I’m one of those rare guys who do not produce much in the way of PSA. Even after my diagnosis at Stage 4 three years ago my PSA remained normal. After hormone therapy started, my PSA fell to undetectable and has stayed there. BUT my mets are so far confined strictly to bones, so when my bone specific alkaline phosphatase began to rise three months ago, my oncologist wanted me to repeat the sodium fluoride (F-18) bone scan I had last 9 months ago. There was a big catch, he told me: Medicare no longer covers the F-18 scan. Since my last one, the approval for that scan which was signed by officials during the Obama administration has expired and Trump has not appointed anyone with the authority to renew the approval. This explanation was given to me by a Medicare representative and reaffirmed by every imaging center I contacted. So I had a dilemma. I could either rely on a T-99 scan (much older and more primitive) which Medicare still covers, or pay for the new scan out of pocket. A canvas of imaging sites in my area revealed charges from most ranging from $1600 to $3600—way out of my means. So I elected to have the old T-99, and was partially relieved when the results showed no change in bone mets. Then my MO called to say he’d found an imaging center many miles away that would do the F-18 for $600 and urged me do have if it was possible. So I cancelled a vacation and scrounged and did the preferred scan. The results came back yesterday showing new mets in my rib cage and progression in the already known mets in my spine. That sounds like bad news, but most of you will appreciate that the new imaging gave me perhaps critical month’s head start on new treatment. Thanks to that expensive decision, I’m starting next week on new and promising chemo therapy. I love my life and am grateful for every chance I get to enjoy it. I worry about those of you who might be relying on the old T-99 scan and worry even more about what other life-saving protocols the Trump administration is blocking. For heaven’s sake, people, let’s have compassion.