MRI - possible bad results (update)results suck (update II)

[Precision]

Our appointment in Miami went something like this.

Got there a tad bit early.
Was told by the reception lady to do paperwork and they would fit us in as promised.
Later, was told by the same reception lady that the doctor was running a bit late due to a surgery being a little more complicated then anticipated, but he was looking forward to meeting us. We probably had an hour plus before going back to an exam room.

The wife was hungry, so I left her there and ran a building over to the cafeteria to get her some fruit. Fifteen minutes into that twenty minute process, she calls and says she is in exam room 4 awaiting the doctor. I scurry back. She has time to eat her banana and the doctor shows up.

He says he decided to see us first as he is enraged by the story he has been told regarding her previous consults.

We discuss with him our previous consults, he reviews the MRI. We talk some more, he goes thru the MRI a bit slower and tells my wife that he has only really glanced thru the MRI but he sees more than 11 lesions that the other guys counted. Her face tightens up. He paused with a confused look. Stops and asks her why she looks upset. She starts to explain, he interrupts, "wait they told you they wouldn't do this on over 5 lesions didn't they". She nods ruefully. His face contorts in anger. "Those guys are fucking morons. Just because they have the machine doesn't mean they know how to fucking use it. We routinely do 30 - 40 lesions in a session. I have done as many as 60 and done another 30 on the same patient the next day. This is not a problem."

Dawn exhales and gives a timid smile.

Dr. "You were right to come here. Those other people are too lazy too stay current. I haven't used whole brain radiation in 22 years. I treat people with gamma knife every single day. We do as many as 6 surgeries per day. Over 90% of my patients die of something other than their brain cancer. I have patients who I have been treating for 10 years and they are significantly older than you. Although I can not promise you any particular outcome, I can promise you, your cancer is a simple case for our practice. There is no reason we can't take care of all the tumors you have. You may require follow up treatments, but we will do those as are needed and you should have a good long life.

We talk about some other things.

He asks if there are any questions.

I ask "so this will in theory keep her brain mets under control, but what do we do about the cancer in her lungs?

Dr., "Aren't they controlling that where you are?'

Not really, they said take some mild chemo to act as a place holder because the lung cancer will take 5 years to kill her and she will likely be dead from the brain mets in 18 months.

He let out a low volume tirade of cursing, then called in his primary nurse. Call (other doctor), get her an appointment right now. She needs a lung treatment plan or all my hard work is for shit. She drove 3.5 hours to get here, tell (other doctor) she needs seen today.

Direct cell call to other doctor. Other nurse walks us down the street to the other office. We wait an hour and meet that doctor. She tells us the gamma knife doctor was very annoyed with what he heard about her lungs. Please tell me the story directly.

We tell her, on three separate points her eyes grow big and she shakes her head. She examines Dawn, and says, you are in good hands now. Stay on the minor chemo you are on. a month from now, we will do a CT scan and see what effect it is having on your lung tumors. It may make it completely go away or it may not, but if it works, it is the simplest way to control it. We will see what effect it is having then re-evaluate. If need be, we can then do aggressive chemo, or use my new edge machine to nuke the tumors, both or figure out something else. This is not a big deal right now. Lets get the brain under control, then we will fix the lungs. We are ALSO not going to rely on tumor markers in the future, they are only 50% predictive of mets for breast cancer. WE don't flip coins here to determine diagnosis. You will be getting scans periodically to see what is going on and we will be VERY proactive with this. You should have many years to torment this lovely husband of yours.

This is the kind of passion and competence you want in your advanced cancer clinicians.

We are now quite hopeful. Treatment to start at 0530 on Tuesday.

[First Shirt]

Wow!! That's great news, all things considered. Good luck, and we'll keep prayers and good thoughts headed your way.

[Denis]

That is very encouraging. Fingers crossed for you both!

[Netpackrat]

Very glad to hear that.

[MarkD]

Excellent news!

I admit I had to wonder about the whole-brain radiation from the other place. As I mentioned before, my mother died of metastatic brain cancer in 1990, and whole brain was the treatment of choice, the treatments were so bad she stopped them. I found it amazing that nothing had improved in 24 years, shit, in 1990 MRIs were the hot new thing.

Sounds like the prognosis is good.

[MiddleAgedKen]

Excellent news, and may there be more to come.

[Rod]

Not all doctors are quacks nor are they all Godhood candidates. These two sound like treasures and pretty down to Earth. Best of luck and it sounds like you're in great hands.

[Weetabix]

This is excellent. I'm not normally an emotional guy, but I got chills reading your new experience.

Fight on!

[Durham68]

Ear-to-ear smile with tears of joy. So happy for you guys.

[Precision]

Thanks guys, We are still letting it sink in. Going from no future, to the probability of a future is a BIG switch. A good big switch, but big.

We are happy with this new turn.