53. An Anniversary, and Making Progress
March 31, 2023
Doreen the breast cancer mascot celebrates the first anniversary of boobless-ness with one of the foobs from Knits by May. They are also known as “knitted knockers“.
April 4, 2023
It’s been a busy couple of days, and will be busy through next week. I will be undergoing all sorts of surveillance tests, in preparation for my follow up visits with the medical oncologist and breast surgeon.
In the meantime: baby steps towards restarting clinical practice. Some of my morning was spent at the Philhealth office (the national insurance body for universal healthcare) applying for accreditation as a physician so I can be on their roster. That was approved, and I should get an identification badge in 2-3 months… at which point I can apply for practice privileges at hospitals. Waiting in line at government offices isn’t my favorite thing to do, but surprisingly this one wasn’t too bad. It also helped that many people are already on “vacation mode” for Holy Week so the office wasn’t too crowded and the queues were short.
After dropping off some food gifts for my relatives and then having lunch, I proceeded to the weekly Neurorehabilitation Rounds at the Philippine General Hospital’s Department of Rehabilitation Medicine. We – two consultants (faculty members) and four residents (physician trainees) – discussed the new patient referrals received in the last week. Suffice to say this took a lot of brain power, additionally fueled by caffeine.
One of the patients was a lady with breast cancer with metastases to her brain and bones. While she denied having pain, she was unable to stay still in the MRI machine for 30-45 minutes because of discomfort… perhaps that was “pain” and she just couldn’t put a label on it? We physicians agreed that she needed a bone scan before getting her up and moving, as her last bone scan was 2 years ago and things may have changed since then. This hit a little too close to home: I just had a bone scan yesterday and needed to stay still for about the same amount of time. Thankfully I was able to do so, and without pain. Our patient was also getting set up for radiation therapy to her breast, which made me acutely aware of the continued tightness I am experiencing in the left armpit area – effects of the radiation therapy course from August and September 2022. “Radiation is the gift that keeps on giving”, said some wise women on my Facebook support group. Side effects can continue to occur months and years after radiation therapy.
On the way home, I stopped to make a house call: the father of one of my medical school classmates had spinal surgery recently and I offered to see him at his home. I am happy to report I still know how to do a physical exam and had fewer word finding difficulties compared to last month. Making progress! It was also good to catch up with a classmate whom I haven’t seen in years. I got “paid” in pastries. Mom is excited to have them for breakfast tomorrow.
Truthfully, this was good for both me and the patient – a win-win situation. He and his family got advice and reassurance regarding his rehabilitation course, and I got to dip my toes into a pseudo-clinic visit. This reassured ME that I still know stuff despite seeing my last clinic patient in 2019, and additionally confirmed that my communication skills are improving with time and practice.
All in all, it was a full day. I would like to think that tolerating all this activity is also a sign of progress. I usually do not have my days packed with back-to-back-to-back activities, so we will see tomorrow whether I will be extra tired and extra achy. The pain in my knees (side effects of the anastrozole I have to take daily for five years) is worse when I am tired or lack sleep; however it is still tolerable overall and I do not need pain medication. Grateful that tomorrow will be a relatively light day, with me working from home – reading, writing and listening in on a virtual medical ethics class. I will be taking it easy!
