Tag Archive | oncologist

Check and Double Check

The trip to Philadelphia was for my 6-month check up. I had four appointments in all: 2 ultrasounds, 2 doctors. I’m grateful for my hubby, who sat in the lobby watching Star Wars movies on his iPad, since he was not allowed in with me to any appointments. He refuses to let me go alone, and he insists on doing all the driving.

My first appointment was for a repeat thyroid ultrasound. This is the third one I had. The first two were done locally but the PennMed docs reviewing those reports and films did not think they were done well, and there was no recommendation action in the report. Since I will be going to Penn every six months anyway, it made sense to just have them re-do it. It was certainly a much more thorough ultrasound, but my developed test anxiety had me nervous. The amount of time the doctor spent doing the test made me start to panic a bit, since my default assumption is always that something is wrong. I waited the longest (about a week) for these results. Everything was stable, but they did want me to start seeing an endocrinologist. I have an TeleMed appointment with a Penn doctor at the end of March. Part of me just wanted to find a local doctor for ease of visits, but the quality of care at Penn can’t be beat, so… Penn it is. For those of you wondering why thyroid… This was an “incidental finding” from a prior CT scan that they are required to follow up on.

Appointment number two was a chest ultrasound to continue monitoring the “lump” that we all believe to be a “surgical remnant” but want to monitor to be safe. Everything was stable/same, so that’s good.

Before my doctors’ appointments, I had my vitals taken and my meds/history reviewed. Apparently, my heart rate was higher than normal. I didn’t realize this until I got into my third appointment was with my oncologist. She said, “oh, I see you were tachycardic…” Really? Heart rate was 103. I have to believe it was an error or typo or something. I didn’t feel like my heart was racing or anything like that, so I’m not really worried. But hearing the word “tachycardic” was surprising.

Everything went well. She was happy with how I was doing, that I’m continuing to exercise, that I got my first covid shot (at her recommendation), and that my side effects from the meds were all manageable.

My last appointment was with my surgeon, who I haven’t seen in a year, due to the pandemic. She finally got to check out said “lump” and her thoughts are that it’s a suture. It isn’t the size, shape, etc. of a surgical clip, per her assessment, and it’s just something we’ll watch to be on the safe side.

I love all of my Penn doctors. They always spend a good amount of time with me, and they seem interested in me as a person. Am I still exercising every day? Am I still writing? How is that grandson of yours? I think it’s important to feel a connection with your physicians and I feel so comfortable and confident every time I go there. I could conceivably stop seeing them and stay local only, but I just feel so much better going there (in addition to my local doctors). I am getting checked and double checked.

I will return in August for a repeat of all the same appointments.

IMDb: Check and Double Check (1930)

Unleashed

Around this time five years ago, I winding down on my treatments. I had completed chemotherapy in January 2013 and finished radiation in March 2013. Since that time, I have continued with a pretty rigorous schedule of doctors’ appointments. Seeing my radiologist and oncologist twice a year; my surgeon, urologist, and gynecologist once a year or more.  Throw in all the testing that was required and I felt like I was always on my way to some medical appointment.

During my last appointment with my surgeon in 2017, he gave me the option to not see him anymore — an offer I jumped on.  In the fall, my radiologist switched me to one time per year. And today, my oncologist also unleashed me from her schedule, moving me to a once a year schedule also!  Yea!

I am so encouraged by this news, as it’s a final confirmation that I’m doing ok. Actually, better than ok… I’m thriving! Cancer is no longer a daily thought for me (although it does rear it’s ugly head in my subconscious from time to time). And now I don’t have to worry about always running to a doctor.  Schedule is freed up, I’m saving money in co-payments, and I have a clean bill of health from all my docs. AND my oncologist is interested in learning more about my health coaching business! (She took my business card and talked about how I might be able to integrate into some of their existing programs!)

Life is good.

*****

It’s been a while since I’ve shared any recipes. I continue to add recipes to my new webpage: http://metamorphosismindbodyspirit.com/apps/recipe/

Last week I added several, and the goal is to add some every week.

I am continuing to work my way through Dr. Greger’s How Not to Die Cookbook, which I love! I highly recommend it, as we have enjoyed everything I made from the book. It’s completely “WFPBNO”… Whole Food Plant Based No Oil… so no modifications are needed.

Peace!

IMDb: Unleashed (2005)

Are You Listening?

Another frustrating six-month check up at the oncologist… She’s like Dr. Jekyll and Mr. Hyde, and I can never quite guess which will show up with each visit.  I should have know which would arrive today, when she showed up at 8:55 for a 7:50 appointment. I mean, who is that far off schedule at that time of the day? So, of course, she’s rushed and I have to wonder how well she is listening to me.  I hate that everyone in this office faces the computer and types while trying to ask you questions. Can you possibly be listening to me when you are typing a hundred words a minute?  I tend to go to silence to make them turn around once in a while.

When she asks how I’m feeling, I launch into a story about how I’ve been sick with this sinus thing for about 5 days, but am starting to feel better.  I tell her how my husband has been sick for two weeks and he even took an antibiotic. “No antibiotic for me”, I brag, explaining how I’ve been trying to fight it off with natural remedies. But the sinus thing seems to have messed up my lymphatic system so I do have a flare up of my lymphodema.

She turns around and says “I think you should do a week of antibiotics.”  No joke.

Blank stare.

I couldn’t even bring myself to ask if she listened to a word I just said. I mean, she was busy typing and all. So I just continued to look at her quizzically.

Finally, she got the hint and came up with a plan I liked better.  Continue the lymphatic massage (which was helping) and if my lymphodema condition worsens (fever, redness, area warm to the touch), then I can call for an antibiotic.  I’ll take what’s behind curtain number two, doc. (I’ve also been applying lemon essential oils, but I didn’t tell her that.  It’s not like she would listen or understand.)

The only other suggestion from her was to ask my GYN to have my hormone levels checked because I’m using the Estriol cream. First, you think she would have mentioned that last time we talked about this. Second, I do get my hormone levels checked… by my naturalist.  I didn’t think she’d listen to that, so I didn’t tell her. But seriously, she fried my ovaries… I don’t think getting too much Estriol is going to be a problem when taking the prescribed dosage.

An hour and a half after arrival, I learned all is well.  Blood work is good and blood pressure cruising at  104/52. I’m grateful, as always, for the good news. I do realize I sounded a little “Mr. Hyde” myself, but is it too much to ask that our doctors listen to us?

IMDb: Are You Listening? (1932)

Day of the Flowers

I got to go to the local farmers’ market at lunch today (Thanks, Chris!). Even though I went grocery shopping yesterday, I couldn’t help making a few purchases: leaf lettuce, red beets, corn on the cob, a loaf of bread and some olive rolls, and zucchini flowers. I was most excited about the latter purchase!

I grew up enjoying “pumpkin flowers”. My mother always made those, dipped in egg and flour, and, of course, fried. They were delicious and I looked forward to those delicacies for the brief time we got to enjoy them every summer. I was so glad that Chris pointed them out at the market. I bought a dozen. I made a light batter with water and flour and bit of egg. And then, yes, I fried them. I imagine there are other ways to cook them, but I wanted them to taste the way my mom used to make them. I think she would have enjoyed them.  I know Ethan and I did!

*****

By the way, I am still waiting for my oncologist’s office to call me with my tumor marker results. I called and left a message on Friday but no one called me back yet. *sigh* I suppose no news is good news, but I’d like to know for certain.

*****

New recipes:

FOK Broccoli Rice Casserole with FOK “No Cheese” Cheese Sauce. These were both easy to make but I made them even easier by a) using my Instant Pot to cook the rice, and b) steaming the broccoli in the microwave. The cheese sauce was easily whipped up in the food processor. We devoured a 13×9″ pan of the stuff, with a teensy bit left over for lunch today.

Spinach Artichoke Wonderpot was another easy and yummy one-pot pasta dish. I think it was a bit too much like something I made last week. Since I love spinach & artichoke dip, I think I was hoping for a bit more of a tang.

*****

IMDb: Day of the Flowers (2013)

 

Mushrooms

I had sort of forgotten that I had a follow up with my oncologist today (well, with the physician’s assistant). Normally, I worry about these things ahead of time, but this time I didn’t think much of it. I guess that’s a good thing, but I don’t want to get too complacent. Or too comfortable that I’m doing well. Of course, I don’t want to live like I’m always waiting for the other shoe to drop either. I guess there’s a happy medium in there somewhere!

At any rate, I had my labs done. All of my blood work was perfect (again! yea!) and I need to wait a few days for the tumor marker results. Stay tuned for those.

I have to say that it wasn’t much of an exam. It was a PA I hadn’t mebefore and I was surprised that she did not do an exam of my chest wall or arm pits (lymph nodes). I’m not concerned because I just had this done by both my surgeon and my gynecologist in the past few months, but I still would have expected her to do this. She certainly wasn’t as thorough as some of the PAs, and if I hadn’t had it done recently, I would have definitely said something.

She did seem surprised that a) my labs were perfect, b) my blood pressure was an awesome 100/76, and c) I wasn’t taking any prescription meds. (In fact, I only disclosed that I take a B complex and vitamin D3. I figure none of them will have any idea what I’m talking about with my other supplements, so there’s no need to disclose.)

*****

Tonight’s new recipe: Forks Over Knives’ Mushroom Stroganoff. A friend of mine just bought the FOK – The Cookbook: Over 300 Recipes for Plant-Based Eating All Through the Year.  (Yes, a long title, but a good cookbook!) I found a bunch of recipes I liked and I knew this stroganoff would be a hit. Ethan loves mushrooms!  And so I can say it was totally a hit. Everyone loved it and there was not a drop remaining. I even made it with whole wheat pasta (instead of the usual multi-grain) and it was amazing. I have to admit that it was not 100% vegan. Since I don’t use soy, I replaced the tofu sour cream with regular sour cream. Considering 8 ounces go into the whole dish, I’m ok with the little bit of dairy I did consume. I highly recommend this one, and it will certainly become a go-to recipe for us.

*****

IMDb: Mushrooms (2011)

 

 

Alien

Alert!  An alien has kidnapped my oncologist, assumed her image, and is treating patients on planet Earth!  I have no other explanation for the super pleasant encounter with this being at my follow up appointment today!

As you know, I have been most fearful of today’s appointment and my big confession about stopping the Femara.  I lost sleep over this over the past few weeks, as I replayed a possible confrontation over and over in my mind.  Based on our last Femara conversation (as well as a few others), I had reason to be nervous.  So I put my big girl panties on this morning and was prepared for a duel.

It didn’t help that she was her usual, fashionable 80 minutes late.  I paced in the examination room, preparing my arguments for the expected attack.  But it never came (I think I may actually be a little disappointed!).  Yes, she arrived late, but she was all sunshine and rainbows.  We had some casual conversation, and then she asked “so what’s new?”

I had my opening and with great confidence said “well, I need to tell you that I stopped taking the Femara.”  There!  It was out.  I waited for the scolding.  I waited for the lecture on why I needed to take it.  (Remember, I was told I had “no options” back in July.)  Instead, only a question:  “when did you stop?”  I explained that I stopped back in October, that my quality of life was impacted, that the joint pain was unbearable.  I told her about Best Doctors, and talking to my radiologist, and all the other things I was doing to stay healthy.  I explained that giving up my quality of life for a 5-10% improvement wasn’t worth it.

She asked if I wanted to try something else, or if I was done.  “I’m done.” She explained that there is some benefit to taking it, but agreed with the numbers I provided and said that it wasn’t for everybody.  That was it!  Whew!  What a relief.

In other news from today’s visit:

  • BP 108/70
  • Blood counts all normal
  • Chemistry results were all perfect (For those who think that you don’t get enough protein as a vegetarian, I should note that my protein was 7.7 within a normal range of 6.0-8.3.)
  • I don’t have to go back for SIX months!  (It feels a little like graduating from school!)
  • Physical exam was all good.
  • She said she needed to get my results from last year’s pap, as well as my colonoscopy, but I already know those were good, so no worries there.  She was happy to hear that I see the dermatologist annually to have my skin checked.
  • Tumor marker results are due back tomorrow, so I still have to hold my breath on that one. While I’m optimistic that the results are good, I’ve learned over the years that nothing is a sure bet.  (Not even difficult doctors.)

*****

Alien (1979) – http://www.imdb.com/title/tt0078748/

Relax

I finally got around to calling the spa at the Flamingo Resort to book my massage!  I opted for a “classic Swedish” massage and was surprised to hear I had a choice of 50 minutes or 80 minutes!!  In a moment of weakness, I, of course, signed up for the 80 minutes.  🙂  I can’t wait for the trip (have I mentioned that lately?).  I haven’t had a massage in quite a long time — not since my breast cancer diagnosis.  During treatment, with a compromised immune system, it didn’t make sense to risk it.  Following treatment, I was contending with all the joint pain from the Femara.  I just didn’t think I could tolerate it.

So now that the Femara is long gone, along with all the pain, it’s time to indulge and relax.

Speaking of the Femara, Wednesday is my next follow up appointment with my oncologist.  And it’s time to come clean… as in I need to let her know that I stopped taking the Femara.  She doesn’t know, and she won’t be happy.  I’m actually a little scared!  (She’s tough!)  I keep anticipating how that conversation will go and am trying to prepare a response.  She tends to put me on the defensive right away, with her wonderful communication style.  I’m trying to prepare myself so I don’t react badly…but she tends to bring out the worst in me.  Gotta love that in a doctor!

*****

Relax (2005) – http://www.imdb.com/title/tt3395128/

“Soy”lent Green

Let’s face it, soy is very controversial.   Consider first that most of soy (90-98%, depending on what source you reference) is genetically modified.  Consider, too, that this GMO bean, or some semblance of it, is hidden in tons of processed foods, not unlike HFCS.  Many people have soy allergies, and tofu gets a bad rap.

But for so-called “breast cancer survivors”, soy rages even more of a debate.

When I first told my oncologist that I see a naturalist and take a variety of supplements, she paused for a moment and then said “that’s fine, just stay away from soy”.  Soy has phytoestrogens which make some people very nervous, particularly if you have (had) an estrogen receptive tumor.  After all, as part of breast cancer treatment for hormone receptive tumors, women are placed on one of several drugs of choice:  Tamoxifen, Arimidex, Femara, etc.  These drugs are intended to reduce estrogen and block it from being consumed by any rogue cancer cells.

But soy is a plant.  Phytoestrogens aren’t quite the same as the “bad” estrogens, aka xenoestrogens, that you might consume through pharmaceuticals (i.e., birth control pills), plastics, perfume, and a host of other environmental sources.  So it begs the question, is soy really bad for you, since it comes from a plant?  Is it really bad for breast cancer?

I was having a conversation on soy with a coworker this morning as we traveled to another office for meetings.  Ironically, when I checked my personal emails, Kris Carr featured this very topic, including a guest blog titled “Hey, Soy — Let’s Be Breast Friends Again!”  I found this guest blog to be quite thought provoking and wanted to share it.  The link to Kris Carr’s blog is also below.

http://kriscarr.com/blog/are-soy-foods-healthy/

If you search “soy myths”, there are numerous articles on this very topic if you want to read more.

So, to my fellow breast cancer warriors… to soy or not to soy?

Dad

I am happy to report mostly good news from dad’s appointment with the radiologist today.  A summary of the visit:

  • Actual type of cancer is salivary gland cancer (which has a strong likelihood of being the result of chewing tobacco for most of his life… so those of you who chew, STOP!)
  • He has a “garden variety” poorly differentiated carcinoma.
  • The PET scan results showed no evidence of cancer anywhere else!  (whew!)
  • Based on the PET scan, and a physcial exam, no additional surgery is recommended.
  • Radiation is a “must” and it is recommended that he get an oncology consult.  Chemo may or may not be recommended.  The radiologist referred him to the best oncologist around, a brilliant man who he knows will give proper consideration to the situation.
  • There are two reasons that he MAY need chemo:
    1) Positive surgical margins.  As it was explained to us, for something like breast cancer, if there were positive margins, you would go do surgery again.  But with head and neck cancers, you typically don’t do that because of the collateral damage, so chemo should be considered.
    2) Perineural invasion.  This refers to cancer spreading to the space surrounding a nerve.  Per Wikipedi, it is common in head and neck cancer, prostate cancer and colorectal cancer.
    Based on these factors, the radiologist indicated that there is good data to believe that chemotherapy will be beneficial, but he will defer to the medical oncologist.
  • Radiation will be for 6 1/2 weeks and side effects, because of the location will likely include fatigue, skin sensitivity, mouth sores, and dry mouth.  Keeping hydrated will be critical.
  • If chemo is suggested, both chemo and radiation would happen concurrently.

I was quite relieved to hear that the cancer had not spread to lymph nodes or anywhere else.  It seems this is a slow growing cancer, so that’s also good news.  Potentially having to go through chemo was not welcome news, but Dad seems to be taking it pretty well.  (Mom, of course, will worry for all of us, as is her nature!)  🙂