Tomorrow is the first day of this month's "chemo week." Dave has chemotherapy treatments once a month and this is the third month/treatment. Each treatment regimen goes something like this:
"Week 1", Monday - lab tests to see how his liver, kidneys, and bone marrow are holding up to the chemo.
Tuesday - the doctor physically examines him to check on the condition of his lymph nodes, liver, spleen, and so forth. Then she orders the treatments for the next few days.
Wednesday, Thursday, Friday - Chemotherapy infusions and any other treatments the doctor orders.
Saturday & Sunday - Sleep.
"Week 2", Monday - Dave thinks about going back to work, but usually decides against it.
Rest of "Week 2" - Dave slowly returns to work, for short periods.
"Weeks 3 & 4" - Dave's appetite and energy slowly return, or not. Lymph nodes swell up, and then go down. Night sweats come and go. Various other symptoms unexpectedly appear on stage, spread a little terror, and then fade into the wings. By "Week 4" he can finally eat a little bit of tomato sauce, so he gets to have his favorite Italian and Mexican dishes once or twice, before the next round of chemo puts him back on a bland diet.
Then it's time to start the whole thing over again.
Although this is the third cycle coming up, it hasn't quite reached the point where it could be considered routine. Last month, the anemia and ProCrit injections were the big new thing we needed to adjust to. This month, who knows? If the anemia hasn't improved, he may need a blood transfusion. But I can tell you what I'll be doing first thing Monday morning - fighting with the HMO over Dave's medication coverage. Theoretically, his insurance has drug coverage, with a $10 co-pay. In practice, they seem to make exceptions to that plan whenever they feel like it (sometimes they charge $28, sometimes $65 - if there's any rhyme or reason to these figures, I haven't discovered it. And he's on 5 prescription drugs - so far.) The latest problem is the Famciclovir - a drug that fights viral infections. Dave has been taking it since the first day he started treatment, and he is expected to be on it for the next 6 months, maybe longer. This is a life-or-death kind of medication. He called the HMO pharmacy last Thursday, per their policy, to notify them that he had 24 hours supply left. They said he had no refills ordered. Wrong. Twenty-four hours later (on Friday), he had no Famciclovir left, and we were still arguing with the pharmacy. So Dave went to the Oncology clinic and talked to one of the nurses. Dave's doctor wasn't available, but the nurse got another doctor to write a new prescription for the Famciclovir, then he went back downstairs to the pharmacy. After the usual eternity in the waiting room, his name came up on the board, and he went to the counter, where they told him his drug was ready - and he owed them $462! He argued, he pleaded, but they were unmoved. Of course, by now, the clinic was closed for the weekend, so he came home without it.
After I got the news, I spent the next few hours thinking I was going to be a widow sooner rather than later, but eventually I got past it. We hunkered down for the weekend, in extreme infection-avoidance mode. Tomorrow I go into warrior mode.
Stay tuned . . .
(Image is "Kali" - a painting I did in 1996.)