Oncology

The internal medicine vet finally got back to me with information about the oncologist she had been consulting with.  She recommended I set up a consult. Finally! I wanted to do that weeks ago – just didn’t know who to go to. I scheduled an appointment for the first one available – February 4th. As Josie and I waited in the waiting room at the oncologist, I felt like we were the outsiders. There was one other dog, Ruby, waiting. Ruby was missing an eye, and was shaking. I don’t know if she was scared, cold or both. But I looked at her and thought – she’s here because she has cancer. That is really sad. I can’t even say that about my dog. She might have cancer, but I still don’t know for sure. Do we even belong here? They ushered us back to a room where we waited. After an extremely long wait, someone came to see us. I’m not sure what her role was. Ever get a gut feeling that someone is young at their job? I had that feeling. But it was ok – she wasn’t the oncologist. I’m here to see the oncologist. This person was here just to get the history and take Josie away for an exam. Waiting in a room by yourself is even worse than waiting with your dog there to keep you company.

Josie.20031230

December 2003

Finally, the oncologist came in. I could tell she was rushed. She was running an hour late and barely took time to breathe. I wanted to tell her it was ok – she could slow down. I had no other priority right then but to be here for my dog and could be there all night if need be. She told me she had reviewed Josie’s MRI and even though the biopsy indicated everything was fine she had no problem diagnosing Josie based on the MRI. She was pretty confident Josie had adenocarcinoma. Finally – someone willing to say my dog has cancer without just suggesting it as a possibility. Nothing other than cancer would be this aggressive and do as much damage as we can see on the MRI. Based on that, she had no problem proceeding with treatment – whether it be radiation, chemo, metronomic therapy or just sticking with Piroxicam. But she did have one more recommendation – and it was the surgical biopsy that the internal medicine vet had recommended before. It has a name – a trephine nasal biopsy – aka a needle biopsy. I told her I was interested, but when I went to go talk to the surgeon he wanted to take it all out. She immediately threw up her hands and said “That is because you talked to a surgeon! I wish all nasal tumor cases saw me first.” I really wanted to get defensive and point out I was just following the path laid out in front of me. I can’t help it if the surgeon side tracked it! I didn’t. Instead, I asked how we avoid the surgeon doing his own thing. She made it easy – she went and got on the phone with him and set it all up – telling him exactly what she wanted done. Where was she two weeks ago? She did give me some good news. Josie had airflow out of both sides – something she did not have when they did the MRI and the biopsy. I don’t know if it is the Piroxicam or she sneezed out so much she cleared it up. Either way, it confirmed she was improving. I made the mistake of asking her about the biopsy before I was done asking all my other questions. She rushed off to go set it up and never came back. She sent her assistant(?) back with estimates and to answer any of my other questions. I asked them, not trusting the answers. But even if I had the answers, they may change once Josie has the biopsy. Because once we know what it is – that will determine the next step. As I left, not feeling 100% confident in the oncologist since I only got a rushed consult, I witnessed her with an owner in the waiting room. Patiently talking and discussing a difficult decision. She wasn’t rushed. She wasn’t technical. She was kind, empathetic and everything you need a vet to be at a moment like that. I was encouraged. I may not have all the answers now, but its ok. I’ll have them when I need them. And I’m finally working with someone who understands the struggle ahead for Josie.

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