Class 5 Medical Clearance- DRAMA!

These last couple weeks have been filled with all sorts of emotions in regards to our "Out of Country" Adventure.

A couple of weeks ago, we were so excited that we have beat Cancer, are continuing to get ready to go (getting rid of things around the house, getting our passport stuff sent off, changing our post of duty date, etc.) and finally got all our my medical stuff off to the State Department. We had prayed long and hard to make the decision to go and have only felt that cancer was a little bump in our road. We are so ready to get on with things!
Then on October 1st, we received an email from the State Department. We I have received a class 5 (domestic only) medical clearance. Let's say feelings of denial and shock were probably first to hit. Are you kidding me?? What else can be thrown in our way? It's getting a bit ridiculous if you ask me! As soon as I read the line about an opportunity to have them review the decision, I wrote the Review Board an email. Funny thing actually- I decided to start an email and then had plans to talk to the State Department lady first to know what details to include to help my case. I went to save it in my Draft Folder and accidentally pushed send. Oops! Oh well! At least they know we want it reviewed and we can send details when they respond. LOL Too funny! At least I told them what I wanted and who I was. Technology bloopers can be so funny!
Here's the Email I received from the State Department on October 1st:

Dear Mrs. Seamons,
Your medical clearance review is complete.  Your case was discussed with Medical Clearances Medical Advisor, who recommends issuing a class 5 (domestic only) medical clearance until 4/2013 at which time your case can be re-evaluated.  This decision was made secondary to your continued medical treatment for the medical condition followed by Dr. Panwalkar.
Per 16 FAM211.2 (c), a class 5 clearance is issued to all who have a medical condition which is incapacitating or for which specialized medical care is best obtained in the United States.  Employees or eligible family members with a class 5 medical clearance may not be assigned outside of the United States.
If you have any questions you may contact me at      or at this email address.
You may request a review of this decision by requesting a file review by a three physician Medical Review Panel (MRP). If you wish to proceed with such review, please send an email to MEDMRP@state.gov .
Respectfully,
Sharon Mallory, RN
Nurse Consultant
Department of State
Office of Medical Clearances

The next couple days were filled with sadness and confusion. Answers to prayers can be so tricky. We know that we received the answer that we should take our family to Colombia. At least that's what we thought. Back at the end of last year, Colombia wasn't even an option. But we were looking for a new position and had asked the Lord to send us where He wanted us to go. Out of the blue, International called and offered us the Colombia position. Specifically in our prayers, we asked over and over again for His influence on those making the decision to put us where He would have us go. Then even after the offer, we took several days to think and pray about it and decided that that is where the Lord wanted us. BUT.. then we were diagnosed with Cancer. Are you freakin' kidding me??? Even then, after the initial shock, we felt like this is where the Lord would have us go, that we would beat the Cancer and do our best to go where God wants us regardless of obstacles that stand in our way.
Now this....
What does THIS mean? Brett and I have discussed a couple Scripture stories of answered prayers lately. And basically we are trying to decide what story our life resembles. One of the stories is about a man that asks over and over and over again for the same thing. And even though God says no, he repeatedly keeps asking until God says ok truly thinking he is doing a good thing. But the consequences of that action are life-altering (and not necessarily in a good way). The other story is of a man who is given an errand from the Lord. But then is thwarted by obstacles on every side. Others tell him he should give up but he will not. He will go and do what the Lord asked him- not matter what! And He does (after some pretty hard stuff) and the results is lives changed forever for the better!
So... what is OUR answer??? Is it-- "The answer is NO! Are you listening???" or is it "Work harder. Find a way!"? Frankly at this point, I don't know. Brett and I tried to talk about it but every conversation ended up in tears (me- not Brett) so we decided to let the dust settle a bit before we do anything. We haven't had a chance to talk to International yet so we're not sure what this would mean for Brett's position and the possibility of holding it any longer. So far they have been so patient and understanding. But there's gotta be a point where they just say "forget it", right?
Unfortunately for me, the Review Panel got back to us really fast, forcing me to face this sooner than I want to. But they got back to me quickly and the email looks encouraging so chin up, right?
Email from Review Panel on October 3rd:

Dear Ms. Seamons,
I am glad to initiate your request for a  Medical Review Panel (MRP) assessment of the medical clearance decisions made by MED/Clearances on your  Class 5 Clearance.    The following is a brief description of the process:
The Medical Review Panel process begins with a written request for an appeal of medical clearance to my office.   I will review the available electronic medical record and any other information provided for consideration.   Then a panel of three physicians who are familiar with living and working overseas will review the file and the request.  The panel makes a recommendation to the Medical Director, who makes a final decision on all cases.   The process normally takes about 7-10 days once all of the needed information and/or documentation are received.
 I will review your medical record in the next several days and contact you if additional information would be helpful.   If you have supplemental information you would like for the panel to consider, by all means, prepare something for them but please be brief-limit your explanation to one page if possible.  If you have questions regarding the reasons behind MED/Clearances decision, you should contact them directly at  MEDClearances@state.gov.  I would suggest that any supplemental information you desire the panel to consider also address those reasons, issues, or concerns raised by MED/Clearances.
I (we) look forward to working with you.
Sabrina R. Haas, MD

OR NOT! We were just getting our feet back under us to be able to call and see what we need to get to help our case when we received the next email. Let's just say that the shock, denial, sadness and confusion has turned to anger. I feel like I have done everything that I possibly could to be healthy and cancer-free so that our family could have this opportunity of a lifetime. It seems so unfair (and don't give me the "life's not fair" line cuz I don't really want to hear that this week) that I am in BETTER health now then I was before I was diagnosed but they won't clear us because some study says that Herceptin for a year is "recommended". It's such crap!!! Seriously! Everyone says a positive attitude is what beats cancer but these doctors are doing everything to ruin any positive outlook I have!!! Oh I know...Let's just keep her on a experimental drug that will cause heart failure so then we can deny her for that too! It's crap, I tell you! I know I am being unreasonable and not thinking straight but I am just SOOOOO freakin' mad!

Email from October 5th:

Good morning Mrs. Seamons,
I just left you a message at home to talk directly but wanted to give you some more information.  In speaking with the Medical Review Panel yesterday regarding your case, we cannot even panel your case or consider a Class 2 Clearance until you have completed your Herceptin (whether it be in November or later upon agreement with Dr. Panwalker) . At that point Medical Clearances will need an updated report from Dr. Panwalker  demonstrating completion of therapy and stability and with no evidence of cancer recurrence, as well as detailed summary of follow up imaging studies needed and frequency (MRI’s, CT scans) and  physician/ oncologist follow up.
I still am available to discuss your case in the meantime.
Thank you, Dr. Haas
Sabrina R. Haas, MD
Chief,Exam Clinic
Office of Medical Services
Department of State

October 9th:
Four days later, I have calmed down a little- and I mean a tiny little bit. My anger is more of sadness and frustration and ????? Who the heck knows! If someone could just tell me how to feel and what to do- that would be great! With Brett's insistence, we conference-called Dr. Haas to discuss a few things this morning. She was very kind but it wasn't exactly the phone call we were hoping for. We talked for a very long time and she threw out so much information that I'm not even sure what was all said but the main gist is this:
You only get one shot at a Review Panel. And they will NOT even begin a panel until I am completely done with treatment. And then I would need a very specific letter from Dr. Panwalker stating that I am finished with treatment, along with any future followups that are required including doctor checkups, MRI, scans, blood work, etc. Then, with all that information, the Review Panel would look at all the info, compare it to their guidelines and their medical opinions and if they feel any of the followup could even be done in Colombia and finally make a decision they feel would be best. So basically, it's still not a done deal but a "my life is in their hands" coin toss. ALSO-- If I quit Herceptin early (which I also have felt like was an answer to my prayers) and Dr. Panwalker doesn't agree, there is a good chance that the Review board would deny my case anyways for not following a doctor's recommendation. Screwed if you try not to ruin your heart/ screwed if you don't! I can't win!
She kept saying that they "want" people to be able to travel internationally but at this point my bad attitude has a different opinion!

October 10th (& into the 11th): 
Tonight and right into the morning, I had a long discussion/cry/scream with Brett to figure out our options. Let's just say, I don't handle conversations like this well. I feel helpless! First of all, I just want one other person to think that I should get off the Herceptin because it's what is best for me! But alas I am the only one. And it looks like it's the only way to even have an option to still go. Even then- I am totally confused at what God wants me to do? Why won't He just tell me. Cuz I would do it!
Even with my complete meltdown here on the blog, (cuz I actually have been pretty busy in real life), I do know God loves me! I really do and know that He has a plan and that it is way better than the one I have BUT I am so mad right now! I just can't see any direction or answer!!!

So as of this very early hour, (perhaps it is the lack of sleep? LOL) I have decided to keep taking Herceptin for the "doctor recommended" time and see what happens. Looks like we are here at least until April or until God tells us to move somewhere else.
Alright.... Enough blabbing for a lifetime so there you go! The Seamons' Colombian/ UnAnswered Prayers Drama!