So this morning came the appointment with the oncologist favored by my gynecologist.

You may recall that not one but two docs — my GP and my gynecologist — so worried about my insecurities over the ongoing (painful, disruptive, miserable!!!) treatment of NOT-a-breast-cancer that they felt impelled to refer me to the medical oncologists of their choice.

Young Dr. Kildare’s choice, visited last week, was perhaps not the God’s Greatest Gift to Diseased Womankind.

Today I visited Sainted Gynecologist’s guy, and he proved to be a great deal better.

First, he could figure out the difference between DCIS and invasive cancer. That was a good sign.

Second, this guy was fully, completely, UTTERLY up to date on the current research. Having made myself almost up-to-date on said current research, I was impressed. Oh, no. I was more than impressed. I was delighted and astonished. The man actually knew what he was talking about. A God’s miracle.

Third, despite being a high-powered medical doctor, the guy possessed an underlay of common sense. This is not a man given to flying off the handle in the various hysterical ways that some doctors  are wont (I’m sure you know who they are because you have visited some of them).

Fourth: being of an age comparable to mine, he knew my (now retired) internist at the Mayo, he knew the redoubtable Dr. Packaj and was similarly awed and worshipful of her, he knew the venerable gynecologist whose practice Present Gynecologist purchased (the guy was famed as the finest OB-GYN in the city, back the the day, and all the local doctors and — equally significantly — lawyers sent their wives and daughters to him), he knew Present Gynecologist well, and he did not know Young Dr. Kildare (YDK’s defining characteristic being “young,” after all) but nevertheless did not even flinch when I expressed a certain distrust of John C. Lincoln with the words “this is Arizona, after all.” All of these are signs of a medical doctor with a brain who is savvy in the ways of a large small town that has been fed too much Monsanto-style fertilizer.

(It’s another story…ask me some day and I will tell you, my children.)

Fifth, he did not treat me like a nine-year-old.

Sixth, he answered all my questions in ways that made sense. To do so, he spent well over 70 minutes with me.

Medicare may not pay for this antic, but if I have to pay for it out of pocket, I will do so cheerfully. The guy was ever so much worth it.

To make a long story short, this is what I now think:

On the repeated excision attempts vs. the proposal to cut to the chase and just get the damn mastectomy over with:

It’s worth letting Dr. P take another shot at getting the abnormal cells out of there. Although her chances aren’t good, they’re not hopeless, either. If she succeeds, bully for her — she’ll be proven right. And bully for me — I’ll still have part of a boob left. If she fails, the world will not end: a mastectomy will guarantee no return of the Evil Entity and will mean I won’t have to have radiation therapy.

On the side effects of radiation therapy:

Knock off worrying about that. It’s not great, but it’s not especially horrible either.

On tamoxifen:

Nix. Don’t take that.

On reconstruction:

Stand in front of the mirror and practice repeating this: NNNNN OOOOOO, NNNNN OOOOOO, NNNNN OOOOOO, NNNNN OOOOOO, NNNNN OOOOOO, NNNNN OOOOOO…..

Put the two sounds together and practice that a few times: NO…NO…NO…NO…

Utter this sound to Dr. P.

Refuse to sign any papers permitting anyone to do any reconstructive surgery.

Voilà. Problem solved.

On the advisability of declining reconstructive surgery:

His patients who have had implants removed or who have refused reconstruction report that they’re happy with their decision. But if I feel I am not a complete human being without a blob of flesh or fake flesh hanging from my chest, one can have this procedure done at any time in the future.

On recovery time from simple mastectomy:

Probably three or four weeks. Maybe a little longer to get over the fatigue. No point in working yourself into a state of hysteria over that.

On finding someone in town who makes custom prostheses:

Doesn’t know of anyone and believes no such company exists in Phoenix. Find a maker in some place where you’d like to take a medical vacation.

Okay, okay, he didn’t say that last thing. But that was the implication. No one in Arizona that we know of is making light-weight, comfortable custom prostheses. To get measured for one, patients have to travel to other states.

So it goes…

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As old-timey FaM readers know, one of my strangest eccentricities is that I cook and feed real, actual FOOD to my dogs, rather than giving them the fake stuff that comes in bags and cans. This came about during the late, great melamine scare, during which we learned that virtually all dog foods, from Walmart’s cheapest to Petsmart’s fanciest, are manufactured in the same few factories in China. And, as we learned from that and a number of other flaps (remember the poison toothpaste?), quality control is not China’s strong suit.

Cooking up a week’s worth of dog food for one dog, even a relatively small one like a corgi, is a job. Fixing it for two is a real chore. Cassie eats a a little over a half-pound of food a day, but because Ruby is still a growing pup, she needs a pound and three-quarters to two pounds a day. That is a lot of artisanally home-cooked dog food!

When the present medical adventure started, I prepared and froze a ton of food for them. But I didn’t plan on two, three, now four and maybe even FIVE surgeries. Even though I made more food between procedures 2 and 3, we ran low.

So I supplemented with a product made by a company called FreshPet. The stuff comes in rolls — my son says it looks like mortadella, a delicacy that tosses his belly — and it contains exactly the same ingredients I put in my concoctions: meat, veggies, some kind of starch, and a vitamin pill. You slice off a chunk in the desired amount, mash it up, fork over the plateful to the dog, and stick the rest back in the fridge.

Okay. Very nice, but you find the stuff at places like Whole Foods and PetSmart (the Whole Paycheck of the pet industry….). Meanwhile, I was pretty fuzzy about how much it costs to make up a week’s worth of dog food in my kitchen — calculating the cost of all those ingredients and then factoring out the number of days they would supply is beyond my English-major math skills.

So, there I am thinking this expensive dog food can’t POSSIBLY cost any less than what I make, probably costs more, and besides, I really do know what goes into my dog food, whereas when I buy a prepared product I have to believe what’s on the label. Decision made: keep on cookin’.

Then, Ruby developed ear infections and runny eyes. The vet, whose experience in this issue proved correct with the now-deceased greyhound, speculated that she had a food allergy. When he learned what she’s eating, he pointed out that beef is one of the commonest allergens among dogs. He recommended taking her off beef — and while we’re at it, let’s cut out the grains, too.

:roll:

Well, this presented two problems:

a) Hamburger is the only pre-ground meat that is even vaguely cost-effective. All other meats available in grocery stores — the meats you can afford, that is — have to be ground up in one’s food processor, a messy and time-sucking project.

b) Therefore, I had stocked the freezer with a lifetime supply of hamburger-based dog food. I was not about to throw it away, and with another surgery coming up, neither was I in a position to cook up MORE pounds and pounds of food.

So I paid another visit to Whole Foods, where I found large dog-food rolls. Got a grain-free turkey concoction. Pup was beside herself with joy. And, when I had to board her with my son after the last surgical excursion rendered me too infirm to care for her, it was mighty useful to be able to hand a roll of prepared food over to him.

After about a week or ten days free of beef products, Ruby’s ears and eyes cleared right up. No steroids required, no nothin: just hold the beef.

Then I found some rawhide chews shaped like donuts, a design that makes it hard for her to reduce the thing to a size and shape she can choke on and easy for me to get it away from her before she can harm herself with it. Three or four days of chomping on beef hide: ear inflammation came back.

Obviously, this is a dog that can’t tolerate beef.

Ducky. As it were.

That locked us into the most work-intensive versions of my home-made dog food recipes: highly undesired, under the circumstances. So, it was permanently on the dog food rolls for Ruby. Cassie could consume the rest of the frozen beef concoction.

Now that I’m feeling better, my hot little mind returns to a key cheapskate’s question:

Which of these fancy concoctions — hand-make artisanal dog food from my kitchen or effete natural organic made-in-America(!!) turkey doggy salami from Whole Foods — actually costs more?

Recently, I bought five pounds of boneless chicken at Costco. Combined with a yam and a dose of mixed veggies, it produced seven pounds of home-cooked dog food. That is a shade under one week’s worth for Cassie –  about four days’ worth for Ruby. At about the same time, I’d bought five pounds of turkey roll at Whole Foods; from that I managed to extrapolate how much it would cost to feed Cassie that stuff for a week. Result:

Home-made dog food: about $22.
Fancy turkey roll dog food: about $21

Huh. We call that diference negligible.

And once Ruby is past the high-calorie puppy diet stage — which will only be another three and a half months — her rations can drop to about half of what she’s eating now.  Thus in the near future dog food costs will drop significantly, no matter which fancy cuisine they’re dining on.

Well, as it develops, Fry’s Supermarkets also allegedly carries the elegant FreshPet doggy salami. I don’t go into the Fry’s in my part of town because both of them are in dangerous neighborhoods full of panhandlers and muggers (last time I went to the Fry’s in Sunnyslop, a panhandler parked his wheelchair behind my car so I couldn’t pull out and sat there screaming at me after I told him, truthfully, that I don’t carry cash). It’s reasonable to believe that the customers of these low-rent establishments do not buy their dog food in the shape of staggeringly expensive mortadella rolls.

But the other day when I was at the Fancy-Dan Fry’s in Paradise Valley, I did find it there (why are we not surprised?). They charged $12.99 for a  hefty five-pound chicken roll.

A look at the latest Whole Foods receipt revealed a bill for $20 for a five-pound turkey roll. Other than the different birds — chicken, turkey — the ingredients were identical.

At $12.99/five pounds, I could feed Cassie (and eventually Ruby) for a week for $16.76.

That is a far cry from $22 and change!

So, I’ll be shopping at Fry’s for gourmet dawg food after this. And when Cassie runs out of the home-made stuff, she also be moving out of Alice’s Restaurant and over to the joint that serves up prepared chow.

How is Ruby doing on this food? Well. Exceptionally well.

She was beginning to look a little scrawny, so I upped her rations and added a boiled egg at mid-day. After a week of this, she’s filled out handsomely and is beginning to look like a mature dog. Here she is, on the right, almost as tall as Cassie.

P1030263

My iPhoto has decided its red-eye function no longer works…sorry about that.

Cassie weighs about 23 pounds. Last time  I put Ruby on a scale, about two weeks ago, she weighed 16 pounds. This morning she’s up to 21.3 pounds. She still  looks slender and healthy, but clearly I’ll have to keep an eye on the rations to be sure she doesn’t get fat. Corgis regard food as something that must be vacuumed up (they try to inhale the leftover molecules from each others’ dishes!). As you can imagine, they tend to overweight, a risky condition for long short-legged dogs with vulnerable spines.

For the nonce, though, she looks good. She’s actually becoming pretty: where before she looked like a scruffy waif, now she’s taking on the kind of magical doggy beauty that Corgis can affect. Her coat looks good, her eyes are no longer runny, her ears are no longer red and itchy, and she’s looking more and more like Cassie, who is truly a handsome little dog.

It seems to be working.

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Annals of the Floored and Flabbergasted: Back Office Staff Edition

October 15, 2014

This morning I get on the phone to an assistant in the gynecologist’s office, to whom I’m trying to explain, for the THIRD time today (not to her, but to two other folks) that because it looks like I’m headed for a mastectomy, a medical oncologist advised me to consult with a plastic surgeon before […]

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Breast “Cancer” or Not: Another Amazing Adventure in Medical Never-Never Land

October 15, 2014

Okay, so after I had arranged an appointment with the medical oncologist my gynecologist wants me to see for a second opinion about the advisability of further surgical attempts at a successful lumpectomy, Young Dr. Kildare became concerned enough that he unilaterally scheduled an appointment for me with his choice of oncologists. Interesting. I decided […]

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Fry’s Kroger’s

October 14, 2014

Fry’s Supermarkets is an Arizona subdivision of Kroger’s. By and large it’s a fairly downscale chain, catering to the (non-union) working class and the immobile. But recently this outfit decided it wanted to take out AJ’s, a ludicrously upscale outfit that had a store in Moon Valley, a district of mixed fortunes (one minute it’s […]

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Voting in the Dark

October 13, 2014

Yesterday I shipped off this year’s mail-in ballot. What a HUGE passel of things and people to vote on…most of them people and things no one ever heard of. Several extreme propositions appeared on the ballot, among them one that would take away firefighters’ and police officers’ defined pension plan and one that, if passed, […]

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