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Topic: I hate timid and mellow doctors!! horror story!

Forum: Caring for Someone with Stage IV or Mets —

A place where family members, caregivers, and loved ones of people having a Stage IV (metastatic) diagnosis can share, discuss, and support one another through the tough times unique to this diagnosis.

Posted on: Jun 15, 2019 10:15PM

MexicanMary wrote:

My sister and I have been running all over to find a Medical Oncologist that would take care of my mom's chemotherapy. My sister -since she's an ENT- has a unique approach to other doctors who happen to have relatives that have gone through cancer themselves, so references are high and mighty. I do not know any. and since I am busy helping around and trying -because moms never stay still- to keep mom to do what the doctor stated and take it easy on her back. I only do the logistics: get the appointments and stuff.

So I took an appointment for Doctor A. Highly recommended, retiree from the county hospital with flying colors. very busy person, so I called everywhere to get a soon appointment. I finally got one and when I took mom to her practice:

doctor: "well, once cancer metastasizes it means it is here to stay. anything we do is only palliative . What we would do is get her on this medication. and then this one and probably county will get her on this one. so we would need to choose medicine 2 or 3. Indeed it is not a good idea for her to have two medical oncologists. I recommend medicine 1 which comes in shots and the first set will be three in one month and then one each month. Medicine 2 is once a month for as long as she LASTS. costs are for medicne 1 70k PER SHOT and for medicine 2, 20k per month."

I was: "WTFF?!?!?!" I promise you guys, while the cost is way over the clouds (I checked, medicine 2 costs 2k a month) it's my mom, so there is literally nothing I could not or would not try. I was already doing math to see how could I afford this when she said: "for as long as she lasts". I was. "lady, do you think we are talking about a pair of shoes? your brain? lasts?!?! really??

When we got out of the office. I was silent, pissed off at that attitude, but I wasn't saying anything as mom was depressed and my sister was quiet. Eventually, my sister also snapped against the "doctor" and we agreed that she was an unfit physician.

We turned to another doctor. This one is still working in the county hospital. she's also recommended by the friend fo a friend who got her to treat her father (though the father apparently died before she finished her treatment -which perhaps should have cast some big red flashes-) she politely declined and said that the best doctor was the county doctor mom's scheduled to see in TWO months!

she did not offer any treatment. however she ALSO stated that "in your mother's state, any care is just palliative. the best course of action is to take a biopsy of both the spine and the liver" At that point I stopped listening to her. I did so because the surgical oncologist that performed the mastectomy on mom 11 years ago saw us frist (actually we went to see him first of the long list of doctors we have seen now) and he said, at first that recovery of breast cancer metastasis in spine is total and no problem. When he saw the two small dots on mom's liver he looked grim and apparently he believes that mom's cancer is now terminal though he continue to say that there is remission possible.

In any case, he said that biopsies are not an option due to mom's damage on the bone and the delicate state of her liver. (she as Nash).

In both cases, the few times I spoke during consultation I asked three questions:

a) is remission possible?

b) I do not understand this paliative thing, if remission is possible, then how can medications be paliative?

c) can we start chemo right now

and all of them have said:

a) yes, remission is possible. it either happens or does not happen

my mind: Duh! you sorry sack of shit! of course, you are either stupid or just lame

b) they are paliative because they could not work, but if they work they will heal her.

my mind: "omg! what cereal box did you get your degree from?!?!

c) no, actually, the first thing to do is her radiotherapy on the column to prevent T11 from collapsing. Then, after she has recovered from it, THEN we can start chemo. and actually it is not chemo since your mom's Ca is hormone based it is hormone therapy

my mind: IDIOT! so if it is NOT chemo, and it is not a "serious" treatment since it is hormone therapy, how the flying fuck you tell me it is "only paliative"?!?!

it's a long rant. I am sorry. my bestie, the one who used to listen to my rants passed away two years ago this september. Not cancer, an intestinal aneurism that was poorly cared for.

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Jun 17, 2019 12:53PM vlnrph wrote:

First of all, I am sorry to hear your 'rant recipient' died so recently. Second, I trust that your mom is grateful to have two devoted daughters overseeing her care. I am not familiar with the Mexican health care system. That being said, it is true that bone disease is usually expected to have a better prognosis than metastases to organs such as liver, lung or brain. The common understanding is that mets are treatable but not curable.

Sometimes the palliative approach is confused with hospice. Formerly, the attitude was that since patients are not going to survive, why bother with research, etc. Now that we see folks living over a decade past diagnosis, advocates are demanding more attention. Don't Ignore Stage IV is one slogan.

Hormonal therapy is a rational initial step for tumors confirmed to be estrogen sensitive which is why biopsy is suggested (however not always possible) because receptor status can change from the original diagnosis. I get fulvestrant/Faslodex injections, the medicine 1 you describe since I did not tolerate the aromatase inhibitors many are able to take. My other med is also an oral agent. Both of those were started after radiation was done and are pretty expensive as you learned. Luckily, our insurance covers the cost. To summarize, it actually sounds as though the doctors are following conventional standards of practice although their choice of words is poor...

IDC too! 🎻💊👪🐩 🇫🇮 🌹🦋 Rt MX+DIEP 4-2011; ALND 5-2011 d/t micromets; TC X 4; tamoxifen; lymphedema 9-2011; switch to letrozole 3-2014 for 1 yr; bone mets 8-2018: Zometa, rads to spine, Faslodex+Verzenio; 11-2018 vertebroplasty Dx 3/7/2011, ILC, 2cm, Stage IIA, Grade 2, 1/25 nodes, ER+/PR+, HER2-
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Jun 17, 2019 02:22PM MexicanMary wrote:

Hi vlnrph!

Thank you for your kind words. Yes, stupid GP. I miss him so much still.. . I know he "hears" me and "replies" but it is not the same. I see. It is a hard thing for us, despite my sister being a doctor, there are so many things that feel "paternalist" and that is just infuriating. But through your words I am able to understand that these lame ass doctors are not stupid, just lame. which is a good thing.

Mexican medical system is chaotic to say the best. we have three major medical care systems and you can be in ONE of them: government issued (this one changes with each president). government based (it is only for government employees -allegedly) and government subsidized (this is partially paid with employees, employers and government money) all three lack medications and all three have million patients per doctors, so consultations are usually of 5 minutes or less. Still, it is my hope that, with what you tell me, the medications that my mother needs are basically covered through this system.

My sister is already looking into alternatives and other health insurance services. So, when you remember me, cross your fingers. haha

Mom is a very religious person. I'd say you can label me an "electic heretic" as I do not agree with most of the cardboard standards of religions. But know that I do thank you and wish you thousand blessings. your words have given me a renewed hope and soothed my anxiety to look for a medical oncologist.

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