervisor and tried to get a hold of my doctor so I could get my labs drawn on time.  The funny thing to me though is that Dr. Cripe can go to 4 years of undergrad, 3 years of med school, do a residency, and complete a fellowship, yet a patient is just about sent home because a computer says to draw labs on a different day.  It’s a good thing the computer didn’t tell them I was there for breast implants, or I might have walked out with some new C cups.

Thank you God for each day.  I do not know the time or the place when I will be called home, so I am thankful for the time that I have.  While surviving leukemia consumes me, I could just as easily be harmed while driving in to work or cheering on people in a race.   I do not know when.  I do not know where.  I do not know what will cause me to leave this earth, so I am thankful for the time that I have with my friends and family.  Help me to use it wisely and help me to live each day in a way that honors you.  Thank you for another day.  Amen.

I finished up my chemo this past Friday.  Everything was pretty routine except for one little incident.  Well, and they had to poke me twice to get my lumbar puncture done, but otherwise nothing eventful.

I got my chemo at 2p and 2a.  Typically my nurse will come in just before 2a, I’ll wake up and we’ll begin the process of getting chemo started.  On Friday morning, that is exactly what was happening until my little incident.  The nurse came in, I woke up and turned my head towards him and he flipped on the lights.  The next thing you know, he’s quickly walking to my bed and saying “where’s that blood coming from?”  Well, that’s a mighty fine question.  Considering I’m the only one in the bed, I quickly deduced it was coming from me.  Problem is, it was a rather large puddle of blood and as I checked my nose and other obvious exit points, I couldn’t find the source.  My nurse jumped into action with all the knowledge and skills endowed to him by his red scrub top and black pants.  He quickly concluded that my IV line had separated.  One end was steadily pumping normal saline on the floor, and the other end was slowly dripping blood from my port.  We aren’t quite sure how much blood I lost, but there was a good sized stain in my bed sheets with some blood pooled.  Granted, I didn’t feel dizzy or anything, so it wasn’t so much as to cause a lot of paperwork.

Having identified the source, he cleaned, flushed, and capped my line and I then went into the bathroom to clean up the blood that was on me while he took care of the bed and IV fluids.  Needless to say, we were a little late getting my chemo started that time.

A few days after every admission, I get a Neulasta shot to help with my counts.  I show up, I check in, and after about 15-20 minutes I get my shot and leave.  Every Monday and Thursday, I get blood drawn to check my counts. I show up, I check in, and after about 10-15 minutes they draw my blood and I leave.  It just so happened that this past Monday I was due for both my shot and my blood draw.  Unfortunately, much like bleach and ammonia, apparently you should never mix these two things.

I thought I’d be smart and schedule them together so I could just go to one place and be in and out.  About 10 minutes after I checked in, I got my labs drawn and thought I was well on my way to a quick visit.  Somewhere along the way though I think there was some confusion in clinic, as they wouldn’t give me my shot until the lab results came back.  I was both too tired and too mentally dead to argue, so I sat in the lobby and waited and waited.  Eventually, after about 2 hours of waiting I got my shot.  What should have taken 30 minutes or so took a little over 120.  To add insult to injury, since I had been in the parking garage so long, I had to pay $1 to get out.  So IU Health, it doesn’t matter to me whether it’s a credit on my next bill,  $1 off my chemo, or an extra buck on my paycheck but rest assured, ya’ll owe me a dollar.

I sleep a lot.  Like go to bed at 730pm, wake up at 9am and take 2-3 naps during the day a lot. All things considered though, fatigue isn’t the worst side effect to have.  Between sleeping a lot and taking a regular dose of phenergan, 2B hasn’t been as bad as 2A.  Now the questions is…was 2A and anomaly, or will 3A and 4A be just as bad.  I guess we’ll see.

My next date with chemo destiny is April 24th.  Of course this will be dose 3A.  After I’m done with 3A, then there is only one more A to go.  I like that I’m half way through and being able to count down.  It helps out mentally a lot.  All I need are two more A’s and two more B’s and I’m outta here.  It’s a lot like my last semester of college.

Thank you God for rest.  Thank you for those around me who take care of me so that I may rest and recover.  In a busy world of constant connections let me not forget to take time to rest with you.  Let me not forget that you are my most important connection.  Thank you for another day.  Amen.