Influential Insurance: Aloxi vs. Zofran

The chemotherapy regiment I have been on since January 4th is Taxol (chemo) with Herceptin (not chemo, although wildly expensive... about $2000/dose every week, which will triple when I start going every three weeks and getting three times as much). With this regiment I get the following premeds in the following order: Zofran (for nausea), Dexamethasone (a steroid), Zantac (for my stomach) and Benadryl (to prevent an allergic reaction to Taxol). They take about two hours to be administered and have varying side effects.

I have been on the Dex since my first Adriamycin and Cytoxin (AC) treatment, where I received the premeds Aloxi (like Zofran, but better) and Dex as well as an Emend pill (hard core nausea preventer at $354/3 pack of pills) which I ingested as soon as they got my blood counts and found out whether my white blood count was high enough to get chemo, and then on the mornings of the second and third day. Dex has a cumulative kind of side effect, it seems, because I have noticed that my anger levels have risen since I've been on Taxol. Or perhaps it's the Taxol. Or perhaps it's the Dex, but I didn't notice when I was on the AC treatment because the Adriamycin more or less wiped out all familiar and healthy feelings and replaced them with weak, nauseated aliens.
Anyway, in case you weren't aware, steroids cause noticeable differences in mood.

The Benadryl makes me sleepy, especially since it is administered in high doses and directly into the blood stream.

I don't think the Zantac causes any side effects, but that's only because the nurses haven't blamed it for causing any of the many that I have.

The Zofran, on the other hand, causes LOTS of side effects, even though they run it very slowly in an attempt to minimize these effects. Despite their attempts, however, Zofran is powerful and still kicks my butt, leaving me with the following annoyances: dizziness, blurred vision, inability to focus, inability to walk in a straight line, jumpy vision, loss of balance, loss of appetite, and, on the following day, the feeling that somehow a succession of queen size mattresses were dropped on me from a distance of at least 15 feet, the force of which caused my body to slowly slice through the concrete to the underlying surface like a spoon through a slightly under ripe tomato.

Now, as I mentioned before, Zofran and Aloxi have the same function, but Aloxi is much better for me. I can feel when my system is saturated with Aloxi, but it does not cause the symptoms that Zofran does, which last beyond the day of treatment. I know that this is not at all in my imagination because last week one of the nurses came to me and said, "I'm going to run your Benadryl a little faster because you're already going to be getting out of here pretty late tonight. Let me know if it bothers you," to which I replied, "Ok. I think I should be fine, though, because the Zofran didn't really bother me much this time. I only got a little bit woozy at the very end, and it went away pretty fast." About twenty minutes later the nurse came back and said, "The reason the Zofran didn't bother you is because we accidentally gave you Aloxi, which is better for you, but your insurance doesn't want to cover it."

At which point I said, "WHAT? My insurance dictates how you guys are allowed to fix my cancer?" And she said yes, that the insurance companies very much dictate what the medical professionals are allowed to do with their patients and what their patients are allowed to have TO CURE THEIR LIFE THREATENING DISEASES. Now, I know that Aloxi isn't going to cure my cancer, it is just going to help make my treatment more tolerable to my system, but instead I have to have Zofran, which is supposed to do the same thing but has all of these other side effects that very much effect my quality of life. I don't mean to sound like I'm whining, but my head is seriously messed up right now and while I am aware that it is mostly the chemotherapy, I am certain that the Zofran is a contributor, and it is extremely irritating to me that the insurance company gets to tell my medical provider what she's allowed to give me.