Monthly Archives: May 2013

The Radiation Oncologist

5/10/2013

Friday. Another day with yet another appointment.  My biggest meltdowns so far have been over the abundance of appointments.  There have been SO many.

Today’s appointment is just a consultation with Dr. Ilahi – the Radiation Oncologist who will administer what will hopefully the final phase of treatment, at the end of the year.  She is in the same practice as my oncologist, Dr. Perez, but she is in another office in another neighboring city.  It is MUCH bigger and MUCH busier than my small office nearby, but hey, I gotta do what I gotta do.

I was ushered to the back within a few minutes of arriving and checking in, and soon was waiting in an exam room with Harrison sitting in her stroller – NOT being quiet, by the way.  I finally got The Lorax rolling on Netflix on my phone (God I love technology), and soon she was quietly watching when the doctor came in.  After introductions were made, she began asking my history:  discovery of the lump, time frame of mammogram to surgery, when was chemo to start, etc.  She then asked about my PET scans and realized that while she and Dr. Perez had conferred over the phone on the day of my last appointment with HIM, she did not have the scan results right in front of her to refresh her memory.  She excused herself for a few minutes and went to print it out from my record, and returned to discuss.  Dr. Perez had not been too specific when he told me that the cancer had spread, but rather just told me that it was in several of the intramammary lymph nodes (that can’t be taken out) and that I would need radiation.  I appreciated that over the next several minutes, she took the time to explain that the PET scan results don’t specify how many nodes, but just whether or not it lights up on the scan in small or large amounts.  I guess on mine, it lit up in several nodes, in small amounts.  She also told me that it lit up in one node in my left collarbone area, in a tiny spot of an area.  What???  I know that this may not seem like a big deal to most, considering that it had spread, so what’s one more node, right?  Well, it was a big deal to ME.  I had a minor little freak out there, spouting off that Dr. Perez had failed to share with me the fact that it was up near my collarbone as well.  Dr. Ilahi was very understanding and told me that it should make me feel better that it was only a tiny spot in that location.  Yeah, great.  She then went on to explain to me that after I finish chemo, we will wait a couple of weeks, get me fitted for my radiation stuff, and then start 6 ½ weeks of daily (Monday through Friday) radiation treatments.  Um, what???  I know that THIS may not seem like a big deal to most, but it was a big deal to ME.  Dr. Perez had told me that it would be “about four weeks” of radiation at the end of chemo, but here I was, hearing that it would be 6 ½ weeks – 32 or so treatments.  I was already upset enough that I was having to even do radiation, and now I am hearing that it is longer than I was initially told.  I know that she, the radiation oncologist, ultimately made the call on the length of treatment and NOT Dr. Perez, I was still stunned to hear it.  Fortunately for me, Dr. Ilahi was very calming and reassuring, and somehow made me feel okay about venturing down the radiation road eventually, even if it DOES totally freak me out.  

She then asked if she could examine me, and she went over my scars and all of the edema that I have.  She was very personable, asking about my family and my life.  Once she was done and I was dressed again, she asked if I had any questions.  My last question was about staging.  I told her that after surgery, the surgeon had told me that I was officially a Stage 2b.  I knew that the discovery of cancer that had spread had surely changed my staging, but when I had asked Dr. Perez about it, I wasn’t really given a direct answer.  It seemed that nobody wanted to answer me, and while it may not be a big deal to some, for some reason, it was a big deal to ME.  She responded so sweetly, saying that no, she understood me wanting to know, and that this raises my stage to a 3.  OK.  That was all I wanted.  I had been afraid that it raised me to a stage 4, and that nobody had wanted to tell me.  It was actually a relief to hear that it was a 3!  I asked what that meant for my odds, and she said that with medicine and technology now, there was no reason for me NOT to beat this and live a long life.  Will I see her grow up, I asked, as I pointed to Harrison?  She smiled and said, “I don’t see why not.”  She then walked with us back up to the front, chatting in the hallway, and hugging me goodbye at the door.  I left feeling good, rather than scared of the next step, and super confident that I had been given the perfect match of a radiation oncologist for me.

Being good at my appointment absolutely wore her OUT
Being good at my appointment absolutely wore her OUT

And while that may not be a big deal to some, it was a super huge, big deal for ME.

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The PET Scan & Results

5/1/2013

It is Wednesday morning, May 1st.  I am scheduled to have a PET scan this morning.  Nothing to eat since midnight the night before.  They are going to see if the cancer has spread.

I arrive at Texas Oncology in Plano, which is HUGE compared to the office that I go to in Carrollton.  There were SO many people of all ages, and it made me very sad as I sat among them in the waiting area.  Cancer is absolutely a demon of a beast, and it is random, nor is it discriminate in whom it chooses to challenge.  Soon, a sweet tech by the name of James came out to get me, using humor to ease my anxiety.  I spent an hour in a quiet room, sipping clear contrast liquids and reading Facebook on my phone.  Then James gathered me up again and moved me into the room with the giant, intimidating scan machine.  He basically strapped me to the table, and explained that it would take a while, but he would be coming in to check on me several times.  While listening to all of the whirring noises of the massive machine, I tried to think about anything else – my wife, my babies, upcoming chemo, my friends, any plans that we have.  I almost thought that I might possibly be able to take a little nap, if I meditated myself into a relaxed enough state, but then James came in and said that I was all done.  Within minutes I was on my way out the door and in search of food, with promises that the results would be in Dr. Perez’s hands before my appointment two days later.  

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5/3/2013

It’s Friday now.  I have an appointment this afternoon with Dr. Perez, my Oncologist, to go over my PET scan results and plan for chemo.  Erikka leaves work early to meet me for lunch before my appointment, and then we are on our way over to the hospital.  We are taken back almost immediately, and put into a room to wait for the doc.  When he walks in, with papers in his hand, he shakes mine and asks how I am.  “Well,” I respond, “I guess that will depend on those test results in your hand.”  He laughs and gives me a warm grin and says, “We need to talk.”  Well SHIT.  That is NOT what I want to hear, obviously.  He sits down, Erikka reaches over and takes my hand, and tells me that the cancer has spread.  There are lymph nodes all over our bodies, as we all know; and under the chest wall in the middle of our chests are intramammary lymph nodes.  It is here that the PET scan lit up with spots of cancer cells.  Just before I was going to ask if that meant more surgery, for Dr. Garner to remove these lymph nodes as well, the doctor proceeded to explain that these lymph nodes are NOT usually removed in surgery, as they are difficult to reach.  Well SHIT.  So what does this mean?  He tells me that it means that they will need to add radiation on to my cancer-fighting regimen.  THIS is what makes me cry.  Having chemo didn’t make me cry, but radiation?  Now THAT was what upset me!  I was thrilled when I was told initially that I wouldn’t have to do radiation, so it was a huge disappointment that I was now going to be facing that as well.  But I have to see the good in the situation – there always has to be something good to focus on, right?  

Dr. Perez told me that it had NOT spread to any organs, or to my bones – a HUGE good.  He takes a moment and goes to call Dr. Ilahi – one of his colleagues who is the Radiation Oncologist that I will consult with regarding my radiation.  When he returns, he says that they consulted on my case, and they believe the best results would be to start chemo right away and do four weeks of radiation after chemo was finished.  I felt stupid that this made me cry, but it is what it is.  

A few minutes later, we were all done, with plans for chemo to begin on Monday, May 13th.  We were originally going to schedule the first treatment for Friday, May 10th, but decided against it so that I could have the weekend enjoying my family and Mother’s Day.  

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Cancer may be taking some things away from me, but it can’t take everything.  I’m not willing to let it have any more than it has already taken.  I can kick chemo AND radiation in the ass, no matter what.