Monday, February 8, 2010

The Verdict on a New Doctor

Things that are helpful... actually writing a post before I publish it...

So, after weeks of anxiety, mental exercises, and kicking myself for not going to the doctor sooner, the day of the appointment came and went. I was planning on posting something about my anxiousness before now... but by the time to do it came around I had so much going through my head I frankly didn't care about the endocrinologist any more (after 5 years, I have finally learned how to spell endocrinologist). And things couldn't have gone much better than they did.

I went into this appointment, not really praying for some good, or even using positive thinking... it was more the mentality of this has to go well, there is no other option. Rather than spend the day studying beforehand, I spent my day trekking up and down virginia beach and norfolk hunting down eye doctors and dentists and others to fill out my peace corps paperwork. I figured, why not do multiple things that bring me stress and anxiety all at the same time, and just get it over with. It helped. I was pretty pumped by the time I had to go in.

I got there 45 minutes early... as one of the local high schools was letting out, passed the building, and went to turn around on this back road where apparently all the high schoolers park. You ever want to feel real fear when you are driving, drive down a small road of a parallel parked teenagers trying to get out of school. By sheer luck, the end of this road actually went into the building I needed to go to, so I didn't have to attempt to turn around. As I pulled up there was a very angry man standing in the parking lot, pointing me back to the road. Yelling out, "this isn't a road, this is private property can't you kids read the sign." I had just been mistaken for a highschooler. My shocked response was, "I'm not a highschooler"... his response back, "It doesn't matter this still isn't a road."... "But I'm a patient"... "Oh... these people just cut through here all the time real fast, its dangerous"... He didn't apologize, but I think the sheer embarrassment of yelling at a patient trying to park was enough.

First impressions of the office: I hit the restroom before I went in. It was trendy. After the sterile environment of UPMC... being somewhere trendy was amusing. The walls were done in shimmery tiles, and the sink was a bowl sink... where there's a bowl... that has a drain in it... like i said trendy. I couldn't help but acknowledge this appointment may in fact cost more than I realized. I also picked a doctor in the wealthier part of Va beach, which may have hit on the trendiness. The waiting room was a fantastic deep turquois, and again, shimmery tiles. Probably the most calming waiting room ever.

The doctor: Mellow. Probably in his 40's/50's. As is per usual, he hadn't read through my file earlier. But we sat through it together. He was impressed with my care up till now, and agreed with everything done. Chastised me a little for not coming in sooner, and apologized for the wait. Then to kick off the actual exam, he took me back and ultra sounded my neck right there in the office. No waiting, no prep time, no radiology technician or student. Just him. Honestly, I wasn't mentally prepared to do an ultrasound right off the bat. It really is my least favorite thing to do, and I panic a bit. But he went hrough, and as he finished a section told me what he saw, and when my head was towards the machine, watching him measure nodes, he pointed out that it was benign and the middle bit I saw was just some fatty deposit. And then he cleaned me up like a baby, and told me everything looked clear, even my thyroid bed, which is what they had concerns about a year ago.

The plan: So we developed a new plan of action, pending blood work. Basically, he pointed out that the last round of radiation was based on a slightly elevated Tg level, and something that showed up on a pet/ct, but not on a RAI scan. So technically, they never really confirmed there was in fact cancer there. And now he didn't see anything on the ultra sound, so pending the blood work, things there's a possibility that I could have been cancer free for a while now, or at least everything slowly disappearing. He pointed out that the Tg could have just been some lingering thyroid cells, that weren't actually cancerous, but w/o biopsy no one would ever know. He still agreed w/ the course of treatment I was given b/c of how unusually aggressive my thyca was (he even broke that down to say i'm probably in a bout a 5-10% group w/ papillary thyca that aggressive). But he doesn't think a thyrogen stimulated round of blood work would be particularly helpful now, and maybe my body's been run through the gambit enough over the last 5 years. Needless to say, i'm cautiously happy about his opinion.

Blood Work: Our only point of contention was here, and it was only minor. I asked him if he tested free T3, and he said not normally, and asked me if I wanted it tested. I told him I did, and he let me know it wouldn't change his course of treatment, but he was willing to do it. This is also the point that actually impressed me. He asked if I've ever had a CBC work up, which I haven't, and he was like, "I want to run this because of how much radiation you've had." Shock and Awe! He wants to follow-up to make sure the radiation hasn't damaged my blood. I also told him to throw in my vitamin D levels for good measure.

Follow-up and the peace corps: I told him about the peace corps and gave him the paper work at the start of the visit and he never blinked an eye... except to ask me w/ my education if I would be getting a bit higher of a position. When talking about when my next visit would be, we planned for 6 months, so he could see me before I shipped out. It was like it never even occurred to him that the whole cancer thing might be an issue, and be part of the reason that I was sort of twitchy and anxious during the whole visit. So finally, I asked, do you think this should be an issue? And he just looked at me, sort of surprised, and was like, "no, why should it? Get blood work done once or twice a year. Do you have a plan for getting it done already? Both morocco and jordan have decent medical facilities that should be able to look at your TSH, T4 and Tg... be great if i could see you once a year, and there's always Dubai." My response was, "you should write that down on the paperwork... the peace corps needs to send me to Dubai once or twice a year for blood work." And that was that. A doctor told me that I should be fine, and even though he didn't really know me, it sounded like I would do well.

And that was it. 2 hours of my life w/ a new doctor, and the rules of the game have suddenly changed, and things are looking better than they have in a long time.

And a final story, while the nurse was taking my blood pressure, she was reading my wristbands, and was, like, "stupid what?"... "stupid cancer"... she looked a little closer at the wrist band, saw it was flipping her off, and just started cracking up.

So this is my "Fuck you cancer, you can kiss my ass, I'm getting my life back," moment.

1 comment:

Kauline said...

this was a great post for me. It's inspired me to ask for a few specific levels to be test at my next work up. I need to add you to my thyca blogroll, you have lots of great info

Cheers from another thyca fighter!