Just reading the recent emails on frustrations with care, I wanted to chime in here and add my own thoughts. I, too, am disgusted.  I am in my 6th year of CML treatment and have just about seen it all. I am now without an oncologist, as mine left the hospital this week. Plus, I just had to pay $996.00 for my pain medicine because someone in my HMO forgot to put the paperwork through for my 6th month preauthorization for my refills. I am appalled that the patient is the one who has to keep track of this!! And someone dropped the ball on the paperwork and now I am out $1,000 of my own money.  Talk about disgusted.  Like we all have enough to worry about!  Being out of a doctor, a thousand dollars, and getting over pneumonia is just about to push me over the edge.   I am not in an area that has a great reputation for cancer treatment. Worcester, MA is , depending on traffic, an hour or so away from Boston.  I like Dana Farber but it is just too inconvenient for me.
So, I guess we all have our problems, right?  So, Sue, your daughter is not alone in being disgusted and feeling like she is being treated shabbily.  I can't understand doctors who don't "feel" for their patients. I've fired a few in the past few years for various reasons which sound similar to your daughters. Tell her not to give up trying to get the BEST.
Also, I was told that Tylenol is now acceptable up to around 1600mgs. per day, but if she has liver problems it is not the best thing to be taking.  I was told that Tylenol was deadly in the beginning of my CML treatment, but I think only one patient died early on in the trials but he had liver problems to begin with and he was taking way too much for the bone pain Gleevec caused. Initially, Novartis put out a warning that it could cause high risk, but they recanted the warning a few years later, and it is allowable in small doses.
I know how frustrating it is. The first week I was on Gleevec, I had internal bleeding and called the hospital. I got the on-call oncologist who told me to take Tylenol and call him the next day. I was furious, so I know how you must feel.
If your daughter suffers from severe bone pain as I do, tell her that there are certainly other pain meds out there that can  help without compromising liver function. However, as in my case, Oxycontin, while safe, is highly addictive and as you can see by my recent financial problem paying for it because someone screwed up on the HMO's end, it is very expensive.  I looked it up on a computer website and it said that it costs anywhere between $1.00 - $2.25 per mg. so if your insurer won't pay for it, then it is not worth looking into.
I tried Ultracet early on at the onset of my bone pain, but I found out the "cet" means it has tylenol in it. Tramadol, on the other hand, does not, so perhaps she could look into that if her pain is not too severe.  Hope you can find something.  Pain is not pleasant, and it took me two years to find the right med for me, with the help of my primary care physician. Still, when he dropped the ball on the paperwork this month, it cost me.  Best of luck and keep on pushing to find a solution. I had to document daily medical problems for one month, itemizing each affliction on paper, then sending it in to a board of doctors with my HMO. I had a hearing (which took me 6 months to finally get from them)  then I went to see a rheumatologist.  He contacted Novartis who issued a statement confirming this is a bona fide side effect of Gleevec therapy; don't give up!  You must advocate relentlessly and believe me, it took a lot of perseverance on my part- Sincerely, Lynne Andrews


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