3/19/21: I Checked My Insurance Claims Online

As usual, I'm adding these costs into the total amount, but there was no out-of-pocket cost to me because we've already met our insurance deductible for the coverage year. 

12/23/20: Lupron + Medical Oncology NP Appointment + Blood Work: $1,959.16
12/28/20: GYN Appointment: $324
12/28/20: GYN Hospital: $248.60
1/2/21: Exemestane (generic): $1,499.99
1/7/21: Breast Center NP Appointment: $221
1/11/21: Pelvic Ultrasound Radiologist: $227
1/11/21: Pelvic Ultrasound Hospital: $857
1/11/21: Blood Work: $764
1/21/21: Medical Oncologist Phone Appointment: $260
1/21/21: Medical Oncologist Hospital: $105
1/22/21: Lupron: $571.16
1/22/21: Tamoxifen (generic): $228.99
2/19/21: Lupron: $571.16

Total cost to date: $422,571.99
With insurance, cost to me: $8,254.63

3/18/21: Lupron + Medical Oncology NP Appointment

I wore a KF94 mask again today, and they didn't bother giving me a new surgical mask.

I was originally scheduled to see my oncologist, but at some point the online patient portal showed that the appointment was switched to the NP. I don't know why, and I don't really mind. I like my NP a lot now.

I had expected to get my blood drawn today, and I'm curious to know what my estradiol number is. But my NP said my oncologist decided to put it off for another month, so that my body will have had 3 months to adjust to Tamoxifen before we look at my hormone numbers again.

First we went over all my side effects. 

I seem to have a runny nose all the time now. Sometimes I wonder if I might be developing seasonal allergies, but it's also listed as a side effect of Tamoxifen, so who knows. I keep meaning to try some seasonal allergy medication, just to see if it helps, but then I never quite feel like the runny nose is that bad, I feel like I can put up with it. Interestingly, my NP asked if my nose hairs have all grown back! It's true that I lost all my nose hairs during chemo, and whatever hair that is growing back now, including on my legs and underarms, has grown back much thinner. So, maybe part of the problem is that I just don't have enough nose hairs anymore. 

My hair is growing in thin, presumably because of the Tamoxifen. If I don't shower for a couple days, and my hair gets a little matted, my part becomes pronounced in the back. Not quite as bad as in this photo, but similar, and definitely evident. The friendly medical assistant I saw today was very positive and encouraging about my hair growing back, but I told her I still just don't feel like myself, and I'm impatient for my hair to grow longer. 

The first three fingers of both hands continue to be very mildly numb and tingly. This persistent neuropathy doesn't interfere with my activities of daily living at all, but I can feel the numbness and tingliness when I tap my thumb and fingers together. 

I still feel some stiffness in my fingers, particularly in the morning when waking up, but it's not nearly as severe as it was before. My legs are much improved, too, and they no longer feel stiff like they did when I was on exemestane. I first noticed the difference in the kitchen; in the time it took to cook dinner, my legs used to stiffen up so that sitting down to eat felt like a huge relief. Thankfully, that's no longer the case. Going up and down the stairs feels easier now, too.

After talking through all that, the NP did a physical examination, which went fine. I'll see my oncologist again in another 3 months.

Upstairs in the infusion room, the nurse who gave me my Lupron shot was new. She said she's a traveling nurse from Florida! I don't know how hospital staffing works, but she said she's filling in for one of the regular nurses for the next 3 months.

Incidentally, today my left arm only feels sore at the vaccine injection site if I touch it. I suspect all soreness will be gone tomorrow.

3/17/21: Day 3 of Moderna Vaccine Side Effects

Much better. Today I no longer felt especially cold or tired. My left arm is still sore, but only around the injection site, and I can lift my arm above my head; the soreness isn't limiting my activities anymore. 

3/16/21: Day 2 of Moderna Vaccine Side Effects

Last night I was so cold. I piled on the blankets and my hands would not get warm. Maybe that counts as "chills", a common side effect, though I wasn't shivering or anything. Today I still felt cold, but not as much as yesterday.

I've also been kind of tired, but again, not as much as yesterday. Last night I went to bed before 9:00 pm, which is super early for me. 

My arm is still very sore, and I still can't lift it above my head. 

3/15/21: I Got My 1st Dose of a COVID-19 Vaccine

My hospital network has been sending me regular emails about the availability of COVID-19 vaccines. They've been exceptional at communication, letting me know what groups are eligible when, and what to expect from the hospital. 

On February 23, I got an email saying that, based on my medical records, I am now eligible for the vaccine because I have two medical conditions that put me at increased risk for serious illness. I was a little surprised because I thought breast cancer was my only qualifiying medical condition. Looking at the CDC list of certain medical conditions, I think the hospital must be counting the loss of heart function that I experienced while on Herceptin as a "heart condition". The email said that once the hospital could confirm their vaccine supply, they would send another email with an invitation to make an appointment. 

Two days later, I got an email with a link to schedule an appointment. The link was specific to me, and I never had to enter my name or any personal information at all. Literally all I had to do was select a location (out of 11 possible sites), a date, and a time. Once my appointment was scheduled, I immediately got a confirmation email with a link for further information. The hospital's vaccination information site is clear and straightforward and includes maps, driving directions, parking information, basically everything I needed so I knew what to expect. The process was so smooth, it's really reprehensible that the state web site for public vaccination centers has been such a disaster. 

I took the earliest available date, which was 3 weeks away at the time.

So today I had my appointment! I went to my chosen site, which was actually the hospital's records building. The entire process from check-in to the 15-minute observation period was seamless. I got the Moderna vaccine, and made my appointment to get the 2nd dose in 4 weeks. 

The nurse who gave me my shot was super kind and helpful. I told her I had heard that a potential side effect - swollen lymph nodes in the underarm area - can be confused as a symptom of breast cancer, and I had seen an article recommending that patients who have had lymph nodes removed on both sides (as I have) should request to get the shot in a leg instead, which would help prevent lymphedema and also avert the potentially alarming side effect problem. The vaccines were being administered in curtained off areas, so there was enough privacy for me to pull down my pants if I needed to, but since I've had injections in my arm before (like the flu shot), how important is the leg recommendation really? She was very attentive and said she didn't know, so she went to ask the pharmacist. When she came back, she said she spoke with both the pharmacist and the physician assistant, and they said getting the shot in the leg wasn't necessary because I didn't have a lot or all of the underarm lymph nodes removed, and also because I don't have a history of injections in the arm being a problem. 

I got the shot in my left arm, since I had fewer lymph nodes removed on that side. The nurse told me not to worry if I get a rash at the injection site, a common side effect of the Moderna vaccine. She recommended drinking extra water to stay hydrated, and said I can use ice or a cold compress if the injection site hurts, or I can gently massage the area, if that helps.

So far my left arm is feeling very sore. I actually can't even raise my arm over my head because the injection site hurts so much. My arm is achy all the way down to my left hand, and I have this odd sensation like there is something cold running through my veins.