The Answer

I posted a photo on Instagram yesterday with the caption, "A lot of people ask me, "How's Kim?" She's good, very good, thanks." 

But it turns out that a lot of folks would like to know a little more than this. Kim just passed over 11 months since her diagnosis and she's doing very well. She's been riding her bike to and from work, (Hey, the sun is out in Portland and that helps a lot), and is energized about the summer ahead.

We'd heard that her hair would come back and very likely in a different way. It's hard to say what color her hair is because she dyed it violet red a few weeks ago once the peach fuzz began to grow longer and curl.  Nearly everyone who has been through the process says that chemotherapy changes hair to curly and Kim's hair is much curlier than before. The one surprise for me has been how fine and soft it is. Some people had told us that it would be much coarser than before but her hair is incredibly soft. Those curls on the back are luxurious. Kim says that her longer hair often tickles her neck or her ears as she rediscovers life with her own hair again. Now that the heat has come to Portland I'd say she appreciates having short hair.

One of the highlights of Kim's day is just before bed when she can finally take her "squeezies" off. Her squeezies are her bra and an arm sleeve she's been wearing to help with nerve pain and numbness related to lymphedema. She didn't experience significant side effects from the lumpectomy, like neuropathy, though she does have numbness and pain. She credits acupuncture with preventing the neuropathy and she's worked diligently with her PT to get her mobility back. The pain is slowly going away and we both credit exercise in accelerating that process. She still has limited range of movement due to scar tissue though I'd bet a summer of activity will help improve that.

She began wearing the arm sleeve on her left arm just over two months ago. Her first sleeve was a plain tan and I was shocked when she told me it was over $110. (You can get two pair of Rapha arm warmers for that!) Bike joke... But seriously, with all the work in athletic apparel design you'd think there's better stuff, with better design, and for much less than this. 

She found another one a few weeks ago that had a much nicer feel and design.

Every once in a while I call her The Answer

She's wearing the sleeves with less frequency and expects to be done with them in the next few weeks. The heat adds to her desire to stop wearing them and it's likely she'll be done with the sleeves by her one year anniversary of the diagnosis, July 19th.

Now, the big news, Kim is running the Hood to Coast relay with a team from work in late August. It's a 200-mile team relay race from Timberline Lodge on Mt Hood to Seaside, Oregon. Running is still difficult for her. Her scar tissue hurts and, like me, she's dealing with some knee issues. But she's motivated by a challenge and she really likes the people where she works. Both Kim and I appreciate that they believe in her enough to invite her onto the squad. She's nervous but the challenge is inspiring and, again, she has great respect for the folks that invited her to run. It's hard to get her to run when all she wants to do is ride her bike but great strides (ahem) are being made.

Here's to summer.

Radiation - One Month In

One month of radiation treatment is in the books. 20 days of external beam radiation therapy treatment and 10 to go. The finish line, (if there is one), feels close. Kim has settled into a nice routine of getting up early and out the door by 7:20 in order to arrive, change, and be ready for her 7:45 appointment. There's been a nice, elderly man who has the appointment slot just after her and they have a fun little battle going to see who can be ready to go first. The plan to start the day with treatment has worked out really well as Kim gets to work early and has a full, uninterrupted day to work and then relax at home.

Uninterrupted. Huh, hardly. There's still the occasional doctor's appointment here and there and some days she just can't seem to get a break from having to be two places at once. Sure, the treatments are invasive but the time going to and from appointments, not to mention the waiting, is a drag. 10 days...

It's an easy process, though, and she's at the radiation therapy center for no more than 30 minutes total. She walks in, grabs a gown, changes in a private room, and locks her clothes in a locker. She'll sit in the patient's waiting room for just a few minutes having to endure the brainless nonsense that is morning news shows on the TV in the room. The nurse comes to get her and it's a short walk to the room with the linear accelerator. The door is incredibly thick and we're told the surrounding walls are six feet thick concrete. It's a cozy feeling room despite the big machine and lots of cool stuff to look at.

She lays down while technicians line up the machine using small tattoo marks on her chest. Once she's set, it's just a few minutes of radiation time. The doctors have done well to protect her heart from radiation and the treatment area is only as large as it needs to be. Incredible technological and human processing power at work. And everyone in the center is just so fantastically nice. Every single day at 7:45 AM.

Kim pops out, changes back into her clothes, and walks out, off to work. Simple as that.

So far she has not experienced any significant side effects. Her skin is sensitive on that side of her chest and upper arm and she says it's the feeling of a sunburn though there's no evidence on the outside. She only has a few shirts she can wear right now against her skin and we all do our best to touch this area when we hug her. She's been so incredibly tough through this entire ordeal. Now, we're told that two weeks after radiation therapy ends that she will experience fatigue so we'll keep an eye out for that.

My favorite course on Zwift, the 2015 World Championship Course
in Richmond, Virginia. Kim is climbing Libby Hill here. 

Following surgery recovery Kim talked about joining a gym and we had some long talks about the practicality of doing so. Exercise is key to recovery but gyms just do not seem to work out for most people. So Kim and I discussed another option, her bicycle. Now, her arm hurt and she couldn't use it for riding on roads or trails plus she was fearful of falling on it. We've also just completed the rainiest February in Portland history. So she's ridden a trainer indoors.

This is not the same old noisy trainer set up in the garage that induces boredom in five minutes. We invested in a smart trainer, the Wahoo KICKR specifically. Smart trainers use power meters and bluetooth technology that connect your bicycle to devices running cycling simulation training apps. In our case, we have a trainer in the basement, our own bikes installed, and an iPad on a table in front of the bike. We've both been signed up for Zwift for a month now and it's been great. Kim was hesitant on her first session but once she warmed up the fire came alive. Not only has Kim been able to increase her overall fitness using this system, she's had fun, she looks forward to riding, and I believe the increased blood flow and endorphins have accelerated her arm recovery. What I believe she will really love is the fitness she starts Spring with. That will be a big mental boost to kick off a season outdoors.

Give Cancer The Bird!

A recent study confirms the importance of regular exercise to increased survivability for those recovering from breast cancer.  I doubt that the gym would have had the same result and best of all, she gets to ride at home. No aggravating drive to and from the gym. Andrew and Jason often practice music while she rides and it makes for some great time together on these dreary days. Sometimes I think they pick up the tempo just to get one of sweating more. It's been great for both of us.

Hit me up if you have any questions about the trainer or Zwift, I'm happy to offer my opinion and advice.

I'm going to ask Kim to write something soon on how she's feeling because, for me and the kids, she has been as normal as ever. The wig is even gone now and she has a really cool hairstyle going on. We went out to a friend's party at a bar two nights ago and she got lots of compliments on her hair. She looks really cool with short hair. Now, if only the weather would warm up a touch so she could go without a hat for a while. Come on spring, you can do it!

There's always heated blankets. Yes!

10 to go, sweetheart, hang in there!

A confession, I've not been getting up early with Kim over the past two weeks. I want to but I don't. I stay up late most nights now either reading magazines or stuff online. I worry. I worry about Kim, my kids, my job, life, all of it. I worry if I'm gonna go crazy from this weather and how much I miss mountain biking regularly. I worry that I want to move right now to anywhere that's not here and that I'm not shy about saying that aloud these days. It worries the kids when they hear that, they like it here. I worry that I'm likely out of ideas. I worry most of all about missing lay ups. Why did I miss so many open shots tonight?!? I try to cover up the worry with learning about new things or reading but it doesn't always work and I stay up way too late. And so I make up for it with that extra time in the morning. Andrew is up early for school so he makes coffee for Kim and they hang out for a bit. He's out the door at 6:55 each day. As I type this it's 12:37 AM and I've still not taken a shower since getting home from basketball around 10:45. Still gotta do that. I want to be the guy that goes to bed early but I just can't. FOMO. Fear of missing out.

Radiation

Ugh, been a while. Sorry, folks, I've taken about a month off from this blog and it's mostly just been to act like everything is back to normal. Just needed a break from it. Back at it today as this morning is Day One of radiation therapy. In total Kim will have 30 sessions spread out over the next 6 weeks. It's a bit of a long haul but it feels like the fourth quarter so the end is in sight. Time to finish strong.

Here's where we are now. Kim had surgery on December 15th and has been slowly recovering. She's been diligent about her physical therapy, her exercises, and taking overall good care of herself. She moves better and better each day but she is in constant pain. The doctors aren't sure if it's nerve related due to the fact that she's sleeping only on one side and over compensating for the one side or if it's residual neuropathy. No matter, her arm hurts a lot most of the day. Even the clothing on her skin by her wrist is painful. She complains very little but nearly five weeks of pain has taken a toll. I try to offer some comfort though massage isn't all that helpful. Mostly I just try to be a dork and distract her from it. I'm good at that, Dr Dork.

Acupuncture has provided some relief and I'll bet the slight change to warmer days will be well received, too. We could all use a break from the cold. Her arm pain has kept her off the bike and limited exercise overall though tomorrow we hope to get her onto an indoor bike trainer and work on some fitness. She says that walking and light exercise help her arm to feel slightly better so the hope is to move some blood through her system and get those exercise endorphins doing their thing. I only have to help now and then with sweaters on and off though carrying bags, lifting things, and reaching up into cabinets is still difficult if not impossible.

But I do feel as though a breakthrough is imminent. Therapy, exercise, warmer temperatures, and a return to normal life will converge into relief from this nagging arm pain. Now, speaking about normal life, her hair is growing back. Like, really fast. It was just about a week-and-a-half ago that she took off her pink wig and her scalp looked really dark. I investigated and discovered that it was hair poking through. A few days later and it was sprouting out. About a week after that she had the tiniest case of bed head you've ever seen. Today it's got a pretty even growth overall and is starting to lay down just a bit. It's still a buzz cut and very much in the Sigourney Weaver as Ripley in Alien 3 or Demi Moore in G. I. Jane though it damn sure looks like a hairstyle someone would choose. I think she could walk out of the house any time now and fit right in. Again, we'll miss the pink wig but Kim is ready to be done with it. It's still a little too cold out for her to go out without the wig or a hat but she looks really good. And so far the hair growing in seems to be the same color and type as before. There's been talk that it may come back curly so we'll keep everyone updated. Amazing how quickly it's coming back.

Kim has been taking Glutamine supplements since the start of her chemotherapy treatments to reduce the severity of mucositis and neuropathy. Mucositis is the painful inflammation of the mucous membranes in the digestive tract and radiation is a further cause of the condition.  Oral mucositis is also a common side effect though Kim has only experienced the digestive tract side effects. She's been mixing in a scoop of powder with some cereal and almond milk three times daily but is now down to just one. Research has shown that this supplement provides relief from symptoms of chest radiation so she'll stay on glutamine through the end of the treatment. Further new research also shows that honey is a great natural therapy to precent side effects from chemotherapy and radiation induced mucositis. Some other side effects she's prepared for are skin irritation, fatigue, and further lymphedema. Her doctors are on top  of everything and we'll keep an eye on things.

Kim's nutritionist mentioned that her pink wig served to inspire a new patient of hers. The woman is a young mom and didn't want to frighten her children with her hair loss or the sudden appearance of a new wig. Kim's success with the pink wig and how she let the kids be part of the selection process inspired this woman to do the same. It allowed for a calm transition for the family and now the wig is a fun part of the process. I'm gonna miss that pink wig and the light it shined amidst all this darkness though I am excited to see Kim's new curly, golden locks.

Kim's radiation schedule will be every morning at 7:30 AM. It's a really early start but we chose this time on the advice of several people in the process. First, it's great to get it out of the way and still have a full day ahead with no running around. Next, being first into the clinic means they are on time and ready to go. Kim has already been in for her set up so the visits will be quick in-and-outs allowing her to get to work even a bit early. Plus, there's no other patients jamming up the system in front of you. Kim and I made the choice for this early time together knowing that it would inspire us both to be on top of our days early. We'll get up, make a good breakfast, and begin our days even earlier than usual. By the time 6 weeks have passed we'll have a routine in place to make the most of those early spring days.

Thank you for allowing the long break, we're back on schedule. Hair we go...

Six Months

Kim learned of her cancer diagnosis around dinner time on June 19th. Six months later and she's passed through 4 months of chemotherapy, dozens of doctor's visits, and lumpectomy surgery just last week. Her chemotherapy port was also removed during that surgery. Today, December 19th, she's in good spirits and recovering quickly. She's been out for walks, joined us all to see Rogue One, and will return to work tomorrow. Her pain medicine pump came out Saturday evening (by yours truly) and the surgical drain will be removed Thursday morning (by a doctor, whew!). Thursday evening will be the first time in quite a long time that Kim is back to normal. There's some peach fuzz on her scalp. The daylight hours, thankfully, will also be growing longer every day beginning Thursday.

By now I'd bet that all of you know the play-by-play from her surgery last week as so many of you acknowledged well wishes on Facebook as I posted throughout the day. So, for this post I'll just add some detail and let everyone get back to the holiday buzz.

Kim's surgery went as best as we could have hoped for with her doctors reporting successful procedures and her quick recovery from anesthesia.

The real take away from this procedure is that there's never really an easy step. Prior to surgery there's the cleaning of the house, the washing of all the linens and towels, showers for both of us with anti-bacterial soap, all the fasting Kim must do in advance. Next, at the hospital, it's loads of questions, tests, and pre-op procedures. The surgery, for Kim, lasts about 5 minutes. For me, those 4+ hours were spent hanging out with friends nearby because listening to the mainstream news on the TV in the waiting room is mind-numbing. The benefit of this hospital being in town is that there's so much to walk to nearby including snack and treats for both Kim and me.

Perhaps the hardest part of this surgery is that it's not "over" once leaving the hospital. Kim had a pain medicine pump fanny pack attached to her waist with a catheter inserted into her upper left chest. She has a surgical drain exiting her left underarm and a collection tube attached to a special bra. For three days she was bothered by both. Now, it's just the drain. It's unpleasant, uncomfortable, requires regular care, and, of course, requires another visit to finish off. Time, Kim is most eager to have her time back.

Kim's check-in time was 7am for a 9am start. A heavy winter storm hit the city the evening prior so getting up and out early was important. Nothing was keeping Kim from her appointed surgery time.

Please, no more waiting. More than anything, Kim wanted that chemotherapy port out.

Back again in the same pre-op bay as her port surgery. Gotta love those inflatable warming blankets.

Prior to surgery Kim required an ultrasound and trip between buildings. We took the skybridge which was chilly but offered a beautiful view of the quiet, snowy city streets below. Warm blankets are always at the ready.

Ultrasound confirmed location of the tumor and lymph nodes. This doctor was so very nice and quite humorous. Thankfully so, as his job is to give Kim two injections close to the nipple and then insert a very long locating wire into her breast. Damn, Kim is tough. Not a peep from her, just some laughing at his jokes.

Kim was visited by four doctors prior to surgery and each one gave her a thorough, professional, calming talk about what their job would be and the outcome they expected. This is her anesthesiologist. I forgot his name. Sorry, I was nervous.

Each doctor signs their initials at the location of their procedure. Dr Nathalie Johnson is the only doctor authorized to use a symbol, hearts, as her official signature.

Off she goes. 

No one ever wants to see this view of their loved ones.

Though, when it's immediately followed up by this sight, you're filled with great hope. Being married for nearly 20 years there are moments or images that are permanently imprinted and this is one that I will always recall. The image will never fully show that smile or that sense of strength. 

Recovery requires lots of tests, exercises, and such. There's a nurse it at regular intervals to do something and usually just as Kim falls asleep. This is a breathing exercise used post-surgery to fight of pneumonia. Kim had to breath in 10 times with the hopes of getting the indicator to the "500" mark on her first test. By breath 4 she was hitting "3000". The nurse, said, "What do you do? I've never seen a woman do that."

Sunrise after our evening in the hospital. Surprisingly, a restful sleep for both of us.

Kim was so eager for the physical therapist to arrive so she could learn her exercises and get out of the hospital. The therapist came in and I said, "I know you."; she was the star of the PT video we'd watched the night before. She gave Kim a quick talk and then asked her to stand up. Kim got right out of bed. The therapist said, "Oh, you can do that on your own?"

Three days following the surgery Kim's pain medication pump was empty and it was time to remove the catheter. I'd watched the film on how to do this and was ready to go as I knew this was something we could do at home. Now, in the instructional video the catheter is only inserted about an inch or two. This one was inserted from the black mark on the left alllllll the way to the end over on the right. I made Andrew and Jason assist with this. Jason's face wasn't white, it was clear. Kim, as always, didn't say a word.

Ten Years Starts Today

Kim went in for her surgical consultation on Monday of this week. The great news is that the tumor has gone from 3.7 cm to just a bit of 2 cm. Her lymph nodes have also diminished in size though she we be having three of them removed. We went with high hopes that the plan for surgery would be a quick in and out and I'll say that maybe we were flying a bit to high off of the chemotherapy finish.

The surgery will likely be an outpatient procedure on Thursday December 15th though there is a chance Kim may spend the night. It really will depend on what  Dr Johnson discovers during surgery and Kim's comfort level with the drain she'll have in place to manage the lymph node removal healing process. Man, what a bummer. Recovery from the lumpectomy and lymph node removal will have Kim toting a surgical drain for at least a week. There's also a risk of lymphedema, swelling and pain in the arm on the side of the removal. Kim is confident in the surgery process but very worried about long-term effects such as the arm pain. Dr Johnson is as good as it gets and we are confident that the procedure will go well. One benefit to the surgery on that day is the removal of the port in Kim's right chest. It'll be a big day.

Today was the first Thursday in four months that Kim did not return for chemotherapy on the alternating week. She's feeling better and better, her feet don't hurt as much. She also seems to mentally willing her hair and eyelashes to grow more quickly. 

But today is a day to note because it's the first day she's taken a Tamoxifen Citrate tablet. Tamoxifen is used treat breast cancers that test positive for estrogen receptors. It blocks the effects that the hormone estrogen has on cancer cells and lowers the chance that breast cancer will grow. By starting today she'll give the drug a few weeks to work the tumor size down even further. 

She will be taking this drug every day for ten years.

I cannot get my head around that time period. Add to this the possible side effects of hot flashes, nausea, fatigue, headache, and hair thinning and it's a quick end to the sense of joy and optimism we had just a week ago. Sure, we knew four months ago that this drug would be prescribed but it really hit home today standing in the kitchen as she added the tablet to her pile of vitamins and supplements. It feels like another member of the household to me. 

The bright side, right? Kim is strong and healthy and will only become even more so as we go on. To celebrate this fact the family is off to Seattle for the weekend. Art museums are good for each one of us. 

Here's to 2026

Chemotherapy #8

Done. Finished. Over with. No more chemotherapy. Kim's final session was last Thursday. Our friend Jessica Heenan joined in for this last session and really brought it home in style. Jessica works on an organ transplant team in her real life and at home she's her family's version of me so we get along great even though she's not really a dork like me. Jessica even had a pizza delivered to the infusion center for this last session. (Yes, it was gluten free). Thank you, Jessica for helping Kim wrap up this long four-month process.

Thank you, Jessica!

Following the session we said good-bye to Jessica, who had to go to Vancouver for bizness, and then we headed over to see our friends at The Athletic. We checked out all the cool new stuff and then popped next door to The Commissary for a late lunch. Everyone's support through this process has been so helpful for us both. Again, thank you.

Kim and I got home in the late afternoon and spent some time with Andrew and Jason before deciding to walk over to one of our favorite local restaurants. We enjoyed a great meal together with plenty of laughs; Kim and I shared a glass of wine each. We took a nice walk home and I soon found my way to bed at 7:30 PM. Kim was in just a bit later and we were both zonked out by 8. The stress of these chemotherapy sessions along with keeping Kim from getting a cold or flu through the process was a long, four-month grind. It felt good to let that go. Kim doesn't feel very good right now, this final session really stacked up the fatigue on her, but she feels good overall. Every day from now on is back to feeling good. She's stoked.

Kim had a sonogram this week to look at the tumors and they are much smaller than at the start of chemotherapy so at least all the side effects were worth it. She'll go in for a visit with her surgeon to assess the upcoming lumpectomy scheduled for mid-December. Once she's in for that procedure her doctors will now how much radiation treatment she'll need so we do have a bit of uncharted waters before us. Still, it all feels manageable in comparison to chemotherapy.

Kim says she wants to write a post on this blog so I'll leave some things for her to say soon. But for now consider this, other than the 8 chemotherapy days Kim didn't miss a day of work. She didn't miss a moment of the things Andrew and Jason have been up to. She's been upbeat and kept us all on the move and going out to see and do fun stuff. She's so tired, I can see it, but she's resilient and resistant to being held down by it. She has not complained or called much attention to herself. She's embraced the pink hair and I wonder how she'll be someday soon without it. She makes a lot of new friends out in public with it. Yes, her feet still really hurt and her legs ache a lot. I know she's looking forward to the Neulasta (bone marrow stimulant) finally being purged from her system so the aching will subside. I am a little concerned that sometime next summer when she's back to feeling good that she'll smash us all on the bike.

Oh, and she's excited to have the port removed from her upper chest. (Ugh, even just typing about it makes me pee a little bit.) Nope, Kim never complained about the port either other than the time I tried to give her a shoulder massage and forgot it was there and during the final chemotherapy session when they assigned her a training nurse who fumbled with the port injection at first. Kim, sweetheart, you are so incredibly brave and strong. It's just so normal to me and the kids to see this strength that we sometimes forget what you're going through. Thank you for sharing that strength with us.

So, another Thursday with something to do this week although this Thursday will be nothing but good times. I have several cans of cranberry sauce, (none of that hand-crafted crap, this is the good, cheap stuff!) hidden away and we're gonna enjoy all of them along with a good bottle of wine. We all have a lot to be thankful for, as always. Thank you to all of the friends and loved ones reading this, I am so thankful for your support. Happy Thanksgiving, everyone.

 Kim, always baked.

The reason for the season...

Chemotherapy #7

And so it is that I find myself on the eve of chemotherapy session #8 having realized I never posted about session #7. It's become so normal and uneventful in most cases that this one just sort of scooted by. The real highlight of the session was having my mother, Anita, attend with Kim but even they fell under the spell of just-another-average-day and didn't even get a photo. Session #7 came and went and we probably didn't pay all that much attention to it because our eyes are on #8. Thursday November 17. 4 months later. Kim, I know is very excited. To celebrate we are off to see Hypnotic Brass Ensemble this evening at the Arlene Schnitzer Hall downtown; it's a family affair and somehow we are all excited. Should be a fun night.

So, what to say here? I've been thinking about what information might serve best for instructional purposes here and it's a touchy subject, bills. Money, of course, is of no concern when compared to someone's life but it is a reality we face. So here goes.

Every day our mailbox is filled with letters from the hospital or insurance company. There are letters to inform us of treatment services being considered for payment, letters confirming payment, and letters about the letters. Every letter has a privacy statement or some other insert, it's nuts how much paper they waste on telling us nothing. Some envelopes contain bills and, so far, they haven't been all that bad. We are fortunate to have insurance and we've been benefitting from the plan. The bills for all the early doctor's visits and procedures have been small though bills for CT scans and other big procedures stand out. The first chemotherapy bill arrived and the pre-insurance cost is $20k. That's for a single session out of 8 total. Insurance is picking up most of it though what's left is undetermined at present. I'll keep you posted but please know this is not an appeal for help, simply a heads-up on how much treatment costs. So much of this process is never spoken of and only discovered as it happens for those going through it. I'm hoping this blog helps demystify the process for anyone facing it in the future. 

I suspect the health care system is flawed though I won't go tin-foil hat conspiracy here on everyone. That said, why are the prices of cancer drugs so high and why have they gone up in price so much so quickly over the past few years? Drug companies refuse to discuss how they set prices and, under our current laws, they can charge whatever they want. Back in a previous post I wrote about a 22-year-old women in for her first chemotherapy treatment. Will she be forced to choose between a personal bankruptcy she can never emerge from or the best possible treatment to extend her life to its fullest? Hospitals and doctors are pushing back against pharmaceutical company pricing though I think we'll need stronger legislation to protect the people of this country. You should pay a premium for luxury items bought voluntarily, not life-saving medicine. I found this quote while doing some research:

"They are making prices unreasonable, unsustainable, and, in my opinion, immoral," said Hagop Kantarjian, MD, chair of the Department of Leukemia at the M.D. Anderson Cancer Center in Houston, referring to pharmaceutical companies and their cancer drugs.

Kim and I are also fortunate to have some guidance through this process and our most recent education was a very instructive meeting about insurance and bill paying. Very simply, don’t pay anything until it’s all said and done. The billing process is long and not perfectly connected so wait until all the facts are on the board before acting. The best advice I was given on the subject, “This is going suck.” And by “this” I mean the coordinating and tracking of bills and costs. With so much information bouncing back and forth between hospitals, doctors, and insurance offices there’s a lot of unconnected dots and it's my job to connect them.

Match explanation of benefits to services and costs, if there’s no match between numbers for the same visit/treatment, don’t pay the bill just yet. Sometimes it takes time for benefits to post properly between all offices so tracking everything is paramount. The concern here is paying something prior to the full cycle and discovering you paid too much. 

Again, money is a sensitive subject when it comes to someone's health, or life for that matter, but the expectation of a long life after treatment demands that attention be paid to ensuring our future best interests. The worst part of the money conversation is that the person under care often feels guilty for all the costs they are incurring. It's a normal reaction and one that shouldn't be dismissed without acknowledging that person's feelings. Kim will occasionally apologize for all this and I have to be gentle in reminding her there's nothing to apologize for. This is a fairly common relationship between the patient and the caregiver and especially, I believe, in the case where the patient is feeling good. So I am on the job of making certain it's all taken care of and that Kim does not feel any additional stress from the process. Still, there's a daily reminder in the mail for all of us that she has cancer and that there's $ associated with it. 

Kim will finish up chemotherapy tomorrow and then surgery in December. She'll need time to recover from surgery and to allow for the holidays so her radiation treatments will begin in January. For the insurance company that means a new billing year so we'll have to meet our deductible for an additional year. The insurance company is allowing us to change our plan to buy up to a lower deductible so that's a positive result of meeting with them and coordinating payment for care. Yeah, just writing about this seems unsavory, I trust it comes across as helpful. I'm looking forward to writing about session #8.

-Chris

The pink hair always attracts fans. We got to meet a few of the members of the band after the show at last night's Hypnotic Brass Ensemble show. Amazing, amazing performance. Such a great way to energize Kim for her final session. 

Kim's Halloween costume was so much easier this year because she could easily wear a wig. 

Comet continues his antics. How about a nap in the dryer?