The new challenges

          It has taken awhile to digest all of the news that I have been given about my condition and the  strategy to deal with it. 
         First the news. My doctors all believe that the radioactive  drug Xofigo , radium 223 di chloride would be of benefit to my health.  However since the were spots on the liver that could be interpreted as cancer the drug company defers to Medicare for payment and the Medicare states that if their is any indications of soft tissue cancer that they will refer to the protocol of the drug company which only had the drug approved for cancer of the bone per  FDA requirements . Meaning if they had never done the CT and MRI  and not had any indication of the possibility of cancer in the soft tissue,  then Medicare would pay for it. So  the financial part of this is that no one is under any obligation to pay for this catch-22.
        My oncologist also believes that since the cancer that I am dealing with is in the marrow more than in the bone that it would not have as salubrious effect as  would be hoped. I am tired from the lack of oxygen being transmitted to my muscles and other organs and this is from a low blood count caused by the marrow not producing enough red blood cells. The radiologist agreed. So the drug will help but is not a cure.
          The drug costs somewhere between $70,000 to $132,000 to administer for all six injections. It is given in coordination with an IV but only  takes a few minutes to administer. The cost as I am learning is something of a state secret . The two estimates are from a NYT's article and the radiologist .  No one that I have spoken to including a very resourceful patient advocate could give me a clearer picture.
         The statistical effect is that it would enhance the length of life approximately four months. Which means anywhere from no effect to several years.
         The doctors were concerned about the difficulty that I would have in dealing with financial situation. What I did was made it clear to them that my health was my first concern and that they should remove from their thoughts anything dealing with the cost. 
          Since bone pain is among the worst of the pains it is my concern that I die without having to deal with  the most severe form of this. Lack of blood just leaves me sleeping for excessive amounts of time and dying in my sleep is not something to be avoided.
         We have then set a plan that will being with the administration of the chemo drug taxotere which I had positive results with previously followed by treatments of Xofigo.
         The next conversation was with my financial advisor who gave me a positive reframe of the situation by pointing out that I am helping to pay for the research into a very promising cure for some cancers and that will be part of the legacy that I can leave to mankind . 
          A threshold was passed in that I was again offered a prescription of Oxycodine and this time I accepted. Having never wanted to become involved with this drug I now have become aware that there are instances when I am not able to cope with some of the intense pain and merely having  available relief  is reassuring. I have not used it yet having discovered some hatha yoga stretches  that relieve cramps quickly and effectively.
          The other bits of news were some estimates. Estimates  as to how long I have to  live. One year if I do nothing and as many 3 or 4 if I pursue  an active path and am lucky.
         Which leads me to my next pursuit. It is that of Phowa , pronounced PO -wa ,a TIbetan meditative exercise  to prepare the dying for death and to be used by the living to remind the dead person that they are no longer in bodies and to open and expand until they dissolve into the substrate consciousness . In the Tibetan tradition it is to await rebirth . I don't know but it feels good and is reassuring.
          It is simple for those who are students of SHinzen Young it is the process of using Nurture Positive mediations to become focused on the zero point and dissolve the  association with the body.  
         I wrote about this on the June 16th version of this years blog. It is the return of the beloved child to home of his loving parents after playing  late into the evening.