Anyone starting chemo in June 08

HI:  I am sorry to hear of all of your troubles.   In a way, it makes mine seem a bit less.   Knowing others are there or have been there is helpful and that I am not in this totally alone.   My first tx was in the arm vein also, since I do not have a port yet, due to some insurance screw up.   The nurse was unable to thread the vein the first time and THEN she got a pediatric needle and it was smooth as silk.   BUT, I do have a 4 inch long black bruise on my arm.    I will have the 2nd tx on July 3 via arm vein also, unless by some miracle the insurance company gets authorization going.   There is an insurance advocate who is working on "my case" and she flat out said that my insurance co is stupid...   

 I am way past Aunt Flow at age 62... one positive thing for me...Good luck and BIG gentle HUG to each of you.    Nancy  

Deecsw,

You're not gonna like this advice, but I would recommend you get a port.  I know... it's just one more crappy thing to have to deal with..but if your veins are giving you this much trouble relatively early in your treatment, it's only going to get worse.  I resisted getting a port until after I'd have 4 out of 8 treatments.  I had to get it then because all my veins were collapsing.  Now, treatment is so much easier.  And I have way less anxiety leading up to it because I know the nurses won't have to dig around and jab me multiple times before they get a decent vein.  The port isn't so bad.

lisa39--Thanks for the suggestion. I have only 3 treatments left. I was only stuck once for tx #1 and again only once for disasterous tx #2. I think yesterday was just a bad stick. Looking at the mark left by it today, it is obvious that the nurse did not get me in a good spot, and she did not want to try again. I should have insisted she take it out and have someone else try. I still have some good veins on the hand and also on my arm (although this office doesn't like to access the arm). I just don't see the sense of going through another procedure for 3 txs.

I have spoken with many women who also opted out of the port, had 4txs, and their nurses were able to make do, even with the limitation of having one arm to utilize. I think the issue here is that the nurses at my office don't WANT to try. If this is the case, then maybe I need to change offices.

hunkydory, you asked about out-of-pocket costs for chemo, including the Neulasta shot.

I read on several pharmacy websites that the cost for one syringe of Neulasta (6 mg) can be anywhere from $3,000 to $7,000, depending on who's selling it and how much the vendor purchased at once.  A clinic that buys a lot of it would probably be able to negotiate a lower price per dose.

According to the claims reports from my insurance company, the billed charges for each of my chemo treatments was around $7,300.  That included everything associated with the infusion--even the Neulasta shot, which I got on the same day as the infusion.  The "eligible charge" for each chemo treatment was around $5,800, and my insurance paid the entire amount.  My insurance is a work-related, group policy administered by one of the Blue Cross/Blue Shield licensees.

I have read that the way the Neulasta charge is handled depends on the circumstances under which the shot is administered.  In my case, Neulasta was considered a part of my chemo treatment, so it was covered.

For most patients, Neulasta is given the day after the infusion.  If it's given in a doctor's office, it might be considered under "major medical" coverage and could be subject to a deductible and a co-pay based on a percentage of the cost.  Sometimes an insurance company will require that the Neulasta be dispensed by a pharmacy, where it's subject to the prescription drug coverage of the policy.  The out-of-pocket cost in that case would be similar to the cost for other prescription drugs.

Some insurance companies assign drugs to different "tiers", and they put specialty drugs like Neulasta, Neupogen, Procrit, Humira, Remicade, etc., in the highest tier.  In some insurance policies, the co-pay for drugs in that tier is much higher than for other prescription drugs.

After reading some of the comments on these boards about charges for chemo infusions, I thought the charge for my Taxotere/Cytoxan treatments was pretty reasonable.  I've been even happier that my insurance company has not balked at any point in this process.  I think I'm very lucky.

otter 

O.K......so a super long day at the Centre......mostly waiting for the cocktail to be mixed........finally called 2 and half hours later........the infusion was no problem.........took about an hour........then a big wait at the pharmacy......figuring out who was going to pay for the neupogen........so far I'm feeling good........figured I'd take the new haircut one step further.......so I am sitting with dye on my head as I type this.........I'm going for the dark under colour that seems popular right now......so you'll only really see it from the back........figured now's the time to experiment......only have to live with it for 2 weeks if I hate it..........trying to squeeze everything in while I'm feeling good........fingers crossed that it continues this way!

 Cheers

Jax

Glad you feel well, Jax!  I checked with my work drug plan to make sure they paid for neupogen and sorted that out at the Pharmacy the day of 'chemo school'.  We were at the Centre from 11 to 4:30 for treatment 2 yesterday.  Blood work on time, but Dr. was 90 min behind, then a 90 min. wait for the chemo.  Head shaved tonight-actually feels liberating.

Positive thoughts to all!

Hi Everyone

My first chemo was AC and I was not feeling good for a few days then they had to change it because of the muga scan on the heart and had to change it to tc which has made me terribly sick. My hand hurt, my fingernail got all infected ran a fever, my mouth is full of thrush, just feel absolutely awful. Has anyone else had these experiences. Had chemo last Thursday and this is the first time I have gotten out of bed and only because I am pushing myself for half and hour.

Thanks

Bonnie

Going back to bed

Yeah, at 200.00 per dose, I'll say you can now go shopping.  FYI and others, I was never nauseous after round 1 but had a very sour stomach and bad taste in my mouth.  Got a prescription for Ranitidine from my Dr. before round 2.  It's really helping with the tummy so far...

Positive thoughts to all for a good day!

Gina_M,

I haven't been on the board for a couple of days so I am late answering you. I had my second round of chemo Tuesday and all went well. I think it was actually better than the first treatment and shorter. I am getting Taxotere, Cytoxan and Herceptin. My nurse told me the first time is longer because they give you a megadose of Herceptin. I haven't had any really bad side affects. My hair is almost totally gone now. I had things like acid reflux, dry mouth, dry eyes, chemo brain, trouble sleeping the first night. I have been able to eat and my nausea medicine worked great. I have heard that all treatments are the same so I'm not sure what to expect from the others but 2 down and 4 to go! 

Hi All;

Completed my 2nd tx of AC & Avastin/placebo 2 days ago (2 down 10 to go...) 2 more AC + then onto Taxol +Avastin/Placebo. Besides the slight nausea and hot flashes, i'm doing pretty well. Buzzed my head yesterday, and it's taking some getting used to but feels very liberating as well. FUNNY STORY: My DH, and 2 small children were sitting on the porch eating ice cream last night when my 4 yr old pulled my scarf off to show dh (he had already seen it) how i look like him. Laughing hysterical, he ran inside with the scarf and locked the front door. So here i am, first day baldy banging on my front door, ringing bells etc.... Finally my SIL let me in. she hadn't seen my baldness yet, but she had my scarf in her hand. That will be a moment we will never forget lololllol. We are so glad that we can find humor in everything. Whoever said laughter is the best medicine was sooooooooo right!

I'll be starting a second regeime of Chemo tomorrow 6/27/08. I'm doing 4 sessions of A/C over twelve weeks. A treatment every 3rd Friday. I'll take Decadron, Axloi, and Emend. My concern is the dreaded constipation my last chemo regeime gave me. They have told me much of the meds I'll recieve this time also have constipation as a side effect. After each time I had 6-9 days of constipation that was never relieved with out 2-3 hrs of vomiting and lower abdomenial pain. Despite doing every thing my Onc. instructed me to do, 1 cup All Bran daily,4 Senna S/day, Lactulose 1oz twice a day-starting the day before Chemo and continuing for a week. MOM 4tbsp on day 3 after Chemo, then a bottle of Citrate of Mag on day 4. It is a real problem for me.

So I hope Nausea and Vomiting isn't going to effect me the first 2 days after Chemo. and I pray the constipation will not occur again.

Familyroks,

I just got back from getting bloodwork done and asked the billing gal how they work the neulasta.  It is all considered part of the chemo infusion.  They will not allow me to pick it up from pharmacy due to the possibility of damage to product enroute to the center.  That was her explanation anyway.  She told me not to worry, that it won't be that bad.  She is going to have some numbers for me tomorrow when I see my oncy. I appreciate your response.   The only difference between my plan and yours is mine is the standard...104.....not the basic. Thanks again!!!!! HunkyD 

Chocolate Lover - thank you for your post and your positive attitude - it is inspiring.  Sending you back some positive vibes from the north shore mountains in Vancouver Canada!

Good evening.

Vino:  Your haircut is so cute.  I have long blonde (highlighted heheh) and havent done a thing yet.  It will be due to start  falling next Thursday.  I dont want to go in and spend a bunch for a one weeks worth of a nice short cut, so I am thinking about when the strands start going....I will have husband in training for barber school.  I think It might take some good scissors, clippers, and a few cocktails to get it done but that is my plan. 

Chocolate Lover:  You are very positive and it really helps myself to feel your good vibes.  Thanks for posting and keep it up.

Lefty:  You started the same day I did and I am glad you are doing so well.  Green shamrock shake will never happen for me after seeing the movie "Exorcist" in my younger days.  I know thats what Linda Blair puked up.  Hehehe! 

Carry on ya all!

Libra - I can't answer your question #1, but I would highly suggest that you talk to the Onc directly about it.  If tx #2 is the beginning of dense dose (every two weeks) then I would think you would need the Neupogen following that tx, since you're getting a higher dose of chemo....but I would definitely ask the expert.  Don't be afraid to call them...this is your body and your health.  My last treatement, my nurse told me that I didn't need the Neulasta shot the next day.  I said really?  I have the dose at home...why wouldn't I need it?  She double checked and talked to the doctor....she had misread his instructions!  Thank goodness I asked or I wouldn't have gotten my Neulasta and I probably would've tanked and ended up in hospital.

As far as the port....My understanding is that if you have no activity involving the port, it should be flushed/cleaned once a month.  So it sounds like you'll be ok.  You could always call and ask if you are really concerned.

~Adrienne