Hismones 1/28/25

Would my parents be turning over in their graves? I got my first-ever "ink" today: three freckle-sized dots, one on each hip and one in front between (gratefully above the most sensitive areas) for the purpose of radiation targeting. Those tattoos, along with the markers placed in my prostate last week and a full bladder ("Don't urinate for 90 min. prior to your appointment, supposed to help the bladder be out of the line of fire.) will assist the technician in applying the treatment exactly where needed. I'm to have a "dry run" (practice) February 12 and 44 weekday treatments following, starting the next day. But nothing between now and then other than the daily oral med. The doctor and team will look at my case and develop a radiation plan that may have some adjustments before finally approved in time for my first treatment. I'll have sessions after lunch each day, theoretically ending mid-April unless they or I have to miss and be rescheduled (Any missed treatments will be added to the end of the schedule, like when at school you have run out of "snow days.") So now we wait. Thanks so much for those of you who are prayerfully supporting this journey. Now I have a new medical folder, with names and phone numbers and a list of possible side effects. Fortunately,Tammy is helping keep up with all the information. She is an excellent organizer. Financially, this is an interesting endeavor. My PET scan copay was $1116 of an originally filed $20K ($9K for scan, $11K for the radioactive media IV). The SpaceOar/Fiducial Markers procedure incurred a $950 copay (haven't seen total filed yet). There's been no mention of radiation costs, and no copay for the prep CT scan (with three free tatts!) today. So I'm on hold again, this time with insurance to verify what costs to anticipate. The rep is getting the "codes" from the oncologist's office. Breaking news: the office assistant assured the insurance rep that I will "complete" my annual co-insurance maximum of $4000, with about $2800 remaining to be spent. Grateful to have insurance and to have lived conservatively. God always provides, but it's easier on him when you cooperate. Now off to more home projects that retirement allows one to "get around to." Blessings!

Hismones 1/21/25

Back home after 7:15 A.M. "SpaceOar/Fiducial Marker Placement" surgery. https://www.mskcc.org/cancer-care/patient-education/about-placement-fiducial-markers-and-rectal-spacers-radiation-therapy-your-prostate The surgeon placed three "seed" markers in my prostate and then injected gel between prostate and rectum to create space so that radiation doesn't damage the rectum (apparently a very bad collateral damage outcome). Procedure was actually less than 15 min. Next step is CT scan for radiation targeting, then weekday sessions of about a minute or less. It looks like I'll be closely connected to the oncologist's facility until early April. Thanks to all for prayerful support.

Hismones 1/20/25

Is being on hold for ten days worth $3,000? At about 9:20 this morning, I received via FedEx my first 90-day shipment of Orgovyx 120 mg, my two-year hormone (hence the blog title, "Hismones") assignment. The Androgen Deprivation Therapy is supposed to stop prostate cancer growth and help end the disease in me. I actually started calling to find a "90-day pharmacy" in December while visiting with KY family. Apparently, there are only two pharmacies nationally that can dispense the extended amount. Calls started January 3 when back home. The Rx couldn't be filled until January 6 (memorable date nationally) due to my existing 30-day supply. I don't want to go through the entire ordeal, for my fingers' and your eyes' sakes, but suffice it to say that January 8 and 10 and every day afterward, I called the pharmacy and insurance and on occasion sent a message to or answered a call from my urologist. The pharmacy kept getting a rejection when trying to get the med approved. This was unnecessarily complicated by talking to a different person with pharmacy or insurance each time, usually with slightly (or completely) different information. God bless the insurance rep who shared their "pharmacy help line," only accessible by pharmacies but able to dodge or correct approval issues. Finally on January 15, after having two separate reps each from insurance and pharmacy confirm that my medication was approved without further action, "Kyle" said my Orgovyx scrip would be sent for dispensing and offered to enter my information to apply for a copay grant. I didn't think we would qualify, but I gave him our monthly pension information, answered a few other questions and after a few minutes he came back online to tell me we were approved for a $2,000 grant. I wrote $3,000 earlier, correct? Had I simply continued filling the prescription monthly, my copay would have been $125 or $3,000 for 24 months. The 90-day supply has a $250 copay (three months for two-months' cost), or $2000 for 24 months. Had I not buldogged through the approval process, we would be $3000 poorer assuming I'm taking the med for the entire time. That was Wednesday evening, and Kyle said we would receive a call for shipping information. No call Wednesday. No call Thursday. No call Friday morning (my last dose on hand was for today/Monday). So I call one more time, and it's as though they were waiting for me to call them for shipping instructions. After tossing around delivery dates, we agreed that today would be best for me and workable for them. And while it was shipped from just across town (they don't allow pickup), FedEx showed up this morning. And I am both exhausted and extraordinarily grateful. The grant is actually for just one year, but only half of it will be used by then so hopefully extended. Tomorrow, I show up at a surgery center to have gel injected (stop reading now if squeamish) between prostate and rectum. It will harden as a pillow/spacer to allow thorough radiation of the prostate without endangering the rectum which cannot take exposure without damage. Radiation lasts two months; the gel pillow, three before dissolving harmlessly. Thank you for your prayerful support. I have a CT scan soon following the gel procedure to finalize targeting, then two months of weekday radiation. Progress, thanks be to God and to the medical team. The prescription grant softens the blow of the $2K copay for PET scan and tomorrow's procedure. Blessings!

Hismones 1/11/25

Life.On.Hold I spent (without specifically timing them) approximately a half day Friday on hold: Insurance, pharmacy, and doctor's office. Still trying to get Orgovyx filled as a 90-day supply. While waiting for responses, I was at least able to paint trim and baseboards in the front entry. The major failing of both insurance and pharmacy was the inability to reach the same person with each call,and there were several calls and online logins that involved them. Added to that was different staff having conflicting information, so that the reason for the delay was difficult to determine. At the end of the day, a pharmacy rep kept me on the line while calling insurance and was able to confirm that my three-year medication approval only applied to one-month supplies from the original pharmacy. This medication requires prior authorization of medical necessity, which means another doctor request for the pharmacy that can fill extended prescriptions. Following my call, the doctor's office hopefully sent clinical documents to the pharmacy...to submit to insurance for approval...to send back to the pharmacy...to call me for payment information...to fill the medication...to send it to me. I have nine days of tablets left, and insurance approval itself can take three days. Thankfully, the end-of-day pharmacy rep gave me her name and extension, and my next call Monday morning is to her to confirm receipt of the doctor's notes and their submission to insurance. Failing that, it's another doctor call. At retirement, coworkers called me a "bulldog" for pursuing tasks to completion, and I'm not planning to quit. My wife and I agree, though, that it would be so easy, especially for patients with limited experience or understanding, to stop the pursuit and work on finding a way to pay the higher cost of short-term prescription fills. Insurance says what I'm asking is available, and I'll do my part to make it so. I'm not sure I could continue the chase if I were working fulltime. So I'll keep calling and pray for more patience.

Hismones 1/10/25

PLEASE (please, please) don't give up on getting the medications you need. Getting my hormone medication (Orgovyx 120 mg) as a 90-day supply rather than a 30-day fill will literally save us $1000 over the two-year course of treatment. But it is taking 12-15 phone calls and hours on hold and we're still not through. My local pharmacies couldn't fill it, but with help from them I found an area pharmacy that can and I called to confirm its being in-network for insurance. My urologist (Jeffrey Applewhite) sent a prescription and that pharmacy got multiple rejections. Following several calls to insurance (Aetna/Express-Scripts), they say they can specially approve to fill it by mail, but need a release from the doctor. So it may come from them instead of the local pharmacy. Am I back to square one? Maybe not, but I have just 11 days of medication left, a little close for mail order filling. I should know something early next week. And don't wait for people to call you back, unless you're in no hurry. It's your health, not theirs, so be your best advocate. And be gentle on the post-call surveys, because the poor people answering the phone have little to no authority to fix anything. And trust God. I'm sure his eyes roll, too, over the shenanigans involved in getting appropriate care. He is still in charge, but don't expect the miracle to come to you without your participation. While you're at it, if you're in the area, enjoy the snow!

Hismones 1/08/25

Maybe it is okay to pray for healing. I was at www.milestonechurch.com 's Prepare event this evening,and the speaker commented that while God's character and personality are unchanging, his actions are unpredictable. On a couple of occasions, Jesus healed everyone who came to him; on another, he must have stepped over or around people hoping for healing at a pool in order to heal one. In the Old Testament, King Hezekiah learned he had a terminal illness but cried out to God and was given another 15 years. God doesn't change,but he can change his mind, or our prayers would be meaningless. Any healing is temporary: Jesus resurrected Jairus' daughter and Lazarus, but both died eventually. Until he returns, we have to leave this life behind to join him. Jesus most often healed to prove a point,that he was authorized to forgive sins and that everything he did was to bring glory to God his Father. So I will pray for healing and, like Jesus's prayer that last night in the Garden, trust that God knows and will do the best for me but ultimately to fulfill his purposes and that he receives glory. Another aspect of prayer: how may I pray for you? One of the unique practices that Fred "Mr." Rogers had was to ask those enduring illness and disease to pray for him, because he believed they were in closer relationship to God due to those challenges. I expect that I'll be spending more time in prayer and will be honored to join you in praying for whatever is especially important to you. Depending on your desire for privacy, you're welcome to contact me through FB Messenger or jimekrut@gmail.com. Blessings!

Hismones 01/05/25

Happy New Year! We just returned January 2 from a week in Kentucky visiting Tammy's family and then enjoyed a late Christmas with our girls and grands yesterday. God and family are so good, loving, and generous. I learned some important information this week from a friend who has been treated twice for prostate cancer: PSA doean't have to be so high in order to warrant checking. His never exceeded 4.x whereas mine passed 6 before biopsy and diagnosis. My results passed 4 in 2023, an increase of 2 points from 2022. Had I received a biopsy then, treatment might have been simpler. Caveat emptor! I have to get stricter with diet now. I lost weight during 2020-21 to avoid entering the diabetic blood sugar range, but have gained half of that back. Obesity significantly increases the likelihood of a second cancer later, and weight can increase during hormone therapy, so it's time to crank down. I appreciate Tammy's support and help by making healthier food choices available. Tuesday will be two weeks taking Orgovyx, and typically it's a time of reaching full effectiveness of the medication. I'm not experiencing any major side effects, but there may be a little more fatigue settling in. My current prayer is not for healing, although I believe that will take place (or at least the radiation oncologist seems to think so!), but rather to claim the Scripture from John 9, that the blind man's condition was "that the works of God might be displayed in him." I want to live and express hope and confidence in God and to help others find God for themselves. Other than Jesus, my Bible heroes are Daniel and his three friends, with a favorite passage being Daniel 3 in which they declare allegiance to God regardless the outcome. Some area churches are having new year's emphases on fasting and prayer. I am scheduling to attend services this week, but rather than a complete food fast, I plan to follow my initial weight loss diet strictly. Despite some inconvenience, I will feel better quickly. I have a treadmill test this week to verify heart health. The "gel pillow" surgical procedure is January 21, and then radiation begins soon afterward. All the best!