AFLAC is currently denying my claim for using dexamethasone as chemo. They said that one must use at least 40 mg of dex to qualify. When I provided supporting documentation to show that I’m taking 40 mg of dex each week (and the initial 40 mg for 4 days on with 4 days off for 4 cycles at the beginning), they rejected that. They said that the dex was dispensed in 4 mg tablets, so it doesn’t count. It has to be dispensed in 40 mg tablets or has to be infused. Um. Well, there is no such thing as a 40 mg tablet. I wonder if I could have the pharmacy make one for me? Or, can I just have my Dr. write an order for me to have the dex IV? I don’t think Blue Cross, my primary carrier, would like that. That would drive the cost way up. Anyway, I plan to appeal. Apparently, they don’t have much experience with with this drug as an oral chemo. I’m not sure what cancers it’s used in. Maybe not many others. Dex is a very hard drug to take, and I know of quite a few MM patients who can’t tolerate it and have to stop that part of their treatment because of the side effects. They can be quite severe, and include congestive heart failure. I’ll see Dr. Orlowski on Wednesday and show him their letter to see if he can write to them to explain the reason why dex is dispensed in 4 mg tablets.

It’s a really beautiful morning today. The temp is below 70 for once, which is fantastic. It’s been too hot here lately, and too rainy! I enjoy North Carolina weather most in the fall and early winter. Then it’s nice again in late winter and early spring. The humidity has been pretty severe lately, since we’ve been having all this rain. Our county has experienced some serious flooding. I live at the high point of my neighborhood, so I’ve escaped most of it. However, a lot of the gravel from my driveway can be seen at various intervals down the street from me.

The 2004 Toyota Sienna I bought a few months ago came without cruise control, which is a necessity for me. Without it, making long trips is impossible. One thing cruise control is good for is the prevetion of speeding violations. It also makes it possible for me to flex my right leg a lot more. I do need to stop more frequently than I used to, to keep from experiencing that nerve pain that results from sitting for too long. A few hours is the most I can really sit (if that) without having lower back and leg pain, that takes days to recover from. Gosh, when I was in my 20s, it was nothing for me to drive hours and hours. I remember one time I drove from Denver, CO to Kingman, AZ in 18 hrs, only stopping to buy gas when I needed it. I routinely drove for enjoyment. My favorite thing to do after work late at night was to drive from my home in Sunnyvale, CA (near San Jose) to San Francisco and back, just to kind of unwind. Nothing ever seemed too far for me then. Anyway, back to the cruise control! I learned last week that there is no aftermarket cruise control for the 2004 Siennas. The dealer has told me that the only way to have it, is to get it in a new vehicle. So it looks like I am going to be trading my van in some time soon. They’re going to give me top $ on the trade, since I was told at the time of purchase that I could have cruise installed, and even paid in advance for it.

I had my 42nd birthday over the weekend. My sister and her family came down from VA for a surprise party. It would have been a surpise to me, except that someone let the secret out. It was a fun weekend though. I had cake, and that was a nice departure from my typically sugar free life. I had some thoughts about the possibility that I don’t have many birthdays left. I’m going to confess that I’ve never really found much joy in life. I put on a good show though, and not many people know that I’ve suffered terrible depression throughout my life, even having been hospitalized as a child. For many years, life has been a struggle for me. Sometimes I am relieved that I just may not have to suffer through another 30 or 40 years of life. Maybe what I’ve read about depression contributing to disease is true after all. I intend to talk to my doctor about this tomorrow. I’ve been on medication off and on for years, and sometimes it helped. Sometimes it made things worse. I guess it’s a matter of finding the right one.