Episode Transcript
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Speaker 1 (00:00):
Well, hello, my
friend, and welcome to the
Caregiver Cup podcast.
I thought I would just jump inwith an update.
I know I said that I was takinga break and I've decided I'm
just going to jump in and giveyou updates or lessons learned
or insights when I can during mychallenging season.
(00:20):
So, first of all, I'm doingwell and Dennis's treatments are
going as planned.
He had his fifth chemotherapyinfusion cycle just last week
with the typical side effectsand it's kind of funny because
typical is not fun, but he'smaking it through.
(00:41):
He had extreme fatigue, nausea,but it was manageable with his
nausea.
Medications and food and stuffaren't tasting right in his
digestion.
Our digestive system isn'tdoing well, but I think we're
just kind of blessed, and I'mblessed to actually have a guy
that's really tough.
(01:01):
That's really tough the doctorthat we go to.
Dr Goddam is his name and he'sreally good, very professional,
very, very scientific and kindof just really comes in and he's
all business and every so oftenhe continues to surprise me
(01:22):
because he said to Dennis hegoes, you're such a tough guy,
and I take that as a truecompliment because he recognizes
that A typical person, I think,in me included.
As a typical person, I would bein a fetal position just
struggling to make it go a fetalposition just struggling to
(01:49):
make it go, and Dennis hasunbelievable strength and pain
tolerance.
But there was also a bit ofadmin work and advocating over
the last few weeks and I want toshare with you the chemo pill
scenario today because I knowyou, as a caregiver, experience
these admin struggles andfrustrations and advocating
(02:10):
challenges all the time.
So, with this being said, thisprompted me to dust off my
podcast microphone, which it'sonly been a couple weeks but it
feels like it's been forever,and I miss you so very much.
And I want to share thestruggles and challenges that
both you and I, as caregivers,face and our loved ones face
(02:33):
when it comes to advocating ornot getting lost in the maze of
the health insurance and theadministration and the doctor's
notes and getting treatment on adaily basis.
Especially, I'm referring tothe cancer side, but I also can
go ahead and refer to my pastexperiences with my mom and
(02:57):
dad's care as well.
If you don't advocate, if youdon't stay on top of things, you
kind of get lost in the shuffle.
So the doctor explained thechemotherapy pill back on.
I think it was January 24th, wehad his follow-up visit and he
(03:19):
went through what thechemotherapy pill, when he took
it twice a day, could do.
And they're hoping throughconsulting with his freighter
doctor and our Green Bay doctor.
They both feel that this is thebest plan.
In addition to having hisinfusion chemotherapy, he needs
to go ahead and go onchemotherapy pills morning and
(03:39):
at night, so twice a day for hisCLL, which is non-Hodgkin's
lymphoma.
It's the I think it's chroniclymphatic leukemia or lymphoma
that attacks his and thenon-Hodgkin's that he has.
Cll is not there's no cure forit, but the treatments are, or
(04:02):
the there is medication to goahead and keep it under control.
So he went through that andtalked about how it would take
care of that.
But he also went through thesymptoms and the side effects
and the risks involved as well,and so there there's definitely
side effects which he'sexperienced now and there are
(04:23):
risks involved and so we have towatch for bleeding and certain
types of things that the pill isknown for as well, and both
Dennis and the doctor and I allfelt optimistic that he could
handle it because Dennis isoverall healthy.
His pain tolerance and histolerance to going ahead and
(04:46):
making through.
It is very positive and, beingin his early 60s, I think that
we all felt that it was a gooddecision.
So in order to go ahead and takeany type of chemotherapy, you
have to sign an authorization,more or less.
Any type of chemotherapy, youhave to sign an authorization,
(05:07):
more or less signing your lifeaway, saying that you agree to
taking these toxins and I'mlaughing, but not laughing into
your system to go ahead andfight the cancer.
So he signed that on January24th.
The reason I'm telling you thisis because I want to share this
chemo story with you.
So the nurses then came inafterwards and talked about the
(05:30):
process and their nurses saysnow we'll take this
authorization that Dennis hadsigned, give it to our
pre-authorization team, who isgoing to file it with the
insurance company, and then,once the insurance company
approves it, then they'll goahead and start the pharmacy
process, and this should takeabout seven to 10 days, and this
(05:57):
will then help us, because thepharmacy that we have to use is
not a typical corner pharmacy.
It has to be made outside ofthe typical pharmacy drugs, and
then this drug gets shippeddirectly to our home and it will
be mailed to us overnight andall that kind of stuff.
(06:19):
So she explained that process.
So seven to 10 days In theinterim we had to attend another
chemotherapy training.
We did this at the verybeginning with his infusion
therapy.
But Dennis needed to know howto handle the pills.
I had to learn, if I had togive him the pills, that I had
(06:39):
to wear gloves because of thetoxins that are in the
chemotherapy pills.
And we had to make sure that westored them in a cool, dark
place and they were away fromanybody or anything that could
get a hold of the drugs, becausethey definitely are harmful.
And we also had to talk aboutthe precautions that we had to
(07:03):
use.
And if you've had a person withcancer that's getting
treatments, you know that theyhave to have their own separate
bathroom.
Or if they didn't have aseparate bathroom, you have to
flush it, flush the toilet twice.
You had to clean up.
You can't leave any fluidslaying around for anybody else
(07:26):
to be exposed to.
So we went through all of thatAt that time too.
They talked about that.
It was about what was it?
I'm just counting it was aboutsix days and they said that they
saw the note in the systemsaying that the preauthorization
(07:48):
team had it, but they haven'tseen anything else come through.
So they reviewed the processagain with us.
Haven't seen anything else comethrough, so they reviewed the
process again with us.
Well, there was this gap thenwhere nobody contacted us and we
didn't hear anything.
And his next appointment wasFebruary 5th.
Here's just a little note whereI dropped the ball here that I
(08:10):
felt like now I've learned.
But we didn't hear anything andwe had the appointment on
February 5th.
And so we arrived for hisappointment.
And when he comes in for hisappointment on February 5th
which is what?
10 days now since we signed thepreauthorization, or he signed
that authorization for chemopills, authorization for chemo
(08:38):
pills when he arrived for hislabs and he went into the labs
and he knows everybody at theclinic now and the nurse that
came in said how are you doing,dennis?
And Dennis goes.
I'm doing good, but I'mfrustrated.
I haven't received mychemotherapy pills or any word
from it.
Nobody said anything.
Well, there's always a silverlining, because the technician
that took Dennis, drew Dennis'sblood, said I used to work in
(09:01):
the pre-authorization team forthis hospital and this oncology
department.
So she wrote down the numberand she goes.
It should not take that long.
Usually the insurance companiestell you in one or two days and
then there's a little bit ofwork behind the scenes that the
reauthorization does and theypass it off.
(09:23):
So she goes.
I would call, here's theirdirect line.
And so Dennis came out of thelab and then we had a check-in
with the doctor's office, whichis one floor up, and we had a
long wait anyway because theyhave to go ahead and process all
his lab work before the doctor.
And so I said to Dennis I saidwhy don't you make the call now?
And so he made the call andwhat was really funny is he
(09:47):
called the pre-authorizationteam and they said oh yeah, you
were seen.
He was seen on the 24th.
The pre-authorization teamapproved it or the insurance
company approved it on the 27th,so from a Friday to a Monday it
was approved, but nobody hastouched it since then.
(10:10):
So more or less it got lost inthe worldwide internet process
or whatever it is that theoffice there has.
And Dennis said well, I needthese, and both of my doctors
from Friedert and this Green Baydoctor wanted him to be on
(10:32):
these chemo pills before thisappointment.
And so Dennis, you know, toldhim his concerns and told him
that.
And he told him he was upset,he needed that taken care of
ASAP.
And the girl said she's goingto get on top of it and flag it
(10:52):
as priority today.
So we hung up the phone, wewere talking, we were kind of
frustrated, talking in thewaiting room and didn't our
nurse navigator walk by?
And again, there's a silverlining in everything and she
walked by and so we flagged herdown, explained the whole
situation and said thatsomething is wrong here.
(11:16):
Somebody dropped the ball.
My husband said they put thepaper on the bottom of the pile.
And I said to my husband theydon't have paper anymore,
everything's in the system.
But somebody probably had it intheir queue and either clicked
buy it or it didn't get put intoa queue I have no idea it or it
did get put into a queue, Ihave no idea.
(11:37):
And so, to make a long storyshort, through our concerns we
told the nurse navigator, wetold the doctor that day the
doctor sent us down, or Dennisdown, to start his chemotherapy.
Within probably a half hourthat we were sitting down in the
chemotherapy area where he wasgetting his infusion.
(11:57):
The nurse navigator came downand said everything's in a go.
We have everything working.
We've already called thepharmacy.
The pharmacy called us when wewere there to confirm our
address and we had everythingsent to our home within 36 hours
(12:19):
.
So everything was a go andDennis was able to go ahead and
start those as soon as possible.
But I wanted to share with youas caregivers, challenges and
struggles are inevitable.
Changes and struggles areinevitable and they are also
frustrating when you hold yourloved one's care, their care to
(12:39):
the highest expectations, andwhen things don't work out.
It is so frustrating and I knowyou experience this too because
you rush and you get yourselfall prepared for it, like Dennis
did when he had to sign thatauthorization form to go ahead
and take the chemo pills andthen nothing happens.
(13:01):
In this situation, I think thebiggest lesson I've learned is I
trusted the process of seven to10 days and assumed it would
fall into place.
When I look back now at thissituation and I wanted to share
it with you if I could do itover again, I would have started
(13:22):
a follow-up and put a follow-upalarm on my phone or a sticky
on my calendar at seven days andsaid, okay, I haven't heard
anything yet.
What's the process, and if theysaid, well, we haven't heard
back from the insurance company,I could have called the
(13:42):
insurance company and or calledthe nurse navigator to check in
on it, and then I should havefollowed up again in 10 days.
And that's one of the thingsthat I've learned from it,
because, like I said, whenDennis called, it was approved
in two business days and somehowthe authorization wasn't
(14:05):
finished and sent to thepharmacist and we were worried
about all of the cost and stufflike that.
When we talked to thepharmacist and the
pre-authorization team, we evenasked there was $100 copay for
us and we had said is there anytype of grant or incentives or
(14:30):
any financial assistance that wecould get?
And they gave us the incentiveand we were able to get it at
zero cost, which was wonderful.
You know I forget how manypatients, though, and
complicated things are, and so Ihad to go ahead and talk myself
(14:52):
through it and not do the blamegame.
But it's hard not to do theblame game because when you look
at your loved one, they're theonly one that's important to you
when you walk into that clinic,but you see all of those other
people, and so I think that Ijust had to just really learn
that I had to go ahead and betheir advocate too.
(15:13):
I had to be part of thatpre-authorization team and, you
know, even ask for the phonenumber so I could go ahead and
follow up if I didn't hearanything in seven days.
And so I am not going to beafraid to go ahead and ask okay,
you said seven to 10 days.
(15:33):
If I don't hear anything inthose seven days, who can I call
to follow up, to check on it,because this is important to my
loved one, and if there'sanything that I can do from my
end, I can make some calls aswell.
And if there's anything that Ican do for my end, I can make
some calls as well.
And so I'm just going to putthat in my back pocket.
(15:53):
I journaled about it and Iwanted to share that with you
today in this podcast episode.
So well, my friend, that's theupdate that I have for now.
Dennis had his follow-up visitthis past on the 14th, on
Valentine's Day.
That was our lovely date day.
(16:15):
He is doing okay.
He's struggling with lowplatelets, low red blood cells,
low hemoglobin.
He's losing a lot of weight but, like I said, the doctor called
him a tough guy and what wereally have is we have one more
(16:37):
cycle to go and that will be I'mjust looking at my calendar at
the end of this month.
So he'll have another cycle andall the rest of the
chemotherapy pills and we'llfollow through with all of his
treatment plans in March, butwe're looking at, sometime in
(16:58):
April, a stem cell transplant,if he can stay healthy.
Even though we as caregivers hada few speed bumps for me and
Dennis, we kept advocating andpushing, and that's exactly how
we keep our loved ones' care ontrack, and I want you to
(17:18):
remember that too.
You and I know it's not easy tojuggle phone calls and paperwork
and all the back and forth, butstaying persistent can make a
world of a difference for yourloved ones and for your sanity
as well.
As you head back to your day, myfriend, I want to remind you
that you are strong, capable andabsolutely entitled to ask the
(17:43):
tough questions and follow up onthose authorizations and
appointments.
Sure, the process isn't alwayssmooth, but we have to keep
pressing forward and tappinginto our determination and the
reason we're doing thatadvocating we can get our loved
ones the care that they deservewhen we go ahead and hold them
(18:07):
to the accountability as well,and I don't even think about it
as like pulling teeth orfighting with them.
I just think it's just apartner going ahead with the
doctor's office, with theinsurance company, and we're
working together to go ahead andjuggle all of these pieces.
(18:27):
So thank you for being herewith me and, like I said, I
missed you so much and I hope,by sharing these lessons, it'll
help you.
It means so much to know we'rewalking this path side by side
and until next time which I hopeagain is the next week or as
(18:48):
soon as I can, I want you tokeep your head up, keep
advocating and remember you'redoing incredible work, my friend
, and I'm right here cheeringyou on.
So talk to you again real soon.
Bye for now.