Thursday, February 01, 2007

small and limited

Yesterday afternoon Dr. Moskowitz called me again concerning the results of the CT scan. He told me that the test showed that the cancer was small and limited to a few lymph nodes around the duodenum. Concerned about my liver, I asked him about it about which he said the test didn't show anything. Because the affected areas are small and limited, he told me that he didn't think radiation was necessary and that moreover, he agreed with Dr. Schuster's approach of using GND. Receiving this chemo regimen in Chicago would be just fine, he went on to say.

With regard to the mini-transplant, he told me that I should go somewhere that's experienced. He didn't endorse or explicitly tell me to have it done at Sloan-Kettering. But from our previous conversation I know that if I'm in NYC Sloan-Kettering is the place. Again he recommended that I consider seeking consultations at MD Anderson and the Fred Hutchinson Cancer Research Center in Seattle, which it seems are the only two places besides Sloan-Kettering where one would want to have such a procedure. Again he mentioned seeing Dr. Patrick Stiff at Loyola.

I asked him if I should leave Weill Cornell for Sloan-Kettering now. He didn't answer my question directly, but he again reiterated that he felt Dr. Schuster's plan was fine. When this upcoming phase if over, come see him, he said. Stick with Dr. Schuster for now, I sensed he was telling me. Follow through with his GND plan and then, visit me again. Our conversation was very brief - no longer than 3 minutes probably. I forgot to ask him some important follow-up questions, however, such as would he help to get me in to see Dr. Castro-Malaspina or one of his associates (as we had discussed at my appointment). But no worries. I called his office today and am scheduled to see him on March 5th at 9am.

I feel a bit overwhelmed by the number of questions that need to be asked and the various options that are out there, which is why I have felt a bit exhausted these past two days. Whereas I was unable to come up quickly with the important follow-up questions that needed to be asked of Dr. Moskowitz, Su listed them to the me immediately with no hesitation in our conversation last night, which is why I asked her if she wouldn't mind talking to him about them. Even though I'm the patient, today at least my brain was fried. I felt too tired to call his office again, leave a message, be on stand-by all day for his return call that could come at anytime, and then ask him more questions. So, I just delegated that task to Su, who seemed to accept it willingly. Unfortunately, the person who was covering for his secretary when I called this morning never forwarded the message to her, so by the time we found out what had happened the office was in the process of closing for the day. Not today, Dr. Moskowitz's secretary told me. She'd leave the message for him and hopefully, tomorrow he'd talk to Su. I know how time consuming the calling back-and-forth can become, but it's even more ridiculous since I'm at school now.

I scrubbed my appointment with Dr. Smith today. I decided to see Dr. van Besien instead, because he heads the lymphoma and stem cell transplantation program at the University of Chicago Hospitals even though Dr. Schuster mentioned Dr. Smith specifically. They are on the same lymphoma team, so I hope this change will not be a problem. The day and time of the appointment remained, however. I also called Dr. Stiff's office at Loyola this morning. I registered via the telephone, so I'm just waiting for his hospital to call me back with an appointment day and time. Both Drs. van Besien and Stiff will need the pathology slide from the splenectomy as well as my last PET-CT and CT scans. I'm in the process of obtaining these items from Sloan-Kettering.

Today I also learned that Dawn wasn't a match. So, the donor search continues.


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