Originally uploaded by my.third.eye
Other possible titles:
Wet Pink Curves
Flips, Curves and Death
Raindrops on Pink Underside
Wet Pink Petals
I don't really like any of these titles. Oh well. I DO like the photo, though!
Let's see. Today. Walk Olivia. Work on tax stuff in preparation for tax appointment tomorrow. Go to Efrem, get acupuncture. Come back and do Round Robin prep. More tax stuff. Go to SF loft to meet and orient another teacher who hasn't yet taught in that space. A short list but it will take many hours.
I also have to think some more about BCM (breast cancer monitoring). I can't decide how to do it. This is a note that I sent out yesterday to the email "breast cancer alternative treatments" discussion list that I'm on:
" To Anyone Who Might Be Interested,
I'm trying to get clear with myself about how I want to monitor for BC recurrence or metastasis, and am still confused.
I recently tried to get scheduled for the MRI that one alternative doc wrote an order for, which included more of my body than breasts and did not include the gadolinium contrast dye.
My health insurance co. refused to authorize it.
(Background: I was diagnosed in Aug. 2005. My last mammogram was Sept. or Oct. 2005. My last and only MRI, ever, was in Jan. 2006. Had a lumpectomy and sentinel node biopsy. One positive node. Three removed. No chemo or radiation. Technically, that made me a "Stage Two," because of the positive node. The only monitoring I've done since the Jan. 2006 MRI has been manual breast exams, most recently this past December, by the breast surgeon, who didn't feel any new lumps.)
I figured that my health insurance refused to authorize it because it was for more of my body than the breasts and/or because the order wasn't from a conventional doctor. So I went to the breast surgeon who did my lumpectomy, and she wrote up new orders for a mammogram, ultrasound and an MRI of the breasts only, with gadolinium dye. I made an appt. for the mammogram and ultrasound and re-submitted my request for an MRI authorization.
My health insurance co. rejected the second request, too, saying that I did not meet their criteria for being someone who would be at risk for breast cancer! So I got the bc surgeon to call them, and somehow or other she got them to authorize the MRI.
In the meantime, I had a followup thermogram (did one back in Sept., then another in January). There was slightly more inflammation showing in the followup thermogram, but nothing that really worries me too much. Just something to watch, over time.
When I mentioned to the thermogram doctors that I was scheduled for a mammogram and ultrasound followed by an MRI, he balked in annoyed exasperation and exclaimed, "Why bother with a mammogram and ultrasound? They're both a waste of your time; just go straight for the MRI."
I told my acupuncturist/Chinese herbalist) what the thermogram doc said, and he agreed with him.
I'm not big on the idea of regular mammograms anyway, because of the radiation and also because of the fairly high potential for false positives and/or inconclusive, "suspicious" readings that cause them to then recommend biopsies, which I am loathe to do because I think that biopsies stir up the cancer cells, if there are any, and can conceivably cause more harm than good. I strongly suspect that my one positive lymph node was caused by the fine needle aspiration (biopsy) that I had not once but twice.
And although ultrasounds don't use radiation, they too are never really all that conclusive..or as precise as MRIs.
So I cancelled my mammogram and ultrasound appointments, thinking I would just do the MRI with contrast dye.
But then I started reading about gadolinium dye and now feel leery of THAT! But if I ask for an MRI without the dye, how effective would it be? How worth it? For that matter, how worth it would an MRI WITH gadolinim be? What I mean is, what would I do differently if they identifiied "mets" or something suspicious that looked like mets? Anything?
And THEN I find myself thinking, "Maybe I should just try to go by cancer marker blood tests." But I'm confused about those as well, and am not sure they're all that useful, either. Different doctors say different things about them.
So. I need help sorting through this "how to monitor" confusion and am wondering what others think. I see a lot of people doing a lot of testing testing testing, and sometimes it seems like overkill to me. But I also don't want to go too far in the non-testing direction, either.
I also sent this note to one of the alternative docs I see (the one who prescribes my Iscador). His answer was:
"Unfortunately, there is no clear answer to these questions, so it would be best to just go through the pros and cons of each approach."
Uh...right. I was hoping you'd help me do that, doc. But I guess the message is: "You can do this as well as I can, Jane."
On the one hand, his response really annoys and frustrates me. On the other hand, I feel that he respects my abilities to assess my options, and he's not pretending to know what can't really be known in any definitive way. He's not saying, "Just do as I say." He's not professing to know more than he really knows.
I suppose what I'd like is a response somewhere between the two extremes. Chances are, I'll have a better chance of getting that response from the women on the discussion list. Not from a doctor.