Thursday, April 9, 2009

Fighting Through

3 down 1 to go. Maybe...

(Please note in photo that while I managed to coordinate my entire outfit, right down to the blue Gatorade, they gave me a pink ribbon blanket! The outrage. But I was cold. I took it.)

Chemo #3 was not as easy going as #1, but not as difficult as #2. And we were still there from 9:45 to 5:15pm. So is this improvement or not? I guess we'll see what the side effects are this time. Oh, and the talk with the doctor? Interesting.

We arrived on time and they were really, really busy. The waiting room and the infusion room were packed (and not just with Easter decorations...but there were lots of those too). Since there wasn't a chair in the infusion room available, we were sort of wondering why they insisted on us coming in early. But eventually we were called back. I did get to speak with the doctor--she actually did the pre-treatment exam. But not because I called and made the special request. It was because the nurse practitioner was gone. Speaking with the doctor was a battle. I felt like I did when I was dealing with Seamus's first veterinarian oncologist (the one who told me he'd die within the year). I remembered back then saying to Chris, "Is this just two Alpha females locked in a battle for control or is she just a know-it-all bitch who doesn't listen?" I believe he correctly answered "b." This time though, I'm the patient. And I've been probably less aggressive about my own care--at least with this doctor. I think it's because I have to do battle in a paper vest.

She came bouncing in the room discussing my rash/hives situation so at least I knew she had read the file. Or the last note in the file. But she immediately grabbed her stethoscope and moved to start the exam. I backed away and said I had a few questions. She stopped, answer quickly and moved to start the exam again. I backed away and asked another question. And basically that's how the rest of the conversation went. I'd ask one question, she'd answer while moving in to start the exam, I'd move away and ask another questions, she'd answer while moving in, I'd ask while moving away. A lovely dance. I wanted to say, "Would you mind sitting down and having an actual conversation with me?" But I"m pretty sure she'd refuse. Just like she refused to let me contact her by email. Yeah, we'll get to that. We're pretty close though, you can tell that by the photo.

So here's what I learned. She does review my file. "They" email her updates when necessary. The Friday that I had the really bad hives outbreak was a bit of an anomaly in their office--two doctors were in India, she was in Switzerland and the nurse practitioner was in Pasadena covering for one of the traveling doctors. This information was only divuleged by her when I mentioned that we knew she was in Switzerland and that the nurse practitioner was in Pasadena and it was obvious the nurse had no other doctor to talk to. The conversation went like this:

Dr.: "These side effects are very common and the nurses know how to deal with them. We deal with this stuff all the time. " moves toward me with stethoscope....

Me: leaning back, "it's not common to me. And I don't deal with it all the time. And your nurse sounded like she was guessing."

Dr.: "Well we like to have you come in so we can see what we're dealing with." (moves toward me with stethoscope....)

Me: (ducking stethoscope) "I offered to drive in. It's not like I was going to work looking like that, so my calendar had been cleared. But then your nurse said the nurse practitioner was in Pasadena. And we know you were in Switzerland. And it was obvious there was no other doctor in the Rancho Cucamonga faciltiy because the nurse was having to wait for return phone calls from Pasadena. Obviously there wasn't anyone for me to come see."

Dr. "Well there's always the emergency room, but that's not a good choice." (moves toward me with stethoscope....)
Me: (bobbing and weaving) "No, it's a terrible choice. I'd just like some assurance that somebody is overseeing my case and knows what to do about it. I feel like it's all the nurses."

Dr.:"Absolutely not. I know everything going on in your case. They call and they email me with all updates and changes. I know what's going on." (moves toward me with stethoscope....)

Me: "Can I reach you by email?"
Dr.: (drops stethoscope) "Absolutely not. I see way too many patients for that."
Me: "My surgeon didn't seem to have an issue with that."
Dr.: "Sure, he only sees you five times."

I didnt' say it, but god I wanted to point out that that's 3 more times than she's seen me!!!!!
In the end, here's what we accomplished...she switched me from the chemo that caused the allergic reactions to another one that is very close, will do the same thing, but we hope won't cause the reactions. If I have the reactions again we may re-evaluate whether to do the fourth or stop at 3 (and here she said "and just go with hormone therapy"; and I reminded her that my cancer isn't hormone receptive so that would not work. She agreed. Because, you know, she's reading my file.) She also gave me samples to try to control the indigestion/ acid-reflux. She also likes the baking soda remedy (the one my dad told me about...not anyone at the doctor's office). She suggested I take the anti-nausea/sedative medicine I already have when I'm having trouble sleeping. And then suggested something for the nightsweats too. So yeah, when cornered, she communicated and addressed medical issues. I however was exhausted. You think it's easy sitting on a table in a paper vest, dodging a stethoscope while cross-examining a fast talking doctor with wayyyyy too many patients? No. It isn't. But I do think at the end, she was paying more attention and there were efforts to be helpful. We'll see. All in all, I feel like I should have stayed with UCLA. But who knows how that would have gone either.

The actual chemo time was okay. I was already tired, and it took them awhile to get us a chair. We didn't get to a chair until after 11. And actually we ended up in the private suite--which is a hospital bed in a separate room. Sounds more comfortable and it was for the part where I was sleeping, but once I wanted to sit up and have lunch and do some reading and projects, not so comfortable. And Chris just had one little chair and no one to talk to when I slept (although he was willing to pose pointing out the lovely wig display in the suite. We don't know why it's there but it is. Along with a few hats hanging on the wall). I did take the sedative this time, and I'm back to the extra dosage of the steroid the night before and this morning, and they did load me up with Benadryl and Tagamet, so I had all sorts of things that added up to my just zonking out. For a couple hours. Unfortanately, they were doing the drip slowly (worried about the allergic reaction), so the nap didn't even get me halfway through. I had the same nurse as last time, so she wasn't taking any chances.

Chatty Cathy was there again and this time she was the one having reactions--neourpathy (which as I understood it was a tingling and numbness in your hands and feet; can't be good). We didn't see much of her though, since we were hidden in our private suite. The beanie babies are still giving their lives for the cause and the Easter decor was in full bloom. But the rest of the infusion rom was different--we didn't recognize anyone else (we saw Elizabeth and her mom in the waiting room, but the were just there for a quick check-up; mom is already in radiation and doing fine). And as Chris said "It's senior citizen day." And it pretty much was.

Then finally it was all over. No reactions. A little tired, and a little hungry (although nothing really sounded good), but not much worse for wear. Until they told me I had to come back at 11:30 on Friday for the Neulasta shot (the "bone pain" shot). It was 4pm last time--it's supposed to be 24 hours after the chemo. But they are closing their office at noon for Good Friday, so I guess to hell with the medical protocol, there are chocolate bunnies to buy! That also explains why the room was so crowded. Those who normally do Friday afternoon chemo had to come in on Thursday. They have too many patients. That's very obvious. And when you know you have too many patients, why do you close for an afternoon? It's chemo people. It's not flu shots and band-aids.

So yeah, I'm fighting through the chemo and the medical system. They both exhaust me equally. But, I have a nice long weekend ahead of me (save one trip to Rancho Cucamonga for a shot in the morning) and hopefully I'm adequately drugged up to avoid any side effects. If so, we're at Omakase for Easter Brunch. Chris's family is coming out to join us. I just hope Brein and Roryann remember to put cardboard cut out bunnies and eggs, and crepe paper, and pastel colors everywhere!! Oh, wait...I hate that stuff. It makes me feel like I'm at a doctor's office.


  1. For what it's worth, you only have to deal with the nonsense 1 more time....I think. What a wonderfully warm and cuddly doctor you have there. She looks like a real personable woman. How'd you ever get a smile out of her? Did Chris promise there was another necessary vacation in it for her if she treated you like a person rather than cattle? Hope your weekend goes well. Enjoy your Easter Brunch! Sounds like a good time! :o)

  2. FYI: Rory just leave my house....we dyed Easter Eggs for the brunch. But no paper bunnies were involved.


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