Come on People Now

I saw the cardiologist, who said a muga scan gives a better left ventricle ejection fraction (lvef) number than an echocardiogram. So I needed to have one done.

I did. My number is 65, very good and where I was at before chemo. So that's all good.

Not so my love of the medical-go-round after you've had cancer. After finding out from another cancer blogger's post that the company that makes Herceptin tells you to have heart checks every six months for at least 2 years after you finish the drug, and knowing I hadn't had any followup like that and that I was having an odd feeling in my chest, I called my onc and asked for a muga scan so I could see where I was at.

The nurse called me back and got sarcastic/snippy like she has done every time I've requested a muga scan (even though they are considered standard procedure for people taking Herceptin). "And why do you think you need a muga scan?"

Lucky for her, I kept my answer brief and civil and included something about the pains I've felt in my chest. All of a sudden, things shot into panic mode and she said I should go to the emergency room.

No, but I would like the muga scan like the Herceptin people suggest so I can rule out heart issues as causing the odd feeling in my chest.

Instead, I was told to contact my gp and work through him. He ordered the echocardiogram because he said it was the best test. His nurse called a couple days later saying everything looked fine and my lvef was 48.

Hmmm, 48 is low. I told the nurse that and asked what the gp thought of the low number. She called me back and said he didn't know what to think, and that both he and the onc wanted me to see the cardiologist.

The cardiologist said muga is the best test, and yes, we're right back where I wanted to start in the first place.

I'm supposed to go for my regular onc checkup appointment at the end of this month. I'm going to get the bloodwork done in advance as per usual (and even try to get the tumor marker and the tamoxifen test added on), but I'm not sure I'll keep the onc appt.

When you live in a smallish town surrounded by smallish towns, finding a good doc is really hard. And I only know this now because I really need a fabulously good doc, or at least one that will not punt my concerns around so freely.

It seems part of my "new normal" (I hate that phrase!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!) is having to go to at least 2 doctors whenever something comes up.

It would be nice if the ones I had to see would at least WORK TOGETHER!!!!!!!

Taking Heart

The news out of the annual breast cancer meetings is that the A of ACT chemo and Herceptin are each bad for the heart.

It's enough of a problem that some doctors recommend a switch from the A to another chemo drug combination before Herceptin.

Over the last few months I've noticed some odd feelings in my chest--like a rubber band snapping--about once a day at no particular time. It just feels odd, so of course it got me wondering, "Could something be up?"

I read "But Doctor I Hate Pink's" blog about having read the dosing info for Herceptin (which I've never done) and found that the manufacturer recommends every six month followup on the heart for at least two years after Herceptin treatment ends.

So I decided to report my chest pains and get a followup test. I had one after finishing Herceptin, but none since, even though that last muga scan showed my left ventricle ejection fraction (lvef) at 48 (50 is lower level of normal; better is 55 and up).

I'm still at 48. Before chemo et. al. my lvef was in the 60s, so I'd say 48 is a fair drop. Some of this heart function loss is supposedly recoverable, but it doesn't look like it's going that way for me, at least not almost 2 years past ending Herceptin and chemo treatment.

They did an ultrasound on my heart to see where I'm at; now I'm getting a muga scan to make sure the number is correct and then going to see a cardiologist for a consult.

Swell--is there a doctor and specialty that I'm not going to get to visit on this cancer parade?

I'll keep you posted.