medical transcription and chemotherapy

Posted: Feb 2, 2013

I have a question for any MT who is undergone chemotherapy. About a year ago, I was diagnosed with cancer. I underwent extensive abdominal surgery to remove the tumor and had a very difficult and prolonged recovery time. I was unable to begin chemotherapy until a couple of months after my surgery. At the time I had my surgery, with the help of the hospital's social services, I applied for SSI/SSDI. After I had recovered from surgery, my oncologist had recommended that I try to work part time during my chemotherapy. He told me that his patients who held some kind of job, did better, at least emotionally, than those who did not. I was able to work a little. I was on three-week chemotherapy cycles, and I found that the last few days before going to the infusion center for chemotherapy, I was able to work 10-15 hours, enough to keep my health insurance and other benefits, but that is all. And I was beginning to have doubts, as my chemo progressed, that I could continue to work at all, as I was physically and mentally deteriorating further with each course. Six months later, about halfway through my chemotherapy, I received a denial letter from SSDI. I was absolutely without funds, I had really been counting on receiving SSDI to live on and Medicare to help with my copays which were (are) huge. My landlord was giving me a break on the rent, expecting to be paid when I started to receive SSDI, but could not continue to continue to forego the rental income for another two years (which was the length of the time my oncologist estimated I would be disabled.) So faced with eviction, I decided I had no choice but to stop chemotherapy and return to work. (I did get a small stipend from our local cancer society for a few months plus a small limited disability payment from work totaling about $1200, and I exhausted my PTO, but there is just not a lot of help out there, unfortunately, and there was no further help from either of these resources or any other help that I could find.) My choice, it seemed to me, was to try to continue chemotherapy and live on the streets or in a homeless shelter, or stop chemo, elect hospice, go back to work and enjoy what time I had left in a reasonably functional and relatively pain-free state of health (not that I find medical transcription the slightest bit enjoyable) so that I could die in my own bed when the time comes which will probably be relatively soon, since my cancer is not being properly treated. Of course, I did appeal the decision (after all I paid into this fund for nearly 40 years!) with the hope the decision would be reversed and I could resume chemotherapy if it was not too late, fully expecting my oncologist would tell me I don't get any credit for the cycles of chemotherapy I have already endured, and I would have to undergo the full course all over again. However, today, I received another letter from SSDI telling me again that I am not sick enough to receive SSDI, in light of the fact that I have had no further treatment since the original denial, and that I ought to have been able to work full time as a medical transcriptionist while undergoing chemotherapy, and I should be able to do so now. Although it has been a few months since I stopped chemo, I still have a lot of pain and numbness in my hands and feet, and still am not very strong. I am in finding it very difficult to work full time, and I am not nearly as productive as I used to be before I got sick with this (according to the SSDI bureaucrats) minor nonserious nondisabling illness. (Of course, I suspect, if I had fibromyalgia or a gambling addiction, that would be another case entirely, and I would have no problem receiving SSDI.) Anyway, other than the neuropathy and tiring easily, I feel okay now, which basically means I am not nauseated anymore and I can eat, I can control my bladder and my bowels, and I have a little fuzz now on my formerly bald scalp (of course undesired hair elsewhere is exuberantly flourishing, naturally.) However, during chemotherapy, not only was this neuropathy of hands and feet a serious problem early on, but I had nausea and vomiting, diarrhea, nosebleeds and bleeding from my ears, and skin breakdown from chemo meds as well. I had problems with nutrition with electrolyte imbalances, dehydration, and anemia that would crop up from time to time, all of which made it very hard to work. But what made it absolutely impossible to work most of the time was my mental state, I definitely had "chemo brain." I was often confused, very forgetful, could not concentrate, had word finding problems, dizziness, lethargy, had visual and hearing disturbances, and extreme emotional lability as a result of the poisonously life-saving chemotherapy agents, steroids, antinauseants, and various other meds I was taking at the time. So my question is to you transcribing cancer victims/survivors, were you able to work full time while undergoing chemotherapy? Were you able to support yourself? Am I malingering because I felt completely and utterly unable to work, and very very ill? Am I babying myself? (Believe me, if I felt I could work and undergo chemo at the same time, I would, I don�t want to die.) And, also, I wonder if those medical doctors who reviewed the original decision to deny SSDI and found it appropriate, would be willing to hire me to transcribe their medical reports when I was barely oriented to person, let alone time and place, and what is the difference between peritoneum and periosteum anyway and why in the h&!*?! do you care anyway, just leave me alone and let me work, d!&>* you! Would they want me in their offices, in my poopy leaky Depends (secondary to the explosive diarrhea which was a result of the chemotherapy) hunting for the bathroom because I couldn�t remember where it was, or unexpectedly and with no warning puking all over their computers? ;