Monday, July 27, 2009

2 appointments?

We may or may not have two appointments tomorrow. The first appointment, at 10AM with a nurse practitioner at Dr. Meister's office, is likely to be cancelled; the second one is, of course, radiotherapy, which absolutely cannot be cancelled. The first appointment strikes us as redundant, which is why we're probably going to cancel it: on Thursday, we're scheduled to visit Dr. Meister at his other office to get essentially the same exams done and have the same questions answered.

Both of the morning appointments are about Mom's chemotherapy. As Dad and I were talking tonight, we realized that one question has been bothering us: we have no clear understanding of how effective the chemo is supposed to be. One doctor had told Dad that, for GBM patients like Mom, chemo is ineffective without radiation. This was the rationale behind not catching Mom up on the chemo she's already missed due to her infection: taking the pills before restarting the radiation would have yielded no results.

And this is where we're confused. If chemo without radiation is ineffective for people like Mom, then (1) why must she undergo radiotherapy 5 days a week, but take Temodar 7 days a week? And: (2) why will Mom be placed on a chemo-only regimen that will last several months after she's done with her four-week break from the in-tandem therapy? If chemo alone is ineffective, why bother with several months of chemo? The doctors' claims don't add up.

I imagine that there are ways to make all the information seem self-consistent. But part of me is wary about all this. How can I, a non-expert, distinguish between a valid explanation of the apparent inconsistencies in what we've been told about Temodar, and an ad hoc explanation that's little more than a tossed-off rationale meant to mollify the patient's worried relatives? Bleh... I won't dwell on this problem: it's the quick route to paranoia.

I'll be calling Dr. Meister's office in the morning to see whether we do indeed have to come in. If I don't get a clear answer from the office (Dad mentioned he had some difficulty with a secretary whose English wasn't particularly good), I'll cancel the appointment, and we'll see Dr. Meister anyway on Thursday morning. Why see him twice over the span of three days, and for no good reason?

There-- settled. Now I need to hit the hay.


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