Wednesday, November 3, 2010

Part 10: On the Rise




Like an alarm clock buzzing after the third snooze, a muffled beep sounded from her lower desk drawer where her cell phone, nestled inside her purse, annoyingly reminded her every thirty seconds of what she had forgotten to do the night before. Of all the times I forget to charge my phone it has to be when I actually care about receiving a phone call, she grumbled to herself and continued working. That morning she had gone into the local clinic for her second week blood draw. She had been waiting all day for the doctor to call with the results and now was not the time for her phone to lose battery charge.

Her work phone rang. It was her husband.

“Hi honey,” she said.

“Hey. Have you heard anything yet?” he asked.

“No! It’s driving me crazy! On top of that, my phone is dying and I don’t know if there will be enough battery for me to actually hear what my doctor has to say!”

“I wonder what’s taking so long?”

“I know. Maybe I should just call over there and…”

The crippled ring of her cell phone interrupted her.

“Ahh! It’s the doctor. I have to go. I’ll call you back,” the woman said and hung up her work phone, clumsily grabbing for her cell phone to quickly answer the call.

The doctor barely got a word out when the woman interrupted, "I'm sorry. Do you mind calling my work phone? My cell phone battery is dying." She apologetically chuckled hoping the doctor would find the situation at least slightly amusing.

"Of course," the doctor replied.

Within seconds, the woman's work phone rang. After getting the niceties out of the way, the doctor got to the details. “Well, your hormone levels have risen to 20,000.”

While the woman had been hoping that this would not happen, in the back of her mind she knew that rising levels were a possibility with her type of the disease. Her suspicion of higher levels had increased over the past week. She had been feeling mild symptoms again, so the unfavorable news wasn’t a complete surprise. After sharing this with her doctor she asked, “So, what are the next steps?”

The doctor replied, “The first thing we want to do is have you wait one more week to verify that the levels are indeed going up.”

The woman was concerned about this. Fortunately or unfortunately, she had absorbed like a sponge all information on the internet about her condition, officially termed gestational trophoblastic disease (GTD). The fact that her hormone levels were rising meant one thing: the cells were still rapidly reproducing inside her. This left her vulnerable to metastasis, the spread of these cells to other internal organs, including her brain. The next logical phase in the treatment would be chemotherapy.

“What about the risk of this spreading? Wouldn’t it make sense to start chemotherapy to make sure it doesn’t start to spread or spread any further if it has already started?” the woman asked.

“I wondered that, too,” the doctor said, “and so I checked with my colleague, a gynecologic oncologist who is more familiar with this, and was told that the risks of waiting one more week are less than if we started chemo right away. Once we can verify that the levels are going up, we’ll know for sure we need to start treatment.”

The risks of waiting were less? To the woman, having out-of-control cells start spreading all over her body sounded pretty grim. What does that say about chemotherapy? she thought to herself.

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