Kicked to the Curb by Kaiser

Dave has been a Kaiser member for 17 years, via two different workplaces. The company he was recently working for went belly-up so now he's looking for full-time work and looking for health care.

We knew things weren't going so well at Dave's last company, and knowing he had two life threatening chronic health problems, I tried to call and get another health care option lined up ahead of time. Which was useless. Everyone I talked to told me to call back after Dave was laid off and after his health insurance had expired. Until then, they wouldn't answer any questions.

After we got a notice in the mail from Kaiser, saying his insurance was terminated, we visited them to look into their "options for continued coverage" (noted in the handy little full color brochure enclosed with the "you're terminated" letter.) It was one of those surreal experiences with a smiling functionary behind a desk, telling you how screwed you were. Felt like we were in a Michael Moore movie.

You could get Cobra through your employer . . . oh, your company employed less than 20 people? Then they weren't required to carry Cobra.

You could apply for individual coverage but you'd probably be denied for having a pre-existing condition.

Even though I've been a Kaiser patient for 17 years?

You'd be just like everyone else.

You could use one of our "conversion plans" (which allows you to buy our insurance at obscenely high prices, but we won't reject you for having a pre-existing condition.)

Gee honey, which should we choose, homelessness, or health care (hunger is pretty much a given.) Aren't there any other options?

You could apply for Healthy San Francisco but they won't accept you unless you've been uninsured for 90 days.

So in the meantime? When my Coumadin runs out? Wait until that big clot gets bad enough to kill me and then hope I get to an emergency room in time?

Doesn't it seem a little bit insane that an organization that calls itself a "health care" organization, that claims to care about the health maintenance of its members, would look at a member like Dave (still being monitored and treated for Leukemia and a blood clot in the leg) and just cut off communications with that member? No effort at transitioning them to other caregivers, no diagnosis-specific advice about how to prevent his health problems from spiraling out of control. **It's ALL ABOUT THE MONEY!** "Pay up or die" - that's the true Kaiser ethos.

-- Anna

More and More

It seems as if each year is busier than the last. That's very good in a way: I have the energy to keep up and I actually add items to our calendar.

After quite a few years of constantly feeling run down and so out of shape, it's amazing to be able leave the office after a day of work and head downtown, meet a group of friends, go gallery hopping, then out to dinner and enjoy long debates and discussions about art and photography and publishing.

When I do find myself slowing down it's because I've spent so much time on my feet and my aging joints are screaming. I enjoy walking and I've been walking so much in the last year my feet and knees are really showing the signs of taking a beating. I've also put new street tires on my bike, but biking actually helps my knees.

The nature of my job is such that my mind is seldom far from thoughts of my own work. I'm able to devote more and more time to my photography, which is consuming more and more of my entire being, which is just fine with me.

It's been three years since I ended the chemo treatment and almost a year since my last Rituxan infusion. My numbers remain good and are fluctuating well within the range of normal. I saw my doctor last month and he said that after my next visit in March of next year we will probably schedule the next two visits eights months apart then go to once a year.

The goal now is to achieve that once a year schedule.

Photo: ©2010 David W. Sumner

Celebrating What Counts

5 months of chemo
5 blood transfusions
2 years of Rituxan therapy

I never stopped shooting.

Photo: Anna L. Conti

Watch and Wait

David the nurse and David the patient give two thumbs up to the end of Dave's 2.5 years of treatment for B-cell chronic lymphocytic leukemia. (He'll be monitored every 3 months until he needs treatment again.)

Well, we just crossed into new territory today. Dave is officially on "Watch and Wait", which is a term used by people with Leukemia, to describe the state where the progress of the disease is being monitored, but not treated. Treatment will resume when Dave starts having unacceptable symptoms or dangerous blood levels.

It goes without saying that it's been a difficult 2.5 years since he was first diagnosed. But it was harder than I expected it to be. Seriously - I thought, since I've been through this kind of thing before with other family members and friends, that I was not going to have any major problems handling what needed to be done, and I think that part is true - with the help of friends and family, I stayed on track and was able to hold things together. What I didn't expect was the emotional toll. For the first year we were in a constant state of fear, uncertainty, and outright panic. But I had to ignore that and keep on keepin' on. After Dave's condition stabilized, and the situation became more routine, I went into a major depression, which I also pretty much ignored and didn't even recognize until about 8 months ago when I started coming out of it. (Note to friends: if you didn't hear from me for a couple of years, that's why.)

Things are going great now and we're living for today, focusing on what's really important to us, in ways that we couldn't imagine before this all came down.

Dave asked me to post this message from him:

"Today, after two and a half years of infusions, transfusions, injections, and countless bottles of pills, I had my last infusion of Rituxan. Now I begin what I hope will be a long period of "watch and wait." I will be having blood drawn every three months, followed by a visit with the hematologist-oncologist.

Right now my numbers are great and they have been that way for over a year. The question is how long will they remain "great" without the Rituxan therapy? Based on my history and my good response to treatment, I expect to hold good numbers beyond the standard five year estimate. New treatments are coming up fast, so I also expect it will be easier to keep the CLL in check in the future."

Almost done with Rituxan

Dave's next-to-last Rituxan infusion was last week and it was uneventful. His bloodwork still looks good. He gets his last treatment in December and then he'll probably be on "watch and wait" status until he needs more treatment. The blood clots in his leg are still a problem, but relatively minor when you consider all the other stuff he's been through the last couple of years.

-- Posted From My iPod Touch

Quick Update

Dave had an ultrasound of his leg today. The clot is still there (but we knew that.) He sees the oncology/hematologist on Wednesday, about the clot in his leg, and the CLL. More then.

-- Posted From My iPod Touch

Looking Forward to a June Vacation

Shooting with Darren Katin at SFMOMA Photo: ©2009 Anna Conti

Next week I'm at Kaiser for a Rituxan infusion and some blood tests. That leaves one more infusion this year then a revaluation with the Doc. Next January we may decide to end the infusions all together and put me on a watch and wait status. I'm not too sure how I feel about that right now, but I'm confident we will keep things under control what ever we do.

So I'm focused on my photography and my up coming vacation. No trips this year. Staying close to home, spending some mornings out early shooting and hanging out in coffee houses.

All is well.

Keeping Busy

CLL speaking, everything is going very well. My Rituxin infusions are down to four a year now. So I have two more this year and we will reassess in January. The idea of ending the Rituxin treatments is a bit scary right now, but if there is a chance of building a resistance to it over the long term, it would make more sense to save it for when the CLL cells start growing. We'll make those decisions when the time comes.

Anna and I have been keeping a hectic social calendar lately: museums and gallery shows, dinners, a lot of hanging out with the photographers and artists of the Blow-Up! group, family visits. You can check it all out on Facebook.

The photo above is from an evening at Noc Noc, on Haight Street. A bunch of Blow-Up! members got together to wish Bon Voyage to fellow member Tony Remington. Tony is in the Philippines working on a project on poverty and relief efforts.

Photo: ©2009 David W. Sumner

Caio for now.