Dr. Murphy's Briefcase

So much has happened since my last post.  Dr. Murphy got out her briefcase and dealt with the insurance.  (See the "Briefcase" reference in my previous post if this doesn't make sense to you.) The Erbitux was approved in the eleventh hour.  In the words of her assistant, "Heads rolled".  Denny was in the infusion room by 8:45a.m. yesterday morning because of Dr. Murphy.

Adrienne was Denny's nurse yesterday.  She was very experienced with the infusion of Erbitux.  Because of the life threatening side effects, we were very appreciative to have her on board.  Denny received large doses of Benadryl and Dexamethasone prior to receiving the Erbitux in an effort to stop any side effects.  The plan was to administer a small dose (100 mg) of Erbitux to see if he tolerated it. If so, then he was going to get 750 mg as a starter dose; following each Monday with
450 mg maintenance dose. 

We held our breath as the Erbitux started.  Adrienne said most of the time the reaction occurs during the first few minutes of the infusion.  We soon breathed a sigh of relief as the time came and passed with no respiratory distress or cardiac arrest.  "It's all good!", we thought.

Sadly, we let our guard down too soon.  As the last of the Erbitux trickled into the IV, Denny's body broke out in a horrible, itching rash.  It was under his arms, between his fingers and toes, on his palms and bottom of his feet.  There was are dark red spot the size of a quarter right between his eyebrows; above the bridge of his nose.  Dr. Murphy called an immediate halt to the administration of the drug.  She felt the risks were too great.  She has pulled the plug on the Erbitux completely.

As you can imagine, that was a heavy blow to Denny and me.  The Erbitux was an excellent prospect for gaining control of this tumor growth.  As I mentioned previously, Denny's pain level has been increasing and he was anxious to get this drug moving.  The rash disappeared about an hour after the drug was stopped.  Adrienne called Dr. Murphy to see if she wanted to give more Benadryl and "Re-challenge".  Dr. Murphy said, "No".

By this time it was 1:30pm.  I had to be at work by 2:40 p.m.  Denny wanted to go to work also.  So, I drove him to his office and returned to Vanderbilt.  I worked until 11:30 p.m. and didn't get home until after midnight.  Denny went to work; rode home with a friend and then proceeded to mow the field last night.  While we experienced a major setback yesterday, Cancer does NOT control our lives.  We fight to maintain a normal life in spite of it.

Where do we go from here?  On Monday, July 15th, we will find out.  A doctor of Dr. Murphy's caliber cannot be at the level she is without a contingency plan.  I really feel that if there is a solution out there, she will find it.  While we wait, he has at least 100 mg of Erbitux working on the tumor. In the meantime, let's not forget the tissue sample in Boston.  It is undergoing evaluation as we speak.  Let's pray the scientists there can find an abnormality that has a drug available.  Let's also pray to give Denny strength, peace, and another miracle.

The battle is still on.  Thanks for checking in.

Rage, Rain, and Red Tape

Denny and I have had quite a day.  I'm not sure if it was a full moon but the odds were not in our favor today.  We left the house at 9:30 a.m. to get to the oncology department for his labs.  They always draw blood to check his levels before administering chemo.  Today was supposed to be the Erbitux infusion.

As soon as we got to the office, Dr. Murphy came in and explained that Denny would not be getting the infusion today because of his insurance.  His insurance is primary and mine is secondary for him.  If his doesn't approve a procedure; mine cannot be engaged nor will it pay either.  Dr. Murphy said her assistant had spent 4 hours on the phone arguing with the insurance and then she, herself, tried to do a peer-to-peer conversation with the insurance doctor.  She said she couldn't start the treatment without precertification because then the insurance would definitely not pay.  The cost for this drug is $20,000 per month.  Nothing got resolved so Denny went without.  At that point, we rescheduled him for tomorrow morning; hoping it would get resolved  sometime today.

From there we went to the Surgery Center at Vanderbilt to have the biopsy done. Strangely enough the insurance HAD pre-certified the biopsy which had been scheduled AFTER the pre-certification request went out for the infusion.  All of the doctors and nurses were very nice and the procedure was over in about an hour and a half.  Denny was done around 5:30 p.m.

While Denny was undergoing the biopsy, I called Dr. Murphy's office again and left a message.  I wanted to see if anything had been resolved before we left the hospital.  His appointment was for 7:30 a.m. tomorrow.  I didn't want us to have to fight Nashville Morning Rush Hour traffic just to find out the insurance wasn't cleared.

Denny came out of recovery and we left the hospital about 5:30 p.m.  Nashville had just gotten a huge downpour and traffic was a mess.  Accidents all over the interstates.  After the day we had, my patience was about at breaking point.  I was trying to hold in the rage because it doesn't do Denny any good to hear me rant.  Between the people riding the bumper and people cutting in front of us, it was close to becoming a "Murder She Wrote" episode.  We couldn't get home too soon for me! 

While we were driving, Dr. Murphy's assistant called and said the insurance still had not approved so there was no sense in coming in tomorrow.  Dr. Murphy had evidently done some screaming as well.  Supposedly the insurance had submitted the paperwork to the precertification area and forgot to hit the "submit" button.  Wow!  Really?  It has been elevated to the highest level because some yo-yo forgot to hit the "submit" button?  Denny has now been tentatively scheduled for Wednesday morning.

I told Denny I would give Dr. Murphy's office until Wednesday to get this sorted out and then I was going to get involved.  Yes, at that point it will be time to drag out the briefcase.  It is sort of a joke in the family that if I drag out the briefcase, it is "lock and load" time.  In other words, I  go into missile mode and lock on until I get it resolved.  I'm hoping Dr. Murphy can get this done because "lock and load" takes a lot of time and energy.  Something tells me she's got a "missile mode" too.  This doctor is one feisty lady!

When we got home, I made Denny some homemade chicken soup because the doctor said he needed something light.  He's sitting in his chair watching TV from behind his eyelids.  It has been a long, long, long day for both of us.

The good things today?  The good things are he didn't have any bleeding issues and has been able to come home; sleep in his own house and eat homemade soup while watching his favorite shows.  He isn't in any pain (thanks to pain meds) and the tumor tissue is on it's way to Boston. 

I'll keep posting as soon as the info becomes available.  Thanks for checking in and if you have the time, please say a little prayer that a solution becomes available.

Magic Monday

We went into Vanderbilt this morning expecting the biopsy to happen.  Neither of us knew they intended for this to be done in the Doctor's office.  That has never happened since the day he was diagnosed.  We expressed our concern about the procedure not being held in an operating room due to the excessive bleeding issues Denny has experienced in the past.  He wasn't even on blood thinners during those!  The doctor took a look up inside and decided it was too risky to attempt.  The biopsy will be done on Monday along with the Erbitux.  Denny's poor body will be going through the wringer that day.

The doctor is an ENT that has never seen Denny before.  She expressed disbelief upon seeing him for the first time.  "Most of the time, people look noticeably sicker than this when battling this type of cancer for this long.", she said.  I smiled and said, "He's our SUPERMAN."  She said, "He definitely is!" 

The good news is, after careful evaluation, the Woodruff's will not have to pay the $5,500.  That was quite a bit of stress to lift off our shoulders.  When battling a serious life situation, the last thing you want to worry about is finance and insurance issues.  Dr. Murphy stepped in and got the situation corrected.  We cannot thank her enough.

Denny is not feeling 100%.  He has had to resort to using some of the pain pills.  The tumor is starting to affect some of the nerves in his teeth along with the headaches and eye-watering.  He only uses them when he absolutely has to which is good.  Cancer is no match for Superman.  Hang in there, Denny!

As always, I'll post new information as it becomes available.  I'm not expecting anything new over the weekend so Monday will probably be the next time I sign on.  Thanks for checking in. 

Pulling Back the Curtain

Bewitched was a favorite TV show of mine as a kid.  I used to laugh at poor Mrs. Kravitz as she struggled to get her husband, Arthur, to believe her stories of the strange things going on across the street.  Let's pull back the curtain to see what has been going on since my last post.

Denny's biopsy is scheduled for 9:30 a.m. this morning.  There is some concern on our part about bleeding.  He stopped the blood thinning injections yesterday to help with this.  However, the last biopsy he had when the tumor came back in 2010 landed him in the hospital overnight for bleeding and breathing issues.  The second concern is that Denny was told this tumor evaluation that costs $5500 at Foundations Medicine is NOT free to us.  We are going to have to try to file a claim because it is out-of-network and the insurance typically won't pay for it.  This unexpected cost is extremely upsetting because even with insurance, Cancer is an expensive disease.  Just paying 10% of the usual treatments and doctor visits adds up quickly.

The first treatment of Erbitux is scheduled for Monday.  Fortunately, I am off of work at the new job.  That is going to be a problem for me because as a new employee, I have no vacation or sick time available.  Dana will have to go with Denny to the treatments if I am not available.

She tried to put in her 2 weeks notice at Bath & Body Works at the Prime Outlets this past week.  She figured that would be the best thing to do since she would have to be asking off frequently and didn't think that would look good.  The manager said, "I am a businessman and want quality employees for my store.  You are a hard worker and I don't want to lose you.  We can work around your family needs."  She gets to keep her job and Cancer lost another round to the Woodruff family.

The Woodruff family received another miracle with Dan this past week.  He was driving home in a big storm after meeting a friend at the movies.  In Tennessee, there is so much rock that the water has nowhere to go.  He was slowing down for a 90 degree turn on a back road when his truck hydroplaned.  He went off into a ditch; hitting a bricked-in mailbox on the way.  He was not hurt.  We are so very thankful for that.  His truck needed a new front bumper, skirt, and right headlight assembly.  Denny and Dan got the parts from a junk yard and fixed it themselves. Dan stood back and looked at it when they had finished because the parts are a different color until it gets painted.  His comment was, "Now it looks like a catfish!"  The lady with the mailbox said her insurance would pay for the damage since somebody else had already hit it and she had called in the claim.  All is well.

Some of you following the blog from the beginning will remember our neighbors, BJ and Bill.  They helped take care of the kids while Denny was in St. Louis getting surgery in 2010.  Bill passed away suddenly on July 1st.  We are sending our love and prayers out to BJ and her family at this sad time.

It is almost time to leave for Denny's Biopsy.  Like Mrs. Kravitz, I'm pulling back the curtain hoping to see a little magic today.  I'll post any new information as it becomes available.  Thanks for checking in.  Oh...and remember to wave if you see the "Catfish" driving by!

Bridge Over Troubled Water

Denny had his films done on Friday as scheduled.  We spent a long, tense weekend waiting for results.  This morning we met with Dr. Murphy to discuss them.  Dr. Murphy started off with, "Well, the films didn't give us the results I was hoping for."  Life changed again for us with that sentence.  The bottom line is the chemo is not working.  The tumor has grown and has now broken through to the bone at the base of his skull.  This is what has caused Denny's headaches and eye-watering symptoms. 

Dr. Murphy explained that she wanted to begin a new treatment.  She wants to begin using a drug called Erbitux, which is a "targeted therapy".  To put it simply, the targeted therapy drug will interfere with the ability of cancer cells to grow, divide and communicate with other cancer cells while leaving the healthy cells alone.  Chemo drugs affect both cancer cells and normal cells.  That is the difference.

The Erbitux comes with life-threatening risks.  Stopping the ability to breathe and stopping the heart are the most notable.  Dr. Murphy then mentioned a curious thing.  She said 20% of the people born and raised in this area experience terrible side effects; meaning people from Tennessee, Kentucky, and North Carolina.  Whereas people from other areas experience on 1% - 3% risk.  I asked, "Why?".  Oddly enough, she said people in this area are so adversely affected because of their exposure to fungus in the soil. Since we are not originally from here, she thinks Denny will be fine on this drug.  She also expects it to work!

To date, he is scheduled to received a tiny dose on July 8th to see how he reacts to the drug.  If he doesn't have a reaction, he will begin treatment with this drug every Monday for the rest of his life.  What happens if he does react?  Read on...

Dr. Murphy is working to get a biopsy scheduled for this week.  With the holiday, we may be looking at the beginning of next week before it happens.  She wants to send a tissue sample off to "Foundations Medicine" in Boston.  She said they can break the tissue down to it's molecular level to look for genetic abnormalities.  Once they know this, it will be cross referenced with the drug used to treat that abnormality.  Since Vanderbilt is a research facility and Denny has a rare cancer, there will be no cost to us to examine the tumor. Normally, this costs upwards of $5,500.  However, since his cancer is so rare, they are very interested in him.  To date, his cancer has been excluded from all clinical trials and research because it is so unpredictable.  This sounds very promising to me.

Denny wore his "Superman" hat to the appointment.  When we got the news, we sat in the Doctor's office as we struggled to process it.  This was tremendously difficult news to receive when we had such high hopes for the Taxol.  However, the "Man of Steel" has returned and he is ready to get moving forward.

I cannot explain to you how terribly helpless it feels being there with him as he goes through this.   I wish you could be in the room with me to see the awesome strength of this man. The grace and courage he displays during the darkest periods of his life are a beauty to behold.  Daniel, Dana and I are not standing behind him now.  We are standing with him; providing an unbreakable bridge over the troubled water he is facing.  We know we are not alone.  The prayers and encouragement he is receiving from all of you makes a difference. Thank you.

I will post updates as they come in.  There will be lots of phone calls and scheduling in the days ahead.  Please bear with me and I will see that the info gets posted as quickly as possible.

"I'll take your part
When darkness comes
And pain is all around
Like a bridge over troubled water
I will lay me down."

-Simon & Garfunkel, "Bridge Over Troubled Water" lyrics



 

Happy Father's Day!

Denny is actually in Missouri today.  He had to go back to take care of some business for our farm. 

He and Dana went to dinner at Cherokee Steak House & Marina on Thursday night before he left.  She was glad to have him all to herself for some quality one-on-one time.  Dan is still in Martin, TN at Governor's school so he will not get to see his dad.  He will be coming home on June 21st which happens to be our 22nd Wedding Anniversary.

Denny had his chemo treatment as scheduled on June 10th.  We are holding our breath; waiting to see if the chemo is working.  June 28th seems very far away.  That is the day the first CT scan will be taken.  So, we will do what we always have done - live our lives as normally as possible.  One of the Woodruff 4 is feeling a little too much stress with our situation so we are doing our best to strengthen coping skills.  This is difficult for all of us so we are pulling each other closer and holding each other a little tighter these days. This is just part of the battle to help Denny win the war.  We know this and are not defeated.  The fight continues.....

Happy Father's Day!  Take some time to enjoy this day because these moments become treasured memories.

Eye Spy

Denny had his 3rd chemo treatment on Monday, June 10th.  He also saw Dr. Murphy.  We have been very concerned at the return of one of the symptoms he was having prior to receiving chemo.  His eye has been watering; just the left eye as it had previously.  Dr. Murphy said that a CT scan has been ordered for June 28th.  We will see if the tumor is shrinking at that time.  She said there could be a few reasons for why the eye is watering and to wait to see what the CT scan reveals.

He is feeling well and tolerating the chemo.  We are both a little uneasy about the eye watering but don't want to borrow trouble until we know the facts.  The CT scan will help with that.

I will update the blog as more information becomes available.  Denny wishes to thank everyone for the cards and emails.  They are so appreciated!