Opinion: Column: Navigate This

(All these times are approximate – or they're not. It depends. It's sort of an all hands on deck kind of thing. Everybody, everywhere has to be flexible. All of the following appointments/procedures have to be completed this day – or else. If not, it could adversely affect the timing and suitability of my treatment going forward. Not to exaggerate too much, but my life could be at risk if all of the following are not adhered to:)

Lab work at 9 a.m.-ish required for my every-four week bone-strengthening shot. Nuclear medicine at 9:30 for the isotope injection for my 12:45 bone scan. After leaving Nuclear Medicine, I head to Radiology where I have a 10:30 a.m. CT scan. When my scan is completed (it only takes a few minutes, but generally speaking, they're not on time), I then go to the Infusion Center where I will get my every-four-week bone-strengthening shot. (Again the shot itself and vitals only takes a few minutes, but again, the process can take up to 30 minutes depending on the activities of the oncology nurses and the pharmacy's availability to prepare the medicine and the printing of my usual and customary paperwork.) Next – and finally, I go back to Nuclear Medicine for my actual bone scan at 12:45. This scan will read the nuclear isotopes injected into my body at 9:30. The scan takes about 40 minutes as it crosses my body head to toe to assess the condition of my bones. (The condition of my bones is not great. Unfortunately, It's a side effect of my thyroid cancer medicine as well as the 11 previous years of miscellaneous chemotherapies.) When this last scan is completed, my medical day is done and I will then be free to go. I will likely get home at approximately 3 p.m., seven hours after I left home.

This jam-packed day is a first and hopefully will be a last. On occasion, I have had a CT scan and a brain MRI on the same day (BOGO I jokingly refer to it), but never have I had medical madness (five separate appointments) as I will on June 24th, the consequences to my health notwithstanding. Hopefully, by the end of the week – before the weekend of worrying, I will have heard back from my oncologist, and then we'll deal with the consequences of all these previous actions. The waiting is not a huge deal. I have been there and done that for 12 and a half years going back to late February, 2009 when I was initially diagnosed.

However, this is not "concierge care." Any one of these five appointments could be missed for any number of to-be-expected complications when medical care is scheduled. Emergencies, double-booked appointments, staff shortages and longer than anticipated appointments could all affect my day of semi-judgment. And if any one of these appointments/procedures doesn't occur as scheduled, my care/my life expectancy could be jeopardized. From experience I can tell you, when this cancer patient has experienced delays and rescheduled appointments due to lab work (low white blood count, high creatinine levels, high or low calcium, above-normal potassium and on occasion low magnesium), treatment is stopped until levels return to a more normal number. In the interim, after your treatment has been stopped, your life begins to pass by you as you (at least I did) think that a delay in treatment puts your survival at risk. I mean, if your treatment is stopped at all, how does that stop the cancer from damaging you worse than it already has? Whether a week or two delay really matters, no one can say for sure. However, for the patient, especially yours truly; despite the reassurances from medical staff, in my head anyway: IT REALLY MATTERED.

After receiving a "terminal" diagnosis in February, 2009, I just didn't feel I had any margin, life expectancy-wise, for error, missed appointments, rescheduled treatment, et cetera. I figured that the information about my health – and as a result, any subsequent change in that treatment, needed to be known in an extremely timely manner. And when it wasn't – or isn't, I feel my pain, you know what I mean? Nevertheless, there are no guarantees in the cancer-treatment world. One has to learn to go with the flow and hope that flow doesn't turn into a flood.

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