Do You Feel Lucky, Punk?

I hate Kenny Rogers. But how can I not use this here?

I enjoy a little blackjack during our very occasional trips to Vegas but Karen has always felt too stressed out by laying actual money on the line to join me (though she has no compunction about helping me blow my winnings on extravagant dinners). So, bottom line, we are not inherently gamblers. Until just about now. We are gambling, we are using very real money, and we're hoping for the best.

Karen's overall condition is deteriorating. She's not knocking on heaven's door by any means but she's weak, she's having trouble breathing, and she's coughing more than the lead actress in a community theatre production of Camille. And of course she cannot start treatment until we get the results of that damned EGFR test (more on that in a moment). The probable date of that pathology report is over a week away. That's not so much when you look at a calendar but when you're looking at your wife struggling to catch a full breath it's somewhere between an eternity and a fucking eternity. Our insurance company won't approve anything without those results (memo to Sarah Palin: if you ever want to have a discussion about real-life death panels, I'm right over here).

This is not valid US currency.

So we are forgoing the insurance in the very near term. Dr. Sirott believes that Karen is bound to test positive for EGFR and is therefore a prime candidate for Tarceva, which should get to work on that hellish cough straightaway. Apparently there is a small supply of Tarceva in the Diablo Valley Oncology stores and he is willing to write a prescription for a week's supply in anticipation of a positive test. We will have to pay for this all on our own for the very tidy sum of $1000 in American currency. Bartering my hardcover first edition  Dark Knight Returns signed by both Frank Miller and Bob Kane is apparently not an option.

I'd like to say two things here. First, cancer is an extremely expensive way to make your life more interesting so I'd advise against it. Two, it sure is nice that one of my several overdue paychecks showed up in the mail today.

In other news, we have been up down and around and upside down multiple times today trying to figure out just what the hell is going on with this test and why the projected date of our results is doing its level best to redefine "moving target." It's a convoluted tale, but here are some highlights. I checked messages this morning to discover that Dr. Sirott had apparently butt-dialed me while having a conversation with a partner about us. This was a giddy a-ha! moment that made me feel like a super-spy even though I had done absolutely nothing to bring it about. Anyway, in that discussion Sirott revealed that the lab had not sent out the biopsy material to the reference lab (the outside lab doing the EGRF testing) until Sirott had called them on the 13th. This wasn't quite what the stonewalling pathologist told me later on the phone. Karen and I (and especially I) were pissed. It's important to us that we can trust our medical team and rely on them to be straight with us, even if they screw up. We understand human error (though we don't love it) but we don't have patience for ass-covering, misdirection, and half-truths. During our spotty cell phone call last night, Sirott never once said that the lab had erred by not retaining some of the biopsy goo for their test while sending out the rest immediately for the EGFR analysis.

We road this emotional roller coaster most of today.

And I found out a lot of these details from that accidental voicemail (as well as the fact that he wasn't too excited by how "pissed off" I was which I must confess was a great delight). I got my Krav Maga buddy Jim Karol on the phone and vetted all this with him. He's a big shot oncologist specializing in prostate cancer and he confirmed that the lab had screwed the pooch. He also called in a favor and set us up with a colleague specializing in lung cancer, getting us an appointment for tomorrow. We were primed to jump ship to this new guy.

Then Sirott called me back this evening and, unprompted, said all the things we wanted him to say the night before. Maybe it helped that he wasn't calling from his car but a reliable land line as I'd requested. Maybe it helped that I've got a good vocabulary and I'm not afraid to use it to browbeat people into not dancing around me and the truth. And maybe it's not all so nefarious and he just slipped up on another slab of the spectacularly terrible run of luck we've been having.

And with that terrible luck we have decided to gamble and pay for the Tarceva and hope it brings Karen some relief soon. And Karen has decided to stay with Sirott as he basically redeemed himself. And we're still keeping the appointment with the other guy--a second opinion cannot hurt--but barring any sort of game-changing event during that meeting, we're going to stay the course. And we're going to see about moving up Karen's appointment to get her state-issued Weed Card since she will be facing side effects sooner than we thought and also because, in the words of Emily Dickinson, why the fucking fuck not?