1 down; 32 to go

(Warning: This blog is a bit long and a bit ranty. Sorry. Also I had wanted to put up some more cruise pictures, but the link isn't working for some reason.)

I did my radiation yesterday. The short version is that it was fine. I got there early, and they took me in early. I was told it would be 15 minutes, but it actually was 20 from the time I walked away from Mark to the time I got back to the waiting room with him. Of course, it's like any other x-ray or CT scan, just laying on a table while a machine moves over you. A CT scan is taken first, with gel on the body, to find the internal spot where the tumor had been. I am lined up on the table, pushed and pulled on a sheet, until the tattoos line me up properly with laser beams. The CT machine "talks" to the radiation machine, and then I get zapped. It happens from two different angles and then a film was taken at the end. There was no sound and no sensation. I'll go back this afternoon to do it again.

Once I left, I realized there were many issues to address. First, everything I have read or been told said to use some cream after each treatment to help prevent future skin irritation. In Maryland the radiologist had said they would be giving me a lovely homeopathic cream which they had found in their practice to be very good. Unfortunately, he did not mention its name. Here, the radiologist had said to use pure aloe gel, but I forgot to buy any. I asked the two men who are the technicians if I needed to use it right away. They both said it was unnecessary to use it unless I was actually having skin irritation, otherwise it did no good. My pharmacist friend, Barb, whose sister has already done the radiation, had advised me to use tea tree oil before each treatment. Well, that's four opinions, and I had none of the products.

Mark and I stopped at the store on the way home to try to buy something. None of the aloe gels in the store were pure. They all included alcohol, fragrance, and many other chemicals. We actually spoke to the pharmacist in there, and she advised against them. She did not know of any pure aloe gels, but she did say the store sold aloe plants I could buy and cut open. It might come to that. Then we started to look for the tea tree oil. We couldn't find it, so I called Barb at work to ask more details about it. Of course while I was calling, Mark spotted it! She again said I should put it on BEFORE the treatment, but I told her they would not allow it. They said no harsh deodorant soaps or any deodorant is to be used the entire two months. I can use baby cornstarch powder in the morning, but no other creams or lotions four hours before treatment. I am guessing it interferes with the gel they rub on for the CT scan.

We got the tea tree oil and took it home. The bottle said to mix it with some olive oil the first time to see how your skin reacts to it, but it didn't give any proportions. I tried to make a 50/50 mix in a cup, maybe a tablespoon total. Then I rubbed it all over my left breast. YUCK. It smells like turpentine, very strong. It felt fine, oily obviously, but I don't know if I can stand smelling like that every time. The best time to apply it would be right after the treatment, but the little dressing room cubicle has no water and another patient is always right there waiting to come in. So I will have to wait until I get home or in a bathroom somewhere with water to wash my hands with soap when I'm done. I would prefer to find something else, but today I will use this again when I get home.

The other issue now is the billing procedures this clinic is using. I am very angry about it. I had been told that I would have to pay a $20 copay at each visit, 33 times, $660. In Maryland there would have been no copay on either Blue Cross/Blue Shield or the new CIGNA. I had called CIGNA before the cruise, and they said if it was billed as an office visit there was a copay, if it's a procedure, no copay. I went in there yesterday and asked again to speak to the billing office. The charming receptionist tried to get them on the phone multiple times before I went for the radiation, but they were busy. When I came out, she got someone on the phone and was told that they were not billing it as an office visit. They told her they were using "radiation" codes, but there was still a copay. I was also told they had contacted CIGNA to verify this. Hm...for some reason, I just did not believe this. I got the name of the billing office manager, Paul, and his number. I paid the copay before I left.

When we left the office, we immediately called CIGNA on our cell phone. I was told the same thing again, so this time I asked the girl at CIGNA to call Paul. She called the office and put me on a three-way conversation, but Paul was out. The girl at the cancer center said the facility is an "office," not an outpatient clinic, so everything that happens there uses a code indicating an office visit. OUTRAGEOUS. I argued with her for awhile, but got nowhere. I still need to speak to Paul, I think.

The insurance woes got worse when we got home. Our mail that had been held during the cruise showed up yesterday, so when I got home, I sorted through it. There was a bill from someone in Pennsylvania. I could not understand that, so I immediately opened it. It was a bill for $240 for the PET scan that I had at the cancer center the week before the cruise. Weird. I logged on to the CIGNA website and learned the answer. The PET scan, performed at the cancer center, was covered, but the radiologist who READ the scan was in Pennsylvania and is not a CIGNA doctor. So I have to pay his bill of $240. Well, lesson learned, ASK first if anyone doing anything to you is in the plan. I felt like this was my fault, but on the other hand, they KNOW I use CIGNA In-Network insurance. They could have advised me in advance that the radiologist was not in the network. That way I could make the decision in advance to pay or not pay that. I bet there are facilities in the area that could have done the scan AND have it read in-network. Well, second lesson learned, no more PET scans in this facility. They had said they would want another one in about four months, after the radiation, but I will inform them it will have to be done somewhere else. It will be interesting to see if they are still so eager to have it done!

It's not over yet! While I was on the CIGNA website looking at my claims, I saw that there was a huge bill dated February 8-11 and my portion is $80. So far they have not billed me for that $80, but I looked back on my calendar to see what it was. I was there on February 8 for a CT scan and again on February 11 for the radiation simulation and tattooing. I was not charged a copay for those two days, and I did not see the doctor. So today, I need to call to ask what the $80 is for. I am desperately hoping it is NOT a copay for an office visit for those four dates, especially since I was not in the office on two of those days.

NO, NOT OVER YET! I also saw a bill for more than $1100, with my portion $20, billed by the radiation oncologist for services on February 14. It was paid by CIGNA, so I'm expecting a bill for that $20 also. Problem with that is that I was getting on a ship in Miami on February 14!! Why do they think I need to pay a copay when I wasn't even in the same TOWN?? What service was I receiving while I was on the ship? I think this facility is questionable, certainly; unethical, maybe. I don't trust them now at all.

This morning I will be calling a different cancer center farther up the road. I picked Osceola Cancer Center because they are 17 miles from my house, the closest one. There are others, and at this point, I'm pretty sure I would NOT be paying $20 a day in gas to drive another 10 or 15 miles each way every day. If I can find a place that will bill it as an outpatient procedure and no copay, I would love to switch. My concern is how fast can that get done. Now that I've started the radiation, I really should not interrupt it. I would probably have to go to the new place, meet the new doctor, possibly go through another simulation before they would start me. Who knows how long that would take, probably a week or two. Or I can bite the bullet and pay these people the $660 spread out over the next seven weeks. I also need some answers from them about the strange bill for February 9, 10, and 14 when I was not there. I'll keep you posted on what I find out.

Meanwhile it's Tuesday, so that is weigh-in day. I reported the six pound gain on the ship, and I had hoped to get back on track and lose some weight. Now two more days have gone by and I have gained three more pounds. I weighed 255 this morning. I'm going the wrong way for sure. I did go to the gym yesterday and do my four weight machines. I also ate lunch and dinner out in restaurants. Our friend Rudy is here, so we showed him the two restaurants in our community of Solivita. I ate too much, clearly. Some of it could be water retention. Tonight we are taking Rudy to Raglan Road, an Irish restaurant at Downtown Disney. It's one of Mark's favorite places, so we are going back there for dinner Saturday night for his birthday. At least, I will be eating breakfast and lunch at home today. I will also take a good long walk, at least 30 minutes. Hopefully, tomorrow I can post a bit of a loss. Of course, you'll be the first to know!

Now it's time to start calling the cancer center's billing office, possibly CIGNA again, and probably the Florida Hospital Cancer Center. I am not looking forward to any of this. I'm also not looking forward to driving up there and dropping another $20 in their coffers, but I will do it anyway.