Team Players

Over the last few days, Anne and I have been doing a lot of thinking. It's often not clear what the appropriate course is for treatment; how aggressive or passive to be depends upon the possible outcomes presented; it comes down to who you trust. Not who you like best or who has the warmest bed-side manner, but who has the most experience to guide you to the outcome you desire with the fewest problems and the greatest likelihood of success. In short, there is no substitute for solid, experienced team players. I like my doctors, thankfully, but would not be afraid to challenge them if I thought they were dropping the ball on communication/information, either with me or the other team members, and they know it. There is no substitute for self-advocacy and you won't survive without it, period.

Case in point:

My local neurologist and surgeon would like for us consider some new options for dealing with the cyst which they feel is the culprit in my physical weakness lately; if successful, the results would be virtually immediate, but possibly not permanent and not without some degree of risk, as with any surgery. The other, "Advantage," of this would be the possible installation of a catheter for continued drainage and possible future delivery of chemotherapy agents directly to the tumor bed.

The doctor I consider to be my team leader at UCSF is advocating waiting for the end of November and the scheduled MRI results, at which point the edema should subside or even disappear, but possibly not the cyst. We'd go up and see him with the films at that time for a face to face visit and to plot a course from there. He told my oncologist that he did not see the risk/reward payoff in the surgery and that he would not recommend it at this time.

My local oncologist, Gregg Newman, who I consider a friend as well, is on the side of the UCSF team leader, for the simple reason that he deals with probably five cases of this in a week, compared to the five Gregg may see in a year . . . makes sense to him. My radiation therapist is of the same mind; to follow the lead of the most experienced team member. Makes sense to me too and it's what we're going to do.

So it comes down to trusting your team, of which you are the leader. You can't make the decision if you don't have or know the variables, so you need to ask questions and make sure they're answered to your fullest satisfaction and understanding. If you're confident that you have a competent team with a vested interest in your success, i.e., your survival, it makes it a lot easier and lets you sleep better . . . or so I've heard . . . see previous post!