Sunday, February 14, 2016

Gynecologic Oncology

Skin healing is tricky, especially with the hole I had.  I learned yesterday one small part of the wound has torn open.  I noticed that I started to bleed last Wednesday then I was draining again.  It was hurting to sit.  I immediately treated it with an antibiotic ointment.  The draining stopped and the pain that came with sitting slowly went away.  I have been conscious about the type of chairs I pick the past few days.  The person who examined the wound yesterday gave me a lecture about how I need to keep on applying ointment on it and sit on my little travel pillow if any seat feels uncomfortable.  I got annoyed and said, "I AM DONE!"  She said that for something so tender like the scar especially in that area, I need to keep up to ensure full recovery.  So... use antibiotic ointment for one week then it's back to alternating between castor oil and comfrey salve applications for a good while along with more epsom salt baths.  She also reminded me that I went from not working out to working out seven days a week.  I need to be tender to that part of my body and be a bit more patient.  Okay, I can do that.  I am grateful that I have been able to return to my active lifestyle though.  My energy levels are returning.  I just hope that the wound is 100% better soon!

Last night I had a conversation with a guy who has been working in the field of medicine for a long time.  He was curious about why I was going to New York City today.  I told him I was going back for my follow-up appointment.  He asked why I didn't find a local oncologist yet.  I explained that it's hard for me to find a gynecologic oncologist that I can trust.  I was so happy I found Dr. Jewell so I feel really loyal to her.  He suggested that I could ask her if she had recommendations for a local gynecologic oncologist for me to do my follow-up vistis.  I will be doing that when I see her.  I told him about how gynecologic oncologists are different from other oncologists.  Gynecologic oncologists begin training in obstetrics and gynecology.  Their four-year residency is in obstetrics and gynecology as well.  If they want to specialize in gynecologic oncology, then they need to get additional training.  Through my informal research the past year, I have learned that type and length of training in gynecologic oncology vary.  Oncologists, on the other hand, train in oncology and then do residency in oncology.  The guy I was talking with was surprised by this tidbit of information.  The inconsistency in training and experience impact how gynecologic cancer patients are treated.  I explained further that I have met women whose gynecologic oncologists do not require them to follow the typical surveillance schedule when the cancer is in remission.  The typical surveillance schedule: first two years- every three months.  The next two years- every six months.  Fifth year and beyond: every year.  I have spoke with women whose gynecologic oncologists told them not to come back for two years after the cancer has been treated.  I met one woman whose gynecologic oncologist told her that since her reproductive system was out, she was fine and didn't need to come back for tests for the rest of her life.  Some gynecologic oncologists don't do pap smears once the cervix has been removed.  Pap smears are needed to  check for vaginal and vulvar cancers.  One of the women who did not get checked for two years did have the cancer come back and it has metastasized.  Scary.  Yes, the tests are annoying.   And going every three months feels too much.  I do it because it's better safe than sorry.  At the end of the conversation, he asked me which medical center I was going to in New York City.  I said, "Memorial Sloan Kettering Cancer Center."  He immediately understood why I am not ready to switch gynecologic oncologists just yet stating that they do great work there.  Yep.

Since I just moved and am getting settled in my new city, I wasn't ready to find a new gynecologic oncologist this soon.  I will begin by asking Dr. Jewell if she knows of anyone qualified here.  Next, I will research all the gynecologic oncologists here, learning about their training and experience.   Then I will find out their recommended surveillance schedule and procedure to see if they would be able to pick up on what Dr. Jewell started.

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