We met with our Cedars-Sinai oncologist Thursday and went over the results of the latest CT scan. The chemo has had no effect on the tumor. "Only an insane person would keep doing it," Dr. Wolin said. Stopping chemo is at least some good news. Other good news: Scott's MRI of the abdomen and pelvis showed no metastasis.

We completed another insurance hurdle and saw the contracted in-network thoracic surgeon at UCSD that our health plan referred us to. He said that he could not do the surgery — that it was "almost impossible" — and agreed that the Cedars thoracic surgeon is the right guy for the job, if there is such a thing. He agreed to send a letter to our San Diego oncologist with his recommendation. We will see our San Diego oncologist Monday and hopefully get the ball rolling on another request for the Cedars surgeon.

Scott's sister put us in contact with a good friend of hers who used to work as a patient advocate. She has agreed to help us navigate the process, and that has been comforting. It's been a hard week because as we battle the insurance company, Scott is getting worse. He's now coughing up blood and has increasing shortness of breath. And I'm having trouble keeping my stress contained.

If we are still in the same situation next week and no closer to getting Scott the surgery he needs, then I will make every attempt to get hired at Cedars-Sinai in any department where a nursing job is available. I checked into their health benefits, and they start on the first day of employment. This could be the quickest route to getting the surgery Scott needs. I could also change my status to per diem at my current job and lose the HMO benefits, allowing us to buy health insurance on the open market. But those benefits are not very good and the premiums are very high. I also have had difficulty confirming that the surgeon at Cedars is indeed in the network (two conflicting stories that make me fear jumping ship from the HMO we have).

Anyway, lots of uphill battles. Trying desperately to not lose hope.