LID Day 1 + Bureaucracy, not in that order

And we’re back to cancer blogging. Yesterday I spent a couple hours at the Jewish General getting my records in order. I forgot how much bureaucracy there is to being a patient: Keeping files, updating files, moving between offices, the whole gig. Though I have to say that prior experience has meant I know how to work it, at least at JGH. Everyone was super helpful and nice.

Of particular importance was getting some forms to Manulife, my private insurer. In Quebec, there is a public system but private insurance covers lots of things, some of them not covered by the public system and some of them covered but foisted onto private insurers when possible.

As part of my radioactive iodine treatment, I need my thyroid hormones to be low enough for it to work. There are two ways to do this: 1) become hypothyroid. This involves stopping my synthetic hormone drugs for about six weeks and making myself very sick, soporific, and generally living in a miserable haze and being unable to work or do much of anything. 2) receive two shots of thyrogen, 24 and 48 hours before radioactive iodine respectively. You can guess which is preferable. Thyrogen costs about $1600 for a course of dosage and Manulife requires pre-approval.

You can guess what happens next. I have my Dr’s office fill out the forms and fax them to Manulife (and have the receipt to prove it). That was in August. Last week I call to ask why I haven’t heard back. They tell me they “never” received it. So I have to get the documents again, scan and email them, and find a responsible person. Luckily I did. This is the third time in my experience Manulife has “lost” a claim (or part of a claim) for an expensive treatment for which they require prior approval. What conclusion am I supposed to draw?

Also, for the record, I contracted McGill Benefits to ask for an advocate with Manulife, they refereed me to MAUT (aka, our fake faculty association), who promise me they will get back to me, just like they did in August. I’m still waiting.

Of course if worse come to worse, I will just pay out of pocket. It’s just that I shouldn’t have to, and I shouldn’t have to chase down my insurer on top of staying on top of various tests and other medical arrangements in advance of my treatment.

LID Day 1: I am now on my low-iodine diet, which requires that I (effectively) consume nothing prepared by anyone else. If you’re curious about how it works, Thyroid Cancer Canada has a fresh and up to date brochure, based on the latest science. The short version: for a vegetarian, it’s vegan, no soy, no dairy (duh), nothing from the sea, and nothing high in iodine (like iodized salt, which is in everything). But non-iodized salt is ok, so I can go with that.

My first LID meal was lunch, and involved home-made hummus (including boiling the chickpeas ourselves, with some baking soda following the Ottolenghi recipe; though Carrie’s hummus skills are quite formidable at this point) and toast from no-knead bread (half wheat, half unbleached white flour). Tonight is a salad and leftovers from a paella based on Mark Bittman’s instructions in How to Cook Everything Vegetarian, with short grain brown rice, a giant cauliflower from the Marché Jean-Talon, onion, garlic and bell peppers. And way more saffron than he suggests. In addition to the dry chickpeas, I had to track down salt-free vegetarian bouillon (thank you JTM Vrac), and vegan margarine for the toast (ok, not amazing, thank you Carrie for finding it at Loblaw’s).