Friday, July 22, 2011

Doxil shortage

Mom's chemo schedule was a little off this week, due to a shortage of her chemo drug - Doxil. There is a nationwide shortage apparently... and they told her on Wednesday when they were doing her iron infusion, that they were going to give her one of the last two bags. Another woman is getting the same treatment, so there goes the last bag.

She is rescheduled for a doctor appointment in 5 weeks, but they didn't reschedule her for chemo. The nurses at Trinity weren't sure if more Doxil would turn up at that point or not.

As if having cancer isn't bad enough, the drug that you depend on is now is shortage. And it's about the only thing that mom has that we can have a little glimmer of hope of something working. If this becomes a bigger setback it could throw her CA125 count off. It has been such a delicate thing - I think consistency is the key with Doxil. And keeping her on the regimen is crucial.

The chemo went fine yesterday and the were able to hook her up in another part of the hospital (not the normal Chemo room at Trinity) due to the fact that the Infusion Center had the Doxil and not the Cancer Room. It's confusing but at least it got accomplished.

They didn't have a CA125 number available, so mom said she was going to call today and find out. Her blood work was fine - and it looks like the iron infusions worked well. She had her last iron infusion Wednesday and they didn't schedule any more.

One of the nurses at Trinity, Sherry, is helping with all of this Medicare Part D(onut hole) issue, so we should have some good options worked out by the time Caterpillar discontinues her prescription plan. Mom expects to get their final letter soon, and thinks that she'll have until at least September to be covered under Caterpillar before going to Blue Cross Blue Shield's Medicare Part D. There are options where mom can get grant assistance from some foundations during the gap phase.

Interesting point: Supposedly the Obamacare plan was to eliminate these caps set by prescription plans, however, some companies such as Caterpillar, were able to write themselves out of the equation  and continue to enforce the limit. I suspect this was done by lobbyists - which in my mind tells me who really runs our government. I have to do some [more] reading about Obamacare prescription plans but that's my immediate impression. I wish I could read more than two pages at a time without falling asleep.

Her feet are taking a beating- fortunately cousin Gayle brought some Udderly Smooth lotion and cousin Dennis sent some of the Udderly Smooth tubes for her to keep handy, so she's good to go. Our HyVee store in Rock Island is now carrying the 4 oz tube, so that's nice. At least someone listens to me! I put in the request a few months ago and they have been carrying it since June. Now if only I could get them to stock TAB soda again, I would be a happy camper.

Sunday, July 17, 2011

Chemo week

Mom has chemo this week on Thursday. The day before (Wednesday) she will have her last iron infusion so it will be interesting to see what her blood counts are this week.

Her feet were really bad the last couple of weeks - especially the week of Lois' funeral. Several blisters (larger than before) were popping out and the bottoms were red and peeling. She was keeping the ice on them and the Udderly Smooth lotion, and that alleviates some of the burning. I would say that the heat probably aggravates her feet more than in the spring... so hopefully this will be the worst of it for the next couple of months.

Sunday, July 3, 2011

Down the rabbit/donut hole

Mom's friend Lois passed early morning last Thursday. The aneurism surgery didn't go as well as expected on Tuesday and she declined after the procedure. I went out to church this morning with mom thinking that it would be hard for her but she was in good spirits. It's sad that Lois is gone but you just can't be sad when you think of the type of person she was - giving, enthusiastic and always ready to step in and help. I used to think my mom volunteered a lot, but Lois had a one-up on her. Lois' obituary called her a "professional volunteer" and I think that about sums it up.

Otherwise, mom has been feeling ok except for her feet. The hot weather (and we had some doozies last week) really irritate the soles of her feet. And she has been on her feet quite a bit last week as well so that doesn't help. And she will be on her feet a lot this week helping with Lois' visitation and funeral so she is in the mindset that she has to deal with it for now. She has been going to see Ralph, Lois' husband in extended care at the hospital, every day as well.

I don't even know where to pick up about the "Donut Hole" prescription insurance issue. Mom believes she is going to go with Blue Cross Blue Shield, as it really doesn't matter who the insurance carrier is - it's all Medicare Part D and it's all the same. She is learning more of the nuts and bolts of the plan, and now there seems to be not only donut hole (they like to call it a GAP) issue, but now there are Tiers of co-pay coverage: Tier 1, Generic Drugs; Tier 2, Preferred Brand Drugs; Tier 3, Brand Drugs; Tier 4, Specialty Drugs.

And guess what Tier the Lovenox is - yep the two highest Tiers.

They have two plans, a "Value" plan and a "Plus" plan, and depending on the plan she selects, will depend on her monthly premium, deductable and then the co-pays for the drugs. Both indicate that that when the GAP hits, she will receive a discount on brand name drugs, but I can't imagine what they think a "discount" is. After the gap she will pay whichever is the greater amount - flat copay or 5% coinsurance for the drug.

At (another issue) is the original letter from Caterpillar stating that she has reached the lifetime maximum benefits of the prescription insurance plan. If Obamacare is intended to do away with caps, then technically mom should be reaching a "cap," unless the government made a deal with Caterpillar that allowed them to have a cap. Now I need to read more about the health care reform.

That is what turns the donut hole into a rabbit hole.