The Week I Was Fighting Two Battles at Once

This week was full of tears, frustration, fear, and—somehow—some really good news.

While I had positive news regarding my breast cancer diagnosis (I’ll get to that), I also experienced some very real and frightening struggles with my mental health.

For more than 20 years, I have taken medication to manage anxiety and depression. I have been taking my current medication, duloxetine, for at least three years, and I have been on my current dosage since around March or April.

On Sunday, July 12, I went onto the Walmart app and requested a refill. I believe I had run out the night before. Typically, I can pick up my prescriptions the next day, so I wasn't initially concerned.

But the next day came and went.

Then another.

By July 15, my prescription still had not been filled. The app simply said something along the lines of awaiting prior authorization.  At that point, I began reaching out to both my doctor and my insurance company because being without my medication was already beginning to affect my daily life.

And then things became significantly worse.

The depression I had originally been prescribed duloxetine to treat began returning with an intensity I had not experienced in years. I began having suicidal thoughts. I was crying constantly and experiencing what I can only describe as “head zaps,” along with severe aches, dizziness and other withdrawal symptoms I had never experienced before.

When I Couldn't Stand Being Me

At the time, I didn't fully understand what was happening to me.

I thought I was simply experiencing what it felt like to be without my medication.

I didn't yet understand that the intense depression, the crying, the emotional pain, and the thoughts consuming me could be withdrawal symptoms from suddenly being without a medication I had taken consistently for years.

All I knew was that I felt like I had become someone I didn't recognize.

I couldn't stand myself.

I began questioning everything about who I was as a person.

I remember wondering how I had ever managed to get a husband if I was truly this horrible. How had I raised the wonderful, well-rounded, respectful son I had raised if I was really as terrible as I suddenly believed I was?

My thoughts were cruel.

And I believed them.

I was convinced that I was unbearable. That I was too much. That I was somehow fundamentally broken.

I began to believe that my husband would leave me before this ordeal with my medication was over.

I genuinely thought I might end up alone.

Looking back now, I can see how distorted my thinking had become. But when I was in the middle of it, those thoughts felt completely real.

That is one of the hardest things about depression and medication withdrawal.

It doesn't always announce itself by saying, You are depressed.

Sometimes it sounds like:

You are a terrible person.

No one could possibly want to be with you.

You have ruined everything.

Your family would be better off without you.

And when you are already emotionally vulnerable, those thoughts can feel like facts instead of symptoms.

I wasn't fully myself during those days.

But I didn't know that yet.

I only knew that I couldn't stand being me.

I was not simply waiting for a medication refill.

I was watching my mental health deteriorate while trying to get access to medication I had been taking consistently for years.

Fighting to Get My Medication

On July 16, I spoke with a representative from my insurance company. I was informed that the delay was due to a prior authorization requirement.

I explained that I had been taking this medication for years and that I did not understand why a prior authorization was suddenly required.

The representative assured me that he had resolved the issue and that I would be able to pick up my prescription by 10:00 a.m. on July 17.

That did not happen.

By 11:30 a.m. on July 17, my prescription was still delayed.

When I called the insurance company again, I was told that while they understood my frustration, I would need to allow more time for the prior authorization process.

I was frustrated. I was overwhelmed. I was scared.

And during that call, I reacted poorly. Not my proudest moment, but not unlike me either. 

I  wish there were more room in our healthcare system for understanding what it means when someone is desperately trying to access a medication that directly impacts their ability to function and remain mentally stable.

I contacted my clinic to see if my doctor could help. A nurse returned my call and told me she would look into the situation and get back to me.

I pleaded with her to see if there was any temporary alternative I could take while the issue was being resolved.

In the meantime, I called the insurance company again.

I explained again,  that I had been taking this medication for more than three years without any problems. I explained that I did not understand why prior authorization was suddenly required.

At one point, I said that it felt like my prescription was being held hostage.

The representative took offense to that statement, and the conversation became tense.

I tried to explain how critical this medication was to my ability to function, and how it was also a basic requirement for the world to be able to tolerate me. But I became emotional. I started crying. I begged for help.

I was told that the prior authorization process was required and that nothing could be done until it was completed. The only alternative suggested was a peer-to-peer review, which could take additional time.

More time.

That was the problem.

I didn't have the luxury of waiting indefinitely while my mental health continued to decline. 

The Call That Finally Changed Everything

I called the clinic again, hoping to speak with the nurse before the end of the day.

She was unavailable.

I sent one final message to my doctor, knowing it was already after 5:00 p.m. on a Friday.

I was terrified that I would have to endure the entire weekend in the state I was in.

Shortly after 5:00 p.m., I received a call from the clinic.

It was a Nurse Practitioner that is on my care team. 

She had been reviewing my chart and saw my message.

When she asked how I was doing, I started bawling. I told her I was in rough shape. 

I explained everything.

And she listened.

Then she quickly found a solution.

She prescribed the same medication in a different dosage: 1/4 the dosage, with instructions for me to take two capsules in the morning and two in the evening, equaling my prescribed daily dose.

That solution allowed me to get my medication that same evening.

She also found a discount coupon that would have brought the cost to approximately $54 for a three-month supply—360 pills.

But when I arrived at the pharmacy, my insurance covered it for $10.

After days of frustration, fear, crying, withdrawal symptoms, and suicidal thoughts, I finally had my medication.

I was safe.

And I was angry.

Because this situation felt preventable.

I was in a severely vulnerable state while trying to access medication I had consistently taken for years. I struggled to get the support I needed in a timely manner.

There has to be a better way.

People should not have to reach a crisis point before someone is able to find a solution.  

And Then There Was the Cancer News

As difficult as this week was, it also brought some incredibly good news.

I still have bilateral breast cancer.

That has not changed.

But there were two very important pieces of good news.

First, the HER2 status they had been questioning in my left breast turned out to be negative.

YAY!

And my PET scan did not show cancer anywhere else in my body.

The only concern had been a suspicious lymph node located behind my breastbone on the left side.

Then came my oncology appointment.

I met with a woman who I believe is one of the best oncologists I have ever met.

And I have met several.

I was my dad's primary caregiver during his battle with stage 4 cancer until his death, so I have had more experience with oncologists and cancer care than I ever wanted.

She went over everything with me.

She explained the ins and outs. She discussed the possibilities of what might happen and what could potentially change my staging or grade. She answered questions and made sure I understood what we were discussing.

She told me that she wanted to perform a biopsy on the lymph node behind my breastbone.

As we were talking about it, my care coordinator knocked on the door.

The two of them whispered back and forth for a moment.

My oncologist then turned back toward the computer. The screen was turned away from me, and she clicked on an instant message that had popped up in my chart.

Then she turned back to me.

“Well,” she said, “we don't need to do a biopsy on the lymph node.”

I stared at her.

The team that had been running my tests and reviewing all of my findings had discovered something important.

That enlarged lymph node had been present since at least 2016.

And it had barely changed in nearly ten years.

The conclusion?

It isn't cancer.

I cannot even begin to explain the relief that washed over me.

After everything else this week had brought—the medication crisis, the withdrawal, the suicidal thoughts, the fear, the uncertainty, the waiting, and the constant wondering about what would come next—I finally received some truly good news.

I still have bilateral breast cancer.

That remains true.

But the cancer has not spread throughout my body.

The suspicious lymph node is not cancer.

And the HER2 status in my left breast is negative.

Those are things worth celebrating.

Two Battles at Once

This week reminded me that life does not always give us one crisis at a time.

Sometimes, you can be fighting cancer while simultaneously fighting to access the medication that keeps your mental health stable.

Sometimes, you can receive the best cancer news you've had in weeks and still spend another day crying because you are terrified, overwhelmed, and struggling to function.

Sometimes, you can be relieved and angry at the same time.

You can be grateful and exhausted.

You can be hopeful and scared.

You can be celebrating good news while still struggling with everything else.

This week, I was fighting two battles at once.

One battle was against cancer.

The other was against a healthcare system that made it incredibly difficult to access medication I had been taking for years.

Thankfully, both battles brought some good news this week.

The cancer has not spread beyond what we already know about.

The lymph node is not cancer.

My HER2 status is negative.

And, after days of fighting, I finally got my medication.

For the first time in a while, I feel like I can take a breath.

Not a deep breath.

Not yet.

But a breath.

And right now, that is enough.

If you are struggling with suicidal thoughts or feel that you may be in immediate danger, please call or text 988 in the United States to reach the Suicide & Crisis Lifeline, or call 911 for immediate emergency assistance. You do not have to face that moment alone.