Forward motion

October 24. Contact was finally made with UCSF. It was a bit of a cluster since first they said they hadn’t received a referral, but then it turned out they had. And they did not have copies of my medical history and procedures to date, but then they did.

Biggest challenge. Dr. Rugo doesn’t just see anyone who is referred to her. In my favor…I have not had any treatment for my current diagnosis. My cancer is not easily defined. It is currently considered a recurrence…but is it?

Rugo is currently out of the country. My case is on her desk and, hopefully, she will see it when she returns on Wednesday. Halloween. Best case scenario. I get a call with an appointment to see her in the next week or so. Or…I get referred to another oncologist at UCSF.

October 25. I decide to drive over to Adventist Health Ukiah Valley Imaging on my lunch hour to see if the authorization has been approved for a pelvic ultrasound in person. Phone calls just aren’t working for me.

Let me check. Yes. Didn’t Dorothy call you?

Smiling, more like smirking that I try to make look like a smile – No. That’s why I’m here.

The first available appointment is Wednesday the 31st at 5:30 p.m. Will that work for you?

Halloween? That’s creepy. More smiling/smirking – Yes. I’ll take it, but let me know if there are any cancellations. I have a flexible schedule.

Drink 32 oz. of water before you come. You need to have a full bladder.

Oh, boy.

Limbo land

October 19. Waiting to get authorizations for an ultrasound I need to get before I go to UCSF. Waiting to hear from UCSF scheduling. Guessing I should hear something by Monday or Tuesday.

October 22. Called Adventist Health Imaging. Left a message. Waiting.

October 23. Called Adventist Health Imaging. They still do not have authorization from insurance for the ultrasound. They will call my insurance to find out why. They will call me back.

They call back to say Dr. Wang’s office needs to send the order for the ultrasound to insurance for authorization. I say I thought that was done last Thursday (October 18). No. Insurance doesn’t have it and Imaging can’t schedule the ultrasound without it.

I call Dr. Wang’s office. They seem confused by my request and I explain the situation. I’m sympathetic and joke that it’s a full moon. Things happen during full moons. We share a laugh. That’s good. I’ve found that it’s really important to make friends with those who schedule appointments. I ask if there is anything I can do to expedite the situation. They tell me they will take care of it and call me back.

Waiting. Still have not heard a word from UCSF. Waiting. Looks like I’ll be making more phone calls tomorrow and…of course…waiting

PET Scan results

Here is my fantasy. The PET scan results reveal no cancer. The biopsy was a false read. I am cancer free. That is why it is called a fantasy.

October 18. My entourage is with me for the 3:40 p.m. appointment with Dr. Wang. Steve, Katie and I are sitting in the waiting room when they call my name. We go to the exam room and make a brief stop for the weigh-in. I remove nothing – 101 lbs.

The nurse brings in an extra chair and then does the usual blood pressure, temperature check. After a bit of time, Dr. Wang comes in and we introduce him to Katie.

He pulls up the PET Scan images and slowly goes through each frame—from the top of my head to the top of my thighs. He points out my eyeballs, esophagus, heart and talks about how the radiated sugar attaches to cancer cells and glows. That is also true of anywhere there is fluid like the stomach and bladder. He looks for glowing where it should not glow.

The location that glows is my tumor and one small spot under my arm. The rest of the PET scan is clear. Whew. The cancer appears to be isolated. Encouraging news. At this point it is considered a recurrence of the breast cancer 19 years ago. Mostly due to the close proximity to the original cancer, even though this cancer is not estrogen receptive and the breast cancer tumor was estrogen receptive.

We talk about treatment. He suggests that the surgical removal of the pea-sized tumor under the arm would be relatively simple. But the main tumor—the poorly differentiated carcinoma—attached to the muscle is tricky. There is no one locally he would recommend. UCSF is my best option going forward. What oncologist would I like to be referred to? I just happen to have a name given to me by a doctor friend on my Board of Directors. Oncologist Hope Rugo. Dr. Wang holds Dr. Rugo in very high regard and hopes I can get an appointment with her as she is in high demand. He also wants to refer me to a UCSF breast cancer surgeon. A friend who recently had a double mastectomy gave Katie the name of Dr. Cheryl Ewing. a surgeon who she highly recommended. Dr. Wang also knows or knows of Dr. Ewing and agrees I would be in excellent hands in her care. The referrals are made.

So now I wait for the schedulers to call.

There is a sense of encouragement. Steve and Katie see it as good news. For me, it’s hard to see any news as good news as long as I still have cancer. I’m grateful it is in one area, for sure. For me it will be good news when it is gone.

Life is a shipwreck, but we must not forget to sing in the lifeboats. —Voltaire