Riding for Roses

Today we had another oncologist visit. The expectation was Spencer would need Neulasta to help with low white counts and platelets to help make sure his blood will clot. The day did not go as planned.

Basically, Spencer’s bone marrow has completely shut down now and we will continue to see his counts (of everything: hemoglobin, white cells, ANC, platelets) drop until his body starts producing more. Until that happens he will need blood products, and possibly pharmaceuticals to help the white counts. Previous crashes, we have successfully avoid the pharmaceuticals, but Dr. Sharp thinks Spencer will need them this time since the crash started earlier and went faster this time.

Everything started out fine today, with our usual rush to get out of the house and drop Jacob at day care. We actually arrived for the appointment a little early for once. Since we were the first non-procedure appointment, we had to wait a little, and Laura came over to access Spencer since Jennifer, his regular nurse was busy with procedure patients. Spencer was not happy with this change. He is a big fan of having a single nurse and has bonded with Jennifer and trusts her. We worked it out and Laura drew blood. The CBC machine got 27 for the platelets with a flag indicating possible error. A re-run got he same result. This is not the lowest count we’ve seen, but it’s very low. We assumed he’d get platelets. Laura had Rachel go register Spencer as a patient so they could stat the manual in the hospital lab instead of sending out to the outside lab.

In the meantime, Jennifer came by and informed us that our health insurance had bounced the Neulasta request to our pharmacy insurance which had denied it upon asking their first screening question. The appeal takes 2-5 days to process and they did nothing with the appeal letter she FAXed Tuesday so the clock hadn’t even started. Unfortunately, Spencer needs to start the Neulasta today or tomorrow, otherwise he will have to get a 10 day series of Neupogen shots instead. This is not desriable. Rachel spent a bunch of the day on the phone with the various insurance folks expediting the appeal process. We apparently have approval to do it tomorrow.

Not to be left out, Dr. Sharp was following things and decided that tomorrow would be a better day to do the platelets. It gives Spencer a chance of only needing one unit of platelets before his bone marrow starts back up. One plus is that they already ordered the platelets, so we should get a faster start tomorrow and lose less of the day.

Net three hours spent on medical stuff with no medication or blood products. So, tomorrow we get to repeat. With luck, we will go in at 9, get counts, have Neulasta and start platelets almost right away. Wish us luck.