Joelle Kaufman: Welcome to Kicking Cancer's Ass, the podcast that's reframing the cancer narrative from fear to power. I'm your host, Joelle Kaufman, 43 year intergenerational breast cancer survivor and author of Crushing the Cancer Curve Ball. Today I'm joined by one of the women in my book, Jessica Gravel, and her story's just amazing. She's a marathoner who discovered that navigating the healthcare bureaucracy was actually the hardest race of all. Jessica lost 90 pounds, transformed her body through running, was living her very best life when cancer threw her the curve ball, not just in diagnosis, but in the healthcare system that was designed to slow her down when she needed to run. Jessica, thank you so much for joining me and for being part of my book.
Jessica: Thank you. It's great to be here.
Joelle Kaufman: Awesome. let's jump into the healthcare maze. So when we talked, you said at the time you thought there was a problem, you had to pay a massive amount out of pocket just to have your concern taken seriously, and then fight with scheduling nightmares and misinformation. Can you walk us through the absurd obstacles when you realized the system was working against you?
Jessica: Sure, yeah. I, um, at the time, um, was getting healthy. So when my employer offered insurance, I was opting for, you know, the cheapest deductible for month to month because I didn't plan on using that policy at all. I was out, you know, living the marathon life or just doing other stuff. And, um, runners often, uh, ignore different body ments.
And continue to like keep pushing. So I was like, even if I did get hurt, not really planning on using the insurance. So it was the lowest deductible, which then, or I'm sorry, the lowest monthly premium, which then I find out, it ends up having like actually no deductible and you have to pay your out of pocket.
Um, max. So all that's all it is, is it's, I believe it was like $8,000, maybe it was six or $8,000, um, that year. And so anything that I went to go do, I had to pay a hundred percent for a hundred percent of a biopsy. A hundred percent. You know. So the biopsy was actually what? By the time I got to the biopsy, I had met my out-of-pocket mat max from everything.
Um, so I really, my first, um, cancer appointment, I didn't pay a penny towards anybody within the oncologist or anything within that. So like, while I thought that that first year was really, really hard and it was absurd that I am shelling out all this money. Once it actually was cancer, I ended up having the best insurance policy essentially for my situation because I, I didn't have to pay, um, anything I.
For that first year. So while I was going through all of that stress, um, with the scheduling, I will say that it ended up being, one of the blessings was that I didn't have to fight the insurance for, for anything. It was 100% covered. Um, I was staying with that company again for one more year, and so I anticipated that and I knew exactly what my premium was gonna be so I could plan.
One more year knowing that I had to pay like that giant out of the pocket premium. So I scheduled surgeries in the beginning of January, then met my out-of-pocket max, uh, again by, you know, March or April. And then I can kind of like coast for the rest of the year. So I. Honestly now I have changed insurances and I'm on the smaller deductible and 20% plus a copay and I have no clue why.
I just like went to the oncologist on Friday and one bill, I look on the EOD, I'm expecting 80, $18 and I go to hand over my card 'cause she's like. Four 16 and I was like, oh, even less than 18. And she is like, I just wanna confirm $416. And I was like, whoa, hang on. No, I wasn't expecting that. And so then, you know, you have to like sit there and, and nobody will tell you anything at that.
That that register counter, you have to wait for the boss, so you have to go to another office. And then I go there, and of course she's in a meeting, so then I have to leave a note to hopefully get called, and then nobody calls me back. So then I have to send like a passive aggressive message to my own call that's like, help me, help you guys.
Like I would've paid the $400 if I would know. What it's for. And so finally, you know, three days later they call me back and the, the Lupron shot that I pay $400 for I guess, every three months, which I wasn't like used to that. 'cause again, I was used to like, so I guess that's 20% of what, like the shock costs.
And so. The knowing and paying a little bit more. Um, not that I'm paying necessarily more, but it's like spread out and I'm much more aware of that. Finances has all been a lot more crazy. Um, and then, uh, after my reconstruction surgery kind of had some hiccups. Um, I finally united, well my, one of my insurance companies, um, was able to reach out to me for.
Um, a, a case manager, but I was switching the insurance company, so I never utilized that one. So when this one has come around, I have started to ask for a case manager. Um, but of course when I asked for the case manager, she told me that most people have a more serious condition than my, like, tighter muscles or whatever she saw on the diagnostic code.
And I said, oh, ma'am, I, uh, what? What could, what sort of serious conditions are you talking about? And she was like, well, people with cancer. And I was like, great. I'm a cancer survivor, so can I get that case manager
Joelle Kaufman: Absolutely
Jessica: astounding.
I.
Joelle Kaufman: Absolutely astounding. And I, I mean, I'm shaking my head because I don't think, I don't think people realize that once you've concluded, okay, this isn't actually gonna kill me, right? I'm gonna live through this. It's a pain in the neck. I don't wanna do it, but I'm gonna live through it, that you're constantly stressed about. The financial ramifications, whether it's 'cause you can't work as many hours 'cause it's impacting your income. Some people are afraid of losing their jobs. You didn't. I didn't. Well, I was working for myself. It would've been tricky to fire myself, um, but it's opaque. The whole system is opaque. the things you need to care for yourself, you can't. You can't price check. You're just handed bills. And then only if you can't pay them are people willing to work with you. So did you, in year two, 'cause I know we're in year two or three, have you started treating your finances different and kind of creating a fund, a savings fund for the healthcare curve, Bob?
'cause if I remember, I mean, Jessica, you're pretty young. Saving for your healthcare, as a young woman getting healthy.
Jessica: No, it's funny you bring that up. I mean. I, I started off almost as a fin, well, I started off as a finance or marketing or an accounting major. I started off as a business major, so money was what I thought of, uh, and as, as my first, and then money went to the back of my, my head as I wanted to enjoy life and I wanted to experience things and vacations.
And so, um, no, like living in the moment definitely was, was more of what I was considering. And, um, when I created my budget, my budget was. Uh, when it was considering medical expenses, this is how much, like one er appointment costs. Like this is how much, like, you know, and if I, if I tucked away enough for a, a, an ankle surgery or, you know, like some stitches, you know, like, it was like, that's what I'm, but I never considered that.
And so since then, I do have a financial advisor. We did meet, we went over to the spreadsheet and the number, you know, like a one cell is basically like medical expense. I mean, it's rent, but like, you know, mortgages and all that. But like next to that it is, um, medical and, and, and so it goes into planning for, for so much more.
Um, another piece of the planning I had never even considered. I went back home last July into Indiana. And so from Texas, I wasn't able to get any of the medications either. So like, I thought like, oh, Walgreens, or, you know, just a nationwide pharmacy transfer things over and that should work. But like, my doctor's not licensed in Indiana, so therefore the pharmacist can't fill it.
And so yeah, like there's, there's just a lot more of like under of more planning that is needed that I, that I definitely didn't anticipate.
Joelle Kaufman: I think it's really interesting 'cause I traveled, uh, during my treatment, both during chemo and as I was continuing the immunotherapy, I. I mean, the benefit of 43 years is I started talking with my doctors about it really early and started negotiating, okay, can I do an infusion in Texas when I'm in Austin?
Can I do an infusion in New York when I'm in New York? And interestingly, they didn't want me to do that. wanted to do it all here for a host of reasons. But because I was up to just immunotherapy, I wasn't having chemo anymore. They actually switched me from a three week cycle to a six week cycle so I could go away then bumped my last immunotherapy to the day before I left. And my first immunotherapy was like the day I got back, it was as tight as we could, but it came from asking because I knew it was gonna be a problem. you didn't know it was gonna be a problem 'cause you've never dealt with this. Now, speaking of things you talked about Lupron. And another thing I believe younger women going through cancer treatment don't know about Lupron. Do you wanna explain why you take Lupron and, and why that's important? I.
Jessica: Oh yeah. Um, and, and I honestly, I have a young 20-year-old fr or 30-year-old friend she'll like that when she hears this, that I called her 20 though. So I do have a, a younger friend who's in, in med school right now and she wants to go into like oncology and all of that. And she's absolutely MindBlown when she hears about Lupron.
Because it's turning my ovaries off, so I do not produce estrogen, um, anymore within my body. Um, I actually was completely unaware that, I mean, like, I don't wanna say like, I was unaware because when you like, reflect back at it, like it makes logical sense when you say the things that you were told, like you were told your body can't have estrogen.
You're told that like, we need to remove the estrogen out of your body. But like, we're not like, and then, and then I got my first chemo treatment, and when I got my first chemo treatment, I absolutely fell to the floor. My bones were hurting completely. I had all of that sickness, but on top of that, I was having my very, very last menstrual cycle.
And so it was coming from every, it was, it was horrible. And then when I, you know, tell my doctor about it, and she's like. Yeah, that was probably your last menstrual cycle. And I was like, what do you mean? And she is like, well, the chemo is gonna, you know, suck all of that estrogen out of you. And then right after that you're gonna go on Lupron.
And that's where we turn your ovaries off. That's why we asked you if you wanted to freeze your eggs. And it's like, yeah, yeah. I, I was, I was there for all of these discussions, but like, once it like hits you and it's happening, it's, it's significantly different.
Joelle Kaufman: I'll bet. Now, were you er positive? Was your tumor er positive?
Jessica: Right. It was.
Joelle Kaufman: Okay. So one of the things that a lot of doctors don't always bring up is that you some. Types of tumors, they actually recommend you take Lupron before chemo, you shut down the ovaries. But the reason isn't to deprive your body of estrogen because in my case, for example, um, er negative, it's actually to re preserve reproductive flexibility.
So my sister was in one of the first clinical trials for Lupron, 'cause she was 29 when she was diagnosed and it worked, it shut her down. And then when she was done with the chemo, it all came back, which in her case was safe and led to having two kids. For you, this is actually protecting you from recurrence, correct.
Jessica: Yeah, I am, we're, I'm on Lupron for the, um, recurrence. Um, I started off on the three month shot, and then I went and got a second opinion, and that was in my little, like freaked out stage. I wanna do everything by like every single study. And the study was by the one month shot, so I wanted the one month shot.
And then, uh, like a year into the one month shot, I said, I wanna get going outta here. Let's switch back to that three month shot. Like, I need a, I need some time away from you guys. Um, but, so I'm on that, but when I did get my second opinion, um, because some things weren't going so in my way, um, with scheduling with, uh, my, my.
My current on the oncologist I spend with, I got a second opinion and she said the Natalie study had just come out. Um, and so the Natalie study had opened up Ki Cal to um, stage two and stage three, so I guess. Right. I'm new to the, to the breast cancer scene, but I guess previously, 'cause C was only for stage four and then the Natalie study was what opened it up from stage two and stage three.
And that's significant because, um, when I had my surgery. Or when I, when I, before I had my surgery, my MRI had me measured at a stage two and then I wasn't gonna have surgery for a while within my story. So they threw me on, um, tamoxifen and then that actually shrank me. So when I came, when it came out, it was back to a stage one.
And so, because that we have one MRI in which it had reached for me to be a stage two, I guess. It qualifies me for Cal now. And so when I went and got the second opinion, who I'm sure that Doctor had something to do with the Natalie study closely followed. It was related to it, whatever. Um, she was like, did you know that you can also have, um, and so when she, she told me the one month shot she added on K Calv.
And so I'm on Letrozole and then kcal. Um, which 'cause cavi is a three weeks on and then one week off, and then Letrozole is every day. So, um, I'm kind of on those three with a ton of supplements to try to make me feel a little bit better
Joelle Kaufman: And
Jessica: and all of the,
Joelle Kaufman: about, and, and all of those are about preventing a recurrence repeat disease. Right? I. Okay,
Jessica: I was just gonna, so let,
Joelle Kaufman: hmm.
Jessica: yes, my onco score was rather high. I don't remember the quote for that. So the reasons why I guess we're on this too is my onco score was high and then they did a, a, I'm a, uh, luminol B. So because of those reasons, it's the more aggressive cancer. So we're taking a more aggressive approach.
Joelle Kaufman: And you're healthy so you can withstand a more aggressive approach. And you're young and my family always says we're not playing for five years. We're playing for 50 and we're not playing to just kind of get along, get on by. We're playing to be able to ski and hike and wakeboard and travel to live fully.
So bring it. What do you got? Bring it. I think you're in that same ilk.
Jessica: Oh, I am. I mean, and I am, I'm trying mushroom tins and I don't know, like some, I, I ask my doctors about everything, you know, so nothing counter interacts and the big P word, like I know that there's all stuff to look for, but they say they don't care if it's pseudoscience. If, if I can be nicer and more polite and more patient, then they support anything.
Joelle Kaufman: So I was at a conference in November, so I'm gonna throw out to you stuff that hasn't been it's early stage, but anti progestin. Talk to your doctors, see if that works. It might be suitable for you. I have no idea. But that's where a lot of people are looking. Uh, I've, I've read and seen early lab-based things on Zep bound, tep, tirzepatide, and uh, MiFi Prestone, is both mind blowing. Now I wanna go back in time a little bit 'cause I remember you being very persistent. Just a persistent person, and there's a story you told about calling a scheduler and saying something along the lines of, I'm gonna call you tomorrow and at noon and every hour after until you get me scheduled. Which, you know, my version of this joke, or it's not a joke, was trust me, I can outlast your hold music, but tell us your story.
How did, was that. Natural or was that the marathoner in you? Was that cancer bringing it out? Like where did this, I will be on you every hour. I will be relentless until this gets done. Where did that come from?
Jessica: Yeah, that's funny. Um, no, I think that, and I'm a, it, it comes from my family members. I'm fairly confident. Um, I have a very, uh, demanding both sides of my, my mother and my father's side. Um, we are very outspoken and, um, if we have a certain feeling, we're gonna, we're gonna probably say it. Um, so I've been trying to, to kind of reel that in and, you know, uh, now I get to wait in the doctor's office for like 45 minutes and that's the regular, and I'm like, not the biggest priority, you know, and then it's all of that.
So, um, I've been in a lot of pain lately and, um, the pain has made me, well, now we're good, but like. With, uh, the first few months of, of 2025, I definitely felt that way. So I was kind of forgetting appointments and I was definitely irritated waiting in the stupid chairs and moving from this room to that waiting room, to that waiting room.
And then the beginning of the year, you have to give your insurance card and your ID out, even though it was fine two days before when you were just here. Um, anyway, so like. It's, it's definitely I've, I've been more patient, I would say. Um, but also I'm pretty sure all of my doctors have, uh, an expedited me to.
Certain personnel who are gonna help me get my issues solved. I will also add in that I have started using AI technology like chat, GPT to communicate to the doctors as well. So that way, like my tone or my, like pain or frustrations or exaggerations like that I'm feeling in the moment for whoever said whatever to me, um, isn't kind of there, you know, like.
When you go to the doctor, to the, the, the PCP, like your regular doctor, and they ask you when your last mammogram was, and you just like look at them and you're like, so you're new here and you didn't read my file. So, you know, like, you know, so that can rub me the wrong way. So I, anyways, I use like chat ai, um, chat, GPT and AI technology and like say like, this is how I feel.
Tailor eyes a letter for my neurologist, tailor eyes, a letter for my plastic surgeon for my, so that way, um, it, yeah, it's just, it's been a lot more helpful. And then I send the message ahead of time and then we have to talk less, and then I get out of there sooner. So it's been a little bit helpful, I think.
Joelle Kaufman: I think that's really smart and I think it's important for listeners and viewers to understand the difference between asking chat GPT, what to do and asking chat GPT to help improve your c. Communication to this kind of specialist. The second is a great idea. The first could be an avenue into realms of hallucinations you just don't need as a cancer patient.
Jessica: And let me like give an example of what I would say to chat GPT. I have pain when I raise my arm directly up and to the side. And then chat. GPT would say. Does it hurt when you touch your nose or does it and it like asks you to do something and then you say yes or no, and then it's like, it sounds like your T six.
And then I go to the doctor and I'm like, my T six hurts. I don't know what that is, but they do. You know, so that's where it's kind of helped me.
Joelle Kaufman: Very interesting. Okay, so kicking cancer's ass now has. Chat prompts. Okay. Here's my version of the, you didn't read my chart, so I, get an, I'm sure it was an automated thing through MyChart, my Health and it's, you haven't had your annual physical. It's May of 2023. I am still recovering from my surgery and I wrote back and basically said. You need to look at my chart. And they said, well, you need to have a physical, we need your labs, what have you. I said, I am confident you don't have a patient who has as many labs day weekly as I do right now. could you check with the doctor? 'cause I really don't wanna spend any more time in doctor's offices than I need to right now.
And I have a verifiable army of doctors. Watching me and the doctor got back to me over the chat and was like, yeah, how about we check in in December? Sounds, sounds great. Thank you. All
Jessica: All right, so. He might as well say to you like, Hey, we gotta come in just to check your cholesterol, or we, you need to get like a skin check right now and you're like lying in with like a major operation.
Joelle Kaufman: I seriously, I'm like, my skin's been checked. They even found incidental findings. I had giant kidney cysts. Like they were terrified. They're like, your kidney cysts are twice the size of your kidneys. this a problem? Well, no, but they shouldn't be there. Well, okay then, so they're running me through literally the day after surgery, racing me to a CT scan, and they say to me at the CT scan, they were very sweet, but I'm very small and they only had two CT machines, I was going to the pediatric one, so it was small, and they said, okay, please lift your hands over your head. I'd just come out of my mastectomy in deep. looked at them and I was nice. I was kind of amused. I said, I'm a hundred percent certain I'm not allowed to do that. So, this poor tech looks at me and she's like, what are we gonna do with your arms? Right. All right. Enough on this, I wanna blow people's minds. So what blew my mind, besides all the stories of you being persistent and stubborn and wonderful, is that you kept running. I should caveat with, like running. work out, I like to jump rope and jump on boxes and lift weights, but like running a marathon or a half marathon is close to zero on my life list.
But you, you kept running. fact, I think you completed a half marathon during treatment. Like what were you thinking?
Jessica: Yeah. Well, I know, so I have backwards logic within a lot of things, but in my mind I thought that if I could like. Reproduce and make more cells and like just if I was exercising it out of my body, like the more, then maybe the chemo would leave faster and I would make more cells and my nails, excuse me, my nails would grow back faster.
Um, or things like that. So in my mind I was thinking that would happen. The second bonus was, is I would just absolutely take a long nap after doing all of that.
Joelle Kaufman: Okay, so you got more sleep and you felt like you were purging like sweat. I'm gonna sweat this all out. Right? So here's an interesting thing I learned, uh. On the journey, there's a growing body of research. That exercise helps reduce the side effects of chemotherapy. So, you know, you might have been like reducing your side effects by all that running.
Jessica: I mean, I, I could see where it would, um. It was also nice to be outside, so I think getting, because uh, I had chemo in September and October, so it was kind of like a great time down here in Texas. So the sun was better. I don't think that I would be out there as much in July, but yeah, no, the sweat and, and, and then it helped rehydrate too.
You had a natural want to to hydrate.
Joelle Kaufman: That's brilliant. Just brilliant. So your running community got behind you too. You, you told me that they organized some things and you, that you, you're very independent and you're terrible at asking for help. How did that community support, what did they do and how did that support impact you?
Jessica: Yeah. Um, so there was another individual who he, um, may of last year, he did succumb to his cancer, um, around the same time as my cancer. I believe I was starting chemo when he was scheduled to have surgery. He had stomach cancer. Um, stomach cancer seems to be a pretty big, crazy one. And, uh, so, um, so he, he, we, the community came together and they got a bunch of item, bunch of items together and had raffle tickets and we raffled off, um, the, there's a running store, uh, two Rivers running.
Uh, so they would, um, they had a different. Like organizations donate and then we had the drawing there. Um, and so it was really nice and then Jerry and I were able to like split that. Um, on top of doing that, the running group would, I had like a meal train. Um, I was able to create a calendar and I. Don't have any children, but I have two dogs who are used to me running them, and me used to like getting them outside.
And so I could put on the schedule like Monday, Wednesday, Friday, childcare and childcare meant that my dogs needed some running. And so then people could sign up or say like, Hey, can I. Switch a Tuesday for a Wednesday, and I'm like, great, I don't wanna do any of them. So, yes, like, come on. And so it was a lot of that by the end of it, 'cause my parents would have to fly down to help me.
Um, they were, they do attend, um, doctor's appointments with me when I know one's gonna be annoying or stressful. Um, and then they've driven me and are helping me kind of recover from like smaller phase surgeries as well.
Joelle Kaufman: So again, you're terrible at asking for help. You needed help either because you didn't wanna do things or because you couldn't. How did that change your perspective? Now, what did that, what did that either help you realize? If anything, you could say, well, I still hate asking for help, but I'm just curious if you, that experience. an impact on you.
Jessica: It sure did. Um, so after, and so in January of this year, I had, um, like phase 1.25. Who knows like what it is, but that's the fat graphing and that kicked my butt. I. I thought I could do a lot. During that time, I thought that was going to be an easier surgery than it was, so I didn't have help lined up and so I had to be asking for help when I was hurting.
And, um, I tried to, like I said, suffer through it. And then I felt, uh, for the first time, like I wanted to throw up from pain and like, just like would start sweating out of. Out of nowhere. And my like, nursing friend, a neighbor would be, I'm like, why am I sweating? She's like that, that's probably pain. Like you need to take more pain meds and sit down
So then I had to, you know, just help get, help with somebody making me a meal each night and making sure that there's like, for sure food because I couldn't stand in the kitchen long enough to, to cook a skillet. And then I would try to just like, you know, throw a skillet mill meal in there and then. Lay down and then try to get back up and stir it, but then it would be burnt or undercooked.
And you already don't have like the want to eat from chemo. So yeah. So I was like, can someone just come over and cook me food and throw it in front of me and I would eat it. And I'm like, this tastes like garbage still. 'cause I didn't have an appetite. And they're like, thank you. And I'm like, no, you're, I'm very grateful, but this, does this taste good to you?
And they're like, it tastes fine. And I'm like, man, this taste buds are awful.
Joelle Kaufman: So were you surprised, were you surprised that people stood up for you and that they, you know, on the drop of a hat 'cause you didn't plan for it, they were willing to come and be for you?
Jessica: I was absolutely surprised and now they're still lingering around and even though like, so I feel better now and I'll just be like, yeah, yeah, yeah. And like. Five minutes later, text them like, I did it. I'm laying down. Thanks. Like, but I, yeah, no, I mean, and it's, I realize that I can't do it. I, I, I did push myself too far.
So I ran the half marathon and then in January after radiation, I ran 120 miles In January, I ran like two back to back half marathons. And my hip was really, really hurting and I was blaming, um, like. The chemo meds, essentially. And then we did the DEXA scan. When I got that second opinion and it came back, I have osteopenia.
So then one of my doctors told me like, it's really bad if I get a stress fracture in my femur. I. So that was kind of in the back of my head and I thought I scaled back pretty good. So then in September, no in August before my deep in September, I thought I'm just gonna run one mile a day. And I thought that was like a normal thing, but my body, like my leg just wouldn't do it.
So I, I did kind of think that I had a stress fracture. And then I did the deep, and so I had the recovery from that. And when I started running in like November, my hip hurt really, really, really bad. And then that's when I had, and so that's when I found out I have a hip tear and a cyst. So.
Joelle Kaufman: The hit parade. It just keeps coming. Maybe you wanna try swimming?
Jessica: But do you know what happens when gravel goes in water?
Joelle Kaufman: I don't. Tell me what happens.
Jessica: It sinks. I am not a good swimmer.
Joelle Kaufman: I am not either, uh, but I'm also not a good runner, so I love this. I mean, I'm sorry about the hip. Does this mean you're gonna need to have a hip replacement or can they repair the labrum? I.
Jessica: So I did, I did uh, 13 sessions of PT and then I got a shot in there and, uh, all the scans and so, 'cause first we had to like clear that it wasn't cancer, even though we all knew it wasn't cancer. I. I have scoliosis, I know where all my arthritis points are at age 39 and uh, going into, so I get my PT and then we chase the pain up my back and I finished out my rest of my seven PT sessions.
'cause I'm only allowed hard limit 20 PT sessions. Um, and then, uh, I, yeah, so I'm out of PT sessions and so I can have like a scope surgery. But I would have to, again, back to the self care system, I would have to forego pt. Is option one. And do my best to PT myself after the surgery. And when I called my case manager about this, it's 'cause this, uh, PT is not medically required, but it's just suggested according to stuff.
My other option is to pay for one out of pocket pt. Hope that I can jam all of that in my head. Because I am, have my doctorate and body anatomy already, and then I could do it myself after I pay out of pocket one session. So, or I can just kind of live with the pain, I guess is, are my options. And so enlighten the load, so to say.
And I'm not gonna say on here what I'm doing if I do wanna have the surgery or not, because uh, I am supposed to reduce my activity. And that's my final statement on that matter.
Joelle Kaufman: I understand. And, uh, if you want, when we're not on the, the podcast, I have, uh, I have a. Some success with, uh, appealing all the way to state authorities. Uh, the definition of medically necessary is different when it's the insurer versus the state insurance commissioner. And that's all I'll say about that. So speaking of the healthcare system and all these hurdles, like what would you change if you could change how the system works and, you know, make it work better? are the top two or three things you would change?
Jessica: I don't know, and I'm embarrassed to say that as I am. I'm A-B-C-B-A. So I, I mean, I work with codes and I work with insurance as a, as a biller too. Um, I think that there has to be a way of regulating that the CPT codes are being utilized appropriately and not abused, but there has to be a way of allowing more freedom.
So somebody who's had seven surgeries since August of 2023 can have. More than 20 sessions of pt. And I mean it, this, this, I feel this way with any sort of dual diagnosis or multiple diagnosis or, I mean, the insurance company even sent me a letter or like a little research article supporting their like stuff.
And it's like, cool, where's the like, it just so I don't, I think to try to make things more personalized. I, um, but it's so tricky to actually do that. Um, I think. Once you pay your deductible, maybe you have a mandatory, you know, sit down with a case manager and, and like, is there any education that needs to happen?
Um, about that? Um, maybe every five years we try to teach Americans what the deductible actually means and what it, what it network and out of network means. Um, maybe that should be part of high school curriculums. Um, there's, you know, a variety of options. It definitely starts with education because people don't even know about their, people don't even know what their deductible is.
Joelle Kaufman: Yeah, I've had to explain to people what's a deductible, what's a copay? What's co-insurance? What's in network, what's out of network? And I think your point on a case manager, I. You know, we're not experts. Even you who's in the system, we're not experts. Even your oncologist isn't an expert, but there are nurse navigators.
There are people who work across all the specialties. just very few and far between, but I believe they can be billed. And it seems like one of the first things you wanna do with a newly diagnosed cancer patient is sit down with that kind of person. And start to map it out both time and money and sequence, right?
There's, there's a sequence to it. So, okay, so you mentioned this a little earlier that, oh, you have a comment. Go for it.
Jessica: To build on that, some sort of, um, checklist. For when to seek a second opinion. I don't know why that came up in my head, but when you were saying that, that would benefit the insurance company as well, because a second opinion has to cost them more money, we're basically just asking, do you think that person was right?
And most of them are all reading the same research kind of anyways. So they're gonna, for the most part agree. But like. Why get a second opinion? What's happening? Like there should be some sort of, uh, person to communicate to before you get a second opinion or to, to flush that out.
Joelle Kaufman: I agree, and particularly if you live, like you don't live from what I remember, you're in Texas, but you're not close. To MD Anderson or to like the major cancer centers in the United States, of which MD is one of them. So to get a second opinion from a National Comprehensive Cancer Institute, they actually will have more information.
They'll know more about trials. They often have specialists for your kind of cancer. Not just breast cancer, but you know, er positive. I don't know if you were triple positive or, or what have you, but your flavor of tumor, pathology is what should determine your treatment. getting a second opinion can be the difference between torture and not torture, uh, and, and just being a more informed as a patient.
Jessica: I agree.
Joelle Kaufman: So let's roll back to your switch from marketing, finance, and all these things where you were climbing the ladder and you're striving for success. before cancer, you made a shift, right? You made a shift about getting healthy and prioritizing being an average person who appreciated little joys. What. What prompted that shift and what has the impact of cancer been on that shift?
Jessica: Yeah. Um, c Can you say it one more time? I'm sorry. I thought about something else and I got distracted once more.
Joelle Kaufman: Would you, would you like to talk about what you thought about and I can come back to it.
Jessica: Well, so when you said shift, to be completely honest, the biggest shift that has changed probably since I've talked, talked to you is I thought about how I've changed my diet further, is that I'm like now growing. Produce like, yeah, like so I started hydro growing and then anyways my A DHD kicked in and I thought about my plants for a big second.
Anyways, I'll be very honest, but that's right. This, but no, so I started like growing 'cause I wanted to be more, that's one of my biggest shifts. And then to be honest, so my life really is all about plants and then like I'll watch this little cabbage grow. And on harder days or frustrating days like. It's, it's all, it's soothing in so many ways where I, I can see that each day I'm rebuilding and I'm regrowing and the cabbage is rebuilding and that's regrowing.
And it, and it does continue to make me more grateful. And my yard has, like, I have wild flowers everywhere. So I really am just trying to like bring more like positivity and like beauty to what can kind of be an ugly world. And before Texas summer kicks in, I'm trying to just maximize on that part. So, uh, but what was your full question to make sure I answer.
Joelle Kaufman: So, actually I think you answered it great. But my, my full question was you were already making this shift to be a person living, I'll say in gratitude for the little joys, and then you get smacked in the head with this cancer curve ball, you know, you've just gotten healthy. it's kind of absurd, right?
You lose 90 pounds, you get healthy, and then you find out you have cells running amuck. Did you find with that shift you shifted to growing your own food? Which I, I mean, we don't know what causes cancer, but in the world it's one out of every four people, and in the US it's one out of every two, so something's wrong. not good here. And so I think growing your own food to the extent you can is great. But the cabbage, I often give people a picture of, or a plant of a sunflower because it makes people smile and you watch them grow and get big. And, um, I don't exactly know what you do when the sunflower keels over.
Uh, that's probably not a good moment, but. During the process of the sunflower growing, it's a very positive, uh, empowering thing. And I think we just have to keep, you know, there are winter vegetables. We just have to keep cultivating the garden and finding things to focus on because if you focus on what's bad or painful or what have you, that's what you see more of.
Jessica: No, and, and to continue with the analogy, I didn't even, I thought. I in Texas, like, what can you grow? Or really, what can you grow anywhere? But like so much of like kale actually needs some coldness to taste better. So when you actually get into some of it all like. It. So it's, it's been a nice escape on that side of it.
Um, another escape of, of this has all, um, I've been posting on like my Facebook and, and like the meal train. Little things, just keeping in touch with everybody, but like, so as that's kind of like progressed. Um, people have reconnected. Like one of my, you know, just friends of friends from 20 years ago.
They saw each other and then, you know, it gets brought up. So it is kind of nice being open, you know, and vulnerable and kind of like sharing about it. I got a few messages the other day like, Hey, you haven't updated in a minute. So, like, you know, I'm not, and I'm not, you know, saying that it's like a content creator by any anyways, but just keeping my loved ones and those people around me like.
Filled in on what's going on, and I think half of 'em, you know, they love the, like science of this journey as well, and seeing me transform from a runner to a gardener and just, just whatever is next. You know, having short hair now, my hair was always curly before. But now I, I don't know, like it may not be long anymore because it's hot down here.
So, you know, just continue to transform and you have to keep shifting because nothing stays stagnant. Stuff that stays stagnant doesn't, it doesn't, it's not good. I.
Joelle Kaufman: Well, and the environment's gonna change. Something will change. I like to tell people curve balls are inevitable. You don't get to choose the pitch, you only get to choose the swing. So practice lots of different swings. All right. For someone who heard has just heard it's cancer, I'm sorry, it's malignant and is about to enter the healthcare maze. What's your most practical piece of advice?
Jessica: Ooh, I, someone who's about to enter the maze is I would probably, I. Start organizing their documents and their information better, like coming up with a better organization system of your notes. Um, the doctors do not communicate as much as you think they do. As things go along. So you're the one who has to be the, the communicator between it all and to have that piece out.
So I, I, all mine stuff is about organization and, um, if you don't have somebody to call a scheduler, I would, I have considered that if I was to go through like another rough pain spot, I think I'm gonna have to have my friends call people because I can't. I can't sit on the phone and wait, like it's just it.
So like, I guess that's another thing that I would tell them is ask for help in anything that you struggle with. If you struggle with it, it's not worth it because somebody else can help you and not, I don't say they won't care, but they're not gonna be bothered by it. If someone has to call and make an appointment from me, they're not gonna be bothered by it.
Whereas if I have to interact with this person or the situation, I'm gonna be annoyed and it's. Gonna rub me and I, I need all the positive energy and all the sunflowers I need, you know, so I'm gonna go plant a fun sunflower, help me out over here, please. And, and, and having people to support you through.
That's been great.
Joelle Kaufman: I think that's fantastic. Fantastic. Fantastic advice. I think that, um, I created a binder and I called it my Cancer Obliteration Project, and it came with me every time I saw a medical professional. Uh, and I had tabs and the whole thing. I also, since putting out the book, created a workbook that people can download a PDF to help structure their own binder and give them things to do things, to ask things to just go through the journey as an educated In, in the journey, but the asking for help and saying, I, I don't wanna do this. I, I could someone help me Now some places you have to give them HIPAA authorization. So you know, go to Mama Bear Legal or something and download a HIPAA authorization and give it to the people you want to book appointments for you and let 'em do it.
But I agree, let people help.
Jessica: It's not like my friend or, you know, the person your, your, your dad or whoever you're giving HIPAA privileges to. It's odds are they're not gonna want anything else but just you to be happy. So just, you know, I mean, trusted people obviously, but yeah, asking for all of that is needed.
Joelle Kaufman: Absolutely. All right. Lightning round. First thing that comes to your mind, each one. one piece of practical advice for dealing with medical bureaucracy? I.
Jessica: Argue back,
Joelle Kaufman: What unexpected skill from your pre-cancer life proved most valuable during your cancer journey?
Jessica: um, being able to pre-plan.
Joelle Kaufman: Being organized. Love it. the most helpful thing someone did for you on your journey? I.
Jessica: Made me dinner.
Joelle Kaufman: Nourish your soul, nourish your body. If you could change, now, we already did this one, what would you, we've already done these things, nevermind, I'm not gonna go with the other, the lightning round ones. But, um, what do you see, what do you, how do you see the world differently post-cancer versus pre-cancer?
Jessica: I see so many people getting stressed out about things that actually don't matter. I see. See, like, like, and, and myself, I'm sure if I am, you know, I'm a part of the ants going marching, you know. But, um, just when you look around, everyone's stressed and frustrated and, and just tired. And, and this didn't happen correctly.
So like the world's gonna end, but like it's really not gonna end. You're fine. And it's hard to tell yourself that until something that's like really sucky, like this comes at you your way.
Joelle Kaufman: I think that's right. Don't sweat the small stuff and almost everything is small stuff. So Jessica, thank you. Thank you for being part of the book. Thank you for sharing your journey. Again. I hope that now that you're past all the surgeries, that everything is, you know, as they say in Silicon Valley up into the right, you're simply gonna be doing great planting cabbages and sunflowers, and your hip heals and you're able to run with your running group and play with your dogs and everything in your life. Just. Fills you with joy. Uh, eh, it probably won't be everything that's just life. But I hope on the, on the balance you have a lot more joy you have anything else. And with that, I wanna thank the listeners for joining Kicking Cancer's Ass. I hope you learned something. Hope you laughed. Maybe you cried, maybe you slapped your head listening to some of Jessica's story.
But she is a, a winner. She's on the other side looking great, living life. Jessica, thank you for being here.
Jessica: Thank you.