23 April 2024
Apparently, things have been difficult at the cancer center at Holy Cross. I was not wrong that someone failed to schedule my today’s Herceptin treatment. They have a new person on scheduling and they thought it would be more logical to schedule sessions individually, one at a time for each patient. It didn’t work and some of us fell through the cracks. They’ve gone back to bulk scheduling for a patient. It was lucky I caught it and called in about no appointment for today. Once I had everything rescheduled, I had the hematologist/oncologist appointment first and the Herceptin infusion second – usually the reverse.
I had a long conversation with Dr. Velez. First, there’s some good news. My last Herceptin infusion should be June 25 or July 16. The reason there’s some question is Dr. Velez has to go back and hand count every appointment and take into consideration the one that I missed due to Covid. That means I don’t have to go through August of this year.
We discussed whether or not to do another Signatera test to check if I have any breast cancer cells floating around. My last test was in November and the score on the test was zero – no cancer cells. They drew blood for that test today and it’ll be a few weeks before I know the result.
I also asked about another echocardiogram. He intends to have that scheduled before the last Herceptin treatment. Herceptin sometimes leads to heart failure.
We discussed how Gabapentin was not working for my neuropathy. As a consequence, he’s re-prescribed Lyrica. That in conjunction with Cymbalta may have more effect. The Lyrica is 75 mg twice a day and he’s doubled my dose of Cymbalta.
I also asked about what happens after Herceptin. I remember him talking about another test, the Grail test, that checks for 40 types of cancers. It costs $849 but it is pretty definitive and sensitive. He gave the example of a person undergoing a colonoscopy and being told he was clear and then taking the Grail test and coming back positive for colon cancer. They were able to catch it early and treat.
This brought me to my come-to-god moment with Dr. Velez. I started as tactful as I could – you know me – tactful to a fault – not. I told him I understood he walked a fine line between trying to be upbeat for his patients and their chances and then weighing the outcome. I said he might wish to consider the patient a little more. I explained that I was a single, gay male who had never been in a relationship and 75 years old. The one great joy in life I had was hiking and the neuropathy has robbed me of that. I frankly told him I would not go through this again.
It may sound paradoxical that I’m thinking about the Grail test to determine if I have any of the 40 cancers it detects but if I do have some other form of cancer I’d like to know just for the amount of time I have. I pointed out that when he convinced me to do the regimen I’m on, he gave the example of a woman who refused treatment. He said without treatment, there was a 75% chance of cancer not coming back and with treatment there was a 95% chance of it not coming back. I think he was a little stunned with my frankness and confession I would not go through the process again.
It’s a quality of life issue. I’ve given up hope that the neuropathy will go away or even be mitigated. It’s quite painful to walk any distance and the one thing I enjoy most in life has been taken away from me.
I will point out he’s refused to give up on the neuropathy, hence the Lyrica re-prescription and the doubling of the Cymbalta prescription.
Lastly, he’s had the scheduler to make an appointment with an orthopedist to check my ankle. He’s concerned there may be a ligament tear.
I walked out of the examining room and directly to the infusion center and they seated me immediately in Pat’s section. There was a little lagniappe today in TJ, a massage therapist, making the rounds giving out free neck and shoulder massages. Yes, I took advantage of his offer. He works at the Healthplex on Dixie Highway and he was excellent. I’ll go there and see how he does on a full body massage. The rates are $99 for an hour which is very reasonable for Fort Lauderdale.
My blood tests came back with the same readings as always. There are some low levels of red blood cells and hematocrits and neutrophils but nothing to worry about. Pat has pretty much convinced me to purchase a walker. I’ll probably order one from Amazon and see how it goes.
In summary, some good news, some heart-to-heart with the hematologist/oncologist, a possible new massage therapist, and the probability I’ll be on a walker for a while.
Stay tuned!