Wednesday, June 29, 2011

Money Talks I

Adventures of Stevie V - Dirty Cash (Money Talks) - Official Video

Remember this little ditty from the 1990? For some reason it made me think of Beverley Hills 90210. I also think of the desperation of drug addicts who prostitute themselves for a fix. (Yes, seedy.)

On another note, I recently read a study that suggests that cancer is a risk factor for bankruptcy. Of all cancers, thyroid cancer has the second highest rate of financial bankruptcy than other cancers at 4.8% (behind lung cancer at 7.7%, in front of leukemia/lymphoma at 3.6%). I pondered the reason a little bit today with two survivors. Now I think I know why.

1) Thyroid cancer is now the number 1 cancer among young women. We, young women, earn less than older adults especially since we are relatively new in our careers. So we are often working at a lower salary grade. Second, many young women are in the time of their life starting young families so they are not working the same number of hours because they often have reduced income due to maternity leave and childcare. Third, due to gender bias and inequality, women are still earning less than their male counterparts. Lastly, we are young. We don't think we are at risk for cancer because we are young so we live our lives, we work hard to get ahead and party harder, we do not save for emergencies (unless you have a little stashed away), and sadly are already in debt (thanks to student loans and credit cards). (I know that some of these may not apply to you but you are the exception. :-)

2) Thyroid Cancer is still called the "good cancer". Thyroid cancer is generally still one of the most treatable and curable forms of cancer, that is if you have the more common forms of papillary, follicular, and/or differentiated. So most endocrinologists, in my experience, indicate that one is ready to go back to work 3 weeks after surgery and 4 days-2 weeks after radiation. This is does not nearly reflect my own experience or that of other thyroid patients. Physically, the mobility of the neck returns after three weeks and the radioactivity does wear off but if you are adjusting to thyroid medications or especially if you have to "go hypo", without Thyrogen like I did, to prepare for your radiation, it can take several months to a year to feel completely normal. In addition, some people require a second surgery which then results in more necessary recovery time. Since the thyroid gland controls metabolism and protein production, the absence of a fully functioning thyroid gland can make one feel totally off balance, lethargic, and not well for work. A total lack of functioning thyroid hormone mimics depression symptoms. Regardless of these factors, thyroid cancer patients look so normal. Aside from the scars on our necks, we are fairly healthy looking (albeit extremely tired.)

I am often told that I look good for what I have been through and it looks like nothing happened. Thanks for the compliments. But I think this is one of the reasons why thyroid cancer gets the shaft, why more thyroid cancer patients are bankrupt, and why it's still so understated.

There are no major fundraisers or campaigns for thyroid cancer like there are for other cancers, e.g. THE RUN FOR THE CURE (breast cancer), UNDERWEAR AFFAIR (cancers below the waist), and TEAM IN TRAINING (lymphoma and leukemia.) Also, Canada's thyroid cancer organization, Thyroid Cancer Canada is fairly new, becoming a non-profit in 2002 and charitable organization in 2003. It is run by volunteers and a board of director and funded by donations. (Despite this, TCC does amazing work but imagine what could be done with paid staff.) Perhaps, it is because thyroid cancer patients look so normal that the "healthy looking sick people" do not get funding. Don't get me wrong. I am not negating the financial toll of cancer on the whole also know that folks who have other types of cancer. But there does seem to be a gap when it comes to thyroid cancer. This is also why I strongly believe that there needs to be more advocacy for thyroid cancer especially regarding the causes.)

3) Financial support is difficult to access with thyroid cancer. Thyroid conditions are quite prevalent today. Hypothyroidism, hyperthyroidism, Grave's disease, Hashimoto thyroiditis, and various types of thyroid cancers are the most common thyroid conditions. When the endocrinologists said to me that it takes only 2 weeks to return to work, it negates all of the symptoms that I am experiencing, especially those that prevent me from working. When the endocrinologists and surgeons say it is only two weeks, it is even more difficult to access other types of funding. Thankfully, I received government sick benefits for fifteen weeks which equalled about 40% of my salary and did not pay for March Break but before I could access that I had to use up all of my sick days. If I was to return to work after this and needed a day off to go to an appointment or I was not well, I would have to take days off without pay. Another thyroid cancer survivor told me that our condition does not qualify for the Government Disability like other cancers do. Thankfully, after over 3 months of prayers, forms, phone calls, blood tests, doctors' visits, and waiting for an unspecified amount of time, I did qualify for a disability claim through my employers' insurance plan. At moments, it felt like it would not get through. I was so happy. But then I found out what the amount of my coverage would be: less than 25% of my salary which is about $ 950/month. That's right. I will be living on 1/4 of my salary for the summer. $ 600 of this is rent, so essentially for $ 350 I will need to eat, transport, and entertain myself. I feel a bit disappointed which I fully acknowledge on the other hand, it is better than nothing. I have hopefully ended the main portions of my treatment so I will return to full-time salary in September. However this is still a shock. If my thyroid treatment were more complex or required more time off, the impact would be a lot more.

4) Thyroid cancer numbers are increasing. The incidents of thyroid cancer are on the rise. I know of two other teachers in my school board who are younger than 35 that are also experiencing thyroid cancer. I met one woman who knows 3 women going through thyroid cancer now. Another woman I spoke says her friend knows 5. I'm not ready to say "epidemic" but the prevelance is high. Imagine the financial strain if we all were asking for money.

Since some of you might be facing the financial pains that come with cancer, I have listed two resources from the Thyroid Cancer Canada website.

For those living in Ontario, Canada, there is a financial assistance booklet from the Princess Margaret Hospital/University Health Network.

Also read Kairol Rosenthal's blog. She is a thyroid cancer survivor and author of Everything Changes: The Guide to Young Adult Cancer in Your 20s and 30s. She has a really cool post about cancer and medical debt. Although she is an American and her references are a bit different, the stats are similar and we still feel the same pain.

How have I been coping financially so far?
First off, let me first say that I am blessed. I have mentioned it in my post Nature Walking 1, I have been provided for and I am trusting that I will always have enough. My faith in God has been really helpful in this regard. So prayer, and prayers from friends, family, church folk, and strangers, has been helpful in this regard. So even when I thought I would be left in a lurch with less than 25% of my salary (and a wedding coming up next year), I am trusting that I will be okay. Jean at Wellspring said the time of to recover is a gift and instead of gold and diamonds, I'd have time this summer. Instead of going out for dinners, I'll go out for tea. In one way, having less money forces me to do less. (I'm a bit of a workaholic and busy bee.) I will have to slow down. Second, I will never underestimate having an emergency fund. No matter how small the amount you could put aside into savings each week, do it! Thankfully, I had a small emergency amount which I have used. Even on my 40% of my salary, I have been stashing a few dollars aside each week. This comes in handy. Third, my tax return could not have come at a better time. Plus, having credit cards helped (especially those with a balance). I also cook a lot of food so my fiance and I eat at home a lot more which saves money. My fiance and I do not have cable so that is one bill that we don't have to pay. I often take public transit to avoid expensive parking fees. I cut corners here and there. My mother is paying my car insurance. Bless her. My fiance is also a musician and works retail so although our combined incomes are not large at the moment, we have been able to make do with what we have.

Coming up in the next post... Why do I have thyroid cancer?


Kairol Rosenthal said...

Great post. I’ve been mulling this over and have come up with a few hypotheses too. I wonder what you think:

1. Thyroid Cancer has a higher survival rate.

Thyroid cancer has overall survival rates much higher than most other cancers. (According to the National Cancer Institute, 10-year overall relative survival rates for patients in the United States are 93% for papillary cancer, 85% for follicular cancer, 75% for medullary cancer, and 14% for undifferentiated/anaplastic cancer.) Because we have much longer to live than patients with many other kinds of cancers, we have more time for bills to rack up and more time to go into debt and need to file for bankruptcy. For example, I have had the good fortune of racking up more medical bills for my thyroid cancer than my friend Erica, whose particular form of brain cancer had a 2% survival rate. She died less than two years after diagnosis, and ya can’t file for bankruptcy when you are dead.

2. Faster recovery times.

Most thyroid cancer patients are able to go back to work fairly soon after treatments such as surgery and radioactive iodine. (My recovery too way, way longer, but I know I’m not the norm.) Because many of us continue to work through out our disease course, I bet that lots of US citizens with thyroid cancer, who are still working and earning an income, don’t qualify for government assistance like Medicaid, or other financial relief based on income. So I wonder if it could be because we are more so often physically able to work as compared to other cancer patients that we don’t as often qualify for government assistance, have to pick up more of the costs ourselves, and therefore file for bankruptcy more often.

3. The Asian factor.

This study was limited to only the western half of one state in the United States. I think the study should be called ‘Cancer As Risk factor for Personal Bankruptcy in Western Washington State’. There might be so many factors that pertain to western Washington, and not to other geographic locations, that account for the thyroid cancer being the second highest rate of bankruptcy. For example, at 16%, the Asian population in the Seattle-Tacoma area is much, much larger than elsewhere in the United States. Being Asian is one of the top-five risk factors listed for getting thyroid cancer. Is a higher percentage of the thyroid cancer population in western Washington Asian? And if so, are there cultural factors that could impact why Asians would also have higher bankruptcy rates, such as higher rate of uninsured, or overall lower incomes? I don’t know the answers to these questions, but do wonder if issues like this contribute to the outcomes of the study showing thyroid cancer as the second highest cancer group to file for bankruptcy. I hope this study has garnered enough interest for it to be repeated in a way that accounts for geography and population factors.

4. Predisposition to bankruptcy prior to diagnosis.

It was interesting to see that although thyroid cancer was the second most often filed for bankruptcy, lung cancer was still DOUBLE that of thyroid cancer. The two highest risk factors for lung cancer are smoking and exposure to second hand smoke and to other caustic materials and elements like asbestos and nickel. Smoking rates are almost double among people living below the poverty level and exposure to caustic materials is also much higher among the poor. So it seems possible that poorer people have a higher chance of getting lung cancer. This is a factor that the study does not consider. And it makes me wonder if there could be similar factors that could predispose the population in western Washington to higher rates of both thyroid cancer and poverty.

Thanks again for giving me much to think about.


Anonymous said...

Your experience is common among many of us young people with cancer: I just spent a good portion of my holiday trying to get in touch with Service Canada - they were supposed to contact me 5 weeks ago! Worrying about money and waiting to hear if your benefits might be approved can be stressful, but it would be even more stressful to have to work during treatment! You've got the right attitude, so I'm sure the finances will fall into place. Best wishes!