excellence

    I can remember one of the first times I encountered the football team during my college years.  We were all sitting in the gym waiting on the head coach which was a common occurence.  Hurry up and wait, not unlike the military.  All of us freshman players were sitting together trying to fit in.  A group of the seniors were arguing and giving each other flack.  The quarterback was making bets that he could throw the ball across the basketball court from his knees and make it into the basket.  I snickered thinking it ridiculous.  He didn't make it but the ball did hit the rim and bounce back out.  My jaw about hit the floor at his accuracy.  That was, until we saw the seniors all together on the playing field.  It was no Division I team, just a small Division III school, but these guys were operating at a level of proficiency that blew me away.

     I felt that same feeling today when my dad met with his doc at MDACC.  It was like night and day comparing the oncologist we dealt with before to the oncology team at mdacc.  The other doc we saw before was ready to start chemo off of a simple Complete Blood Count (CBC) and a crude biopsy (the pathologist reading the sample even said the sample was subpar).  So MDACC took a biopsy of their own to assess pathology, genetic markers, chromosomal analysis, etc.  They then took blood to look at his CBC in addition to various molecular markers to get a more fine-tuned idea as to what was going on with my dad.  The physician's assistant (PA) met with us first and went through a rather detailed history and answering every single question.  He even taught me how to palpate my dad's lymph nodes (I had never felt them on our actors because a person who is not sick should not have enlarged lymph nodes).  The other doc didn't even bother to feel my dad's lymph nodes.  Then the doc came in the room next.  It was clear that he had reviewed all the files beforehand and was well aquainted with my dad's case up to this point.  In a nutshell, he wants more data.  Nothing clinically shows that my dad requires any immediate treatment so we have the luxury of waiting on more data to come in.  So over the next week or two, the in-depth results of the blood work and biopsy will filter in.  We then meet with the doctor in ~2 weeks to discuss the results and decide on what to do next. 

     Treatment options are pretty varied at this point.  They may range from full blown chemo to just an oral steroid (no big deal, I get them with sinusitis) to just a holding pattern where we monitor his blood counts.  So in a lot of ways, it was a big relief for my parents.  The other doctor had my dad ready to start chemo (he was definitely measure once, cut three times).  Now, we have a much more methodical, comprehensive, rational approach.  It'll probably be another 2 weeks before we have anymore definitive decisions on my dad but all in all, it was a good day.  I can rest a lot easier knowing that he is competent hands now.