I had my 4 or 5 month or so check up yesterday with Dr. R. Everything looks fine.
As usual, we do a three-part visit: I get blood work done (complete blood counts, plus LDH), he does a physical exam, and we talk about how I've been feeling. Without a scan, it's about as thorough a check of my lymphomic health as I can get.
The results: Blood work looks "perfect," as he said. My check on how I'm feeling (good -- nasty asthma this fall, but I'm still running three days a week) led to the physical exam. The last few visits, I've had some lumps on my upper right arm. Hard to say what they are -- they are kind of on the edge of the area of where the nodes are located, but they're spread out, and they don't grow terribly fast, if at all. They aren't bothering me (that is, they aren't making my arm swell, the way the nodes in my leg did, leading to the Rituxan). The only bother is that I wonder what they are. Maybe nodes, says Dr. R.; maybe collections of lymphoma cells under the skin; maybe lipomas, fat deposits under the skin. But at this point, nothing that causes alarm.I'm keeping an eye on them.
I go back in early January. He doesn't think a scan is necessary, though maybe we'll do one next year just to see how everything looks inside. Of course, he said that last year, too. At one time, I would get nervous if I went too long without a scan. I feel less anxious about it these days.
One comment about the office: I can officially say I don't like it. Over a year ago, Dr. R and colleagues private practice was taken over by Yale New-Haven Hospital. It's actually a branch of the hospital now, so when I go, I have to check into the hospital and get a bracelet and everything else. Since this has happened, my visits have been less satisfying.
Don't get me wrong -- I love Dr. R. I love the nurses and office staff. The phlebotomist draws blood and I barely know the needle is in. But lots of other stuff is just....off. My appointment was for 10:15, but my reminder call said it was for 12:00, so I had to call and get that straightened out. They didn't do blood work (which I thought was strange, and asked Dr. R to do it), so I had to interrupt my visit to get blood taken. When the nurse reviewed my history, she had the wrong pharmacy down. None of a big deal, really, but it's all different from the way it was before. I don't know if it's the computer system messing things up, or if it's human error that comes about because they have so much extra stuff to do. I've given it a year, and I don't like it.
No plans to change oncologists. Just one more thing on the road to making me a grumpy old man.
But the upshot is: it was a good visit. I'm still a pretty healthy guy, for a cancer patient, and happy (and a little grumpy) about it.