Bob's Battle with Lymphoma: The Oncologist

I'm drained-emotionally, physically and financially. We just got home at 8pm, after leaving for New York at 1pm. It's been a really long day and everything aches. I think my head is going to crack in half.

I'll quit complaining and get back to the important stuff: Bob.

Today we travelled to Wappingers Falls, NY to meet Dr. I., the Board Certified Oncologist. I was expecting just a consultation and that it would cost about $165.00. He'd look over the blood test results and the biopsy report. He'd talk about next steps and he'd sketch out the costs and we'd schedule some treatment or he'd say Bob cannot be treated for whatever reason.

©2011 Robin A.F. Olson. Nice office and staff, but I KNEW this was gonna cost just by looking at the signage!

But nothing went according to plan.

Bob has many complications: 1. He is FIV+, 2. He's a Senior, 3. He has an upper respiratory infection, 4. He has the remnants of a fungal infection on his head (which MUST be GONE or no chemo). 5. Bob has lost almost two pounds now, since September. He used to be a robust 14-15 pound cat. Now he's just a slip over 13 pounds. He's GOT to stabilize his weight. He's GOT to get rid of this damn URI that he's had for 11 days.

So the Dr. suggests taking x-rays. They have a digital x-ray machine. Very awesome and of course, expensive. I feel a tug at my purse strings, but I let it go. Then he wants to repeat Bob's month old blood work in their own lab AND send another full CBC out to another lab! No! They can wait a day and get the full CBC and not charge me twice for doing the same bloodwork for the most part! Sheesh. I saved $89.00. Oh wait...then he said that the pathology, though done well, should be looked at again by another specialist. He felt that we could get MUCH more information from this other person and we'd get more of an idea of this is “large cell” or “small cell” lymphoma. [we're hoping for small cell]. The problem is that it takes TWO WEEKS to get results and in the meantime, Bob is losing weight and the cancer will have two more weeks to misbehave. Oh, and he will have a radiologist/internist look at Bob's x-rays (ka-ching). I started to guess how much this was going to cost. I thought $850.00. WRONG! $1200+.! I tried not to panic. This is on top of the $5000.00 I already had to “find” to cover Bob's surgery and tests before the surgery. It's probably more than that, but I really don't want to know right now...And the first person who rakes me over the coals for spending this money is going to be kicked in the teeth. For one thing, this didn't come to me as a bill for $5000+. It started with a few x-rays. Then it was an ultrasound. Then it was blood tests. Then, a surgery, etc...Would I have done this differently if I knew up front what this would cost?

NO I WOULD NOT. I've got Bob's back. I'm not going to just toss him aside for MONEY!!! He's a living, breathing creature. He gives me his love and asks for nothing back. He does not deserve to be left to die slowly or be euthanized because of cash. I find that repulsive! Would you cut care to your MOM? Your kid? A stranger, even? A person you passed on the street? You wouldn't deny anyone who had a fair chance to recover and live comfortably, a chance to do so. [stepping off soapbox now]

©2011 Robin A.F. Olson. Not sure if he wants to get out of his cat carrier, after all

I tried to decide if we could get away with not doing what he suggested, but it DID make sense. We needed to compare his bloodwork and x-rays to what we had before his surgery, so I said yes. They took Bob away and asked us to go get a coffee and come back in a hour.

We went to the front desk, of course, because we have to pay 75% of the bill right NOW, before they do a thing. God forbid they wait an hour to get paid in full. So I whip out my good old Care Credit card and they say "they can't access our limit information" so we have to call them. We call them and they say there is something wrong, but won't say what it IS! So we're standing there trying to think of how to come up with the money when we weren't prepared to blow a huge hunk of cash. I did not want to use the old, beaten AmEx, but I had no other choice. Fortunately, it worked fine and they smiled and said thank you and I grumbled under my breath, freaking out about CareCredit's rejection. I was so embarrassed and I had NO IDEA WHY there was a problem. I KNOW we have plenty of room on that card and we pay the bill on time. Sam tried to comfort me by offering to deal with them-which I gratefully accepted.

I'd noticed a Panera Bread cafe on the way to the Vet, so we drove over there to kill some time. We were both ashen, miserable, and glum (which could be a good name for a law firm) as we sat with our caffeine (mine a tea, of course, Sam's a coffee, of course). I said it was a pretty day, with sparkling blue skies. That we were lucky to enjoy a nice day. We were together, neither of US had lymphoma (which without health insurance, I'm guessing we'd have to just crawl into a hole and die). I tried to get Sam to look on the bright side, but I couldn't convince myself-how could I convince him?

We've had the WORST few years of our lives. Work is just not happening and the work we DO get, well the clients just can't pay very fast. I'm on month three of waiting on an invoice for one project. We keep thinking, as so many people do, it's GOT to change for the BETTER SOON. I can't remember a time when the economy was so awful for SO LONG. It makes us feel terrified and desperate. We're trying to smile through the fear. Trying to enjoy our life day to day, but it's getting tougher and tougher. I said we should just kill ourselves and be done with it, but Sam reminded me...who would care for our cats? What about Bob?

I couldn't argue with that.

So we picked ourselves up and went back to the Vet. Dr. I is very good at telling people bad news. He must have a lot of practice. He motioned for us to come over to his computer screen. There was the x-ray of Bob's chest, from the side (lateral view, if you want to be fancy). Dr. I remarked at how GOOD Bob's lungs looked. There was NO apparent cancer and NO apparent disease. He didn't say “BUT,” though I KNEW it was coming.

What concerned him was...then he zoomed in on an area between Bob's 3rd and 4th ribs...it was a small mass. I could not TELL it was a mass. It didn't look significant at all. Dr. I said that Bob's liver cancer, they type of liver cancer, does not normally EVER spread. Once it's removed, it's gone, so he would not expect that mass to be "that" type of cancer.

©2011 Robin A.F. Olson. Bob is not so happy to hear the news that he has another cancerous mass. This one in his chest.

If it WAS lymphoma, Bob has lymphoma based in his abdomen. Usually if it's in the abdomen it STAYS there and it's easy to treat and it often is a “small cell” cancer. Seeing a mass in his chest could mean it's NOT small cell and it needs to be treated right NOW.

Dr. I felt that we needed to change things around. We'd start Bob on chemo tonight, treat his URI with antibiotics and antihistamine, re-check x-ray (ka-ching) in a week and see if we're getting rid of that chest mass and if Bob is starting to gain some weight. They we may continue on the chemo, weekly (so a 100 mile trip each week), for about six weeks, BUT we may have to change course and use something else depending on what the new pathologist finds out.

I wasn't pressured at all. Dr. I. knows his stuff. Lymphoma is very common in cats and dogs. He treats it ALL the time. He loves giving chemo to cats. He says they do great on it. I realized, though, that he barely even looked at Bob. He just went by the x-rays and test results. He was very precise and informative. He told me the bad news and I didn't cry until after I left his office.

They asked us to get lost for another hour and a half while they gave Bob the shot and kept him under observation. We drove around and found a bookstore and a cutely named coffee shop. We broke our cardinal rule and had a small meal at McDonalds, which I think may have been the first time in 16 years we ate at one. We were too tired and too broke to care about where we ate. We sat in a booth. There was a flat screen tv and a fireplace in this McDonalds. The audio for the TV was playing out of two different speakers, slightly off sync so it sounded like we were really really stoned and listening to the news. It was loud, too. We both were irritated and uncomfortable. We looked at the food we ate and made faces at each other. This was setting up to be a really awful day. I could not stop thinking about Bob. I just wanted to go HOME. I wanted to be home so I could hold Bob and CRY, but I was sitting in a weird McDonalds with out-of- phase speakers and a prehistoric guy in a plaid shirt sitting nearby watching the TV in rapt silence, as though everything always sounded just like that awful TV and everything was completely NORMAL when it was FAR from it.

We got out of there as soon as we stopped chewing. We returned to the Vet and paid the remaining 25% of the bill, got the discharge instructions and waited for Bob. One of the Vet Techs brought Bob out. I opened the top on the carrier and he sat up. I petted him and he purred, his Bob-purr. He was still Bob. He wasn't glowing or limp. Like, me, he just wanted to go home.

I loaded him in to the back seat, then took the seat next to him. Sam started the car and drove us toward home. I opened the door to the cat carrier. It was dark, too dark to see into the cage, but I put my hand inside it and felt Bob's silky head. I petted him alongside his face and felt his ear. It was cool. I petted him a bit more and I could feel his purr through my hand. It was a comforting feeling, pretty much the only one I'd had all day.