It was very strange going back to the oncologist's office after a six month reprieve. But once I was there, the old habits took over. I know exactly where to sit, (the waiting room shares space with cardiac and other internal medicine specialities). I know to make a pit stop right after I get called in to get my vitals taken. The vanity in me knows to wear flip flop shoes so I can shed those extra ounces before stepping on the scale. Yes, I need an examination gown. I know where I'm going before being led there. Everything is still very much as it was when I left it. Even the folders on the wall that say "hospice referrals." Yikes.
Dr. P didn't keep us waiting very long this time. I hopped right up on the table as he pulled up my chart. He asked how I'm doing and Eric referenced me doing "lots of miles." That launched us into a conversation about running. I told him about the races I've done recently, and that I was training for the San Diego Rock & Roll Half Marathon in June. As it turns out, Dr. P runs a bit too, but he does triatholons. Cool! I would love to get into that, but I would need a bike! (Santa??)
He asked if there was anything he needed to know about. Nothing bad to report, I said. I used to talk about my paranoia about recurrence, but all he offered before was a referral to a support group or therapy. I think running is my therapy now. So I didn't mention that this appointment had me a bit anxious for the past two weeks. He did an examination: feeling the lymph node area around my collarbones; listening to my heart and lungs; examining what is now my chest for anything unusual. As usual, he asked if I was going to do reconstruction. Nah. Being a runner now, it actually is convenient not to have breasts. Besides, I'm not interested in harvesting other muscles to make a couple of boobs. Just my personal choice.
The subject of my Vitamin D levels was brought up. Actually, Dr. P was the one to bring it up, although I would have if he hadn't beaten me to the punch. He was looking at my results from 6 months ago when they were around 42. He said that was really good. Is it? Says who? He said its an inexact science. I told him I would like my D levels tested again. He asked me how much Vitamin D I was supplementing. I looked at him with a twinkle and told him the truth...6,000 IUs a day. His eyebrows rose as he said that was quite a lot. In fact, he recommends that I cut it back to 2,000. I thought to myself that 6,000 was actually conservative considering I had been taking 10,000 before! Really, my levels were shockingly low a year and a half ago. The low end of "normal" was 30. I was at 14. He didn't think a re-test was necessary. I gently insisted and he said he would order it.
We also talked about switching me over from Tamoxifen to the post-menopausal drug. He said that younger women with breast cancer still may have some activity going on in the ovaries, even in the absence of having periods. Since I was having blood drawn for the Vitamin D, he ordered an estrogen level test as well. I asked him if it would be worth considering having my ovaries taken out. He said there is a clinical trial going on right now to determine if that is of benefit to women taking Tamoxifen, so he couldn't answer definitively. I've known him long enough to know he has opinions. So I asked what his was. He thought that it probably did help outcomes. Well, we'll see what my hormone levels are and talk about it at that point.
All in all, everything looked as normal as one could look given everything my body has been through. It's as clean of a bill of health as I can get. I still wonder if I would have more peace of mind with an MRI or a PET scan. Maybe. Maybe not. I don't know. Does it matter? If it comes back, as he said before, it won't be curable. Talk about having to just trust God with everything!
Even though he's a man of few carefully chosen words, Dr. P is a nice guy. On my after visit summary he wrote, "Good luck with your running." Nice, huh? But even thought he's nice, I hope I don't see him until October!
About this blog
I was diagnosed with breast cancer on June 11, 2010. As a result of my treatment, I have lymphedema in my left arm. I draw my strength from the Lord, as well as my family's Scots-Irish heritage. Our Graham's were a tough and scrappy bunch of fighters on the Scottish/English border. They came to America and continued to fight when necessary: in the American Revolution; the Civil War; and my brother is a Captain in the U.S. Army. My ancestors settled this country against all odds. My great-grandmothers on both sides of the family were pioneer women who settled the West. Along with that heritage, and the full armor of God, I am walking the walk and fighting the good fight.