Visit with Dr. R

I had a good visit with Dr. R today. No changes -- everything looks good.

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Actually, there was one change, but it didn't involve me.

The practice is no longer independent, but is now affiliated with/run through Yale-Smilow Cancer Hospital. This is not necessarily a big deal (I can, for example, get my scans anywhere I want, not just at Yale), and the doctors and staff are all the same at the office. But there were some very obvious small changes: I have to get an ID bracelet when I arrive, just as if I would if I went to the hospital; it took them about 15 minutes to call me in for bloodwork (gone is that nice sign that said, "If you have been waiting for more than 10 minutes, please come and tell us at the desk"); and when they took my weight, it was in kilograms, not pounds. Also, the computers were all down because Yale was installing new software.

The change-over came on January 1, so it's only been a week under the new management, and they're naturally working out some kinks with all of the new procedures. I go back in May, so I'll withhold judgement on the changes until then....

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Anyway, Dr. R said my bloodwork was "perfect" -- no signs of any problems. The physical exam revealed nothing wrong. And I'm feeling fine. So we're good for another 4 months.

The visit with Dr. R was a little different, though -- he seemed slightly more harried, maybe a little rushed. We didn't have quite as long a chat about our families -- that sort of thing.

He did give me a quick update on possible future directions for treatment, when I mentioned it's been just shy of 2 years since I had the Rituxan. He told us there was a "second-generation Rituxan" that was now being used. It's also an anti-CD20 monoclonal antibody. I knew just what he was talking about -- Ofatumumab -- but I didn't want to be obnoxious about it all and say the name, which he clearly couldn't remember. So he danced around his own forgetfulness, telling us that there were a bunch of Rituxan alternatives out there, with some slight variations ("Yes," I thought to myself, "they are humanized monoclonal antibodies"). He told us, still dancing around the name, that some of the Rituxan alternatives were derived from non-human sources. At this point, Isabel also frustrated with his not being able to remember stuff (or remember he was talking to a cancer research nerd), mouthed to me "mice!" without him seeing. He finally remembered that the source for these antibodies like Rituxan was mice, which made me and Isabel both smile. He also mentioned that there were some other antibodies being developed, some that targeted other CD proteins, like CD22 ("Yes," I thought, "that would be Eprituzamab").


I'm going to chalk up Dr. R's forgetfulness to the changes in the office management, which seemed to be throwing off everybody in the office in some way. And I want to point out again how good I was to not show him up with my own knowledge of current treatment options, and in not giving him the URL for this blog so he can learn more about all of this stuff on his own.

The bottom line is, I'm still healthy, everything looks good, and we can breath easy for a little while, anyway.