I fool myself into thinking that I maintain a good relationship with my doctors. It is becoming clear that this is not as much the case as I would like to believe. My primary care doctor, Dr. M set it up for me to have the ultrasound and mammogram that I was due for at a local hospital on Tuesday of this week. I was beginning to feel a bit more secure about the situation and about changing surgeons; then I went to the appointment.
It was a very long and frustrating day. The radiologist refused to do the ultrasound of my left breast because the mammogram that she did of my right breast didn't indicate there was a problem. If you are scratching your head at that one, believe me I am too. This is the precise logic that she used...
"The films that we took don't indicate a problem, so I don't feel that an ultrasound is indicated at this time."
"But you didn't take any films of my left side."
"It's my understanding that you have reconstruction on the left side."
"Yes, and you haven't done anything to follow-up on that side."
"We don't do mammograms of TRAM reconstructions. It is made up of abdominal fat alone and there are no breast structures to image. "
"So, if you aren't going to do an ultrasound on the left side, how do you follow up?"
"If we see a problem on the films, we can do a targeted ultrasound of that area to find out if we need to do further tests. But there is nothing in the films to indicate that there is a problem"
"So, you'd have to see a problems on films that you didn't take?"
"Since the reconstruction is made up of abdominal fat there is nothing there to image. It wouldn't make sence to do a mammogram."
Who's on first....
I left, the pathetic films with me and called Dr. M's office. After being left on hold listening to the revolving commercial of all the services offered in the Emory Healthcare System for almost the entire day, Dr. M. finally decided that having her nurse or assistant relay canned messages to me was not what was needed in this situation. She got on the phone and apologised for misunderstanding what tests I was due for. She said that she would call the Breast Center and order the ultrasound and that I should go back there.
All I'm trying to find out is what's the guy's name on first base...
I went back, even though I didn't want to and didn't expect to be treated well by anyone there. I was right. They made me sit in the waiting room for an hour before the tech came out and said that the radiologist had spoken with Dr. M. and they had decided that she had all that she needed. There had been no check up on the left side; the side that had the cancer.
No. What is on second base...
I walked out in anger a second time. I called Dr. M's office back again and had to listen to the run through of wonderful health services and screenings available to me through the highly advanced Emory Healthcare System. Then her nurse got back on the phone to tell me that Dr. M. had left for the day and hadn't left any notes regarding the ultrasound on the left side. She'd have to schedule it for me for the following day.
I'm not asking you who's on second...
Did I miss something here? Was I being asked to go in for an appointment on a following day because the radiologist is refusing to follow my Dr.'s orders on the day that I'm there? Is a second day going to make her more logical?
Who's on first...
While we were talking Dr. M. came into the office and got on the phone. She said that she was just about to call me. (a little late I'd say) She'd talked to the radiologist and she agreed that since they hadn't seen anything in the films there was no need for an ultrasound.
One base at a time!
I explained (again) that there hadn't been any films taken of the left and that without an ultrasound there was no follow-up.
Well, don't change the players around...
She said that since I'd had a mastectomy there was no chance that the cancer would return on that side. If the cancer returned it would be either in the other breast or metastisize to a distant site. There was no need to do any follow up on the affected side because the cancer had been removed. It was gone and it wasn't going to come back.
I'm not changing nobody!
I told her that this was not what I'd heard up to this point, and was exactly the opposite. I was told that since it was impossible to remove every cell even with a mastectomy, I'd need to be followed to make sure the cancer hadn't returned along the edges of the TRAM, in the scar or on the chest wall. I'd need to have an ultrasound every three to six months.
Take it easy, buddy...
Her answer to that was that I should arrange to have the ultrasound done if I felt it was necessary, and that I should make an appointment to see my original surgeon in August.
I'm only asking you, who's the guy on first base?
Everyone that I've talked to about it, including my medical oncologist, is aghast that she'd say that and has said that I sould change doctors. I'm inclined to agree. The possibilites are slim here. Either she really believes that, and that is a scary thought, or she was saying that just to get me out of her hair. That actually is more disturbing. Still, I'm hoping that there is another answer... actually writing it out, the answer is clear to me.
I'm going to have to change doctors again, aren't I?
Anyone have any suggestions how I go about finding a good primary care doctor?
Tuesday, May 15, 2007
I have the doctor appointments coming up again. I'd managed somehow to pile them all into one day. It worked out well for me; I only needed to take one day off and not annoy the hell out of my co-workers with weeks of in and out of the office behaviors. Also all my stress over the appointments could focus on that day and then be over... Well, no such luck. I don't know what made me think that I'd get away with such a convenient plan. The scheduler from my surgeons office called yesterday... they were cancelling my appointment. The doctor is "adjusting" her schedule. I could make an appointment for three weeks from now with her PA to get the ultrasound and mammogram that I'm due for and then she can see me in August. WAIT JUST ONE MINUTE THERE! Thank you for consulting me about the impact this will have on my life. Honestly, do they think that we all have nothing else going on ever? We just disappear and re-appear at their becon call? Do they not realize that to make an appointment we have to take time off from work to do it? And then...well our last visit with each other didn't turn out so well. The doctor did the biopsy and sent it to the wrong lab. The PA told me "don't call us, we'll call you" when I called for the results and then yelled at me for calling days later when they hadn't called. The doctor never called me back as requested to discuss the pathology report. I was being nice about it and decided that I could discuss it with her at Monday's appointment. I guess not. I refused to make another appointment. I called my primary care doctor and requested that they make a referral to another surgeon to get the mammogram and ultrasound that I need, and to continue care with. I have been tied in knots...I want to cry. The reservationist at my primary care doctor's office called this morning to let me know that Dr. Morgan would be working on the referral and appointments today. Still I feel as if I have been thrown to the wind. First appointment with this new doctor I guess I should ask what their procedure is on relaying the results of tests and how often the cancel scheduled appointments.
Wednesday, May 9, 2007
I'm not sure what it is about the month of May, but I am suddenly participating in a lot of events to benefit Cancer causes. Last weekend was the Relay for Life, which was kind of a last minute one for me. Lizzie came home one day having raised about $50 asking people at school for their spare change and said that she'd signed us up to walk in the event that her school was hosting. I kind of reluctantly agreed because she'd already raised the money, but I'm glad that I went. It was fun...and they fed me a lot of really good barbeque. I'll probably be on the lookout for it next year and actually do some fund raising for it myself. This next weekend Lizzie and I are signed up to do The Race for the Cure and The Walk to Empower. Both causes benefit Breast Cancer organizations. None of the walks are very far. Being a survivor I have the choice to walk in either the 1 mile survivor walks or the 5k events. It kind of pales when I consider that last year at this time I was pushing myself to walk 10 miles on weekends. The sad truth is that I haven't really pushed myself very hard to be active lately and it's beginning to show. I have been making some changes lately in my diet and my habits and I'd hoped that the results of those changes would mean that I'd lose a few pounds. That didn't happen, in fact pretty much the opposite has occurred. So this morning I made the decision that I'm going to have to make a few more adjustments. The first is that while I have grown to love the cheap Gatoraide that is available at QT, drinking 54+ ounces of it a day is a bit too much. Besides, fresh cut lemons and ice water are freely available where I work and I can drink it without adding a bunch of calories...now I have to convince myself that I like it as much as the gatoraide. The other change will cost me a bit more in terms of my time. Pilates and Yoga classes are offered through the Wellness Community that is close to where I work and at a convenient time...if I move another meeting to the morning. It means that I will have to wake up an hour earlier two days a week to get there. The fad magazines all tell me that I only need to make little changes to see a big difference. I hope that the differences that I see don't have anything to do with seeing a bigger me.......