Wednesday, September 12, 2012

The doc's point of view

Spent a couple of hours on Geary street with Padmatara this morning, mostly waiting for my name or number to be called, or to appear on a screen. My name there is my old name, Lisa Cullen, one of the very few places, other than the bank, that it is still used. We picked up a prescription, met with Dr. Nelson, and did my pre-chemo blood draw.

Dr. Nelson is my main oncologist now. Manner-wise, she's uptight compared to Tavakoli. But I guess being entertaining probably isn't the main thing one should look for in a doctor. In any case Padmatara noted that I have improved whatever the patient side of bedside manner is. Well. She didn't say improved. She said "more assertive and clear," I think.

I have been very tired and since we got back and have done the thing that a person with sleep issues is advised not to do (in fact was advised today not to do): lie in bed for...six hours. In the past I would have fallen asleep and then gotten up. But because my sleeping habits - or are they capacities? - have drastically changed, I can lie in bed for a long time without falling asleep. Still, resting is good.

One is supposed to reserve one's bed for sleeping (or sex). Instead of both, I plugged my new JLab speaker into my laptop and watched the end of episode 2 of Battlestar Galactica. I seem to be accumulating a lot of gadgets. I read half of this is getting old, a collection of sweet essays. I listened to a talk by Peter Coyote, who lives in San Francisco and is a Zen priest. I ate chili with kale, potatoes, and goat cheese.

If this blog is for conveying information, I have a lot of that to convey about the meeting with Dr. Nelson, but it's not very interesting to me at the moment, relaying the facts. Perhaps it is the fatigue.

I have a dentist's appointment tomorrow at 5:30. Dr. Nelson assured me that yes, going to a dentist in such a case is good. It's just that you don't necessarily want to schedule your regular checkups, etc., during chemo. It's an issue of exposing yourself to your own germs. (She says that's usually where the germs come from, not other people.)

Here are a few other things I talked to Dr. Nelson about:

Neuropathy - even though mine's getting worse, apparently it isn't..that bad! The danger signs are pain & losing balance. She said that the worse it is, the more likely it is to continue after chemo ends, in which case I am screwed. My feet don't hurt unless Misha sticks a needle in them. I just need to be careful of hurrying down stairs. But I do sort of worry about the neuropathy. My one worry, pretty much, is being disabled after treatment. (I suspect fairly regularly that I am repeating myself here, but if your memory isn't better than mine, then we're golden.)

Before switching to Dr. Nelson as my primary oncologist, I wanted to talk to her about 'complimentary medicine' and make sure she isn't going to protest. When I first brought it up she was somewhat skeptical. She mentioned being blamed by patients for problems caused by herbs. After I told her that Misha participates in studies at UCSF and checks the interactions very carefully, she seemed to relax, and said if it's worked for me for this long it's probably fine.

I had thought that doctors being skeptical about herbs, etc., was simply some kind of prejudice they pick up in medical school, but today it seemed to be more about her practical experience of people taking herbs adding work for them (to check interactions), and about causing bad interactions with the chemotherapy which the prescriber perhaps doesn't understand. Misha is not a typical acupuncturist. I also told her that Misha is convinced that the reason my blood counts have been so high is due to an herbal blend called Marrow Plus, an idea she seemed receptive to.

BTW I got my blood test results - counts are slipping but still aren't too bad. Dr. Nelson said Carbotaxol is not really the kind of chemo that you have to be super worried about in terms of getting infections. Slightly below normal range were Hgb, which I'm assuming is hemoglobin, and 'neutrophils auto-count'. I don't know what 'auto-count' means, but don't have the energy to look it up. Also platelets and hemocrit are just barely above the lowest range of normal. But I think the 'normal range' isn't normal for people on chemotherapy...

She said I don't need to worry about immunity for Mexico, but I should check with travel medicine to see if I need to get shots. She didn't think I would but wasn't sure.

Will save issues and updates about sleep for the next post.

Books in progress (or simply available by my bed)

this is getting old, Susan Moon
Orange is the New Black, Piper Kerman
The Nimrod Flipout, Etgar Keret
The Autotbiographer's Handbook, Jennifer Traig, ed.
The Essential Guide to Getting Your Book Published, Ekstut and Sterry

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