A Visit with the Seattle Cancer Care Alliance

Friday - December 20

Snow!  Yes indeed.  Woke up at 4:50 am to a winter wonderland.  Do I really want to go to the gym?  I read once that no one ever got compliments for sleeping in, so I am up and out the door.  I get through the warm up and the strength portion (85# on two hang cleans with a push jerk... yahoo - my strength is starting to come back). And the snow is still falling.  Seattle traffic could be a nightmare with this white stuff so I leave early and head back home.  In an hour, we are showered, packed, dogs fed and loaded and on our way.  A quick stop at Auntie Pam's to drop off the dogs and then onto the freeway. We pass quite a few folks that attempted some off road action but make it to Seattle without mishap.  The tow trucks will be busy today.
Neil has to go to Spokane for the day to visit with a client, so I drop him off at the airport and then meet up with Judy (husband for the day) and we make our way to the Seattle Cancer Care Alliance.  Seven floors of doctors, patients and all kinds of treatment options.  I take a deep breath and step inside.  Breast cancer is dedicated to the third floor... So we check in and are told to have a seat in their waiting area.  There are quite a few other folks here...a husband and wife sit together closely and the woman is clutching a wad of tissue.  She looks terrified.  I remember feeling like her.  We find a couple of chairs near the window with a beautiful view of Lake Union.
Soon my name is called and we are taken back to an exam room.  This will be our home for the day.  The nice nurse takes my vitals and then I'm told to change into a gown and one of the "fellows" will be in to examine me.  A very kind East Indian woman enters and her role is to review my story, examine me, and then she will present my case to a team of doctors who will then discuss their views on the best treatment plan for me.  The Team Approach is what this place is all about.  So we review the last three months and go over my medical history.  I'm a pretty boring patient when it comes to medical history... No allergies.  No medications.  Never smoked.  No other surgeries.
Exam and interview complete, Judy and I are free to leave and get some lunch but need to return by 2pm.  It's cold and blustery outside but we make our way down to the water and enjoy a wonderful lunch.
Upon our return to our little room, I'm to put the gown back on and will now be examined by the team of doctors (a surgeon, a radiation oncologist, and a medical oncologist). Whew!  While we wait for them, a volunteer comes in to visit.  She is a nine year survivor who had a double mastectomy, chemo, radiation, and reconstruction.  She is good to talk to and to listen from, as a person who has walked this path before me.  She tells me to not be afraid of reaching out to support groups and to embrace your network of support.  She said she got to the point of putting a cooler on her front porch for people to drop off meals or groceries.  Good food for thought (pardon the very bad pun).
There is a knock at the door and three women walk in...this is my "team".
The room suddenly feels very tiny.  The first to come forward is a very slender Caucasian woman who reminds me very much of Neil's sister, Dinah.  She is the surgeon.  Next is a Spanish woman -she is the oncologist.  Finally, a 9 month pregnant Chinese lady (in heels) meets me -she is the radiation oncologist.  They all take turns examining me both sitting up, and lying down.  You can tell by both their touch and their faces that they are each seeking something different.  It's all rather fascinating if you can disengage your sense of modesty from the situation.
They exit the room and I can finally redress.  Now each one returns, one at a time, to visit and give me their recommendations for treatment.
First to return is the surgeon.  She has the largest concern...because three of my lymph nodes were found to have cancer cells, it is their "standard of care" to do a "lymph node dissection".  I guess 3 is the magic number here... 2 or less nodes and you're good.  3 or more and they go for the dissection.  "What did Dr. Kaufman tell you about the dissection?"  Well, to be honest, this is the first I've heard of this procedure.  And I believe that Kaufman plans on letting the radiation do the trick.  She agrees that the radiation approach is also successful, but there has not been enough data to support that as the standard of care.  Her recommendation is to go back for more surgery, and she could fit me in on Monday or the 31st.  Whoa!  That's kinds quick!  I tell her thank you and that I'd like a chance to talk with my surgeon ( whom she knows).  She mentions that the surgery could also be done after chemo and before radiation and still be just as successful, but it skews their data a bit.  It's all about the research.
Next through the door is the radiation oncologist who looks like she's about to give birth any minute. Turns out, she's due on the 31st.  We discuss what Dr. Taylor had suggested and the treatments are very close.  He is 7 weeks of daily (Mon thru Fri) treatment, she is 6 1/2 weeks.  We discuss the lymph node dissection some more and she says that depending upon whether or not I decide to have the surgery would alter the areas of treatment for her.  But she is confident either way that she can get the job done.
Our final visitor is the oncologist.  This is the lady I've been the most eager to talk to... Will her treatment plans be the same as Dr. Chemo?  Turns out she agrees with him 100%!  His recommendation is the highest standard of care. 
It is now after 5pm and our day is finally over.  My head is swimming with all of the information I have received.  I'm a little nervous over the prospect of more surgery, but I am content with the knowledge that my guys in Bellingham are pretty much on the same page as this team in Seattle.  (*sigh of relief*)
I'll give Dr. Kaufman a call next week to discuss his thoughts on the lymph node dissection, but for now, I'm just going to relax with family and friends and enjoy the holidays.  All presents are on hold this year... doctors visits and medical tests have taken every spare moment I've had this month, so I've announced that I'll be celebrating Christmas in July.  But that doesn't mean I can't share a good meal and some holiday cheer.  :-)

So, hug your family and friends extra tight and let them know they are loved.  I wish all of you the most blessed of holidays.