Yesterday's Appointments

Although I commenced my working life as a dental nurse, the fear of dentists, instilled in me as a child, has stayed with me. My Mother's aversion to dentists so strong that she had her own teeth replaced with dentures as a 17 year old. I have spent many hours, and lots of dollars trying to keep my own teeth. The fact that I have numerous crowns, plus a bridge, still count towards my own teeth. Rather than drive the 180 kilometre round trip to see my regular dentist, I was pleasantly surprised to find a young female dentist in this area. Dr Khan gives painless injections, and appears to have an amazing ability to find decay when there is nothing obvious. This was the case when I visited recently believing that the grape seed that managed to wedge itself into a tooth was actually a cavity. As it turned out, apparently it was stuck in a most unusual and intricate bridge. One that had originally been done in Singapore in the 70's. What she did find however, was decay in the tooth beside it.

Today's visit was to have the tooth filled. I remembered to have her note that I am taking blood thinning medications. We discussed the situation, with me explaining to her that I may well be on it for the rest of my life. Dr Khan reminded me that it is important to have my INR levels checked prior to any dental work being done. It seems that even large fillings can lead to excessive bleeding; something definitely worth remembering. She also pointed out that the dry mouth I have from the medications also puts me into the high risk category for new decay. Just what I needed to hear in my twilight years.

Next stop Calvary Mater Hospital Oncology department for a routine check-up. Dr Lombard, my regular Medical Oncologist, is on maternity leave at this time. In her absence I have been seeing her registrar, however, today it was Dr Turner, another young female doctor . The first thing she did was to compare the two PET Scans. My original and base scan, done in February and the second in July. Once again, she explained that she does not like to get patients hopes up but the improvement is absolutely amazing. I did not feel the need to explain that I am also taking a supplement used to balance hormones in post menopausal women. I will never know for sure if the results would have been as good without them and I am not about to find out. While ever I can afford them, I will continue to take them.

My regular doctor had suggested that I ask about the benefit of taking some form of blood thinning medication for life given that my current blood clot is extensive, going almost the full length of my right arm. As is my practice, I mentioned my concerns with taking Femara due to the risk of blood clotting. She immediately said that taking Femara is not an issue, it is Tamoxifen that can cause blood clots. My dilemma then was whether I should refute her statement. I stumbled to find a way to say that the leaflet enclosed with the Femara gives the warning signs of blood clots and states that if, as a patient, you suspect a problem then you should present immediately to your nearest Emergency Department. Dr Turner then asked me to be patient while she did further research. She found the information and agreed that there is indeed a slight risk. As I have said before, the fact that it is in less than 1.2% of the population means nothing if you happen to come into that group.

She then went on to say that there was a single study indicating that there could actually be a benefit for cancer patients having daily Clexane injections rather than taking warfarin tablets. I was surprised to hear that approximately 30% of cancer patients at the Mater require blood thinning medication. Seems I am only now learning that as a result of having active cancer I will always be at risk of blood clots.

Into the mixing pot I add my daily dose of Femara and Epilim; it is no wonder I have concerns.
Apart from the odd lapse, I endeavour to make the most of each day, remaining confident, and optimistic, that 'things do work out best for people who make the best of the way things work out.'