About that second opinion...

Yesterday, I had my first appointment with my oncologist since the surgery.  It had been awhile since I had been in that building!  As I've said before, I really like this doc...he's personable, to the point, compassionate, etc.  Pretty much everything I think you could ask for in an oncologist.  And, as I learned today, he's also humble.

The appointment went well, he was pleased with the cosmetic/reconstructive efforts (slightly weird to have the guy say "its going to look really good" about my boobs...), but admitted to being fairly disappointed in the pathology results from the surgery that indicated presence of cancer in the lymph nodes (12/26....over 10 is a bit of a cutoff).  As he explained, while people think chemo is the "big gun", in my case, since the tumor is so estrogen-receptor positive (>95%), the hormone therapy (oral pills to block these receptors) following chemo+surgery is actually the "big gun". 

I asked him if we needed to do any more scans, to "look" for any other metastases/tumor deposits in the rest of my body, but given I don't have any symptoms, was on chemo, had the surgery, etc. he didn't think that was necessary.  He talked a little bit about how many patients feel a bit of separation anxiety at this point, since my next appointment with him would be 4 months later, after making such frequent visits.  Again, I like this guy!

I left the office feeling like things were ok, and despite my high residual burden of disease we were doing what we could.

This morning I got a voicemail to call the doc's cell phone because he wanted to talk to me.  Yikes.  That was my initial thought.

I called, and he very nicely said how he was thinking about me a lot after I left.  He felt like he needed to do some additional research on my type of a case (premenopausal, estrogen positive, lots of residual disease, neoadjuvant chemo, etc).  In doing, he decided to call a colleague at Indiana University who specializes in breast oncology to discuss the case and an alternative approach he had found (an additional drug) that had been shown a few months back to reduce recurrence rates by ~16%.  In their conversation, she brought up a clinical trial that I would qualify for that uses a different drug (IBRANCE, recently got FDA approval for use in postmenopausal women). 

After describing all of this he basically said, "what I'm trying to tell you is that I want you to go see her [the IU doc]".  So, I'm going to.  His office put the referral in and I'm waiting for the IU folks to call and schedule an appointment.  It's about a 2.5 hour drive, so not the most convenient , but she's now familiar with the case, is doing this trial, etc. 

I really respect him personally and professionally for: 1) doing the research to investigate the most current approach; 2) asking for a second professional opinion; and 3) making the referral because he thinks it might help.  If anyone has questioned the quality of care I'm getting here in Dayton, I would hope this convinces you otherwise. 

It was sort of a lot to go through this, then have 2 student meetings, call Mom and debrief, teach, etc.  In the afternoon I had my second fill of the tissue expander (still pain free!) and an appointment at the OT where I learned some stretches to continue to help increase my range of motion. 

When I got home, I found my new spiffy arm sleeve in my mailbox:

Ready to fly!

 

And then I emotionally ate.  Mostly real food (lasagna and mashed potatoes) and only some sweets (girl scout cookies).  At least I tracked it all, as I have been doing with my food intake (really the only way I'm ever successful at weight loss).  Sorry Mom, I know we made a pact to exercise rather than eat the stress but didn't happen tonight.

 

I'm not sure if I was just feeling overwhelmed with the prospect of a trip to Indiana, fitting that in with an already pretty packed March (Mom's next week, friend visiting, big conference at end of month, lots of student projects, etc), or just the reminder that I have freaking advanced stage cancer.  Honestly, I forget sometimes.  Sure, I take my shirts off differently, am nippleless on one side, fill out all my clothes, have doctor's appointments all the time, but really, I don't feel sick.  So sometimes I think I just remember what's actually happening and it can be a little overwhelming.  But, I'm okay with that.  So apparently the new depression drugs are working, because I'm not downward spiraling into the self-hate oblivion.  Hooray pharmaceuticals. 

Other than the not-really-news news, nothing much has happened in the past week or so.  Work is busy, I've been good about getting to the gym (walking, but working out!) and the weather, like everywhere else, kinda sucks.  I'm working at Runners Plus tomorrow and Saturday for the big 50% clearance sale.  Then it's three days, mostly midterms, and then to Phoenix.  I cannot wait.