Jumping Ship

Late yesterday, after six plus hours of cancer-related tomfoolery, we decided to change oncologists. We're feeling pretty good about it, although there are some things we aren't feeling so fantastic about. For Karen, she's not feeling so great thanks to the cancer. She soldiered in to work today and just about literally passed out. She could be looking at a more dedicated work-from-home approach sooner than we had anticipated. For me, I've got an aching open wound where $1364.30 of my money used to be. I'll be working on healing that today.

We spent a few hours at Dr. Sirott's outfit yesterday, being briefed by his assistant on the chemo and targeted therapies Karen is facing. Then, as we had planned, we gambled and paid $1364.30 for one week supply of Tarceva in the hope that Karen would eventually prove to be EGRF positive. And, to be truthful, we were also paying just for the opportunity to stop sitting on our hands and finally start doing something to murder death kill this cancer. After a few hours there we headed out to Danville for that second opinion/reality check from the oncologist that my oncologist friend had set us up with.

Huzzah! I daresay, good show!

The vibe at the other office was entirely different, much smaller and more personal, less ant farm/factory than what we'd be experiencing. That's all well and good, but it wasn't a reason to switch doctors. What was a good reason was what came up during our consultation with Dr. Sherman. Although the EGRF analysis remained undone, the ALK results were in. This is Karen's first bit of good luck since the chance of being ALK+ is about 3%. The great thing about this is that first line therapy for ALK+ is Crizotonib, a targeted therapy oral drug with a much higher response rate that Tarceva: 60% as opposed to 20-25%. Huzzah! Plus, since the results were in, we could start more or less immediately and we'd get started before the end of the year when our insurance would hit the big invisible reset and we'd be on the hook for big scary deductibles. Huzzah again! And guess what? These results had been in since the 17th. Two full days prior to this appointment. And yet we hadn't heard about them and there'd been no movement from Sirott's office regarding them. Indeed, we had just spent several hours at Sirott's office going over a treatment course that the ALK results rendered moot. We're not saying Sirott needs to check the labs everyday (though, yeah, maybe we'd prefer that) but it might be nice if they were checked the day we came in. That seems in order. Especially considering the epic screw-ups around Karen's pathology.

So that's why we jumped ship. The smaller, more focused feel of the practice, the more aggressive approach they take, and the fact that we felt we could really talk to these people. That and the fact that Dr. Sherman was discussing the potential for "maintenance therapy" that could keep Karen around for years. And I'd be lying if I didn't admit that the fact that the doctor is also a New Yorker was also a real factor--we just speak the same language.

The near future looks like this now: we have another chemo counseling tomorrow, this one with the new doc, to go over Crizotonib. Approval from our insurance is in the works, the prescription is already written and we could be started any day now. I am also endeavoring to return the Tarceva and get our money back. Once I secure that, we're going to end our relationship with Sirott and Diablo Valley Oncology.

If I don't get our money back (we haven't even torn past the staple closing the bag the drugs came in) well, that sucks but it's dwarfed by the first scraps of good news we've gotten since this started. For the first time in over a month we're feeling guardedly optimistic and on the attack. That's a much better way to ease into the holidays.