Sunday, November 19, 2006
Reading is a mixed bag
It's been two months since my rheumatologist did my initial blood work-up. It was repeated on Tuesday. On Thursday I called to see what the numbers were so I could let the medical oncologist I'm seeing at the end of this month know if the CRP stayed up there. I received a call from the nurse letting me know that my doctor would have to look at it before she could give me the results. I got another call saying that the doctor wanted to fax the results to my oncologist and that the CRP was still over 10. I made a split level decision to have them faxed to the medical oncologist. I've never seen the medical oncologist and my regular follow-up is with a surgical oncologist who specializes in melanoma and endocrine disorders and who is the director of the melanoma program at a large research university. I will continue seeing my surgical ONC but my next appointment with the melanoma clinic isn't until March, and that's with the NP. I guess I felt like, since my dermatologist had referred me to a local medical oncologist to get a consultation and work-up that would be in addition to my follow up with the surgical oncologist, I might as well have the blood work sent to him since I see him in less than 2 weeks. My regular melanoma clinic doesn't do blood work as part of their regular follow up. That's okay with me. I know all these clinics have somewhat different follow up for stage III melanoma patients. However, with my weird history I wanted a closer look, which is why I'm seeing the medical ONC. My history is weird because I had a nodular melanoma primary on my hip for over 20 years that wasn't removed until 2005 and I lived to tell the story. Something in my body is good at recognizing melanoma and regecting it or, let's face it, I wouldn't be here to write about it. My concern is that I do have some little issues on my lungs, thorax, and liver that are probably nothing but if they are something, I want to know as soon as possible. I also continue to light up in the inguinal region which is assumed to be from surgical changes, at this point. My surgical oncologist puts a lot of faith in the PET scans and uless something is cooking there, he isn't concerned, or that's the impression I've formed. My concern is that if I'm effective at fighting, something may be cooking but not be that dramatic on the PET scan. At the very least, I'd like to have repeat dedicated scans to measure the new issues that showed up which I wouldn't know about if I hadn't requested my last PET/CT scan. Normally I am given a copy of the report but this time I wasn't and never had a chance to ask questions. That's the reason for a consultation but over all, I do trust my main doctor and want to stick with him. Soooo, back to the blood work. My CRP has stayed high for two months but not in the range that my rheumatologist thinks is likely to relate to his field. It's more in the range to relate to heart disease or cancer, but of course may not relate to either. It's non specific. On the paranoid side I found this back, "Altogether, for first diagnosing AJCC stage IV melanoma, CRP is the superior serum marker when compared to the conventional LDH." I know that doesn't mean I have active melanoma it just means I have a hit on a serum marker which may mean anything. So back to the point of my title, Reading is a Mixed Bag, I found this: "In the body, CRP plays the important role of interacting with the complement system, an immunologic defense mechanism." So what may be happening is my body is doing what it's done all along. It's FIGHTING BACK. So what I need to do now is go on more walks and spend less time on the computer trying to figure out something I will never be able to figure out. It could happen.