2 Crises are Better Than One

"90 miles per hour isn't too fast to drive. I mean, hell, I used to ski this fast. That's it. I'll only drive as fast I used to ski. That sounds like a fair upper limit."

This was one of the many thoughts that drifted through my mind on my way back from San Francisco today. Today, I had my appointment with my new rockstar oncologist, Dr. Mark Moasser, who, by all intents and purposes, is a Cancer rocket scientist. Before I go on, I must openly and publicly thank Dr. Andrew Solomon for facilitating this appointment. Andrew,made a call after i had reached the upper limits of frustration by not being able to get an appointment with UC Davis Oncology or Sutter Cancer Center in Sacramento. Before I called in some of my backdoor contacts, Marek beat me to it and called his old, river-guiding friend from his Bio Bio days and told him of our predicament. 15 minutes later, UCSF called and registered me as a patient. I think Andrew is royalty or something. Either that or he gives really good wine at the yearly Christmas party. Whatever it is, he may have saved my life today.

Today's story is a long one, so get a cup o joe or a lemontini and sit and read. Today started out when I woke up "full of awesome". I was so proud of myself that I asked for help with the kids. Natalie Patterson agreed to pick up Zoe after school and Mr. Tom agreed to take Stella. I headed to the Bay Area while Marek left for San Francisco at O-Dark-thirty to give an important hoity-toity presentation. I was on my own to meet my new oncologist. After a swanky lunch with an old ski buddy, I made it to my appointment on time (unusual, yes). I was taken to an exam room and told to undress from the waist up. As I sit waiting for the Dr., I started having feelings of wishing someone was there with me, and no sooner after I thought it, there was a knock at the door. In walked my extremely awesome husband who, through some miracle, fanagled a way to be there. My husband is a phenom.
On to my appointment: My new oncologist is a New Yorker. Direct, to the point, and short on small talk. He reviewed my case and in no uncertain terms pointed out that my cancer is the highest histologic grade (which means it grows fast), grade 3 (out of 3), Stage III C (out of IV), "High-Risk" and Aggressive. He proceeded to lay out a treatment plan complete with rationale, that included ACT regimen (read "gnarley") chemo lasting 6 months with Herceptin (adjuvant hormone therapy) lasting 1 year, followed by radiation (duration to be determined). He painted a very ugly picture but he was clear to say that my prognosis was "good" because despite this cancer being "high risk" (read gnarley) and aggressive, it is also the cancer most studied and most researched with the most successful treatment options. AND he just so happens to be a
smarty on the subject. He has published papers on my specific cancer and is currently involved with finding a potential cure via the mechanisms that actually turn this cancer on. He's a UCSF professor on the subject having done his fellowship at Sloan Kettering Cancer Center in New York, and he has "sniper-esque" radiation buddies across the hall from his office. He is confident that the treatment plan outlined will reduce my mortality chances from 80% to 10% barring any unforeseen circumstances, which are unlikely, given that this guy leaves no stone

unturned....And he's likeable. He listens, answers questions and doesn't answer what he doesn't know but instead, refers you to the guy or gal who does. I like that in a doctor. He also said I qualify for a Phase III clinical trial after my chemo treatment.

Let's review:
UC Davis actually received my referral paperwork but two weeks later had still not made a decision whether or not to accept me as a patient. They said they'd get back to me. Sutter finally called and said that I was not officially "referred" by my surgeon but that I self-referred even though my surgeon's office sent all of my test results and paperwork (technically a

referral).

Sutter Health apparently doesn't accept "self-referrals" and the oncologist I chose was not accepting new patients. It took them two weeks to tell me that. I think they are missing the point of "early detection." FAIL.

UCSF calls me fifteen minutes after another physician intervenes, registers me, tells me where to have my information faxed, and makes an appointment with a rockstar specialist for me 5 days later. I was impressed by the fact that they actually had real people answering their

phones and they returned calls within minutes. Astounding!

Hmmmm, which system would you choose? Can't wait to write those "How are we doing" letters.....
So, it looks like the winner is going to be UCSF. Marek and I signed up for the whole shebang. What's a 2-hour drive every two weeks when you have a doctor who has more experience with this particular cancer than anyone? I want the rockstar to be captain of my team. I am not

screwing around. If I am going to get the gnarliest cancer that begets the gnarliest treatment, I want the smartest guy on the planet with the most resources....I think i met him today. Not only that but he hooked us up with a genetic counselor, while we were there. She shook my family tree looking for hereditary markers that might have led to this whole mess. Nope. Not looking like it's in the genes.
So....Anybody got a little apartment in San Francisco I can borrow? I start chemo in two weeks.

But wait......there's more.

Caught in the middle of not knowing how to feel about the fact that my cancer is gnarley but treatment is a slam-dunk and in the middle of talking with the genetics counselor, I get the call every mom dreads.
"Um, Where are you?"
"Still in San Francisco. Sorry, I'm gonna be late."

"Well, Stella fell off the monkey bars and hurt her wrist. It looks broken. Which hospital do you want me to take her to?"

Luckily, I have rockstar friends who know how to deal. The Genetic Counselor was very empathetic and kicked us to the curb. It was 5pm. Rush hour in San Francisco. I was not getting home soon. Marek had to return to a conference. Thank you Natalie Patterson for keeping Zoe for the night. Thank you Heather for being one step ahead of me, always. Thank you Mr. Tom

for being calm, cool and collected in a crisis. Thank you Marshall Medical Center Emergency department for being extended family to my family. Thank you Katy Mulligan for dropping everything and running to be by Stella's side as substitute Mom. Thank You Laurie for keeping me from killing the dumbass in the toyota camry who refused to get out of the left lane, and thank you for whoever hosted the CHP convention that kept patrolmen off of I-80 East. Stella did break her left wrist fairly significantly. I made it to Placerville in two agonizing hours to find my darling Stella mildly sedated, reduced and casted by an awesome Ortho, and adored by an entire ER. She was brave and respectful and showed courage beyond her years at a time when she needed her family the most. There are not words for the gratitude I feel for all who surrounded her with love. I am sad that i was not there but I am so proud of her resilience and I

am eternally grateful for the kindness of friends.

Nope. 90 isn't too fast to drive, but I promise to never drive any faster than I used to ski. (And as long as the kids are not in the car....)

Tomorrow will be better.