6 month folllow up with the Radiation Oncologist

Dr. "S" and me

Today was my six month check up visit to the radiation oncologist. Actually, it was a little over 6 months because I'd been out of state and had to reschedule my appointment. When I walked into the radiation oncology clinic, I was surprised when the receptionist handed me a clipboard with a lot of papers on it. I wondered if she thought I was a new patient and must have given her a puzzled look because she said, "don't worry, just first of the year formalities." I took the stack of papers, clipboard, and pen and sat down to busy myself with filling them out. I wondered why they didn't already have all of this information stored in their computers and I'll admit, I was a little frustrated. As I filled out the papers, I saw a little boy out of the corner of my eye. He was zooming a rubber farm truck around the office floor. I saw his grandmother looking to see if he was bothering me and I just smiled. I asked the little boy how old he was by saying, "are you 2?" His grandmother beamed and said yes. I told her I had 8 grandchildren and was able to guess the age of little ones pretty accurately.

As I sat and continued filling out my papers, people were being called back for treatment. There was an older man who struggled to walk through the door, there were two women both with apparent breast cancer. My heart ached for them as they were all 3 just beginning their treatments. I was glad I didn't have to go through radiation any longer.

After about thirty minutes of waiting, the nurse called me back to get my vital statistics. She asked a zillion questions and entered information into the computer. When she was through, she handed me a gown and told me to get undressed from the waist up. I knew the drill. I sat on the crinkly white paper atop the examination table for a few minutes and then jumped up to check out the room. I hate just sitting on the table swinging my legs like a little girl. I looked over the otoscope and blood pressure monitor. I looked to see what size nitrile gloves she wears and even took a peek at the computer screen which the nurse failed to hide beneath an active screensaver. I love reading medical data especially when it's about me! I was listed under the ICD-9 code as a 174.1 which codes as malignant neoplasm of the central portion of the breast.

I heard the doc outside the room so I jumped back up on the table. As she entered, she greeted me with a big smile. I told her I'd missed seeing her but I hadn't missed the radiation treatments. She grinned. "I can understand that," she said. She started asking questions about my general health and how I was feeling. She asked if I'd noticed any new lumps, bumps, or worrisome places. Had I been having weird headaches? Did I have stomach pain? Spinal pain? Belly pain? Bladder? I answered no to all of her questions and then she went down my medication list. Are you still taking....? What about ....? Yes, yes, yes everything was a yes until she got to Arimidex. I told her to cross that one off the list. She looked up and asked why. I explained about the horrible side effects.

Dr. "S" pulled up some documents on the computer screen and they were obviously letters from Dr. Feinstein, my oncologist. "I see here that you did indeed have some odd side effects from Arimidex and also from the Tamoxifen." I talked to her about the effects of the medications and how they made me feel. I don't know why I was so surprised when she jerked forward in her chair at my statement that I'd decided not to take any more cancer medications. "I really think you need to reconsider your decision," she said. "Since your cancer traveled to your lymph system and it's fed by Estrogen and Progesterone, it's very important that you take that medication to keep the cancer at bay." My reply stunned her. I said, "Dr. S., I know you have to speak to me from a medical standpoint but I am trusting that my God is taking care of all that. I've prayed about it and talked with my husband about it and my decision is final. I've decided to change my diet drastically and do all I can to live a good and healthy life." She came back with, "when do you see Dr. F?" I told her I'd see him the end of March. "Well, when you do, please talk to him about this and listen to what he has to say." "Okay doc," I said, "I'll listen but I don't think he'll change my mind."

She had me lie back on the examination table and began poking and prodding me. She slowly and deliberately moved over each of my incisions stopping occasionally when she felt something questionable. She felt under my armpits and mushed around on my belly asking if "that hurt." I wanted to say, "well of course it does! You're pressing really hard," but I didn't. Next she had me sit up and she listened to my lungs, looked in my ears and throat, felt all the lymph glands in the back and sides of my neck and then felt along my arms. She asked about the swelling and asked what seemed to exacerbate it. I answered her questions then she returned to the computer and began typing.

While she typed away, I asked her a question. "Doc, when will I ever be declared N.E.D.?" (that means no evidence of disease in case you don't know) She looked up from the screen and said, "You've been in remission since your cancer was removed but we can't say definitely N.E.D just yet." (According to the American Cancer Society, remission means the cancer is responding well to treatment and not spreading.) I asked her why I hadn't had a P.E.T. scan yet (that stands for positron emission tomography.) She said there had been many recent studies showing that after breast cancer, it was not wise to administer a P.E.T. scan unless absolutely necessary because of the amount of radiation emitted. People who'd undergone radiation therapy were at greater risk and that's why I wasn't going to receive one now. A P.E.T.scan is an imaging test that helps reveal how your tissues and organs are functioning. A PET scan uses a radioactive drug (tracer) to show this activity and it illuminates any cancer cells that remain in the body. "So, without a P.E.T. scan, we can't really know whether I'm free of cancer or not, correct?" The doctor answered, "correct. But, if there ever are any new lumps, bumps or places of concern, you can be sure that I will be the first one to order a P.E.T. scan for you." I was pretty satisfied with that answer although I know in my heart that I'm already cancer free because of my faith in God.

As I was slipping out of my gown and putting back on my clothes, I could hear Dr. "S" outside my door talking with the nurse...."she's decided not to take any medication....don't understand...Arimidex...just don't get it...." Those were the only words I could make out but there were many others in between. I can only guess what they were but I'm sure they didn't understand the choice I'd made.

I should have known Dr. "S" would give me grief over my decision. Medical doctors have a hard time accepting faith and miracles unless they are believers themselves. I wish I knew where Dr. "S" stood in her belief system. I may just ask her next time I'm there. I do know many family and friends just can't understand my decision not to take the meds but I know my body best. I have to do what I feel God leading me to do no matter if people look at me like I'm crazy or don't agree with me.

I used to work for doctors and in fact, I wanted to go into the medical field when I was in high school. I loved and still love medicine. It's fascinating to me. But doctors and medication don't have anything on the Great Physician. He's the one who made me and He's the one I trust. At my next visit, which will be in 3 months, I'm hoping Dr. "S" will continue to be baffled and give me an opportunity to talk with her once again about God. Who knows, maybe I'll get to witness to every single one of my medical team before it's over and maybe they'll come to realize what I already know, that God's ways are not man's ways. Proverbs 3:4-6 says, "Trust in the Lord with all your heart. Lean NOT unto thine own understanding. In all your ways acknowledge Him and He will direct your paths."

I'm trusting in Him with all my heart. I don't understand anything about this cancer journey except He allowed me to go through it. I am choosing to follow His leading and do what He says. The ones who have trouble understanding can just continue to be bewildered. This is between me and God.

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