Wednesday, April 22, 2015

Organize your Medical Team

I am fast approaching the 5 year anniversary of my mastectomy.  Thankfully, I am healthy and quite happy with my progress!!  This post was originally shared on my the Fashionable Giving blog, a few years back.  While it shares the specifics of my situation, my intention is to share a few lessons learned:
  • You do not have to wait around...take care of yourself now!  Start where you are, with what you have.
  • It is great peace of mind to find the doctors/caregivers who are perfect for you - it takes work but is worth every minute invested!!
  • Good medicine is not restricted to those in the medical profession.  Consider your whole self, not just your symptoms.  
  • Do not be rushed into anything that doesn't "feel right" to you.  Don't dawdle in your decision making...take the time you need to be confident in your caregiver decisions.  You will spend a LOT of time with these folks for the duration of your immediate and recovery care.
  • If you are caring for an aging parent, ask permission to start attending their medical appointments.  Get to know who is taking care of mom or dad.  Be present and learn how they interact with your parent.  
  • Learn to be the best advocate for yourself and or your loved ones.
  • Who's on your team???

Breast Cancer….really?!

Somehow, I thought that once you had been dealt the ALS cards, the universe had played all of its aces.   Sadly, I was never very good at counting cards!!

The 2 ½ months between Thanksgiving 2009 and the end of January 2010 brought a flurry of activity including a new job, a move to a new apartment, a battery of tests and a breast cancer diagnosis.  I also discovered that I have crappy sickness insurance.  I have received a doctorate in life in the first half of my health ed semester!

While waiting for my insurance benefits to renew, I’ve taken a proactive approach to my health.  The irony is that my “health” insurance won’t cover any of the procedures or steps I’ve taken to improve my health!  No matter, it’s the right thing to do.  I’ve been extremely fortunate to find a wonderful group of alternative health care professionals.  I assure you, not a single one of them has recommended shark snot or rhino horn dust!  In fact, I’ve become a fan of combining Western and alternative care for my continued well-being.

Gynecologist/Nurse Practitioner – Elizabeth Sivesend

Liz has turned out to be a gift from heaven.  After I found the lump, I needed to find someone to take a look.  I found 6 GYN specialists in my new neighborhood, clustered in 3 practices.  Liz’ office was the only one who answered the phone and was able to get me in within a couple of days.  There are no accidents – I was meant to be in Liz’ care.  Her assistant Lauren lost her grandmother to ALS during the summer of 2009.  A fairly quick, but thorough exam resulted in a referral for a diagnostic mammogram and ultrasound…just to be safe.  As you have probably already guessed, the radiologist delivered the news that there is a very suspicious mass in my left breast, found by the ultrasound.  Not one single mammogram done in the past 15 years raised any suspicion.  Next stop, a local surgeon for a needle biopsy.  Liz had two names for me, I only needed one.

Primary Surgeon – Deborah Kerlin

I called both surgeons and was told that it would be several weeks before I could be seen.  I made the appointments and didn’t give it another thought.  The following day, I received a call from Val in Dr. Kerlin’s office.  I had an appointment 2 days later.  KKL: "What in the world did Dr. Fish say to you?”   Val: “That it would be best if you were seen quickly.  I’ll see you Friday evening!”  Again, the universe took good care of me.

If you have not had a biopsy, I won’t spoil it for you.  It’s sufficient to say, that I was made to feel completely comfortable, for a procedure that is not terribly comfortable.  She had me at the bathroom, which is immaculate and yet very inviting.  But she continued to woo with pillows under my knees which were covered with pristine white pillow cases, trimmed with Battenberg lace.  She sealed the deal by sharing her story, which is quite inspiring, while she carried out the biopsy.  It couldn’t have been easier.

Less than a week later, I was back in the office for the “reading of the diagnosis”, with two of my closest friends, who were prepared to put Dr. Kerlin through her paces, to make sure I was getting the best care.  She confirmed that indeed, the bug in my very personal software is lobular breast cancer, not the cyst I expected.   There’s a lot I could share about this type of cancer, but will recommend a couple of good sites, if you are curious.  What’s unique is that lobular breast cancer tends to grow under the radar and tends to send out little scouting parties, looking for new homesteading opportunities.  Favorite haunts are the other breast, the bones, the lungs and the brain.  Breast cancer in the brain….go figure!  To minimize the chance that Dr. Kerlin had to deliver another diagnosis, she recommended an MRI.  Please check my post “The Claustrophobic and the Tuna Can” for the details.   As we left the office and headed to dinner, I knew 2 things; 1) my life would never be the same and 2) my friends were reassured that I was in the best possible care.

Plastic Surgeon – Vivian Ting

Dr. Kerlin gave me the names of two plastic surgeons she works well with.  This referral led me to Dr. Ting.   Both surgeons would have done a wonderful job.  Dr. Ting had the “x” factor that is personal for me.  I can’t actually describe it, but I can give you examples of what made me know she was right for me.  1) Her office is beautifully furnished.  Not expensive, not lavish but modern, tasteful and beautiful.  The magazines are current; the product display shelves are clean and well displayed.  The music is classical and never heavy.  The fresh flowers in the center of the waiting area are always a riot of color and are never “over done”.  2) Her staff is lovely.  Warm, caring, friendly, efficient and stylish.  Breast reconstruction patients are not her only clientele.  She is in the beauty business and her staff reflects that without coming across as Barbie Dolls.  3) Dr. Ting seems to me to be almost shy and yet very confident in her chosen profession.  She listens patiently, answers every question and quietly builds rapport.  I felt very comfortable, almost as if she was a close friend who just happens to be a gifted surgeon!  4)  Her sister is a pediatric anesthesiologist and each year they take some vacation time and set up temporary “shop” to repair cleft palates for children that could not afford to have this type of surgery.  She and Dr. Kerlin will assist each other during my surgery – which I think is really cool!

Spiritual Advisor – Rev. Dr. Joan Steadman

Early last fall, I started a search for a spiritual community.  I’d gone as far as I felt I could go alone and needed a church – a place to call home.   Searching for a church is a singularly “grown-up” task, like purchasing a refrigerator or contracting to put a roof on your house.  Children are not called to make these types of decisions!  I made the tour of New Thought communities in the greater East Bay and just before Christmas, found my way to the Oakland Center of Spiritual Living.  I was fortunate to be able to take the foundations class this Spring.  While learning the basics of the faith (which has included more homework than I ever remember doing as a student!), I’ve found a way to channel and calm my mind.  I’ve missed very few Sundays since and on May 19th, officially became a member of the congregation, agreeing to bring the gifts of strength and sparkle to the community.   We have an awesome choir, are an open and very inclusive group, and Rev. Joan often seems to speak directly to me during services.  Just what I would expect! 

 Nutritionist – Marc Weill

My girlfriends – women friends really – are the very best source of referrals!  Marc is the primary practitioner at Core Care Center in San Francisco and was referred by my friend Cindy.  Cindy’s an 8-year BC survivor who has been able to keep it that way by following Marc’s advice.  She insisted I go (she drove!) for an “informational” appointment.  While his diagnostic technique is like nothing I’d previously experienced, his advice was rock solid.  Plus…I couldn’t really argue with Cindy’s results!  In four months, I’ve:
  1. cleaned up my diet to get my system more alkaline by: following a 3 week cleanse diet, going mostly organic, dramatically cutting my sugar intake (trust me it’s everywhere!), regularly drinking wheat grass shots, quit Diet Coke (sorry Coke, I know your stock has suffered!) cold turkey, cut my wine intake by 90% (damn the sugar!) and even then it’s organic, and  (mostly) cut out the eggs and dairy from my already meatless diet, to become all but a vegan.  In the process, I’ve re-discovered my love of cooking and a world of interesting vegetables, legumes and spices.   The best part is that my family has embraced my meatless ways and is more than happy to come to dinner if I’m cooking!  I am truly blessed!
  2. taken a boatload (truly!) of supplements designed to boost/support my  immune system.  Vitamin D is my friend.  As are B, C, G, chlorophyll, folic acid, zinc and a whole alphabet of supporting characters.
  3. learned about lymph and my lymph system.  I knew I had lymph nodes but had NO idea why or what they do.  I do now!!  Weekly cold laser treatments and 1 hour naps on a light beam generator have (I hope!) made my lymph system much happier and more efficient.  This is one I have to take on faith because there’s just no way for me to measure it.

Chiropractor – Michael Patrick, DC

Michael’s been in my life for as long as I can remember.  Until this year, I would visit Michael whenever my back decided I was not giving it enough love.   For the past 4 months, I’ve seen him weekly, to adjust my back, check my neck/shoulders for stress, and to receive his unflagging encouragement.  He has also delivered doses of cold laser treatments, designed to support my immune system.  I’ve always appreciated his kind, straightforward style.  Chiropractic is the BEST!

Acupuncturist – Jasmine Oberste

I’ve been curious about acupuncture for a long time, but never got off my butt to check it out.  During a conversation with my friend Kim, I mentioned my curiosity and she began raving about her practitioner.  Seriously…raving!  I called and as long as Jasmine is practicing, I will be one of her grateful patients.  Again, she’s a patient listener who sees me as a whole person, not just a body with achy knees, a sore shoulder and oh yeah….breast cancer.  I’ve seen her once a week for at least 3 ½ months and I am better – physically and mentally – for those visits.  Her hands are sure, her needling technique is fun to watch and I truly enjoy our time together.  She’s focused on supporting all of the nutritional work Marc has me following, so my liver, kidney, lymph and chi have never had it so good.  Marc makes these parts work hard, Jasmine makes sure they are up to the task!  She’s even making a house call after surgery.  Amazing!

Trainer – Creig Nakano & Carlo Maravilla/UFC Gym     Belly Dance Instructor – Leez Aziz/Belly Dance!

The very last part of the health equation for me has been (and maybe won’t always be!) exercise.  I realized finally that I could no longer continue to coast on my desk jockey ways and expect my body to function well, let alone optimally.  I’ve enjoyed my belly dance classes and community for a number of years, but fell off the caravan a year or so ago.  I started back and was relieved to discover that I had not lost all that Leea had taught.  I love the studio, and the women who gather to shimmy, pop, lock, and support each other every week.  My isolations have improved dramatically in the past 2 months and it’s a whole lot easier to do a “Maya” than ab crunches!

This leads me to my final team members - my trainers Creig and Carlo.  I interviewed a number of gyms and came back to UFC because it was exactly what I needed; a no nonsense, kick ass gym.  If you are unfamiliar with UFC, please check Google…I had no idea!!  And no, I haven’t been in the cage…yet!   Creig went to Beijing with the Olympic athletes a few years ago.  He’s quiet, funny and knows his business.  3 days a week for the past 2 ½ months, he’s whittled my formerly considerable backside into a (well on its way to becoming) shapely following.  My brother commented that I now have “guns” for arms – thanks for noticing D!!  I’ve lost 2+” off of my thighs and his fun approach to core work has improved my posture and balance dramatically.  We started right where I was, but he sees ahead to where I can be.  We work hard together and I’m appreciative of the creative program and encouragement.  I still don’t love going to the gym, but I dislike it a whole lot less!

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