ONCOLGGY – “Thinking Outside the Box”

When Oncologist B left the Hospital and Iowa City for private practice, I was naturally concerned, but it was reassuring to know that this time the assignment of an oncologist was not potluck. Not potluck because my nurse, Oncologist B’s primary nurse, was responsible for connecting me to a new oncologist. UIHC oncologists have a primary nurse and they too, get to know you and your case. They are key members of your health team. I am fortunate to have a nurse who sees being a strong advocate for patients as an important part of her role and has been very helpful to me. Besides being supportive and a thinking member of my health team, she is a conduit between me and the doctor. Not routinely, but when I have a particular concern or issue that needs to be discussed, she can relay those thoughts to the doctor and give him a heads up on it or maybe resolve the issue. She also coordinates tests and treatments.

I suppose I am a somewhat different kind of patient. I don’t try to “be the doctor”, but I ask a lot of questions and raise a lot of issues. Many doctors would view me as a royal pain in the butt. I need a doctor who is flexible, who can “think the outside the box” and who is comfortable having a patient actively involved in therapy choices and not passively waiting to be told what to do. So my nurse carefully singled out an oncologist and asked if he would undertake my case. And fortunately Oncologist C agreed. He is what I call a “good thinker”, a doctor who is able to look at a situation with solid scientific underpinnings, but not be penned in with rigid protocols and dogma, who can think clearly and creatively without being rash or “out in left field” and who understands the artistic side of medicine. I imagine he is a person who likes puzzles and, like me, is or was an ace bridge player.

Over the last couple years, I have had medical challenges and am receiving considerable medical attention and treatment. Things are now looking better. I’m not back yet to where I was a couple years ago, but am going in the right direction. During this time, it’s been particularly important to have an oncologist able and willing to think outside the box, rather than just plug in the standard protocol. Sometimes this is a seemingly innocuous treatment choice. For example, at this time, I need iron boosters. The current standard is to do this via an IV infusion which takes several hours and always bothered my stomach. What works best for me is a simple IM shot, much quicker and with less stomach distress. Another and key example of “out of the box” thinking was to do a needle biopsy before restarting chemotherapy. When inflammation, but no actual tumor was found in that very small sample, we tried a drug that deals specifically with inflammation or mucin. The drug was not curative, but I felt much better almost immediately. It has long term value for me and is still part of my medical regime. Most oncologists would have automatically restarted the chemotherapy, bypassing the needle biopsy which provided useful information and a drug that helps me.