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#21 pamsouth

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Posted 19 November 2011 - 04:58 PM

Buzzm1,

  I recently called the Leukemia & lymphoma society in my area, about the Gleevec patent expiration, as Medco and Novartis, didn't seem to know.  Anyhow, LLS said Gleevec was set to expire July 2015.  I did not ask her how much the drug would cost as a generic.  Somewhere I read Gleevec would drop to $5.00 to $10.00 a pill, but I do not know if that info is correct.  I live in Indiana and my last shipment Nov 1, 2011 was $180.00 for 400 mg each pill.  I checked on Tasingna the dose for 600 mg a day for a 28 day supply was several hundred dollars more.  LLS did not know when Tasigna would expire.  My prescriptions for Gleeve, are paid for, however my insurance keeps getting much sticker.  Until a couple of years ago I was allowed a 90 day mail order. Now I am only allowed a 30 day mail order.  They used to ups my shipment to me a week to 2 weeks before my last pill.  The last few months they have changed that.  Medco calls me ever month and will ask when is your last pill, I say Nov 2nd and they say your shipment will arrive ups Nov 1st.  Last year and this year they , UAW Retiree Medical Benefit trust Prescription drug benefit / Medco Prio Authorization Department,  sent me a letter in November stating, "Doctor has to call insurance by Dec 22 deadline, to provide the info needed to determine if you qualify for ongoing coverage.  We will inform both you and your doctor of the coverage decision. If your renewal request is approved before the expiration date, you will receive uninterrupted coverage for the medication."  Even though I still have 7 refills left, it still has to be reauthorized by my insurance every year in Dec.  I called UAW Medical Trust that runs our insurance Blue Cross of Michigan,  some time ago and asked why the changes and they said my Gleevec cost to much, so in case I went off of it or something happen to me, they didn't want to have to pay for pills on hand or left over. So having said that, that is another reason I would not want to change from Gleevec to another patent.  If my insurance should quit paying at least in 2015 it would be become afordable.  When I said something to my oncologist who has asked me to change to a better newer drug, (she has been on me about changing to a newer drug for the last year) she said she would make sure I got the drug if my insurance quit paying, she said she knew where to get it.  I asked if our income would fit in the guidelines (after all how would she know are income and the guidelines?) and she said  they were very generous.  When I went for a second opinion I noted the doctor said he did have some patients who were not able to get the drug due to the cost.  I have also heard others say the same thing on some of these teleconference, they could not afford the drugs.  So it make me wonder where my docotr thinks she will get the money or the drugs.  I know that the drug companies give some co-pays, but they will not tell you what the guidelines are, or if you are eligibel until your insurance quits pay. Yep I called Novartis a couple years ago, when my insurance started complaining about the 90 day supply, & the yearly letter to predetermine if I qualified for insurance for Gleevec, etc. So all in all it makes me a bit skittish to just hear my doctor or others say don't worry there is co-pay assistance.  In fact recently I filled out a letter and sent in to LLS to see if I qualified for other assistance and they sent me a letter back yes I qualified for $5,000.00 a year.  The application had a list of exceptions a mile long.  I did qualify for help with our insurance payment but it had to be in my name only.  My husband is the primary and I am his dependent so therefore the $5,000.00 didn't mean anything!! Just easy for them to kick around don't worry about the cost!!  Just saying something to think about, when playing with your life! 


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#22 Judy2

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Posted 19 November 2011 - 05:44 PM

Hi Pamsouth and Buzzm1. I was floored when I went to fill my first prescription for Gleevec. My ins. covered so little and I certainly could not afford to pay for it. I contacted Novartis, they sent it to me free but then they found me a grant from "Healthwell", The grant took me through about 6 weeks. When I used up my money from the grant I  had to apply to Novartis all over again. As part of the application process I had to get a letter from "Healthwell" faxed to Novartis stating that I had used up my funding. Once everything was complete Novartis started sending me my meds again. I was back and forth on the phone a million times, trying to get that letter and of course I was limited for time, I didn't want to run out of my meds. I've now switched to Tasigna but since that also comes from Novartis I did not need to reapply. I assume I will have to, though, for the upcoming year. Also, I noticed L&LS had closed their funding for CML for this year? I'm wondering why they ran out of money for CML and not some of the other types of leukemia. Is it because CML is a rare leukemia? If that was the reason, though, wouldn't there be less people applying for it? There is a website "Needymeds" that does have some other funding options. All in all I think It's pretty rotten that not only do we have to deal with CML we also have to deal with the exorbitant cost of the meds. I am grateful Novartis is sending me my meds, I'm grateful for any grants I can get but something is WRONG WITH THE SYSTEM. CML is enough to deal with on it's own. I should add I have a friend who lives in France and the system over there is no piece of cake. Your health care may be free but if you get sick, unless it's an emergency, you go to your doctor's office and literally take a number, like at the deli, and can wait hours and hours to be seen. At least where she used to live, in a rural area in the south of France. Just venting.

Judy



#23 Buzzm1

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Posted 19 November 2011 - 07:41 PM

Hi pamsouth and Judy2,

I guess I should consider myself lucky as my insurance pays for Gleevec,

a combination of medicare and my retirement insurance;

so I don't even have to worry abouy the donut hole (yet).

with ObamaCare, who knows?

However, the taxpayers end up with the final bill, and that bothers me a lot.

the U.S has  less than 5% of the world population, yet, we consume 65% of the world's Rx drugs

Big Pharma charges us, in the U.S., the highest prices in the world for drugs,

only with Obama's, and Congress's permission., per WH back-room agreement.

I was diagnosed in Oct. '09  and priced Gleevec at $3900/mo at the time

this was just prior to Obama saying he worked out a 15% drug price reduction deal with Big Pharma

during the ObamaCare fiasco

didn't have my bone marrow test until February '10, and started Gleevec at that time, over $4200/mo

now it's around $5300/mo. at Kaiser

something has to change, for the better, for all of us


For the benefit of yourself and others please add your CML history into your Signature

 

02/2010 Gleevec 400mg

2011 Two weakly positives, PCRU, weakly positive

2012 PCRU, PCRU, PCRU, PCRU

2013 PCRU, PCRU, PCRU, weakly positive

2014 PCRU, PCRU, PCRU, PCRU (12/07 began dose reduction w/each continuing PCRU)

2015 300, 250, 200, 150

2016 100, 50/100, 100, 10/17 TFR

2017 01/17 TFR, 04/18 TFR, 07/18 TFR 0.0012, 08/29 TFR 0.001, 10/17 TFR 0.000

2018 01/16 TFR 0.0004 ... next quarterly PCR 04/17

 

At the earliest opportunity, and whenever possible, lower your TKI dosage; TKIs are toxic drugs and the less we take longterm the better off we are going to be ... this is especially true for older adults.  

 

In hindsight I should have started my dosage reduction two years earlier; it might have helped minimize some of the longterm cumulative toxic effects of TKIs that I am beset with.  

 

longterm side-effects Peripheral Artery Disease - legs (it's a bitch); continuing shoulder problems, right elbow inflammation.   GFR and creatinine vastly improved after stopping Gleevec.

 

Cumulative Gleevec dosage estimated at 830 grams

 

Taking Gleevec 400mg an hour after my largest meal of the day helped eliminate the nausea that Gleevec is notorious for.  

 

Trey's CML BlogStopping - The OddsStop Studies - Discussion Forum Cessation Study

Big PhRMA - Medicare Status - Social Security Status - Deficit/Debt


#24 pamsouth

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Posted 19 November 2011 - 09:10 PM

Hi Judy2 and Buzzm1,

Judy2,  Thanks for the info.  Isn't it cool we can communicate thru the web all over the world and don't have to be in the dark like a few generations ago.

Judy2 I wrote down the Healthwell and needymeds.  I did call Novartis a couple of year ago and asked them what the guidelines were, if my insurance were to run out, they said "what so you can fit yourself into the guideline." Kind of a cold answer don't you think?  So I was wondering Judy2 what kind of application did you have to fill out, did it want like tax return and assets and all? My husband is retired from chrysler and has a good pension and all, but with the cost of these meds, my last shipment of Gleevec was over $5,400.oo (which my insurance paid.)  Of course everyone knows Chrysler filed bankruptcy and the insurance for the auto companies is ran or held in trust by the UAW, Blue Cross of Michigan. Since my husband is retired we pay a more in insurance then those that are not retired and our Dental and vision are cobra.  I do not know what kind of assurance we have in the stablitity of our insurance, as it goes up every year and we seem to develop more health problems as we get older.  Our insurance does not pay for office visit.  But next  year 2012, with a $25.00 co-pay, insurance will pay, 1 wellness visit to the primary doctor with 4 follow up visit, but yep they upped our deductibles several hundred dollars and our cobra. My insurance is paying my oncologist which I usually see about ever 3 months but it is a pain in the butt, they always have to file in twice, but I think the issue is more with the doctor billing problems.  Of course after filing insurance for 6 years you would think Blue Cross would know the issue, but anything to drag it out.  It has to do with the coding as to a follow up to chemo, which is V67.2.  Some doctors don't like to use it they just use a visit code. Anyhow it gets kind of complicated. 

Judy2 I am curious why you switch to Tasigna as I was told by the LLS that Gleevec patent is set to expire in 2015 still a few years away but much sooner then the other drugs? When it becomes generic it will be much cheaper.  I hate to worry about relying on whether or not I will have insurance and to have to beg with millions of calls and letters.   I can remember when diagnosed and not feeling with the new meds and all, and going back and forth to doctors, labs, hospital.  Spending almost daily, hours on the phone with stacks of doctors (etc) billing and the insurance, etc.  I can remember being so sick and vomiting all night and the next day,  on the phone breaking down in sobs, trying to resolve billing and insurance problems, it seemed endless.  No one on the insurance or billing end even seemed to care I had cancer and was sick, it was a zoo!!  I would hate to change medicine and go through the new side effects and deal with all the bills and insurance issues again.  If only my insurance knew my doctor want to switch me to a newer patent and it is even more expensive then the Gleevec, they would be happy to pay for the Gleevec. 

I have been reading on the discussion board that some of the patients that have switched to Tasigna and Spyrcel are having serious side effects even going to the hospital or ER and some going back to Gleevec only to experience new side effects. One can't even get ahold of her doctor he spends most of his time on vacation, doesn't sound like their is a back up system there.  My doc said it would be a piece of cake to switch drugs, easy for her to say.  When I went to a doctor (2nd opinion) at the #1 leading cancer center of Indiana he said the chemical are different for each drug.  We have guideline but that is for the whole population and every one is an individual and reacts differently to the dosage and chemicals. So yep my doctor has no way in this world to know how these drugs would effect each person. He also said some of his patients decide to go off their med's for a year then later about a year when their number go up they go back on medicine.  I guess some patients even take a holiday vacation, to recoup.   I remember how frustrating it was when I went on Gleevec and sometimes they act like it is all in your head. I wouldn't want to go thru that again, unless of course it was for a donor transplant and I had a chance for a cure, with a reasonable risk.  I do have a younger brother who is a donor match his health is very bad, don't look for him to be around much longer.  The older I get the more risk of death, if I do a transplant.  I just thought with time they would come up with a better transplant and a lower death rate. I guess not, just promises. I have a friend who has CLL for about 15 years, she also had breast cancer, i have often wondered if it was from her chemo, because I know a lot of medicine for cancer causes other cancer.  Anyhow she said she calls MD ANDERSON HOUSTON TX every year and asked them some questions and says OK where is the promise cure you promised me 15 years ago!!  I went to a seminar a few year ago by one of the leading cancer doctors at a well know cancer hospital and he said in the old days we were taught to hit them fast and hard with drugs, chemo, and they died of the chemo before they did the cancer.  So what is the right ratio of drugs mg, and good cbc and quality of life, after all you still have millions of cancer cells even with the med's. otherwise you would be dead.

Judy2 Yes I do believe part of the funding problem is CML is because it is a rare cancer.  Therefore as with other rare disease there is a shortage of funding. I get these email from LLS that the federal funding has been slashed.  Probably the donations and other resources are down too.  I just wonder, of the billions of dollars for CML and finding a cure, if all that money went to the right places, or in the hands of the greedy!!  Everything is political these days and who rules the world but the rich and powerful and politicians, probably lump the lawyers in there to, most of the lawyer are politicians.  Dirty politics playing with our drug money. Why are these drugs cheaper in other countries, but it is illegal to get them out of the country. Not a very good playing field for the middle class and those with health issues.  Yep are health care is in a mess. 

As Buzz said everyone ends up paying for it.  Most employers don't want to hire full time because they can't afford the high cost of insurance.  That reminds me Medco said what do you care your not paying for it.  I said all of us pay for it one way or another and I may not have insurance tomorrow and I am trying to be proactive and line up all my ducks in a row.  Maybe they just like to keep us worried.  Everyone surely know that when you retire, most senior insurance go up and up and up.   Finally many of the seniors lose all they have due to health issue.  I have old school mate all over the country who have worked hard and are devastated by their illness and the cost, losing their savings and homes. Our health care is in a mess, and those that have profited off of it have gotten richer. My husband worked 38 years and I worked 32 years here and there and they act like it is an entitlement that you have to beg for!!

Buzzm2, thanks for your comments on the cost.

I have some many friends on facebook with children and grand children with devastated desease, one with a grandchild with MD waiting for the cure for her sweet little boy.

We all pray for each other and support each other!!

I was content to stay on Gleevec until my doctor starting pushing me to change drugs.  Not I am siked up, or whatever!!!   Why go thru all this again just for my life to be consumed of cancer and its treatment.  But if I am going to have to deal with her I might well bone up on what is going on out there and keep up with the board and go to a few seminars and probably change doctors to someone who will at least listen and give you a choice an is at least an expert in the field.

Stupid, dumb, cancer, where do all these diseases come from?   Could it be; x-rays, radiation, chemicals, immunization shots, (autism) in the med's we take like cholesterol and such, our food, water, air that we breath.  I have always been one to take care of myself.  My brother-in-law who has been a health freak all of his life came down with child's osteo sarcoma and they had to cut off his knee and take two tumors off his lungs.

I sometimes wonder more and more about holistic medicine perhaps the ancient days were better educated then we are.  Don't we have rain forrest with herbs and stuff for cures.  Maybe modern medicine isn't the answer I don't know, just thinking out loud.  Not only for myself but for the next generations to come.

If the doctor wants to stir up the bees nest, well she certainly has, so I will dig until I get some answers, maybe not what I want to hear, but then I will make a decision, and live with it, be done with at least that is the way I feel today, may change down the road who knows.

I pray for all of us, It is the good LORD to direct us, it is HE that is in control.  After all are not going to live for ever, so I will make the best of what is left, and just keep singing praises to the LORD!!  I pray that we will all be guided with wisdom and peace and compassion for each other, That doctors and the health care will be reminded of their oath and that we are human being and not and experiment or money in their pockets for their boats and house and vacations.  Is it possible that doctors have lost their compassion??  Maybe I have gotten a bit sinile after taking care of my mom for three year, my husband who almost died because the doctor wouldn't take him off medicine he was allergic to and kept piling up more medicine.  Maybe we as a society are over drugged?  Maybe it is partly our fault that we want an instant cure for ever little head achne so they just get out their little prescirption pad.  When I go to the doctor for my routine visits I don't ever like to complain, just tell her I am great.  She says how your energy level well I just spent 88 days in the hospital with my son on life support so I expect it will be down.

Actually I think there are good doctors and nurses who care, but I think some of them ought to retire or get out of the business as they give the health care providers a bad image!! Yep I think that sums it up.  Just venting and thinking out loud.  Wonder if my blood pressure is up yet. 

I pray for a cure for this stupid cancer! 


PamSouth


#25 Judy2

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Posted 19 November 2011 - 11:41 PM

Dear pamsouth. It is soooo cool that we can communicate through the web to anyone in the world. I know, since I have started posting on this board, I don't feel as alone with this disease.

I am sorry you got a nasty person at Novartis, I must say they were all nice to me but still there were applications, letters and more applications. BUREAUCRACY!!! I am providing a link to the Novartis application, I'm not sure if this will work as my computer in on its way out. If it doesn't come through go the the Novartis patient assistance program on the web and download the application from there. http://www.pharma.us...ion_English.pdf

Yes, you do have to provide tax returns and all that other good stuff. I'm sorry about the billing problems at  your doctor's office. Last Feb. I was an inpatient, had a kidney biopsy and the specimen was sent via courier to another hospital. I got a bill for the pathology report for over $5,000.00 They billed the specimen as an outpatient. I tried to explain to the person who did the billing that I was an inpatient at the time. She explained to me that I might have been an inpatient but my specimen was an outpatient. I said to her "What, you're billing my kidney as a separate person?" It was eventually all straightened out.

I switched to Tasigna because the Gleevec wasn't working for me. I was dx last May and my 5mo. PCR test showed no improvement. I just started the Tasigna Thursday so I am concerned about side effects, hopefully they'll be tolerable

I'm so sorry about your younger brother. Did you say your son was on life support? I am so sorry for all that you have to go through. I wish I could do more than just be supportive but at least there's that.

You need to find a doctor you can trust. There are good doctors out there. My step-father was a physician, he practiced for 60 years full time. He was truly concerned about his patients, and made house calls up until about 15 years ago.

Pamsouth, I'm glad you're venting. I think venting makes us all feel better. I'm sending you a hug and hopefully one day, in our posts, we'll be saying "Remember how we used to have CML".

Judy



#26 Tedsey

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Posted 20 November 2011 - 01:03 PM

Universal Healthcare is soooo needed.

Teds



#27 pamsouth

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Posted 20 November 2011 - 04:31 PM

Hi Tedsey,  My daughter was a Nurse at Riley Children new born ICU for about 10 years and her husband a gastro doctor.   So I don't dare discuss health issue with them.   They are on the opposite playing field them I am.  Beside when I was DX with cml all my daughter did was scold and lecture me.  I didn't do the 400mg vs 800 mg research program, I didn't go to the doctor of her choice and she found out I flew to MDAnderson Texas.  She got so upset when I found out my oldest sister of 10 years and my younger brother were transplant matches.  She went to the doctor with me and when I asked about the transplant she just went into the drama queen and just about had a heart attach.  Doc turned his head to me and said they don't want to deal with it.  I am sure she had done her research a transplant means someone is going to have to help care for you and i am sure she would not have wanted to upset her jet set life with the rich and famous!!

Anyhow regarding Universal healthcare I hear bad things about it, but then after mom being in a nursing home for a year on Medicare and Medicaid, Well if I hadn't of been there for her, God only know what kind of care she would have gotten.  In the end I had to fight just to get her a bath, let alone they were not changing her blood pressure patch because it cost to much.  You know you keep up the pass for awhile, but it sure wears you down. 

But then you hear stories in other countries that they wait for months for surgery.  But then Oprah had a show where she interviewed people in several other countries who were very happy with the health care and they took care of the aged and those who had no money as well as those who did.  So there you, maybe it just depends on how the language would read for the US to  switch over.

Maybe it would be better then what we have.  I think a lot of the people who become indigent is not because they are lazy or want to it is the only way they can get help.  So I which the people would get off the back that people are just lazy.  I truly many just fall thru the cracks because the way our system is set up.  Unless you come from wealthy parents, which I did not!  I just worked my butt off but now I am almost 64 and with cancer.  So there you go, if my insurance runs out, the health care almost makes you feel like you are lazy or asking for entitlements.  Just like paying social security in for years and paying your taxes on it, while the government makes interest off of it.  Then if you live long enough to collect what you paid in (after they made the feds made their interest) you pay taxes again!!  Now how is social security and entitlement?? 


PamSouth


#28 Judy2

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Posted 21 November 2011 - 03:33 PM

Hi pamsouth. Were you able to download the link to the Novartis application that I posted for you?

Judy



#29 pamsouth

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Posted 22 November 2011 - 12:35 AM

Judy 2 I don't see where you posted it, but it is late.  I will check on it tomorrow? Thanks Pam


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#30 Buzzm1

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Posted 22 November 2011 - 01:21 AM

gang, i was glad to hear that someone, other than myself,

lives in their pajamas, like I do, 24/7

was rolling in and out of bed so often, than it just made things a lot easier

I'm in my winter pajamas now, Timberland double-knit thermal pullover,

fleece bottom, thermal socks, sheepskin lined boots at hand,

when I need to go out.  I've stockpiled enough to last a loonnnggg time

did the same for my summer pajamas, equally as comfortable

neither the winter, or summer apparel, actually look like pajamas (at least to me..lol

gives a whole new meaning to "dressing down."


For the benefit of yourself and others please add your CML history into your Signature

 

02/2010 Gleevec 400mg

2011 Two weakly positives, PCRU, weakly positive

2012 PCRU, PCRU, PCRU, PCRU

2013 PCRU, PCRU, PCRU, weakly positive

2014 PCRU, PCRU, PCRU, PCRU (12/07 began dose reduction w/each continuing PCRU)

2015 300, 250, 200, 150

2016 100, 50/100, 100, 10/17 TFR

2017 01/17 TFR, 04/18 TFR, 07/18 TFR 0.0012, 08/29 TFR 0.001, 10/17 TFR 0.000

2018 01/16 TFR 0.0004 ... next quarterly PCR 04/17

 

At the earliest opportunity, and whenever possible, lower your TKI dosage; TKIs are toxic drugs and the less we take longterm the better off we are going to be ... this is especially true for older adults.  

 

In hindsight I should have started my dosage reduction two years earlier; it might have helped minimize some of the longterm cumulative toxic effects of TKIs that I am beset with.  

 

longterm side-effects Peripheral Artery Disease - legs (it's a bitch); continuing shoulder problems, right elbow inflammation.   GFR and creatinine vastly improved after stopping Gleevec.

 

Cumulative Gleevec dosage estimated at 830 grams

 

Taking Gleevec 400mg an hour after my largest meal of the day helped eliminate the nausea that Gleevec is notorious for.  

 

Trey's CML BlogStopping - The OddsStop Studies - Discussion Forum Cessation Study

Big PhRMA - Medicare Status - Social Security Status - Deficit/Debt


#31 pammartin

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Posted 22 November 2011 - 06:17 AM

Stylin' in the pj's, awesome!



#32 Judy2

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Posted 22 November 2011 - 02:51 PM

Hi pamsouth: I posted the Novartis link etc... under the subject "Questions" dated Nov. 19, 2011.  Scroll through all the posts and I think you'll find it, if not let  me know and I'll repost. It may be hard to find as there is getting to be a long list of posts under this subject heading. Anyway, please let me know,

Judy



#33 pamsouth

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Posted 22 November 2011 - 08:08 PM

Hey Judy2,  I found the Novartis link and printed it out OK, thanks!!  I am so thankful for this discussion board!!  I was diagnosed in 2005 and the first year I did a lot of homework and seminars, etc on the CML and flew to MD Anderson in 2005 and 2006,  then I decided I didn't want to think any more about CML then I had to, so I just to continued to go to 1 annual seminar a year by several leading cancer doctors.  That was until this whole thing came up with my doctor that supposedly my PCR labs were all over the place.  Then I called the LLS and made sure I understood how to read them, and yes I did understand how to read the labs.  Then I called Medco and asked about the new drug Tasingna and the side effects and the cost, which are considerable more expensive and became a patent in 2007, Gleevec patent will expire in 2015.  Then I went on this LLS discussion board to see the comments of other people on the the different drugs, etc.  Then I went to a different doctor at the leading Cancer Center of Indiana for a second opinion.  Having said all that I made a decision that for the time being I am comfortable with, and that is I am changing doctors and where I do my labs, where the hospital does their own labs and interpretations and the there are a group of Leukemia experts. So I will be getting my next labs in January at the new hospital which LLS has rated as the number 1 premier cancer doctor/hospital of indiana.  So I am at peace with that and not stressing!!  Well I need to get off of here and taking a break.  Got my grocery shopping done.  Am going to make my mom's (passed away in 2003) famous oyster dressing with a little white whine.  Oh, I sampled the whine it is pretty good.  HAPPY THANKSGIVING  and thanks for all your help!  Pam


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#34 Judy2

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Posted 22 November 2011 - 09:44 PM

Hi pamsouth. I hope you have a great Thanksgiving. If there is any way I can be of help to you please let me know.

Judy






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