tgif i guess

if you have siriusxm, the doctor radio channel (110) has a show on thursdays called healthcare connect. they provide a lot of information on medical coverages and options some states have their own healthcare sites but others rely on healthcare.gov to provide the information. it looks like nc uses healthcare.gov. you can explore to see if you get a subsidy (most people do) and what plans are offered in your area there is a ton to know even with the info they provide and plans change every year. IF you can find a good an independent broker, it might be worth talking to them. with or without insurance, apply to all the drug companies for assistance. hopefully, the oncology center will do it for you. some are easier to qualify for than others. its not a matter of free drugs or nothing. merck pays my copay. the process is not so complex that you can't apply, but the clinic workers know all the tricks and handle appeals and the phone work for you.

like you, my stage 4 diagnosis came from losing my voice - i asked to see an ent when i lost my voice. he asked why i had not had a pet scan that was recommended by the radiologist. i assumed no scan was ordered because i had no diagnosis at the time. the ent shoved a wire up my nose and said my left vocal cord was paralyzed. he ordered the pet scan. evidently the left vocal cord nerve has a path near your heart and the lymph nodes with cancer had pinched the nerve. its annoying but all the 'what ifs' won't change anything. on the upside, i was put on 2 chemo drugs and keytruda. after a few months, my pet scans came back clear. my ent said about 90% of the time, my vocal cord paralysis would be permanent. i hit the lucky 10% and regained my voice. that was about 2 years ago and my scans are (so far) still clean. the side effects of treatment have been minimal for me. hopefully for you too. don't be surprised if they order a pet scan. i have them periodically. with the cea blood tests, its my way of knowing where i stand in the battle. i know you are scared. i was too. but the diagnosis may not end with all the fears in your head coming true.

chemo and keytruda has taken me from stage 4 to clear pet scans and cea tests. i had no surgery but the lymph nodes (hilar thing) were involved. my chemo was carboplatin and alimta. once in remission, the carboplatin was discontinued. never puked or lost hair. it all started about 2 years ago with remission about 6 months into the 2 years. i don't know what got me into remission but i suspect the keytruda played a big role in it. i'd push to start it as soon as possible, if he is eligible. when diagnosed, i took all my vitamins to my oncologist. he said they were good vitamins but 'what would happen if you don't take any of these' was his response. i quit taking all of them. i do take foliic acid (rx) twice a day and have a b12 injection monthly. i don't follow any special diet. i try to eat reasonably healthy and drink an ensure daily. the future brings what the future brings. but edive is right - this does not mean its a death sentence. optimism goes a long way. my life changed remarkably little throughout the treatments. it might be the same for him.

chemo and keytruda has taken me from stage 4 to clear pet scans and cea tests. i had no surgery but the lymph nodes (hilar thing) were involved. my chemo was carboplatin and alimta. once in remission, the carboplatin was discontinued. never puked or lost hair. it all started about 2 years ago with remission about 6 months into the 2 years. edive is right - we have some miracle drugs to fight this battle.

did they give him a wbc booster like neulasta the day after his carbo/alimta treatment?

i only had chemo and immuno for my treatment. no surgery (other than a biopsy). my guess is that the worst part of your fight is done - the surgery. i can only speak to the chemo/immuno. and my experience with it. it might be that i had the wimpy chemo treatments. i had carboplatin and alimta for the chemo part. carboplatin was dropped when my tests cleared but i am still taking the alimta 20ish months later. immuno is keytruda. started it with the chemo and still taking it. in the midst of the initial diagnosis panic, i ordered a dozen knit caps. doctor prescribed pain and nausea meds. i was ready to be sick, bald and feel like crap until i died. life turned out differently. i have not lost my hair or puked one day since my diagnosis. throughout my treatment, my blood work has been remarkably normal. i go to work every day. i see the side effects as inconveniences. i'll take that if the deal is inconveniences or dead. for me, the inconveniences have been few and manageable. constipation remedied with colace and miralax every day. while on carboplatin, most foods tasted like a yeti cup. (But chocolate and peanut butter still tasted like chocolate and peanut butter!) i would still recall how good fraud chicken and texmex tasted. still ate it. disappointed for sure but it was not a struggle to eat. disappointment or dead. you'll choose the disappointment too. taste clears up when you stop the platinum chemo (carboplatin or cisplatin). the steroids. remarkable drugs but do NOT shop for groceries when taking them. you will buy EVERYTHING you pass. you will also have the cleanest bathrooms and find yourself alphabetizing your spices in lieu of sleeping. i take steroids the day before, day of and day after the chemo. they also put more steroids in the chemo bag (with stuff like benedryl, nausea meds and who knows what). forget the crack pipe. and the meth. the chemo nurse hooks you up and its legal. lose a few nights of sleep or dead. i had a shot the day after chemo. only when taking the carboplatin. it boosted the white blood cell production. the shots worked (kept the count in normal range) but you feel a little yucky a couple of days. not that bad. better than dead. fatigue - yeah i guess. i am not sure if its fatigue or just my nature to be a lard butt. i still get things done though it might take a little more pushing myself than it used to. a few months ago my red blood cell count dropped below normal range. the 'will you go get me some reeses peanut butter cups' ploy will work a few times but eventually, the normies catch on. you'll have the strength to fetch your own. get a port if offered the option. it makes chemo SO much easier. easier for you and the chemo nurse. one tiny prick and its done. i am a 'no counter'. my chemo nurse tries her best to remember if each of us is a counter or no counter' (the 'ok, tiny prick - 1, 2, 3' thing.) i got on a lot of prayer lists. mostly old blue haired ladies that are friends of our family. never underestimate their pull upstairs because they are too old to sin. i am fortunate that i have chemo in a group environment. about 12 of us in a room with recliners facing each other. our chemo nurse will direct the new patients to sit next to a veteran that will reassure them. you can read or do a crossword or eat or go pee - or participate in discussions with others. its strange to say, but you will be able to say things there that normies would find unsettling. you can say things you would not say to normies too. you will learn a lot. you'll form an odd bond with people that have heard the cancer word also. they have been through (or going through) all the things you are experiencing. we bring in water, snack crackers, wigs, reeses peanut butter cups, pies and old ladies bring in knitted caps. i donated my sheepskin seatbelt pad (to pad the port - i didn't need it). it can be fun and uplifting or a little sad at times. it is a great equalizer in that rich or poor, powerful or meek - everyone is the same in the cancer battle. you'll settle into your new normal. it might be shockingly close to your old normal. there will still be joy in life and the bathrooms will still need to be cleaned. there will be a few minutes when you are not obsessed with the cancer word and with time, those minutes will be longer and longer. try to make chicken and dumplings as good as my mom's. or 'dressing' for thanksgiving. you'll never succeed but the grandkids will love them. now i am going to venture into a guess. if you were waiting for a table and they called out 'patty', you would not react. your mama and everyone else calls you pattyann. i might be wrong. you yankees might be different. you'll be shocked at what you can endure if you have to. and you will.

i think my primary symptom was the pressure in my chest. when my voice changed, that is when i insisted on seeing an ent. began as hoarse voice and eventually became difficult to speak because i was out of breath. the ent shoved a little wire up my nose (it was a camera) and said my left vocal cord was paralyzed. that allows all your breath to escape when you try to talk. he said the nerve that controls your left vocal cord passes down through your chest. the right vocal cord has a different path. the lymph nodes in my chest (cancer) pinched the nerve causing the paralysis. the ent ordered my pet scan that led to my diagnosis. pulmonologists missed it completely. one surgeon said he could not biopsy without cracking my chest open. a more experienced surgeon said he would try to get to the lymph nodes in my chest by entering under my arm pit. he was successful. i went on chemo and immuno. after maybe 6 months, my pet scans began to come back clean. and my voice cleared up. the ent said that when the nerve is pinched, its rare to get the voice back to normal. i do not know if my left vocal cord is still paralyzed or if the right somehow compensated. i had no surgery to remove cancer. this began about 2 years ago and i still take one chemo and immuno. and for me, i have had remarkable few side effects. sounds like they caught hers earlier than mine.

siriusxm has a 'doctors' radio' channel - one show is on insurance and medicare - they said the maximum out of pocket next year will be $2,000 - it amazes them that no one is talking about that - for all parts combined - no more donut hole - maybe someone can confirm that for us i doubt anyone pays retail for any of these treatments - if you know the 'j' code, you can look up what medicare pays lawyers hike the costs of drugs too - but we all like to see our investment funds go up

alimta - $21,000 - insurance paid $170.00 keytruda - $33,00 - insurance paid $11,115.06 i have never met anyone that pays retail for this stuff medicare dropped their reimbursement rate for alimta below the cost of the drug - but have brought it back up some - private insurance must pay at least as much as medicare and are allowed to pay more, but are also allowed to drop their reimbursement rates as medicare rates drop infusion centers make their profit on the benedryl, steroids, nausea, etc given with the infusion gave rise to the $50 aspirin merck pays my copay - some drug companies approve lots of assistance applicants - some are harder to qualify for my infusion center handles all that for the patients

strange that they did not start keytruda with his first chemo. i had no surgery but started with carboplatin/pemexetred (chemo) and keytruda (immuno). took me from lung/lymph nodes/bone to clear scans in about 6 months - then they dropped the carboplatin. i have been clear for over a year while continuing with pemexetred/keytruda. like him, i tolerate the treatments well. one doctor told me if there is a cure for cancer found, it will be through these immuno drugs. there might not be any progression. try not to assume there will be progression. not easy, i know. at least try not to participate in his assumption that there will be progression. you don't know if the dam is about to burst. you don't even know there is a dam. so grab your walker and get your 'dam' butts out of the riverbed. 80 and tolerated the chemo well. that is remarkable. the keytruda addition might be the thing that works for him. it might be what has worked for me so far. we are so blessed that our cancer fight has been easier than so many others. we are relatively free from the worst treatment side effects. i know you are asking what to watch for 'next' i can't answer that. i am hoping you can focus on the hope of keytruda. my first step out of the riverbed was optimism and (like edive said) staying busy. start with washing the riverbed dust off and replacing those tennis balls on your walker. they have a lot of miles on them and its time for a retread.

sounds encouraging. they cut out the lobe with the tumors. chemo and immuno for insurance. i guess it depends on the chemo, but i had chemo day 1, then immuno day 2. repeat every 3 weeks. some chemo and immuno can be given from day 1

thanks for the replies. i was curious about that since my diagnosis. the first surgeon i talked to said he could not get to the area. the second surgeon said he'd try. from his operative report An axillary incision was made. I dissected into the deep axilla and there was a hard, firm, matted node deep in the axilla. I dissected down to that and resected the lymph node and used a 3-0 Vicryl pop-off suture to secure the vascular inflow to lymph node. The node was sent fresh for analysis and the pathology department was made aware of our concerns. from the pathology report Final Diagnosis MICROSCOPIC EXAMINATION AND DIAGNOSIS: LEFT AXILLARY LYMPH NODE, EXCISIONAL BIOPSY: - METASTATIC CARCINOMA MOST CONSISTENT WITH PRIMARY LUNG ADENOCARCINOMA. - TUMOR IS PRESENT IN LYMPHOVASCULAR CHANNEL LUMENS. - THE CANCER IS PRESENT AT THE EXTERIOR MARGIN OF THE SPECIMEN. i should have paid closer attention

is a biopsy of your lungs the only way to diagnose lung cancer? i never had a biopsy of my lungs. but i did have a surgeon go in under my arm pit and snag a lymph node in my chest. that was sent to pathology. i had 2 different genetics tests done but do not have a copy of the results i have had no radiation or surgeries, just the chemo and immuno from my oncologist's notes Principal Dx • Non-small cell lung cancer (disorder) (Lymph Node Involvement: Cervical; Lymph Node Involvement: Axillary; Lymph Node Involvement: Hilar; Lymph Node Involvement: Pectoral; Lymph Node Involvement: Mediastinal; Metastatic Sites: Bone; Metastatic Sites: Spinal cord; ICD-10:C34.12 ;Malignant neoplasm of upper lobe, left bronchus or lung ) Diagnosis date was about September of 2022 history CT Chest with contrast- Stable partially calcified mediastinal and holar adenopathy which could be due to prior granulomatous exposure. Irregular parenchymal density in the left apical region which appears minimally thicker than on the previous study. PET recommended found an ENT that ordered a pet scan Extensive mediastinal and left hilar lymphadenopathy is redemonstrated. The adenopathy is FDG avid. In the superior mediastinum the nodes measure up to 5.9 SUV. Right paratracheal nodes measure up to 8.5 SUV. At the aorto pulmonary window than lymph nodes measure up to 6.3 SUV. At the left hilum maximum SUV of 6.1 is recorded and in the subcarinal nodes maximum 7.9 SUV is demonstrated. Left subpectoral and left axillary lymphadenopathy is also demonstrated and is FDG avid. The largest node at the left axilla measures 2.1 cm with maximum 7.4 SUV. The tiny 1 cm spicular focus in the left upper lobe demonstrates intermediate FDG activity with maximum 2.2 SUV. At the L4 body there is a focal area of intense activity in the right pedicle measuring 7.1 SUV suspicious for metastatic lesion. IMPRESSION: 1. Extensive mediastinal and left hilar FDG avid lymphadenopathy most concerning for lymphoma or metastatic disease. Left subpectoral and axillary FDG avid adenopathy are also demonstrated. The largest node is at the left axilla measuring 2.1 cm. 2. 1 cm spicular lesion in the left upper lobe with intermediate FDG activity may be inflammatory or neoplastic. 3. Focal FDG avid lesion in the right pedicle of L4 concerning for metastatic lesion. chemo (carbo and alimta) and keytruda for 6-8 months - then carbo discontinued latest pet scan (but they have all been the same for about a year, when carbo was discontinued) Brain: Visualized brain has normal physiologic uptake. Pharynx: No abnormal uptake. Larynx: No abnormal uptake. Stable left vocal cord paralysis. Lungs, pleura and trachea: No abnormal uptake. No nodules or masses. No pleural effusion. Heart: Normal physiologic uptake. There is no cardiomegaly. There is no pericardial effusion. No coronary artery calcification is visualized. Mediastinal space: No abnormal uptake. Liver: No abnormal uptake. Stable simple cysts measuring up to 1.5 cm. Gallbladder and biliary ducts: No abnormal uptake. Pancreas: No abnormal uptake. Spleen: No abnormal uptake. No splenomegaly. Adrenal glands: No abnormal uptake. No nodules. Kidneys and ureters: Normal physiologic uptake. No hydronephrosis. Stomach and bowel: No abnormal uptake. Mild diverticulosis of the sigmoid colon. Vasculature: No abnormal uptake. Lymph nodes: No abnormal uptake. No lymphadenopathy in the head, neck, chest, abdomen, pelvis, and extremities. Skeleton: No abnormal uptake in the visualized axial and appendicular skeleton. Soft tissues: No abnormal uptake in the visualized head, neck, chest, abdomen, pelvis, and extremities. IMPRESSION: Stable exam with no abnormal radiotracer uptake. my oncologist used the remission word when the pet scans cleared up. still doing the alimta and keytruda

you will come to know this is true maybe not right now, but it will happen

carboplatin, alimta and keytruda for about 6 months alimta and keytruda since then - about a year i have been amazed at how effective it has been - and shocked at how well i have tolerated the treatments it might be the same for your friend - i tell people, you can always quit chemo