The cost of Health.

 This was finally The Year of Remicade.

I'll give you a brief rundown of what it took to get approval. We first heard of Remicade a few years ago, and it was being touted as "the wonder drug" for severe Crohns patients who had exhausted all other avenues. At that time Steven was on a regimen of drugs  that seemed to be working quite well, his Crohns was in remission, so he was not eligible for Remicade. 

Then, his Crohns came back with a vengeance and he needed surgery, so they were hoping the operation would solve his problems, so once again he was not eligible, and, as a matter of fact, he was pretty much symptom free for almost 5 glorious years.

Then, as Crohns is prone to do, it returned. This time surgery wasn't an option, or, I should say, it was but it would mean a colostomy. What the BC Health care system now has to decide is whether the money they spend on his ever more frequent hospital visits is more or less money than the cost of Remicade every 8 weeks, perhaps for life.

It's $4500 per infusion. 

He was in the hospital for a week in April, again for a few days in May, 2 ER visits in June, an overnight in July and a week in August. Finally, the powers that be decided to set up a visit with a gastroenterologist in Calgary.

Really long story short....a pain in the leg bad enough to warrant a visit to ER, diagnoses: blood clot, ambulance to Calgary (they wanted to fly him,but this was the week of the rains and floods and the airports were closed, the highways were closed, the detours and delays were unbelievable, but eventually he got there, but not before the ambulance actually broke down half way there, and they limped to Sparwood and borrowed one of theirs...jaysus!) anyhow, when they got there..., diagnosis: broken bone in foot (what? Yes, you read that correctly) Meanwhile, the specialist in Calgary phones to book an appointment, and when they discovered he was already in Calgary, they set the visit up. Result? A plethora of tests and an "OK...let's do this!" And the first Remicade was ready to be administered when....hold on....what's this? A anomaly on the ultrasound? More specialists.....diagnosis: ....kidney cancer. Cancel everything for 24 hours....more specialists....diagnosis:  just a (whew) genetically deformed kidney.

Actually....this is what the oncologist said: "Considering the amount of test results I've seen, I'd say the chances are a million to one that you didn't have cancer. Today I'm telling you to go and buy a lottery ticket, because you're that "one".

So, the Remicade is once again a go, and it actually got done. The first infusion is monitored very closely because there can be so many side effects, but he sailed through without a problem.  It's 3 vials of Remicade.

Eight weeks later he had the second treatment done here in Cranbrook, also no problems, also three vials. The third one is four vials, didn't go so well, we ended up back in emergency that night, with severe abdominal pains, but apparently that's "normal" because it's a higher dose. 

The fourth sort of went well, a few days prior to the infusion we ended up in emerg again, a Crohns flare up, and the doctors here decided to admit him for a few days, on IV fluids to give his gut a chance to "rest", and they ended up doing the infusion while he was there, in his room, and the nurses on that floor weren't used to doing it, there was all sorts of running around and question asking, plus Steven was to fly to Calgary the next day to see his specialist and the Drs here were not sure that they'd discharge him, plus, while there was no rain and flood this time, there was snow storms.....the worst in years with temps of -40, flights being cancelled, all this resulting in one huge stress attack....will the flight be cancelled? Will the Dr in Calgary even be able to make it to his clinic? Will our motorhome shelter collapse due to the heavy, wet and freezing snow? (see below for the answer to that.) So infusion 4 was rife with panic and more unneeded stress.

(I didn't tell him about this until he was home from his Calgary visit.) and "booo" to the fellow up the street who drove by as I was trying to get the snow off the roof, before it collapsed and hollered "Put a hat on....it's cold outside." Oh well. We got it fixed up shortly thereafter.

But infusion 5 was the other day. We arrived a few minutes early, and got a bed a few minutes early. They nurse got the IV in on her first try (that never happens, they usually have two or three nurses give it a try, and often the anesthesiologist has to come and do it, the result of years of prednisone that ruins your veins). Anyhow, kudos to Sharon who had him hooked up and on the drip in minutes, she said we should be done by 12:15, and we were done and out the door at 12:20! We both slept like logs that night, finally, a successful infusion in Cranbrook, and the weather was beautiful!

So the hope is, now he can have the same thing every 8 weeks for about a year and then they reassess the situation and we'll take it from there.  

Each infusion requires a "letter of special authority" from his Calgary specialist to BC Medical, as BC does not cover Remicade. Then, when they eventaully agree to pay 80%, we have then go to bio-advance (the distributor)  and after more back and forth, they pick up the rest. It's a long procedure, and kind of a pain, but the end results will hopefully be worth it, and I'm just thankful that I live in a country where we can at least get the help we need....in one way or another.