Doctor appointment today

So here's the short of it,
I had an appointment with my medical oncologist today.

And here's the long

I saw Dr. Schlabach today for my "next step" appointment. I had lots of questions, and I got lots of answers.  One more time, I feel so fortunate that we saw Janet Kramer-Mai that day after Dad had his surgery.  She knew Alan from his work on the Baroness Foundation Board and I think she could tell that I was having troubles that were more to do with comfort level than the illness itself.  She made a quick phone call and I was able to see Dr. Schlabach the next morning and within five minutes he had made me feel as though I could get through this.  He actually made me feel like he would be with me every step of the way.  


Today's appointment made me realize how grateful I am that I ended up under his care.  


So here's the gist of the appointment:


Neuropathy - I'm to stay on the Elavil for awhile. Apparently this is another one of those opportunities I've been given to become better acquainted with patience.  Nerve damage can take a long time to heal - apparently there can be nerve recovery for a year or more.  Some people do have permanent neuropathy.  My fingers are much better, and that makes me hopeful that my feet will continue to improve as well. 


Soy Products -  I've read and been told that I shouldn't eat soy because I've had breast cancer.  Since my tumor was estrogen positive, I am to be careful about ingesting all phytoestrogens.  Dr. Schlabach did tell me that I could have these foods once in awhile, but not to make them an everyday part of my diet.  


Herceptin Side Effects - Apparently the only real big side effect with Herceptin is the possibility of heart damage.  If heart damage occurs, they stop the Herceptin and the heart almost always returns to normal.  I asked what symptoms I should be aware of and it would appear as shortness of breath.  They'll also monitor my heart with a scan every three months. 


Coumadin -  It seems that I'll need to stay on the Coumadin for five or six months.  Several people were really concerned that I was eating greens and so I looked that up. Dr. Schlabach told me not to worry that since they are monitoring my PT/INR that they'll know if I'm out of whack.  It was really funny when he told me to eat healthy foods and not to obsess about greens.  I'm also cleared to continue taking my ginko supplement.  I've had benign positional vertigo for several years now and if I take a ginko supplement every day it doesn't bother me.  Once in awhile I'll think I can do without it and sure enough it comes right back when I stop.  So I'm really glad that ginko won't be problematic with coumadin. 


Stiffness and fatigue - A friend suggested that I see if I could get some weeks of physical therapy to help me get myself going again.  Dr. Schlabach's answer to that was that it would be much more beneficial for me to enroll in a structured exercise program.  I thought that was funny.  Of course that would be beneficial!  I should do that.  


Mammogram Schedule - I've been wondering what kind of follow up I should do - so I'm to have a mammogram again in May.  That will be a year since my surgery.  


Tumor Marker - I've heard people talk about tumor markers, so I asked if they'll be checking me using that.  They won't make that decision until after all my treatments are finished.  Apparently the reliability of tumor markers for my type of cancer may not be as reliable as with some other cancers. 

Arimidex - The next step in the treatment protocol now that radiation is over is to begin an estrogen blocker.  My tumor, in addition to being Her2 neu, was also Estrogen positive.  There are three or four possible drugs.  I was thinking maybe Tamoxifen, since it is less likely to cause osteoporosis, but when I asked which one, Dr. Schlabach said, "Well, it won't be Tamoxifen since you had that blood clot".  Arimidex it is and I'll be on it for 5 years.  There is some new research that indicates I might even stay on it longer than that.  I'll be going in for a baseline bone density very soon - then I'll have periodic check ups.



We also had a great conversation about the status of medical research.  It seems that cancer research is exploding.  He expects that within our lifetime people will not have to have surgery or maybe even radiation - there will be drugs which will be able to get rid of the tumors!  He even thinks that there will be a time when targeted drugs will take the place of chemotherapy.  Won't that be a wonderful day.  I wish we could sell tickets so that people could watch the research scientists!  Wouldn't it be great if tickets to a research session could cost as much as a ticket to an NFL game.  Oh what a dream.