Gratitude, mostly.

This is a cancer post.

I was really, really grateful on Friday. Thankful, relieved, and lots of other happy and positive words. I did really enjoy the #D&DGOP thing, but for the most part I don’t have a lot of room for Schadenfreude, if that even counts, because for once more room is being take up by happiness, gratitude, thankfulness, etc.

I don’t have access to healthcare through my employer, so I have a plan I purchased from the marketplace. I know for a fact that I need a scan that will run thousands of dollars, at least once a year, for the forseeable future. Annually, I have a PET or CT scan done to check my body for cancer, in addition to blood work and labs every six months.  My deductible is currently $500, and my co-insurance after that is 20%, so that means that I’m not going to be completely on the hook for a procedure that is $5000 or more.

A lot of people don’t really understand healthcare.  At least one of my parents voted for Trump, which I do have feelings about as at least one of the things he had said often on the campaign trail was that he would make the repeal of the ACA a priority, so I felt like either this parent did not understand that health care is a priority for me, or thinks my cancer will never come back and nothing else will ever happen to me so it won’t be a problem, or maybe since Oregon is a pretty blue state, I’ll be okay regardless of what the rest of the country does. One of my parents said “Do you really think the state of Oregon is going to just let people die of cancer?” I mean…I don’t know? I know that lots of times people don’t go to the doctor to find out what’s wrong with them because it’s too expensive. I was one of those people. Both of my sisters have said things to me along the lines of “Oh, but most insurance just Is Bad and expensive, so I don’t really think it matters.”

I guess that’s a very Person Who Hasn’t Had Cancer thing to say? I used to say I was fairly sure most people didn’t understand health insurance unless they’d had a serious medical condition or been pregnant, which many people don’t consider to be a serious medical condition but certainly seems like it would be to me — but one of them has had two kids and the other is pregnant now, and neither of them knows what a deductible is so I think my initial assessment was just wrong.

If anyone’s curious, I will break some things down in numbers, “Erin Brockovich”-style.

3: The number of times I went to doctors at Kaiser who told me that probably, nothing was wrong, even though I showed up several months after my initial visit with a second lump right next to the first, on the left side of my neck.

4: The number of denials I got from various insurance companies when I tried to find affordable insurance in my gap months — insurance from my old job ended in August of 2013, and insurance at my new job wasn’t available until November. I had been treated for anxiety, which was a pre-existing condition, so they weren’t going to take me. I ended up getting useless gap coverage just so that my new insurance couldn’t refuse to cover pre-existing conditions as well. The lumps hadn’t been diagnosed, and they also hadn’t gone away. It was before “Pre-Existing Condition” part of the ACA kicked in.

19: The number of months in between when I felt the first lump and when I found myself on an operating table, counting backwards from 10 so that a surgeon could take one of the lumps out, send it to a lab, and tell me what it was.

13: The number of dollars I was making per hour. Sometimes, you simply can’t afford to have cancer. You can’t afford to go to the doctors, so that they can rule it out. So you just tell yourself you’re fine. That’s free.

3 again: The number of lumps that I had to feel on my neck before I finally decided that I had to find out what it was, even if it meant I had to be in debt for the ret of my life. The third one was on the right side and the other two were on the left. I’d been able to tell myself that maybe something was just wrong with some muscle or joint when it was on one side, but when it was on both sides I knew there was a problem. The ENT did, too. He knew as soon as he felt them. He told me not to leave without scheduling the biopsy. There was definitely a very cool surprise later on when I looked at the first PET scan of my body and saw the mass that had been growing right next to and above my heart for at least two years, maybe three.

4: The number of days I had to wait after the biopsy before finding out I had cancer.

3,000: My deductible, which was part of the reason I waited, part of the reason I put off even going to an ENT (Ear, Nose, and Throat specialist) as long as I could. A deductible is that amount that you have to pay before your insurance will begin to contribute. If you have 20% co-insurance after your deductible of $3000, that means you have to pay $3000 before they start to help you.

5000: My out-of-pocket max. After I hit $3000, my insurance paid 80%, and I was responsible for 20%, until I hit $5000, after which point, mercifully, I would have no more costs that year aside from copays. The timing of my diagnosis and treatment actually was pretty lucky, as my plan year had just started and I was able to get treated and cured within that year. You are absolutely going to hit your out-of-pocket max if you have cancer, no matter what it is.

3, one last time: How many paid sick days I had per year.

8: The number of Aetna representatives who told me that my wig would be covered even though in the end it was not, which I realize is not the worst thing that happened that year but my current job has confirmed for me that Aetna reps in particular do not always provide correct information.

100,000: How much it would have cost me without insurance. That’s more than my grad school tuition. And even though I wish I had better insurance, of course $5,000 is a lot better than $100,000. It was slightly more than $100,000, but I like tidy numbers, and inside that particular tidy number were three surgeries, two ultrasounds, an EKG, lots and lots of lab work, at least four PET scans, 8 rounds of chemo, and various other things I can’t remember or have blocked out. My favorite test was the one that checked to make sure my lungs were in good shape before chemo (bleomycin fucks them up) because when I looked over the bill I got from my insurance, it was listed as “Explanation of Wheezing,”
and I thought that was funny. There were not very many things related to treatment or insurance that I thought were funny.

If I have a point, it’s that cancer is expensive, and it’s hard, and it’s especially hard if you don’t make very much and you don’t have very good insurance, and a lot of people in America don’t make very much and they don’t have very good insurance, and a lot of them don’t get diagnosed with cancer until it’s too late. I became friends with one, via a mutual friend. (My poor best friend. Two friends with the same kind of cancer at the same time.) He was stage 4 before he even saw a doctor, because he didn’t have health care. He didn’t make it. He very likely could have if he’d been treated sooner, because Hodgkins’ has a 95% cure rate if you catch it in stage 1 or 2. His wife is now one of the youngest widows I’ve ever known. It shouldn’t be that way. He should be here. He should have been able to treat it.

I didn’t write the number of times I’ve been terrified that it would come back or that I’d have a worse kind than Hodgkin’s as a result of the chemo and radiation, because that has happened far, far more times than I could begin to imagine. Like daily. Sometimes several times a day. Currently, because it’s been a couple of years and because my next scan is still several months away, when the thought rears up I push it back down with a “Not right now. You can worry about that later.” I might as well kick that can down the road as much as I can. I have been doing better with each day and month and year that passes, gotten more efficient at telling those thoughts “Nope. Not today.” I try to Arya Stark the shit out of them.

My biggest fear, since the election, has been that the ACA would be repealed and replaced with nothing, that I’d have cancer a second time, that no insurance company would touch me, and that I’d have to ask other people for money or take on massive amounts of debt or…just not, I guess. And my parents would probably say “That’s ridiculous. We would never let that happen to you. No matter what.” I believe their intentions. But they aren’t made of money. It was $100,000 for an easily treatable type of cancer that went away quickly. I can’t even say what that might look like if it happened a second time.

I’m privileged to have that be my biggest fear. I’m white, straight, and cis-gendered. Increasingly afraid that “The Handmaid’s Tale” is about to be real life, but there are many, many things that I do not have to worry about happening to me personally. That’s privilege.

I’m not always very good at wrapping up, or at having a point. I’m really good at talking and talking and talking and spinning my wheels in the mud. I started this post out very positive and happy. Because even though I know those who oppose ACA will be back, probably empowered by the dark side of The Force, for now I feel much safer. For now, I can begin to imagine a 2018 in which I might have health care that I can afford.

I’ve been terrified since the election and now I’m less terrified about that particular thing for right now.

So, in other words–typical 2017.





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