Monday, February 25, 2008

Some Days Are Like That

Started chemo cycle No. 3 today. Numbers will come in next Monday. Couldn't be examined by Rifkin as he had hospital rounds, so I'm scheduled to be seen by one of his partners. The one doc I don't like walks into the examining room. My last experience with him was just prior to my transplant and, without repeating the details of the encounter, I had a deep dislike for him. So I think, make it short and sweet and get out of here. First he tells me my white count is too low and he's not going to authorize my chemo. I object and tell him my white count has run low through much of my treatment. Finally he agrees to call Rifkin and, not to my surprise, Rifkin tells him to authorize the chemo.

Then he starts questioning me about "what's the long term plan here?" Although he won't be the one to recommend my course of treatment, I'm always interested in getting another viewpoint. Well, I certainly got that in response to my comment, "well, what do you think should be the approach?" He is a fervent believer in another transplant, as soon as my IGGs are in the low range, especially because I am doing so well---better able to withstand the assault of the high dose chemo and/or donor transplant from one of my brothers. His view of the chemo approach is that it is prepartory for transplant, not a long term treatment modality. Not a pleasant conversation as I am not interested in the transplant option except as a last resort. And I think the landscape is changing with these new drugs and they may become a long term treatment alternative. I listen and don't argue with him. He leaves and my nurse walks in. She had been in and out of the room and had heard much of the conversation. "what was that about?" she asks. After I tell her, she leans forward and says in a whisper, even though the door is closed, "I wouldn't take the risk of another transplant unless I had no other choice. People often get quite sick after sibling donor transplants. Quality of like is important." I agree and am aware that this is the second time in a month I've heard this "quality of life" comment. It makes me uncomfortable. She then tells me I'm lucky to have Rifkin as he is more informed on the advances in chemo drugs and is not as fond of transplants as some of his partners. If I didn't know it already I know it now: sometimes your health care is wholly dependent upon the luck of who you get as your doctor. Of course, when I was referred to Rifkin I had no idea what his philosophy was compared to his partners.

I think we'll ride this velcade/dexamethasone/and revlimid if necessary, until something else comes along or it isn't working anymore. Tough to get my head out of the negativity of this doctor's visit. Some days are like that. Tomorrow's a new day.


Joan Walton said...

Hang in there,Dan. With your attitude and your good doctor you'll do fine. Just have faith. You have so much going for you,a loving family many loyal friends and a wonderful personality and attitude that it will carry you through the bad days to the better ones. Much Love, Mom

shawnandjaike said...

Yes, some days are like that.
Rifkin sounds like quite a good doctor as well as an approachable human being. So many doctors are neither. You are lucky to have him. We put our house on the market last Friday.......let the games begin.
We love ya Dan.

Arlene said...

Just cut and paste - I have nothing else to say :)

Arlene said...

Dear Dan,

Re. my previous blog today - please open, as I just showed Jimmy and his comment was -

I think it's cute and he thinks it's disgusting. But, you and I know that I am right! But Jimmy and I both love you the same anyway.

Ingrid said...

OH, yes, your whole health depends on which doctor you have.
Want an example?
Since I got to know my doc in Vienna, here in Siena my assistance got so bad, that one day, they even refused to visit me.
I fought for almost 2 decades (that is almost 20 YEARS) with my doc here in Siena until she finally left, got substituted by a young one, who is still far away from the one in Vienna, but at least 10 steps closer than the one I had before here.

It was pure luck, that my Mom got to know the one in Vienna, that is sure, but that shows you, that somebody has a leading hand over you.

Seems to be the same case with you and Rifkin, so keep him tight and follow your heart, your info's and who you most trust.

I am with you a 100 %

Love and hugs from overseas,