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Wednesday, March 3, 2010

The more things change

...the more they change.

I've always been one to choose fewer medical interventions over more. When I was having babies, I chose midwives. When I chose midwives, I chose ones that were not interventionist. I had one baby at home. I managed my son's ear infections with alternatives to ear tubes when it looked we were going to be encouraged to go that route.

When I have a cold, I have my own way of handling it that has always worked pretty well.

It's rare that I take antibiotics; my kids need clear symptoms of bacterial infection before I'll give them antibiotics. I was all about minimizing antibiotic usage before the medical community jumped on the bandwagon.

Then the whole cancer thing happened.

Once a person is diagnosed with cancer, there is no "bandwagon" per se. It's a high speed bullet train. Or at least it is with breast cancer. There are scans of various types: CT, PET, MUGA, MRI, probably more that I've forgotten. There are blood tests and appointments. Various minor surgeries: biopsies and port placements.

Suddenly, you have to decide on doctors to treat you. Before, I'd always chosen doctors willing to work with my quirky ways. Our family doctor, I chose because I knew I had a kid with pneumonia, our current doctor (at the time) couldn't see him and wouldn't call in an antibiotic until he did...instead he suggested I take the kid to the ER, so I called a doctor who was advertising for new patients in the paper. It's a good fit. His passion is sports medicine. We've used him quite a bit for that, too, and he at least doesn't argue with me about my quirkiness.

But when it comes to cancer. Wow. How do you decide? A bad decision could hasten death at best, result in imminent death at worst. I am very fortunate that I had a friend I could turn to, and I chose her dream team of doctors. My cancer is pretty black and white. "Garden variety" as my oncologist put it. The treatment is pretty much the same from doctor to doctor, clinic to clinic.

This is not something that I want to take chances with. I've read of people "going off the grid" so to speak with their cancer treatments. I respect those choices, but I'm not willing to do that. I'll take my supplements to enhance treatments, to support my health during treatments, but not in place of treatments.

Um, no way.

I did make one unconventional choice in all of this. That being to have a tissue expander inserted on the side to be radiated. My plastic is OK with it; it's pretty cutting edge in the literature; it makes the radiation a little more challenging; it gives more options for final reconstruction if it works. If it doesn't work, nothing is really lost. Because I heal well, my breast surgeon and my plastic surgeon trust that--physically--I won't have a problem. It's up to the expander. It needs to survive the radiation. The radiation oncologist I first saw wasn't pleased, but he was young and had little experience. I've since switched to a different doctor in the same practice (there really is only one radiation oncology practice here) who has 25 years of experience, was recommended by my plastic surgeon, and didn't bat an eye at "the plan." Personally, I'd not choose the guy as a friend. He was pretty off putting, didn't make eye contact, hadn't read my chart before coming in to examine me, very off putting bedside manner.

And that's the thing. I'm NOT choosing a friend. I"m barely choosing a partner in my care. He can be horribly offensive to me, as long as he's good at what he does. I am trusting he will not damage my heart too badly (there will be heart damage, it goes without saying). I don't have to live with him. Or even share a meal with him. I need him to do his job, do it well, and I have to trust that neither my oncologist nor my plastic surgeon, both women very proud of their work, would recommend someone if they thought he was going to impede their work.

All of which is a long way of saying that I've made some choices in the last six months I might not have given great consideration to in the past. For instance, my family all got the H1N1 vaccine. No questions asked. My family and I all got the seasonal flu vaccine. My first ever. Tynan's first vaccine ever. No questions asked. I didn't even investigate other alternatives. Whatever was in the doctor's office was fine.

And today, I started taking antibiotics for a cold. Why? Because if it is more than a cold, it needs to be dealt with. I don't have an intact immune system. I'm sure it's a virus, though, because I don't have symptoms of a bacterial infection. Plus, I've already taken a child to the doctor for this same illness, where I was told, "It's a miserable cold." Truth be told, my child was so miserable that I was hoping that he'd be prescribed antibiotics. Alas, he just had to suffer. Even cold medicines barely touched the symptoms. Then, the other two kids got it. Same progression of symptoms. No fever. Typical cold symptoms .

At the same time, if I'm on antibiotics, there is that much less of a chance that I'll get a secondary infection. Or, the antibiotics will cure any little bacterial infection lurking in there. Hard to imagine that there isn't some sort of bacterial infection in full, snotty sinuses.

Even more importantly, if I'm on antibiotics, I'm less likely to be turned away from chemo on Friday.

The only thing worse than getting chemo is not getting chemo.

As much as I dread it, it needs to be over. Friday is my last chemo. It just needs to end. And if I take these antibiotics, the infusion nurses are less likely to freak out about less than ideal health.

So, without even thinking about it, I skipped off to pick up my zithromax. Yep, Z-Pac for a cold. I've never taken such a strong antibiotic in my life. None of my kids have taken it.

Interestingly, two hours after taking the first dose, I actually think I feel better.

Maybe it wasn't just a cold.


Abby said...

Yuck...Dawn, I've been thinking about you with that cold or whatever it is and hoping it goes away fast. As always, I admire your strength and courage and the directness with which you describe your experiences. You rock!

Anonymous said...

Shadi had a head cold for a month...first dose of his z-pac and he could breath and stopped making 24/7snot...cleared up in 4 days! sometimes they ARE the miracle drug.

suzee said...

If it's the same cold I had in January, it's the first time I've ever ASKED for abx for a cold (I'm sure my sinuses were infected - it was the worst cold I've had in years, worse than what we think was H1N1 by FAR). I was turned down.

Three cheers for the end of chemo. I hope things get sunnier for you soon.

Dionna @Code Name: Mama said...

Positive, peaceful thoughts your way for your last chemo session tomorrow. I've been reading through some of your old posts and wish I'd found you sooner.
Coincidence of my day - I was in contact with someone today on the national board of "Cleaning for a Reason" (I'm planning on profiling the organization on my site soon). And reading your posts made me wonder - would you be interested in being interviewed? I have some thoughts brewing - mainly things like "what the heck can I do for my friend who has cancer and kids?" (i.e. visit frequently and read to her young kids when she's too wiped out from chemo)
If it sounds at all appealing, please contact me. You can find me on Twitter (CodeNameMama) or send me an email by visiting my site and clicking on "contact me" on the menu bar (right below the header).