Trip to Oncologist with New Plan in Mind

15th October 2015.  Thursday.

It has been a tiring week.  The wait to see the oncologist has to be a week.  Apparently, she only has clinics on Thursdays and half a day.

I have been going to school, preparing and teaching lessons for one class. The class has been a gem and the students have been understanding.  I told them about what happened to me apologised that I may be missing lessons.  But so far, apart for one lesson my schedules have been able to match them. For my other class, as they often clash with my hospital appointments I thought it was best they be entirely taken over by another teacher who can then deliver her lesson plans for the topic in a more coherent manner.

Colleagues wise, the unit all knows about my illness. However, a small matter that happened today while waiting to see my onco did bother me.  It is a small matter but it does bug me...I should learn to control my feelings like these.

Today is suppose to be marks appeal day and students are suppose to submit their examination papers with their written appeals for marks.  One colleague who was suppose to cover me in the morning lesson volunteered to grab the submission box - the problem is that it is the same timing as my lesson.  I told him it was okay as I would be in in the morning and could take that lesson personally.

While waiting to see the onco, our heads texted us to ask why my colleague could pick up the box since he was to be at my lesson. I replied that because I was taking back my class.  My head then texted me to tell me why I was replying and somemore saying that I was taking back this class. She sad people were already imbalanced in the team as I was still reporting for work and not seeing all of my two classes and I was taking one class only.

On the spot, I was lost....not knowing what to reply.  I had meant well for the other teacher taking the other class for not going in.  My scans appointments are not fixed, I don't get to decide when to see the doctor and I am not even sure of my treatment plans now - it keeps evolving.  So if I take some and she takes some, it will make a mess of everything - giving her stress and well as me stress. For this class, I started team base learning with them and not all teachers are comfortable with full tutorial method and hence as and when I can take, I will take them.  Sucked in my breath and replied her with an apology for messing things up.  Didn't know what to say.  There is really no point explaining things at times.  Furthermore, she is my long term friend, she must be understress managing my illness for me as well as the team and our emotions.

--------------------------------------------------------------------------------------------------------------------------

Finally got to see my oncologist again after an hours wait.

Told her straight in the face that I was not going to try the clinical trials.  She kept telling me that at anytime I was keen I could inform her again.  - TW (Hubby) says I keep cutting her off when she mentions the trials.  But her focus seems to be on the trials.

Told her that I would like to get my ovaries removed and asked her about financial models which I could pay.  Then I realised that government doctors really have no inkling, unlike my private surgeon who is able to better advice me.

She then decided that she would then put in me on Letrozole after my ovaries are removed.  She again did not check my genes test (which I gotten back 2 days before where my genetics doctor has written to her - same hospital) and seems entirely uninterested in it.

I observed her when she speaks.  She has a lot on her mind and yet on another she does not seem to organise her thoughts well.  This shows up in the way she files her notes.  She doesn't take alot of clinical notes and seems to be thinking of other things.  Maybe she is overwhelmed with other work like her research.  In the end, she ends up talking about the research and the patient seems secondary.

I asked her for how she intends to monitor me and when we would start on Letrozole.  It seems that she had not thought much about it.

"As soon as possible perhaps?  Maybe one or two weeks after you have ovaries removed?  Hm...monitoring......"

"Erm....my blood test results does not show cancer markers."

"Oh yes.  You are right.  Then we can do CT scans.....PET CT will be an overkill."

"How frequent will be the monitoring?  What will the schedule be like?"

"Erm...maybe in the initially it will be more frequent."  Pause.....think...."Yes, but it won't be as frequent as in the clinical trials.  You know if you go on the clinical trials, you will be monitored more closely.  You can consider it and tell me if you change your mind."

Oh no. The clinical trials again....let me get you back on track.

"I am sorry to disappoint.  But I really do not want to go on the trials.  You must be disappointed.  But I am really not considering it at the moment.  So how frequent?  Weekly, monthly?  What is it like."

"It depends...I don't need to see you weekly.  But more frequent initially.  You know....to see how you react to drugs.....Hm....maybe every fortnight or even monthly...."  Another long pause with her shifting eyes over the computer screen. "I guess we could do fortnight first."

"So what should I do now?"

"Erm....ok see your gynae....get your ovaries removed.  I get you an open date appointment and you make an appointment for one - two weeks after your ovaries are removed and we put you on Letrozole."

"Must my period stop?"

"Yes, but I think the onset will be quite fast....I think it will be very fast."

She quickly looked back on the screen again.  I guess that was it.  I would go for my oophorectomy and make appointment.

"Oh do you want to see my PET CT scan images?"

"No....I don't need......wait....on another hand why not."

I passed her may scans and she looks through the images.  Suddenly she pauses for a long while at the scans.

"The tumors are very clear, right?... I think you should start hormonal therapy as soon as possible.  You sure you are not feeling anything for your lungs, breathlessness?"

I was a little taken aback by her reactions, suddenly she had an urgency in her voice.

  "No, I feel fine at the moment," I replied.

" We still need to you to remove the ovaries.  Ok...remember to make appointment 1-2 weeks after the ovaries are removed.  Meanwhile the appointment will be open date for you and if you need anything else and feel any unwell before that call the appointment centre."

Was it me?  Cause, she suddenly became a little more urgent after she saw the scans.

I walked out of the room.

TW remarked, "Hm...she is still only keen on the clinical trials."

"Maybe it is her personality. Maybe she can't get her points across with empathy."  I replied.

Hm....but I don't like her remark.  Can't point out why.  Should try and dispel my doubts about her.  I need to work with her for a very long time.

One thing at a time.  Time to go make appointment with my gynaecologist and seek advice.  I think I will go with her.  I trust her.  Yes, one step at a time.  No time for worries.