Wednesday, September 23, 2020

Oncologist Appointment Today

I had my 6 month oncologist appointment today (a little more than 6 months since my last one, since the hospital messed up my last appointment). Everything looks good.

It didn't start well. It was probably the earliest appointment I've ever had -- blood draw at 7:30am and then seeing the Doc at 8:00am. I'm an early riser, so that was OK, but it meant I had to miss my morning 2 hour walk with my wife. Lots going on at work and home, too, so I was more distracted than usual.

I ended up going into the wrong parking garage (the one at the cancer hospital gives free or reduced parking to patients), and then when I realized my mistake, I went out the wrong exit, and it put me directly on an interstate freeway. So I had to drive to the next exit, turn around, and start all over again. 

Not a great way to start the day.

The hospital has strict policies about how to enter, so I went through that process to get in -- answering Covid questions, getting my temperature taken (by a machine, and not being able to line up my forehead correctly).  When I went a month ago, there was an army of people making sure only one person got into the elevator at a time, and giving directions for where to go. Not this time. They gave me a Visitor sticker and sent me on my way.

Now, where I live, Connecticut, was hit pretty hard by Covid in the spring, but people have been very good about wearing masks and keeping their distance, and we're now at one of the lowest Covid rates in the U.S. That helps a lot with my anxiety, knowing that there are fewer people around who have the virus and who might spread it. I'm still good about avoiding large crowds, and I always wear a mask around other people, but I'm still not much into big crowds these days.

So I was a little taken aback when I got off the elevator and walked into a crowd of people, all wearing scrubs. Apparently, 7:30am is the time the shifts change, so much of the hospital staff was either leaving work of arriving for work just as I stepped into the hall. It kind of threw me a little. It's the most people I've been around, by far, in the last six months. 

I went to blood draw first, and it was pretty uneventful. I am, and always will be, grateful for phlebotomists who do their job well.

The nice things about being in so early (other than the shift change issue) is that there are so few other people there. I'm guessing my 8:00am was the doc's first appointment of the day, so he has no excuse about being behind.

This morning, I was first seen by a Hematology Fellow, one of a small group of new doctors who have finished their degrees, finished their residency, and are now doing extra work in their chosen specialty. He was a nice young man, who asked me lots of questions and did a physical exam. Before he left to consult with Dr. H, my usual oncologist, I asked him why he chose Hematology/Oncology. He sat himself down (people like it when you ask them questions about themselves, and I genuinely like to hear people tell me their stories). He said he seriously considered being a General Practitioner, because he liked the idea of having a relationship with a patient for a long time. But he also knew that so many of the issues that a GP deals with don't really have solutions (people will live with high blood pressure, for example, for their whole lives). While he was in medical school, trying out different specialties, he found himself drawn to cancer patients. He thinks Hematology/Oncology will let him have long relationships with patients, but because there are so many new advances in blood cancer treatment, he'll also be able help fix their problems. He apologized for being "long-winded," but I told him it was really good answer. (And it says something that someone so new to the field thinks treatments are improving so much that he'll be able to help them.)

The Fellow left, and after a few minutes of consulting with Dr. H, they both returned, and I went through the whole thing again, answer questions and getting a physical exam, this time from Dr. H.

He said my blood work looks great. (I don't usually check myself, if the doc thinks it's OK, but so much of what we do now is through tele-health, so I'm on my "patient portal" more than I'd like to be. So I checked my numbers after the appointment, and I have to say, they look good.)

A couple of other interesting bits from our conversation:

He thinks a Covid vaccine will be available sometime in the spring. He also thinks that I should consider myself "medium priority." The people who should get the vaccine first are the elderly (I'm not there quite yet) and those who are in active cancer treatment, and thus have more compromised immune systems. Given how long it's been since I had treatment, my immune system has recovered somewhat from the Rituxan. This, however, is his (admittedly informed) opinion, and not set in stone. But it does give me a better sense of perhaps how I see myself in the middle of the pandemic -- not of the highest priority, but still taking it very seriously. 

He also mentioned possible treatments, if and when they become necessary. He thinks, right now, given the way my FL has stayed in check, he would probably recommend Rituxan again, or maybe Obinituzumab. He also mentioned CAR-T, and expects it to be approved for Relapsed and Refractory Follicular Lymphoma sometime next year. "We may be able to cure this thing," he said. (I told him "I'll believe it when I see it." I'm also optimistic about CAR-T's place, but I'm still not willing to say it's The Cure, at least not in its current version.)

I go back to see him in 7 months. 

A rough start to the day, but a good visit overall. 

I hope al of you are staying healthy, and having good days yourselves.



6 comments:

bibliobede said...

So great that you got to see your medical team in person. I have only been able to get telephone interviews (Canada) for the last two times. Thanks again for all your updates and discussions. Appreciated this post.

Mike said...

The start of your day sounds like a scene from "The Nutty Professor" . Heyyyyy Ladeeeey!

Lymphomaniac said...

Bibliobede,
Yes, it is nice to actually see the doc. I had telephone interviews with another doc earlier in the summer for a breathing issue. Kind of useless when they can't hear you breathe. Telemedicine has its place, but it has its limitations, too.
Hope you're doing well.
Bob

Lymphomaniac said...

Mike,
Yeah, Nutty Professor about sums it up these days.
Or maybe Benny Hill.

Anonymous said...

Thank you for update.
My oncologist said I’m at higher risk of getting Covid due to lymphoma being a cancer of the immune system.
I also had a breast cancer scare, but biopsy showed it’s my lymphoma on the move. Damn
Relieved not breast cancer, but anxiety inducing.
He also said having lymphoma makes one more susceptible to other types of cancer because the immune system scours the body for cancer and kills them, when the immune system is working normally.
Donna

Anonymous said...

Hi Bob

So what started out as a bad day actually turned out pretty good. I'm happy that your labs and doctor checkout turned out great. Due to covid-19 Gretchen (NIH ViPOR clinical trial) rarely sees the trial oncologist, usually a Fellow who sees her labs, talks with her, then goes to talk with the trial oncologist - bummer.

We do not trust that a covid-19 vaccine will be thoroughly tested before released to the public. Giving it to senior citizens first (because they are less value to society) seems to be an underhanded way to test it. With all of the politics surrounding covid-19 we do not trust THEM. We WILL wait for at least 6 months after it is released to get the shot ourselves.

William