Thursday, May 9 – Cha Cha Changes

Before this whole boob thing happened, I had three little Planters warts on the ball of my right foot, below my big toe and middle toe.  They did not bother me so I just left them alone.  When I was told I would need ALL the treatments – chemo, surgery and radiation, I had a little thought in the back of my head “Oh good, chemo will kill those damn warts on my right foot!”  I was not so lucky; instead, they spread to five warts.

About three months ago, I woke one morning and when I put my foot down, I immediately felt like I was walking on pebbles on the ball of my right foot.  At first, I thought it was my neuropathy acting up; but when the sensation lasted for several days and only in my right foot, I realized it was not the neuropathy at all but the warts.  I called my Primary Care doctor for an appointment and was able to get in the very next day.  She looked at them and said we could try freezing them off.  I agreed and she had her nurse get the gun of liquid nitrogen.

A month later, I was back, and she tried again.  Despite cutting and digging at the deadened skin, trying to get to the bottom of the black spot in the middle of each little wart, they returned as if nothing had happened.  The black spot is the blood supply for the wart.  When I talked to my doctor the third time she referred me to a podiatrist.  Last week I met with the podiatrist and he said we had three options; freezing, acid, or cutting.  Since freezing had not worked the first two times, we both agreed that was out.  He was worried that because they were so small, but deep, that acid would take a long time and cause me undo pain from burning the skin around the warts.  I agreed with that as well, so that left surgery.  His wife was pregnant with their third child and due in a week.  When we started looking at what appointments were available since my originally scheduled appointment the receptionist forgot to include reservation of the “surgery room”, we decided he would squeeze me in the next day.

I arrived last Friday afternoon for my appointed surgery, and advised both him and his nurse that I suffer from Vasovagel Syndrome, and it would be best to have the chair fully extended into a prone position with my head lower than the rest of me.  They were a great team and worked so well with me to keep the effects of the Vasovagel Syndrome in check.  His nurse got me an ice pack for my neck, and he allowed me time to breathe and center myself between injections of lidocaine into the bottom of my foot.  A couple spots needed an extra boost of lidocaine.

Dr. Truong ended up only cutting four times, as two of the warts were so close together he cut them out as one unit.  He did send them to pathology to be sure they were just warts, not a sign of something else.  He told me I had to soak my foot twice a day with Epsom salts and apply Silvadene to each hole in the bottom of my foot before I bandaged it up.  I took my biggest/widest shoes with me, but after he applied a 4×4-gauze sponge folded in half, gauze wrapping, than stretch tape to apply pressure to control the bleeding, my foot would not fit into my “big” shoes.  I ended up with a small walking boot, not one that goes up the leg; the kind with a flat bottom, soft sides/top and Velcro closures over the top of the foot.  Yesterday was the first day where I could apply one gauze 4×4 with some tape and fit my foot into a normal shoe.  

Today I had my check up with one of Dr. Truong’s colleagues, as his wife went into labor yesterday.  Dr. Ishibashi looked at my foot and said it all looks good.  Keeping it moist is what we want as it slowly heals up.  I sure hope those damn Planters warts do not come back after this!

I also had my latest follow up with Dr. Sikaria this morning.  Evidently, my insurance no longer partners with Cancer Care, and I will be set up with new Oncologist in the group that my insurance now has a contract with for Oncology services.  Dr. Sikaria said they should have sent me announcement last November.  I think I would have remembered if I received such a notice from my medical insurance provider.  I am going off to a new oncologist in good health, with the recommendation to see my new oncologist in four months and to have a screening mammogram in 6 months.   Robert was with me and asked about those patients currently going through active treatment, did they have to change as well?  Dr. Sikaria advised no, they could not make them switch mid-treatment, but once they complete active treatment they will have to transition to the new provider.  She did confirm that my latest mammogram was good, they only detected the changes from surgery, and my last blood work was good too.  My liver really did not like chemo, but it has recovered nicely and my liver panel is completely back to normal now.

As we were leaving, Robert asked me how I was doing with this change, which for me is sudden since I swear I did not receive any notice from the insurance company.  I told him I was ok.  I am in a good place, cancer free still and working on staying healthy.  Cancer Care provided me a number to call once the referral letter approving my switch to the new Oncology partner arrives in the mail.  When I arrived at work I Googled the new partner groups to get an idea of what my options are going to be once the referral comes through. That is when I started to feel a bit overwhelmed and anxious.  I took a moment for some deep breathing to clear my head and center myself, but the sense of unease continues to niggle around my dragon.  She remains curled up, just fidgety.  I guess I am not as good with this change as I thought I was.  

As I continued to peruse what my possible locations and doctor choices might be, I could feel the panic starting to swell.  What if’s start popping in my brain.  My dragon continues to be unsettled in my gut.  Then I think, I should call Evelyn my Nurse Navigator at the Breast Diagnostic Center, she may have some recommendations for me.  That thought helps bring some calm to my mind, as I try to rationalize, what would happen if we changed insurance carriers altogether at work, or if I had to get a different job, I could be faced with the same changes.

On a good note, I have been experimenting over the past four weeks with the Klonopin, and have come to a good dosing schedule that seems to work.  It controls my neuropathy symptoms well and does not seem to impact my short-term memory or my ability to do simple multitasking.  Two days taking a full dose of .5mg, followed by a day with half a dose.

Life is dealing with change