Tuesday, July 1, 2008

Good News and Stanford

We went to Dr. Cohen's office this morning for a check-up to see how my body was doing on the Gleevec. My white cell count was 11,000! Normal range is 3,900 to 10,900. This was very good news. It means my body is responding well to the drug.

In the afternoon we went to our appointment at the Cancer Clinic at the Stanford Advanced Medicine Center for to see Dr. Coutre. He's a specialist in cml and we wanted to get a second opinion as well as have some additional questions answered.

My appointement was at 3:15pm. We arrived at 2:15pm to have blood drawn. We then waited in the clinic lobby till almost 4:30pm trying to entertain ourselves wondering why the clinic was so slow.

The kind of people you see at this clinic aren't like what I've gotten used to seeing at Dr. Cohen's office. A good percentage of the people here are wearing respirators and rubber gloves. A few even have I.V. carts. I assume that because chemo causes your immune system to weaken, they need to be extra careful to prevent getting an infection. There are a few people around my age here. At least they look like they might be in there 30's.

The hematology oncology center at Stanford is clinic C. Clinic D is neurology oncology. In very poor taste I joked with Wendy that we were lucky, we were only one letter away from a brain tumor.

Finally around 5PM I asked the lady at the front desk why we hadn't been seen yet. She said "Oh, you're back?"

Are you serious?? We still don't know if they forgot us or if we missed when they called our name. Either way, finally at 6pm we were called in and shown to an examination room. A male nurse took my vitals and left promising that Dr. Coutre would be in soon. At this point, we were worried that we'd waited all day for a rushed visit due to the late hour. We were afraid we would get none of our questions answered.

A med student named Rena Patel entered the room about 15 minutes later and asked if it was alright if she did the preliminary medical history questioning and examination. We agreed after which she proceeded to quiz me about my past medical history, how we had ended up at Stanford, what side effects I was seeing from the Gleevec, etc., etc. She also did a physical examination checking muscle response.

Rena was fantastic. She was very patient and forgiving while translating our layman's descriptions of what I was feeling into something medically comprehensible. We could tell she was a little nervous. I don't envy medical students in training. People expect doctors to be unwavering pillars of knowledge and wisdom. We expect them to be decisive and confident. After all, we're trusting them with our lives. Medical students are just learning. They're not yet confident in their place and they can't yet call themselves doctors. If it were me, it would be difficult to work with patients who might not understand that doctors need training and that I was still just learning.

Rena finished up and left us alone. We then waited another 15 minutes for her to return with Dr. Coutre. Our fears of being brushed off were quickly abated as Dr. Coutre proceeded to outline cml, what it was, how it affected your body, how it was treated and what we could expect.

We had many questions to ask, but only one that I really cared about:

"At this point, what are the chances that this is misdiagnosed? Is there any possibility that it's not cml?"

His response was short and confident: "None. This is what it is."

Fuck, now I really have cancer.

We finished asking our dozen or so questions which Dr. Coutre patiently and graciously answered before making our way out of the clinic and heading home.

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