New Year Resolutions

My resolutions for 2008 include some healthy improvements.

• Walk more! Make time for aerobic walking at least three times a week.
• Cut out sugar. I've done it before but it creeps back in.
• Learn to handle my fears about my husband's health without bickering.

Uncomfortable Memories

A friend just signed herself into the psychiatric ward of a hospital. I feel bad for her because I know she was feeling desperate. At the same time, sad memories have reappeared in my mind. When I was twelve, my sister was committed to a mental hospital. What a scary place it was! And she did not get well there; if anything she got worse. The last time I visited her, she was staring into space and laughing. She did not look at me; did not know I was there.

The doctors diagnosed her with a schizophrenic disorder. She never came home. After two decades in state hospitals, she died of an intestinal blockage.

Medical Billing Blues

I get frustrated dealing with doctors and the insurance company. I had thought that sticking with "preferred providers" would keep things simple. They bill Blue Cross directly and agree to accept the negotiated rates. Unfortunately, with the large number of charges we've had this year, I've had to create a spreadsheet to track the medical bills and insurance payments. And sometimes it's difficult to match them.

In one instance, Blue Cross paid their portion of a bill, then sent out a statement "correcting" it, saying that the anesthesiologist was not a preferred provider so they paid less. Whether they asked to the doctor to send back a portion of the payment, I don't know. But when I checked with the doctor's office, they said they were indeed participating providers, so I called the insurance company and they agreed. They said that they had made an error and that the first statement was correct, so they had corrected the second statement. Meanwhile, the bill we got does not match the corrected amount so I have to make yet another long-distance call to try to straighten it out.

Sigh! It would be simpler to use an HMO... but our choice of doctors would be too limited, and we would have to drive an hour farther for every appointment. Meanwhile, we have spent over $6000 on medical this year not including insurance premiums, dental bills, and hearing tests.

The Big C

I've put off writing this entry because I know I need to discuss the biggest health issue facing our family: my husband's cancer. It's prostate cancer, discovered a year ago. A bit scary to write about - I feel best when not thinking about it. But let me give you a summary.

A high PSA score indicated that a biopsy was warranted, at least in the opinion of his doctors. The biopsy revealed prostate cancer that appeared to be confined to the prostate. The urologist gave us a book about prostate cancer and suggested that we consider the options carefully. He personally felt that surgery was a suitable treatment.

Other tests indicated that the cancer had probably not spread yet. For several months, we studied the options, worried, and procrastinated. My husband (I'll call him Knute) consulted another urologist, followed by a surgeon at UVA Hospital and finally a surgeon at GWU Hospital. The latter had done hundreds of robot-assisted surgeries. So eventually Knute had robotic surgery to remove the prostate at GWU Hospital.

The surgery went smoothly and he came home the next day. Three months later we returned to the surgeon's office for a follow-up visit. Unfortunately, Knute's PSA level turned out to be .85, and it is supposed to be lower than than .2 after prostatectomy. This indicated that not all the cancer had been removed. The surgeon said that eventually Knute would want additional treatment, probably hormone therapy, to slow the progress of the cancer.

My husband does not want hormone treatment because (a) it has unpleasant side effects and (b) it does not cure the cancer anyway, just slows it down for a few years. Fortunately he does not have to decide yet because the doctors feel that he should wait until his PSA doubles before starting it.

We did visit a radiologist for another opinion. She recommend radiation treatment of the area where the prostate was removed because it might help. The other doctors, however, did not feel that the slight chance that it would work was worth the risks of radiation.

Meanwhile, my husband is still struggling to overcome the side-effects of the prostatectomy. They are the common problems result from this surgery: incontinence and impotence. He has made tremendous progress with continence, probably because he does Kegel exercises. However, he is still impotent and it has been six months since the operation. He has read that it can take a year to overcome this so we are not alarmed, although he feels less manly and sometimes gets depressed with the situation.

He is 62. If the cancer grows slowly, it could take a decade or more before it debilitates him. But it is too soon to know how much time ...

Still, we never know how much time we have left on this earth. At 62, he would only have a few decades left of good health even without cancer. And since he also has diabetes, he faces the other health risks that are known to face diabetics.

One thing that we have been forced to face is that we are aging and that vigorous years ahead are limited for us. Even if we are both alive 15 years from now, we will probably be less able to do active things than we are now. So we need to enjoy what we can.

Introduction

Health problems can be very personal, but sharing them can bring comfort to myself and to others. I hope to make some discoveries during the process of reading and writing about the medical issues that challenge me and those close to me.

I am a woman of the baby-boom generation who reluctantly realized that her prime of life had slipped away while she ran around doing other things. My reproductive years are behind me but plenty of productive years are still ahead, I hope.

My husband is a couple of years older than I am and is dealing with more serious health issues than mine. Perhaps writing about his struggle with cancer will help me deal with the fears that it brings.

I'll be using invented or altered names for the sake of privacy. Otherwise, expect an honest diary.

Please feel free to add your comments.