Cancer Diary – Fourth Entry

Posted in Health - aging, mostly by EloiSVM42 on July 10, 2011

Friday, November 20, was our pre-operation preparation day at the Mayo Clinic. Cynthia and I drove down to Phoenix that morning for a series of meetings that began at 9:45 am and ended at 3:30 pm.

It should be recorded that we began my own preparation by meeting with my cardiologist the day before. I had recently had an echocardiogram, and the first order of business was to review the results, which were fine. The second was to discuss the surgery.

In response to the news about the surgery the cardiologist changed one of my medications. He also raised a concern. Mayo Clinic wanted me to stop taking my daily aspirin tablet two weeks before the surgery. The cardiologist preferred one of a couple of alternatives. I told him I would raise his concern when in Phoenix. He also scheduled a stress test for me on Tuesday, November 24 for another check step before surgery.

When we arrived at the Mayo Clinic we were given a written itinerary for the day, listing each meeting, at what time and where. Mayo Clinic is organized and professional, more so than any medical facility I have ever visited.

The first appointment – check-in – lasted only about 15 minutes. They just confirmed we were there, and, of course, as with all medical facilities, that we had insurance coverage. First things first. They had me state my name and date of birth, to be sure they had the right patient.

At 10:30 am, a nurse escorted us to our next appointment – the pre-operative medical exam. On the way the nurse asked me to spell my name and state my date of birth. When we arrived for our appointment, we were greeted by another nurse whose job it was to prepare me for the examining physician. The nurse began by asking me to spell my name and state my date of birth. She asked a lot of screening questions about my medical history and then told us what to expect from the examining physician.

The examining doc came in and asked me to spell my name and state my date of birth. He examined all my records and we discussed them. I gave him a copy of the report from my recent echocardiogram, and he was delighted because the results were good, and it meant that he wouldn’t have to give me an EKG there. Likewise, he was very pleased to learn that I am going to have a stress test on the 24th, and gave me a fax number for sending him the results.

It was at this point that the difference of opinion about aspirin between my Mayo surgeon and my cardiologist came up. This doc laid out both sides of the debate concisely, and relieved my mind by saying he was sure a compromise could be worked out. He even listed a couple of compromise possibilities. We left it that the two docs would talk and work out a decision the following Monday or Tuesday, and let us know what to do. Finally, he gave me a list of which of my meds I should take the morning before the surgery and we were done.

There was time before our next appointment, so we had lunch at the cafeteria, which is available for staff, visitors and even ambulatory patients. I had fasted since the night before, and as it was now almost Noon, my first need was a cup of Starbucks coffee. So was my second. The food was so good that when we were finished at the end of the day, Cynthia actually wanted to have dinner there. We didn’t.

Our next appointment was at 12:30 pm for a Radiology Exam. The nurse who escorted us to the technician asked me to spell my name and state my date of birth. I gave a date one year off my birth year to see if she was paying attention. She was. The appointment was quick and easy, just a few chest X-rays. We finished in half an hour.

Our last appointment was at 2 pm with the Radiation Oncology department. Like Ebenezer Scrooge, I dreaded this last appointment the most. The preparing nurse began by asking me to spell my name and state my date of birth. This I did, and then I asked her a question. “Please state the name of this hospital.” I guess you had to be there.

Our dread was heightened at bit when the nurse asked a lot of questions we had answered previously. We inferred this was an autonomous department and that these people might try to sell us on a therapy different than what we had already agreed to.

Our worries were assuaged when the oncologist came in. He was very impressive and professional. After asking me to spell my name and state my date of birth he did a thorough on-site inspection, via the tube down my throat. (Ever since I heard about this procedure it seemed dreadful to me, but now it has happened to me so often I hardly notice it.) Then he told us several encouraging things.

First, he said he had discussed our case with the surgeon, and after examining me he agreed completely that surgery is indicated in my case. He noted that the surgeon always has his patients speak with the radiation oncologist whatever his, the surgeon’s, recommendation is, to be sure the patient has all the facts and options.

The oncologist said my tumor is a T1 – the first person to use this term with us, though we had read it. This means the tumor is in the category of smallest size, and presumably in a very early stage. He estimated the chance that I will need follow-up radiation therapy at 30%, much lower than we had expected.

The oncologist told us what to expect from radiation therapy. I’ll skip the details of this unless and until it should prove necessary. Suffice it to say that Cynthia and I have been talking about spending several weeks in a warmer place this winter, such as on the desert floor in Phoenix or Tucson, and if I need radiation we’ll have our wish. In the future, we need to wish more specifically.

The oncologist ended the interview by saying, “Of course, sometimes we get surprises.” Nevertheless, Cynthia and I left the Mayo Clinic this time feeling both more informed and more optimistic. We chatted and smiled all the way home.

It’s conventional wisdom, except among plastic surgery patients, to avoid all surgery unless it is absolutely necessary. I interpret this to mean eschew surgery until the discomfort gets to the point I am ready to do the surgery myself with a rusty tin can lid, with our without anesthesia. My throat gets a little sorer each day, and I project that by the surgery date – December 7 – I’ll be in that mood. Unless something unexpected occurs, I probably won’t make another diary entry until after the surgery. We’re going to spend next week enjoying a visit from one of my daughters, who is coming for Thanksgiving.

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