The office of Dr. Pare, the vascular surgeon recommended by Dr. Mehta called me Thursday to remind me that my appointment was today (Friday). I arrived at his office. Waiting room was empty and three professionals were busy updating their Facebook status. Finally someone from the far end of the counter asked if he could be of assistance. Yes, I'm here for an appointment.
Without eye contact, "Name?" Page, Richard, I said. Do you have your insurance card? Yes, here it is. Still no eye contact. He then began asking me a series of questions. The same questions I answered at each appointment. I guess he was completing the form electronically. I suppose that was more efficient, but I'm sure there's something in the HIPAA laws that should have protected my answers and discouraged someone from soliciting this from across the room in the presence of third parties. Apparently their status updates where more important and there were no patients there so it probably didn't matter much. After all they probably have access to all patient files anyway. Just odd.
When he was done entering my responses, he looked at me and said $20. After processing my credit card payment he said, "Come on back" and had me follow him to the examination room where he asked me to wait for the doctor.
I had done my research and checked out the doctor using all online resources so I knew what he looked like. I did see him walk past a few times. It wasn't like he was working with other patients or updating his Facebook status. I guess it's protocol to make all patients wait.
I guess he figured I had him pegged because he dropped in on his last walk by and introduced himself. He asked a few questions with one being who referred him to me. Dr. Mehta from Holy Family referred you. Dr. Pare said, "Who is he?". My oncologist at Holy Family. "Oh you have cancer?" He starts looking at the chart and his notes and quickly comes up to speed.
He indicated that he looked at the CT scan and by his measurements the aneurysm is 4.8 cm. Like others and what I've found through research, he said that generally it has to grow to about 5.5 cm before there is surgery. Until then the risks of surgery out weighs the risk of rupture.
He wanted to 'look at it' now so he asked that I get comfy on the examination table. He rolled over the ultra sound and asked me to lift my shirt. He slowly moved the gooey device below my rib cage and above my belly button on my left. He then asked me to lower my pants so he could see if I had aneurysms behind my legs (where they bend). I know I had one area that looked like varicose veins, but attributed it to age and years of standing. After his examination he said that the veins were big but no aneurysms were found. (YAY).
He got some paper towels and rubbed off the guck and asked me to get dressed. He sat down and said he could really concentrate on my AAA with the ultra sound and recommended that I do nothing. And suggested that I come back in three months to see if it grows. He said that he has had patients where the aneurysm had stabilized and grew no larger. Because we have no history of when I got this and how long it has taken to get to this size he now has a base line to compare future images. Given the size and the reasons stated earlier. He suggested taking care of the cancer first.
I asked him a number of question that I had as a result of my online research. He answered them to my satisfaction. [The body is a marvelous creation. If a vein is closed due to insertion of a stent, it finds an alternative way to get blood to the organ or muscle.] I even asked if he had heard about the modified EVAR (with the polymer). He said he did but he thought there wasn't enough information yet, but he also thought that eventually that would be the preferred option. He remarked that I had very intelligent and informed questions. The Internet is a wonderfully scary tool, I said.
I made a follow up appointment for July.
Every day more information affects the information received the previous days and results in more questions and change in direction.
At this writing and until I get more input from Drs. Moore/Chatson I'm leaning to waiting and monitoring the aneurysm. Something Dr. Pare said today made me think of something Dr Kansal said - It's my choice and gamble on whether to wait or not. Due to the size, I do have time.
I don't see the benefit of rushing into something that can wait - as long as it's monitored this may be the best option - for now.
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