Ponderings

As I've passed the year mark of being diagnosed and as I hit the anniversary of certain events, I find myself getting kind of philosophical about this whole experience. When I look back on doctor's records and think back about where I was a year earlier I think a lot about what I've been through and dealt with this year. I want to thank you all for being so supportive and great during this year. My support system has been terrific and I am totally grateful for the support I received and feel blessed to have such caring people in my life.

Partly things were brought home yesterday. First it was my work Christmas party, which last year corresponded to the day after first chemo when I felt really bad. Later, I'd figure out that 6 days in or 2 days post steroids I felt terrible due to steroid withdrawal, but this first day I just knew I was at a Xmas party saying goodbye to someone who was retiring and starting to have the worst headache and need to get home. After it happened again after chemo 2 I'd figure out what it was, but now looking back I just realize how long this year has been and how grateful I am to be where I am right now.

I also found out that someone who was diagnosed with breast cancer during the year after I was isn't likely to have as good an outcome. R, who is the ex-nanny of a friend of mine was diagnosed with breast cancer in the Spring. She came here from a foreign country to earn money for the family she left behind and has been doing grueling work working as a nanny. While not having health insurance, her current employer and my friend found treatment for her and have been helping her through this process. While her initial prognosis seemed promising, her cancer ended up metastisizing first to her brain and then to her spine. She is having more chemo to try and get things stabilized so she can go home to see her family and those around her are being terrific.

On the surface, even without health insurance R was able to get treatment and has a support network in place. It might seem totally random who ends up with better or worse outcomes and I am acutely aware that things can go wrong for anyone but I can't help thinking that socio-economic status and the way health care works kind of stacked the deck against R and in my favor. While in the country legally and working on the books, R doesn't earn much and sends much of her money back home to her family and kids. This meant scrimping on things for herself which included health insurance. This probably meant not getting diagnosed right away and her lack of health insurance probably meant that it took longer to figure out how to get her treatment and to figure out logistics which I'm guessing added to the probability of this worse outcome.

I realize that one can't make generalizations from specific cases and an n of 2 isn't robust but our contrasting outcomes just seems to bring home to me what the statistics show. Breast cancer, while found across all groups and income levels and a pain for anyone to deal with tends to be more deadly for poor women and women of color. And this for me makes the case for health care reform to pass, despite all the politics and crap going on right now in Congress. Basically doing something to try and close health gaps seems clear.

There are many reasons why different groups have different outcomes but our situation just seems so stark. I'm hoping R is able to get home and see her family and I am sad that her situation seems so bleak. I'm hoping we make some progress to getting others insurance.


Thanks again for all your support and I'm trying to send positive thoughts to R and her family and hope you are all well and have a happy and healthy year.