Tuesday, September 9, 2025

9/9/25: I Got a Pfizer Updated Covid Vaccine 

Two days ago (on Sunday) I got the updated 2025-2026 covid vaccine. It happened to be Pfizer. 

I had thought about trying to get Novavax this year, since I had better luck with it in regards to side effects, but given the chaos and confusion created by anti-vaxxer RFK Jr. and his fellow anti-vaxxer cronies, I decided it would be best to get whatever vaccine I can, as soon as I can, in case vaccine access actually gets worse under this administration.

Here in MA, due to state laws, originally even pharmacies weren't able to administer the new covid vaccine, though CVS Minute Clinics could, because they are governed by the state Department of Public Health, not the state pharmacy board. (PCPs are always authorized to give covid vaccines, but in recent years, my PCP's office has directed patients to commercial pharmacies.)

I went ahead and scheduled an appointment for myself, my husband, and my son at the closest CVS Minute Clinic. In order to be eligible according to the FDA's new politically motivated restrictions, I had to attest that we all have a high-risk condition. My husband legitimately qualifies, and I had no qualms clicking "yes" because my cardiologist said I qualify. I felt a little weird clicking "yes" for my son - because I'm generally a rule-follower - but with the American Academy of Pediatrics saying that any kid whose parents want them to get vaccinated should be vaccinated, and with widespread encouragement for people to get vaccinated any way they can, I ultimately felt justified. 

Luckily, the issue became moot because, as it turned out, the same day I made our appointments, MA Governor Maura Healey issued an order allowing pharmacies to administer the covid vaccine and also making all people over age 5 eligible despite federal restrictions! I'm so relieved, thankful, and proud to live in MA!! 

(My daughter got covid in August, so we're following recommendations - which are still based on science - to wait 3 months, and we'll just have to hope the covid vaccines will still be accessible in November.)

Anyway. So I got the shot Sunday morning at a CVS Minute Clinic. Almost immediately the area around the shot started to feel sore and achy. Before we even left the store, the achiness had spread through my left shoulder just up to my neck. I went about my day as usual. By mid-afternoon, my entire left arm down to my wrist felt heavy, and my upper arm was painful if touched. By early evening, I felt wicked tired. None of this was particularly surprising, as I tend to get a lot of side effects from mRNA vaccines

Overnight, my whole body got achy, and I slept very poorly. All day yesterday, I felt lethargic, moved sluggishly, and my upper left arm hurt even when not touched. I cancelled plans to go grocery shopping, spent the day in bed with a small headache and low-grade fever, and made sure to stay hydrated. 

Today, after a full night's sleep, I'm mostly recovered. The only remaining side effect is that my upper left arm still hurts a bit.

Incidentally, both my husband and son only had a bit of upper arm soreness at the injection site, no other side effects. 

Friday, August 29, 2025

8/29/25: Cost Update

By the time I had my annual oncology and cardiology appointments in June, at the tail end of our July-to-June insurance coverage year, we'd finally met our deductible, which means those appointments were fully covered. 

The only other cancer-related medical charges I had were for anastrozole, which thankfully is always fully covered. 

So for this update, I'm only listing the amount billed / retail price (which gets added to the "total cost"), since the cost to me was $0.

10/24/24: Anastrozole (generic): $545.99 
1/22/25: Anastrozole (generic): $545.99
4/18/25: Anastrozole (generic): $545.99
6/5/25: Medical Oncology NP Appointment: $273.00
6/5/25: Medical Oncology NP Hospital: $181.00
6/24/25: Cardiologist Appointment + EKG: $353.00
6/24/25: Cardiologist Hospital + EKG: $504.00 
7/19/25: Anastrozole (generic): $545.99

Total cost to date: $481,186.34
With insurance, cost to me: $16,908.63

Tuesday, June 24, 2025

6/24/25: Cardiology Appointment

Not too much to report for this appointment. 

I've been abbreviating "electrocardiogram" as "EKG", but "ECG" is equally common.

So, the cardiologist said my EKG still shows the same "non-specific" abnormalities as before, but she has no idea why. Her online notes say, "Compared with ECG 6/25/2024, STT changes less prominent." Given the results of my most recent stress test and echocardiogram, and the fact that I don't report any cardiovascular symptoms (like shortness of breath, dizziness, or fatigue), the doctor didn't seem worried at all. But she did say I should continue to get a yearly EKG for monitoring purposes. 

She also said my next echocardiogram can be in 5 years from my last one, so in 2029. 

With talk of access to updated covid vaccines being restricted this fall, I asked if I would qualify as having a high-risk condition. She said yes, mentioning my history of cancer more than my history of heart conditions.

We actually spent more time talking about non-cancer-related issues, like cardiovascular health in general. My blood pressure and cholesterol are both a little high, so we covered the usual instructions of exercising regularly and minimizing sodium intake. 

She used a cardiac risk calculator, which put my risk of having a cardiovascular event in the next 10 years to be 1%, well below the 7.5% threshold for concern. 

She also talked about a CT scan for calcium deposits in arteries as something we might do at some point, as a precursor to considering statin medication. Not really sure why she mentioned this now, since she said my cholesterol numbers aren't high enough yet to be really worried (and if they were, I'd probably want to try diet and exercise first), plus she said this test isn't covered by insurance.

Thursday, June 5, 2025

6/5/25: Medical Oncology NP Appointment

Today's appointment was a full year after my last oncology appointment, and I have to say, it felt different. Cancer somehow seemed less close, like I can now imagine being in a mental place where cancer might feel like something "in the past". It's not something I can ever really forget - my missing breasts are a constant reminder - but maybe it could be more like "something I went through" rather than "something I'm going through".

Anyway, my NP greeted me with a big hug. She asked all about how my kids are doing, and what our summer plans are. It felt almost like catching up with an old friend, except it was all one-sided about me, though she does sometimes drop bits and pieces of information about herself in the course of our conversations. (For example, I know our families enjoy the same types of board games.) I expect to be cut loose from oncology appointments once I'm finished with 10 years of hormone therapy, and I anticipate feeling kind of sad about "losing" this semi-personal relationship. 

Of course we did get around to actual medical stuff. She brought up my last bone density test results. Yes, the numbers are getting worse, but she spoke positively about how they haven't crossed the osteoporosis threshold yet. She recommended I increase my weight-bearing exercise by wearing a weighted vest (like 8-12 pounds) when walking, which her own doctor recommended for her as well.

Other than that, I basically reported no change in my hormone therapy / menopause side effects, as described in my post for last year's appointment. 

My next appointment is in another year, and it will be with my oncologist. It's typical to alternate appointments between the doctor and NP, and I have no idea why they kept scheduling me with the NP in recent years, but I didn't mind since I like and trust her just fine. I haven't seen my oncologist since 2022, so it'll be almost 4 years by the time I do see her! I wonder if I'll be able to tell if she really remembers me personally, or if she'll just be going off my medical file.

Wednesday, January 8, 2025

1/8/25: Update on Brain Fog + I Got Covid Again

I continue to have trouble "finding words". In my previous post about chemo brain, I suspected that my "loss of words" might be similar to the "brain fog" associated with long covid, and it remains a big part of why I am covid-cautious; if getting covid means this problem could potentially get worse, then to me it's worth it to take steps to try to prevent getting covid. 

Recently, I came across this study, which basically reinforces my resolve to stay covid-cautious. The abstract says:

These findings reveal significant word retrieval difficulties in PCS [post-COVID-19 syndrome] patients, suggesting that cognitive impairment related to language may be more pronounced than previously understood.

Of course I haven't had any cognitive testing, and I haven't been diagnosed with PCS a.k.a. long covid, but now I'm even more inclined to believe that maybe my 2022 bout with covid did exacerbate my chemo brain, at least in regards to word retrieval. I also wonder if this type of brain function might improve on its own over time, or not. The study does note that "intervention" may help:

The findings suggest that patients with PCS may benefit from tailored interventions focusing on improving lexical retrieval and semantic processing.
Unfortunately, it also occurs to me that if one covid infection might have aggravated my brain fog symptoms, then even if they do improve on their own, they could still get worse again if I get another covid infection.

Which I did. I had my second known covid infection a week before Christmas 2024, so I'm 2-for-2 for covid ruining Christmases. For the record, the course of my illness was very similar to last time, except the duration was shorter. Instead of having a fever for 3 days, this time my fever lasted only 1 day; instead of finally rapid testing negative on Day 11, this time it was on Day 8.

I will now take this opportunity to gripe and rant about the pitiful state of public health. I take precautions to try to prevent infection, but ultimately the transmission of viral illnesses comes down to public health requiring widespread public action. Individual action just isn't enough. I got infected because someone else was infectious and didn't stay home or wear a mask. Current CDC guidelines for covid are based solely on symptoms; there is no longer any isolation period nor any recommended protocol for using rapid tests to help gauge infectiousness, and masking is only tepidly suggested as optional. (The guidelines surprisingly do include "Steps for Cleaner Air" - conceding that respiratory viruses are airborne - but it feels disingenuous because there are no required building standards and as an individual, I have no way to assess or control the ventilation or air quality in schools, at work, in stores, or in any indoor public places at all.)

Since it's already known that symptoms are not an indication of infectiousness, these guidelines literally encourage people to spread covid. Even this mainstream media article states:

With COVID-19, you can expect to be contagious for about one to two days before symptoms appear, and stay contagious for up to eight to 10 days after symptoms start.
Previous CDC guidelines, available now only in archives, were much clearer about infectiousness. As far as I know, nothing has changed in terms of rapid tests or the virus itself that would make these recommendations invalid: 

Note: If your antigen test results are positive, you may still be infectious. You should continue wearing a mask and wait at least 48 hours before taking another test. Continue taking antigen tests at least 48 hours apart until you have two sequential negative results. This may mean you need to continue wearing a mask and testing beyond day 10.

I know not everyone can afford rapid tests, so don't get me started on how I think the government should make rapid tests free and widely available in unlimited quantities. Why are we still paying roughly $10 per rapid test in the U.S. when they can be purchased for less than $1 per test from this German retailer?

Considering the fact that we eliminated a flu strain with precautions designed for covid, it's clear that mitigations work to reduce the spread of respiratory viruses, covid or not. Yet, still people will not wear a mask even when they know they are sick. They are happy to spread their viruses to others, and I just find that lack of consideration so disheartening.

Friday, September 13, 2024

9/13/24: Cost Update

Our high-deductible health plan runs from July to June, which means our deductible gets re-set on July 1. So far, it seems like I (along with the rest of my family) have enough medical appointments that we reach our deductible late in the coverage year, which means finally in June some appointments are 100% covered by insurance! And then we start all over again, paying a lot for appointments starting in July.

Here are the latest numbers, including the amount billed (which I add to the "total cost") and the amount I had to pay after insurance processed the claim (which I add to the "cost to me").

10/23/23: Anastrozole (generic): $545.99 (Covered by insurance)
1/11/24: BreastCare NP Appointment: $221.00 (I paid $195.29)
2/1/24: Anastrozole (generic): $545.99 (Covered by insurance)
4/27/24: Anastrozole (generic): $545.99 (Covered by insurance)
6/4/24: Medical Oncology NP Appointment: $221.00 (Covered by insurance)
6/4/24: Medical Oncology NP Hospital: $134.00 (Covered by insurance)
6/25/24: Cardiologist Appointment: $326.00 (Covered by insurance)
6/25/24: Cardiologist Hospital + EKG: $586.36 (Covered by insurance)
7/26/24: Anastrozole (generic): $545.99 (Covered by insurance)
8/14/24: Bone Density Radiologist: $44.00 (I paid $24.30)
8/14/24: Bone Density Hospital: $764.00 (I paid $304.90)
8/21/24: Echocardiogram Cardiologist: $230.00 (I paid $175.39)
8/21/24: Echocardiogram Hospital: $1,494.00 (I paid $1,348.20)

Total cost to date: $477,691.38
With insurance, cost to me: $16,908.63

Friday, August 30, 2024

8/28/24: I Got a Pfizer Updated Covid Vaccine

I decided to make this post because I've kept track of most of my previous covid vaccinations on this blog, and my cancer-related medical history is a big reason why I remain covid-cautious.

I got the new updated 2024-2025 covid vaccine on Wednesday, the first day it became available at my local CVS. I didn't have a choice for the brand and it happened to be Pfizer. Primarily I wanted to get my daughter vaccinated before she moved into her college dorm, and I was so relieved it was possible, since earlier estimates put the new vaccine roll-out in early September. Once I decided to get her vaccinated ASAP, it made sense to schedule my son to get vaccinated at the same time because he'll also be facing crowded classrooms again soon. Then it was just a matter of convenience to make it a group appointment for all of us.

My experience this time was pretty similar to my previous mRNA shots. I got the vaccine at 10:00 AM, and felt mostly fine all day. By the evening, though, my left arm (where I received the injection) hurt a lot, from my elbow through my shoulder and back. I couldn't raise my arm above my head. That night I hardly slept at all, I felt achy all over and couldn't get comfortable. Around 6:30 AM I had a headache and a fever of 100 F, so I took 2 Advil and went back to sleep. When I woke up again around 9:00 AM, I felt a whole lot better. For the rest of the day, besides feeling a little extra tired, I just had the sore left arm.

It occurs to me that since I had a lot fewer side effects with last year's protein-based Novavax vaccine, it might be worth it for me to hold out for Novavax each year instead of getting the first available mRNA vaccine. Apparently it takes longer to produce the protein-based vaccine, which means Novavax will almost always be released later than the mRNA vaccines from Pfizer and Moderna. But there's a lot to be said for the convenience of the whole family getting vaccinated together, and with my kids still in school, I think I'll always want them vaccinated as soon as possible when classes start.