Monday, January 26, 2009

Monday, Jan 26, 2009 - Oncologist Appt.

Hiya Bloggy!

Geez, I can't believe I was waiting until I went to the appt. with Sharlene Gill today before I entered a new blog entry... but I was going to talk about the weekend as well as the appt. Like getting dressed up and going to the Ovation Awards (celebrating Musical Theatre in Vancouver), but darn it all anyways... I didn't write down the winners and I don't want to miss anyone, and I didn't take any pictures! So I have nothing to report other than it sure was fun seeing all sorts of musical theatre folk in one hall (they were held at the Academy of Music). Of course, I didn't get to talk to as many people as I would have liked to ... but a good time was had by all!!

Today, I went to my oncology appt and because I'm being incredibly lazy and want to go to bed early tonight because I'm sleepy... I'm going to copy and paste a the relevant part of an email I sent to my family tonight. It goes into fairly lengthy detail, so I'm just going to put it here... and will hopefully be up to having a chatty, just for fun, blog entry one of these days real soon... complete with pictures!! LOL!!

Here goes...

Ok... have I mentioned how much I adore my oncologist recently?? I know I've told you all this in the past, but I tell you, she is the most wonderful, compassionate, confident, person a gal can have as the head of her team. The difference I feel after a visit with her, compared to the consultation appt. and, even the lung ablation procedure, with Dr. Brad Halkier, the radiologist who did the lung procedure... is like night and day. Don't get me wrong... the fact that he blasted away the largest of the spots/tumours and a couple of hours later I was walking out of the hospital with my two girlfriends and having a nice visit over tea with them, just goes to show he is skilled at what he does... and I have no qualms about his skill and I am very grateful for him having ablated the tumour that he did. BUT, his bedside manner and overall attitude... well, let's just say he and I were never on the same page. And I felt it was important that I tell Sharlene (oncologist) this because it did set me back (attitude/depression) for about 4 days after the consultation appt. with him, even though I left it with him saying he would do the ablation. I also said to her that, in hindsight, after thinking about all he had said prior to doing the ablation.. and that he even admitted that he was trying to talk me out of it because he didn't see just how much benefit I'd get out of the procedure when he thought the better treatment would be for me to go on chemo.. I understood what he said, but I still thought that if we could ablate the spots/tumours that lit up the PET scan, indicating they were cancer, that this WAS a benefit to get rid of them. He was of the mind that these are only 2 of probably many more to come, so it would be better to go directly to chemo, than pick them off one at a time.

Sharlene listened and said that she could certainly understand my frustration and that sometimes she even has a hard time following how some doctors/specialists come to their opinions, which is not to say they are wrong, but that they are not her way of going about it. So then she explained how she sees where we are at with my situation and what we should be looking for and doing over the next while:

1) the spots on my lungs are still considered extremely sloooooow growing... and they are still too small to even light up a PET scan at this stage. Normally, when colon cancer spreads anywhere in the body, outside of the intestine, it grows very quickly. The spots on my lungs should be quite huge by now, and they are still considered extremely small... and so slow growing. Two of the spots have not changed at all since we found them in March so they still could be scar tissue. So really, we are keeping an eye on 4 spots.

2) She does not agree that we should bombard the whole body with chemo, which is hard on everything, for 4 spots that have not gotten big enough to light up a PET scan.

3) She suggests we do the following:

- keep monitoring my CEA levels. I had that blood test taken yesterday but the result wasn't in yet so she will have that tomorrow (Tues) and because of the lung ablation, she is not going to get too excited if it is up a couple of points... surgery can do that to the CEA levels. But we will continue monitoring it on a regular basis to see if it stays low or starts rising. If it starts rising, then we will decide to go for a PET scan to see if we can figure out why it's rising... but she is not going to get excited until we know the lung has totally recovered from it's recent ablation.

- in 8 weeks, we will do a CAT scan as part of the monitoring of the spots on the lungs. I told her that Dr. Halkier wants me to come back to Royal Columbian in 6 weeks for a followup CAT scan and that his office will be in touch with me to set up that appt. I told her I'm not overly confident with the communication from the hospital so it might mean I will have to followup with them and keep hounding. She told me not to worry about it. She will order a CAT scan here at VGH and IF Royal Columbian calls me and has one organized for 6 weeks from now, then I can go to that one and she will cancel the VGH... but we'll have it as a backup in case RC screws up again with their booking ;)

- we will continue to do ongoing CAT scans every 2 months and regular CEA monitoring. IF one or two of the spots starts growing, but the rest remain dormant and there are no others that show up, then she will re-visit us doing the Ablation procedure. She has heard of this other fellow who has moved up here from California and he does lung ablations... but he has not been set up to do them in BC yet. But if he is able to do them and we might need another one done, then she will pursue seeing if we can get a referral to him... if not, she can refer me back to Dr. H. with proof we are only talking one or two on the same lung are needed doing. But it sure would be convenient if it could be done out of VGH!! :)

- if the spots were to start growing faster and/or others were to start appearing or the CEA levels were rising indicating activity somewhere in the body, well we could always revisit using chemo. She just doesn't want us to use chemo and bombard the body if, in fact, there is no reason to do that at this point. We want to save that until we have to use it.

So, I'm feeling a lot more confident ... because I really do trust her and her logic. We definitely are on the same page... and she's very understanding about the frustrations I went through. She says that she can tell when I'm doing well, it's when I have eliminated stress from my life. So the last thing she wants to see me going through is a stress caused by a doctor, even though we both are sure that he did not mean to intentionally cause that. I tell you, it's a full time job eliminating stress from one's life!! :)




Anonymous said...


Your oncologist is definitely a keeper. I'm so glad Dr Gill is in your life, during this time.
To me, a doctor with her personality and bedside manner, is a true doctor. She's in the profession for all the right reasons. A good doctor not only takes care of your illness, but your mental state of mind too. No stress has top priority now.
Keep those positive thoughts flowing.

Hugs, Maryann

Truly Low Carb Karen said...

What a gem your doctor is, no doubt about it. Sounds like very good reasoning to me too!