I wish I could sit here and tell you that I had a great visit to Baltimore, and in one way, it was a great visit. MaryBeth and I spent Tuesday tooling around the Inner Harbor with my brother Isaac and my Mom. We ate wonderful crabcake sandwiches at a really great harborside restaurant and in the evening, my brother Sid joined us and we went to Bo Brooks for some steamed crabs. It was a long day with the traveling and what not, but I enjoyed having a great time with my family.
…and then there was today.
Before I get to the events of today, though, I want to fill you in on the back story of this trip. Back in May, I had sent Dr. Cameron all of the written notes and CDs with all of my scans and imaging on it. After reviewing these materials, Dr. Cameron had requested that I get a 3D CT scan; however, it was not possible to get up to Johns Hopkins to get the scan before I began treatment in the clinical trial.
Last Thursday I had my follow-up CT scan here in Atlanta and, upon receipt of the CD, I rushed over to FedEx to overnight express the CDs with my pre-treatment and post-treatment imaging on them to Dr. Cameron. Originally, Dr. Cameron’s administrative assistant had said that if the doctor wanted additional imaging, I could get that done BEFORE my appointment today. When I called his office yesterday, Dr. Cameron’s assistant informed me that Dr. Cameron had not even looked at the CDs I had sent yet. When I reminded her that she had suggested that we could get additional imaging, if needed, this morning, she said she would get the CDs to Dr. Cameron yesterday.
Well, suffice it to say that I don’t think Dr. Cameron tried to look at the imaging until just before my appointment. He walked into the room and informed me that they could not open the images I sent him. He then ordered a 3D CT scan (which I got this afternoon). If Dr. Cameron HAD tried to look at the imaging I sent him, I could have had the 3D scan this morning and he would have at least been able to look at the cross sectional images before my appointment (the 3D imaging takes a while to be rendered). I’m supposed to call him tomorrow after 2p to get his opinion about my surgical candidacy based on the images taken today.
I did show him the Emory report from my post-treatment CT scan and after a quick read, Dr. Cameron said that he could not recommend surgery because according to his read of the report (which, admittedly, was quick while the bunch of us waited for him to finish) the mesenteric arteries were completely surrounded by the tumor. I was dumbfounded. That was absolutely not what I was expecting to hear. Of course, Dr. Cameron said he could not make any definitive statements until he saw the 3D CT. He did say that he would NOT operate unless he thought there was a 30% chance I would benefit from the surgery.
Thoughts about the visit: I was disappointed that Dr. Cameron did not look at the materials I sent him last week until today. Both MaryBeth and I left with the feeling that Dr. Cameron was not necessarily invested in my treatment. I understand that he has lots of patients and that I am one in many, but I am not concerned about the others and I felt like he was not particularly concerned about my treatment. Dr. Cameron’s read of the the report was that the mesenteric arteries were completely encased by the tumor, whereas my oncologist and surgeon here in Atlanta, said that the tumor was “kissing” up against the arteries. Perhaps he just misread or misinterpreted the report, but I have to say that I was really upset when he told me he did not think I was a surgical candidate.
Given that Dr. Cameron was commenting on the report while my Atlanta surgeon had reviewed the actual images, I’m hoping that Dr. Cameron misread the report and that the 3D CT scan shows that the tumor is, in fact, only tangentially involved with the tumor. Here’s hoping.
Other things that Dr. Cameron did that put me off include: (a) saying that he wished he had seen me back last August because when he sees unexplained billiary strictures, he immediately thinks ‘cancer.’ Besides being a useless statement, Dr. Cameron implicitly suggested that I had bad medical advice since August ’07 and that had I only come to him in the beginning, all would be better. In my opinion, Dr. Kulkarni did a great job investigating what may be the cause of my problems (as I have outlined in previous posts). I do not think it’s useful to tell a patient that he made a mistake not coming to him sooner. (b) When I told Dr. Cameron that Dr. Sarmiento was my surgeon in Atlanta, he responded that he didn’t know Sarmiento and he “thought he knew everyone doing this kind of surgery.” Again, the implicit message is that Dr. Sarmiento is not good enough because Dr. Cameron didn’t know about him. Again, this is a useless comment. (Interestingly, when MaryBeth pointed out that we had requested the possibility of having imaging done this morning, Dr. Cameron said that it was just “..water under the bridge.” As if to say, we may have screwed up by not looking at your stuff sooner, but there’s nothing to do about it now.”) Nevertheless, Dr. Cameron was willing to make similar useless comments about my medical treatment to date.
Dr. Sarmiento encouraged me to go into my meeting with Dr. Cameron with an open mind and to decide who I felt most comfortable with. Right now, I feel like Dr. Sarmiento, who is perhaps overly optimistic about my surgery, is willing to be more aggressive, and does not have as much experience as Dr. Cameron, at least seems more invested in me and my health. We’ll see what Dr. Cameron says tomorrow, but if I had to make a decision right now, I would go with Dr. Sarmiento every day of the week and twice on Sundays.
In the end, the news is that there is no news….today. Besides the good time with my family, I really feel as if this trip was a waste of time and money. I’ll hopefully have more to say about this tomorrow.