On the 29th. Day... Oncology 101

Brenda takes time off and we drive to the Cancer Clinic, park, and stroll on down to Starbucks... We're 20 minutes
early, just the way this rednecked tradesman likes it... I don't do "late"...

Precisely at 07:59AM we walk into the BC Cancer Agency (BCCA) Clinic at 600 W. 10th. Ave., right up to the Admitting
Desk. The "lady" gave us a cursory glance and her standard frosty schpiell... I will need your full name, your date of
birth, your BC Care Card and the name of your Dr. ... I presented my 3 Ring Binder, and politely informed the "lady"
that my name, age, D.O.B., and BC Care Card # were on the front cover and the Dr.(s) that I see were on the back...
(Neurologist) (Respirologist) (Lung & Chest Specialist) (General Practitioner)

The "lady" appeared somewhat taken aback, then momentarily intrigued as she thumbed through my binder... She entered a
little data into her keyboard, then asked "Which Doctor is your oncologist??

Witch Doctor?  WITCH DOCTOR??

T H E Y   G A V E   M E   A   W I T C H   D O C T O R !!  I asked incredulously....

The ice was broken....

No, no... She laughed.... I need to know your oncologists name...

I'm a NEW Patient I explained... And I had no idea I would be assigned a Witch Doctor, much less know his name...

Ahhh... New patient... Fill out these forms and take them to the second floor desk 2B...  She smiled and laughed
again...

Would it be Dr. Spear, I asked, innocently?   Will there be dancing 'round the fire??  You're an impossible nut she
declared but I love your attitude... I'll warn the 2nd. floor that you're on your way up.... she laughed...

At 2B we turned in our completed forms and were introduced to "Susan" a very pleasant nurse councillor...

She took my height and weight and we chatted about my job, my lifestyle, my new diagnosis, and my family.  I told her
about the "Witch Dr." and showed her my 3 Ring Binder... (Description Follows...)

* * *

My 3 Ring Binder... (Presentation Type 1" standard 3 Ring Binder)

Front Cover: (8 1/2 x 11 Paper Insert in Clear Plastic Pocket)
Title: Emergency Medical Information;
My Full Name; Age; Date of Birth; BC Care Card number; Lung Disease; Parkinson's Disease

Rear Cover: (8 1/2 x 11 Paper Insert in Clear Plastic Pocket)
Title: Attending Medical Professional(s)
Doctor(s) I see, their area of expertise, their phone #, their fax #, mailing address; and their e-mail address...
(Neurologist) (Respirologist) (Lung & Chest Specialist) (General Practitioner)

First sheet: (8 1/2 x 11 Paper Insert in Clear Plastic Pocket)
Title: Wife / Care-Partner;
name; relationship; address; phone #'s; Fax #; employer; etc.

Back of First Sheet: (8 1/2 x 11 Paper Insert in Clear Plastic Pocket)
Title: Medical Alert: Lung Disease:
My Name; Gender, Age, DOB; BC Care Card #
Brief Description of My Medical Condition (Lung Disease); and date diagnosed;
Attending Professional(s); Name; Specialty; Phone #;
Medication(s)
Instructions
Blood Type
Allergies

Second Sheet: (8 1/2 x 11 Paper Insert in Clear Plastic Pocket)
Title: Medical Alert: Parkinson's Disease
My Name; Gender, Age, DOB; BC Care Card #
Brief Description of My Medical Condition (Parkinson's Disease); and date diagnosed;
Attending Professional(s); Name; Specialty; Phone #;
Medication(s)
Instructions
Blood Type
Allergies

Back of Second Sheet: (8 1/2 x 11 Paper Insert in Clear Plastic Pocket)
Title: Patient's Personal Data;
My Name; Gender, Age, DOB; BC Care Card #
My Full Mailling Address;
Phone #; Fax #; Cell #; Pager #;
My Employer;
Employer's Full Mailling Address;
Phone #; Fax #; ;

Care-Partner
Her Name; Gender, Age, DOB; BC Care Card #
Her Full Mailling Address;
Phone #; Fax #; Cell #; Pager #;
Her Employer;
Employer's Full Mailling Address;
Phone #; Fax #; ;

Third Sheet (8 1/2 x 11 Paper Insert in Clear Plastic Pocket)
Title: In Case Of Emergency Contact(s)

First Contact
Name;
Relationship;
Phone #; Fax# ; Cell # ; Pager # ;

Second Contact
Name;
Relationship;
Phone #; Fax# ; Cell # ; Pager # ;

Third Contact
Name;
Relationship;
Phone #; Fax# ; Cell # ; Pager # ;

etc...


Back of Third Sheet (8 1/2 x 11 Paper Insert in Clear Plastic Pocket)
Title: Immediate Family

Block Diagram Family Tree
Myself; My Wife; Phone # ;
Our Children; Oldest to Youngest; Names and Phone #'s


Fourth Sheet ( 8 1/2 x 11 clear plastic business card pockets)
Title: Business Cards / Contact Info
Dr(s), Pharmacist(s), Dentist, Lawyer, Eye Dr., Support, Employer, Trade Union, Family Members Work
(Any card you might conceivably require should you be hospitalized)


Fifth Sheet ( 8 1/2 x 11 clear plastic business card pockets)
Title: Business Cards / Contact Info Page 2


Sixth Sheet (8 1/2 x 11 Paper Insert in Clear Plastic Pocket)
Title: Telephone Directory
Personal Telephone Directory, computer generated;
(Any name; relationship; phone # , address, you or your care-partner might require if you are hospitalized)


Back of Sixth Sheet (8 1/2 x 11 Paper Insert in Clear Plastic Pocket)
Title: Telephone Directory Page 2


Seventh Sheet (8 1/2 x 11 Paper Insert in Clear Plastic Pocket)
Title: Telephone Directory Page 3


Back of Seventh Sheet (8 1/2 x 11 Paper Insert in Clear Plastic Pocket)
Title: Telephone Directory Page 4


Eighth Sheet (8 1/2 x 11 Paper Insert in Clear Plastic Pocket)
Title: E-Mail Directory
Personal E-Mail Directory, computer generated;
(Any name; relationship; E-Mail address, you or your care-partner might require if you are hospitalized)


Back Eighth Sheet (8 1/2 x 11 Paper Insert in Clear Plastic Pocket)
Title: E-Mail Directory Page 2


Monograph's For Each Prescription Medication


Contra-Indicated Medication(s)


Copies of Recent Blood Work


Point Form Diary of Recent Medical History
Date, Time, Place, Dr. Visited, Why, Prescription, Note(s) X-Ray;Scan(s)


Anything else you can scan or 3 hole punch that you consider relevant...


That's what I mean when I refer to my "3 Ring Binder"...

* * *

Susan was impressed!

I told her about Parkinson's Resources on the WWWeb and about my family and supporters (you)...

A few more forms were completed...

Take off the street duds, get into this skimpy.....and wait .... ahh... the familiar routine... the Doctor will see you
soon...

Witch Dr?  Dr. Spear??

Nooo...  A nederlander...

Enter Dr. Hagen Kennecke MD, FRCPC, Medical Oncologist...

A tall youngish professional, pleasant dutch accent, great personable bedside manner, puts-you-at-ease Dr. ...

I ask for his business card and file it promptly in my 3 Ring Binder...

He has my chart(s) from VGH and as we go through the brief history from chest Xray July 23rd. to first oncologist visit
today, we realize there is a "piece" missing... Where is the paperwork for the thorocentesis (draining 750 ml. of
pleural effusion fluid) and the subsequent biopsy of same?

Dr. Kennecke orders the missing documentation...

We go through a physical examination, look in the eyes, reflexes, stethoscope on my chest, on my back, breathe
deeply....

He probes all of my lymph nodes and confirms that there is a "lump" in the node just left (my left) of my neck and up
against the collar bone...

The missing documents arrive and he reviews them...

The cancer is at Stage IIIB... with a primary tumour in my left lung, cancer cells in the pleura, and now a lump in one
of my lymph nodes.

He quietly confirms the results...

Stage IIIB - resection is not viable (no surgery); incurable; not M1; definitely M0... most definitely very treatable,
given that I'm relatively still young at 59, still relatively robust, have a very positive outlook etc.

We discuss treatment options...

He recommends Chemotherapy... probably Platinol® (brand name) Cisplatin (Generic name) ... he will have to consult and
check contra-indications for the long term Parkinson's meds...

We will decide in a few days... He needs the time to discuss and research contra-indications closely...

In the meantime, he wants me to get a proper sleep and thinks codeine base Tylenol III should provide that
opportunity... He asks if I've ever had allergic reactions to any meds... (I have not)... Have I ever taken Tylenol III
before (I have)... Dr. Kennecke writes a prescription for the Tylenol III's...

If we decide on Platinol® / Cisplatin it will be an IV administered regimentation, once every 3 weeks for 4 cycles.

After the fourth cycle we may entertain the option of some radiation if an Xray so indicates...

The side effects of this chemotherapy are:

nausea;

tingling of extremities;

some temporary hearing loss;

may interfere with kidney functions;

Just as in Parkinson's, everyone is a unique individual, so it is not easy to predict just who will experience which
side effect and to what degree...

He mentioned the nausea as an example... With the correct anti-nausea med and chemo, many people do not ever experience
the nausea much less actually vomit...

I said Gee, I thought I would be able to spew... Not on my watch, buddy, says nurse Susan... Don't even think 'bout
it!!

What about the "Kojack" look??  No, Dr. Kennecke says, Not everyone loses their hair...

Damn!! They're takin' all the fun outa this....

We discuss my concerns...

My narrowed airway in the left lung... should not be restricted any further and should ease with any reduction of the
primary tumour... Dr. Kennecke feels the cancer is not restricting my airway or my throat... but rather that mucous is
accumulating, causing a cough...

Will the cancer be further tested, monitored... Dr. Kennecke assures me continuing bloodwork will monitor both kidney
and liver functions...

He sends me upstairs for bloodwork and Xrays...

Old hat! Piece a cake!

We bring the Xray films back down later and again join Susan for a little more "councilling"...

Nearly 3 hours have passed now...

Dr. Kennecke reviews the Xrays and rejoins us...

We run over our options, questions, concerns once more... I feel very positive...

Brenda asks if we had come a month or two sooner would it have made a difference??  Sheer speculation he replies but...
you've probably been incubating that cancer for many months...

I agree and tell the Dr. that I never look back... only straight ahead!!  I will do the chemotherapy and look forward
to it!  I'm quite used to the concept incurable, but treatable, after all, now I have two!!

Then what?

We may decide on a second regimen of chemotherapy after a break to give the body a rest...

Time will tell...

Meanwhile... you keep smilin'... I am !!

* * *
Murray Charters <[log in to unmask]>
http://www.geocities.com/murraycharters/

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