STEAM ROOM FOR ANGER

Coincidental timing. I was pondering this issue last night. My CT scan showed up in my portal before my appt (next week) to discuss. This cancer center posts a disclaimer that you can look, but you might be reading info before the Dr and that you might find disturbing info. I want to know the big pic so I'm prepared when I see the Dr. I also read over my bloodwork to see what was too high/low. Until recently all this was hidden from the patient. My PCP sends me to lab a week before my appt so we can discuss what might be an issue (thyroid, cholesterol, etc) and what drugs might need adjustment. In the past I recall going to Dr for 4pm appt, being asked if I was fasting (no! why? no one mentioned that!) and they said "well we'll do blood work anyway". Never heard a word about it. When I switched Dr and she had me do fasting bloodwork so we could go over it, the 1st thing that came up was that I needed thyroid meds. SO..that's why I had no energy! But unless the test is done fasting, the info is inconclusive. Additional transparency over the last few years has benefited the patient. No longer can the Dr play God and keep us in the dark.

I've never been told to fast for any blood work, just some scans.

This is what I found easily on fasting for basic blood tests:

Not all blood tests will require you to fast beforehand. Blood tests that you will likely need to fast for include:

• blood glucose test
• liver function test
• cholesterol test
• triglyceride level test
• high-density lipoprotein (HDL) level test
• low-density lipoprotein (LDL) level test
• basic metabolic panel
• renal function panel
• lipoprotein panel

Had labs and scans last week and phone visit w/MO 2 days later. Between that time I really studied my labs and brought some glaring issues to MOs attention. She passed it off as due to Ibrance but I complained of a number of symptoms. She ran a B12 test and guess who is severely anemic? And as I look back at my lab results, I probably have been for some time. Thankfully these results are available but I shouldn’t have to do my doctors job. And how many patients are able to advocate for themselves?

I’m angry with myself. I have stage 4 cancer and could have prevented it if I wasn’t so vein and get implants. Cause God knows if I hadn’t gotten implants and felt that sore knot I wouldn’t have left it there so long. 😔 I don’t have a full clinical picture yet. So just let me vent and move on. Today while Halloween shopping with my kids, an old coworker said I looked tired. I wanted to tell her well I just found out one month ago I am dieing.

barb,

I also want to add that you are not dying!* Cancer in the axillary lymph nodes is not stage IV in almost every case I have heard of and does not meet the definition of metastatic breast cancer. I am not a doctor and understand that there may be circumstances in which it could be considered stage IV,possibly. You may see the words metastasis to axillary nodes on a path report but that is not the same as metastatic breast cancer. Take care and fill out that signature line so we can support you better!

* Although stage IV is not curable, neither is it an immediate death sentence. Many of us are living longer and new drugs continue to be trialed. I have lived with stage IV for 10 years. I am still living with it and won’t put my foot in the grave until I really have to. I am not typical, but not as atypical as I once was.

I review the notes of every single doctor's visit. I send messages through the portal when I see something that is significantly incorrect. I want it all in writing.

My primary sent me to a sleep clinic because of my lifelong insomnia. The nurse practitioner I saw was arrogant, dismissive, and absolutely determined to sell me a very expensive sleep study so he could then sell me a very expensive CPAP machine. I don't have sleep apnea, I said. I don't need a sleep study and I don't need a CPAP machine.

After the less-than-great visit, his notes included "sleep difficulty began at menopause. Patient counseled to consult gynecologist for hormone replacement therapy." We had talked about my 100% estrogen-receptor positive breast cancer and the fact that I'll probably be on an aromatase inhibitor for life. We had NOT talked about HRT to relieve insomnia. My note of correction was polite but pointed.

I know our physicians and care providers are over-the-top busy. Managed care, referrals, pre-authorizations, forms, and a ridiculous amount of documentation are time consuming tasks, and accuracy suffers. Reality doesn't always match what's written down.

My dermatologist charts that she does all this education on various things, but she doesn't. No one there has ever instructed me on the use of SPF, but it's there in my visit note.

I have a job where I write my own patient visit notes, and it's a lesson in what NOT to do.

Incidentally, we never have patients fast for a basal metabolic profile, or CMP, or LFTs. It might affect a glucose, but there are ranges for nonfasting levels, so you can still tell if there's a problem or if something needs further investigation. I would fast for a lipid panel though.

I'll consider myself fortunate that the notes I see in my portal are consistent with my visits. There is some junk in there like hepatitis and other vaccines I've already had, and none of which any of my doctors ask me or recommend any of this stuff to me. There is a mistake with my covid vaccine not showing the date of my 2nd dose. I cannot fix it.

I do fast before labs.

Primary and other specalists other than cancer doc are easy. MO uses a different system and their own. Much more confusing and harder to communicate and read things.

We should all go post a comment on it and add to their education. I tried but it's asking for my email and I don't want their junk - Need to get home and get my junk email address.

Well for starters this piss__ me off "But nearly all cancer cases—90 percent or more—are linked to lifestyle, not genetics."

“ Banish household dust" - I have always hated dusting. Mystery solved - now I know why I got breast cancer. /sarcas

Harley,

I hate dusting too and I live in very dry Northern CA! Thank you for solving the mystery of why I got bc 🤣

Ack, we've got new people here just in the last few days who are bending over backwards to blame themselves for having cancer! I HATE these type of articles. And where's the articles blaming men for giving themselves prostrate cancer?