Author: riyat577

My last day at Waverly Oncology kept me pretty busy. I had to say my goodbyes to Mrs. Blumenthal yesterday because she was off work today. I mainly worked with administration and Dr. Graham. One thing I learned is that working with admin isn’t quite my field of interest. Regardless, it was a good experience. Later in the day Dr. Graham pulled up some patient X-rays and pathology reports and walked me through what different images meant. Dr. Graham and Susan Blumenthal are extremely admirable figures as both a medical professionals and people. Working with them truly was an amazing experience and I am now more interested in the field of hematology and oncology.

As my time at Waverly Oncology is coming to an end, Dr. Graham is making sure that I get to absorb as much information as possible before having to depart. When working with Mrs. Blumenthal, I first worked with a patient who had many health problems, including cancer. He had been a heavy drinker and smoker for about 30 years and the effects unfortunately caught up to him. From what we had seen, he was lucky to be alive. I saw a few other patients with Mrs. Blumenthal but was called into a room where Dr. Graham was working. In this room he was seeing an 83 year old patient with a heavily enlarged liver (due to cancer). Dr. Graham told me where to place my hands and I was able to feel the liver tumor!

Today was the day where I had to wake up super early and head down to REX Hospital. I arrived at the Cancer Care Center and was immediately greeted by Dr. Graham who had been patiently waiting for me. He took me into a conference room (which I could not photograph because there was patient info in every corner), and he sat me down next to him. There were a handful of patients belonging to different doctors that were reviewed. Basically the conference was a panel of specialized surgeons and physicians gathered together to discuss possible treatment options for special patients. It was a time for plastic surgeons to ask questions, oncologists to give advice, and specialized scientists to offer clinical treatment options.

After hearing the discussion of the first few patients (which Dr. Graham contributed many ideas to), the panel came to AR’s case. Dr. Graham introduced me to the panel and explicated the severity of AR’s metastatic breast cancer (which was classified as triple negative). The rest of the panel discussed possible treatment options. However, AR’s reports had everything except a PET scan (a positron emission tomography (PET) scan is an imaging test that allows a doctor to check for diseases in your body) which she was scheduled to have later in the day.

After AR, other patients were discussed at the medical conference which was extremely interesting to hear. In all honesty, I came into the meeting thinking there would be at least one minute where I would be bored out of my brains. Thankfully, there was not one second of that meeting where I was bored. Even during some parts where I didn’t understand everything the panel was talking about, I found their communication skills and way of analyzing situations extremely admirable.

Once the conference was finished, I returned back to the clinic to assist both Dr. Graham and Mrs. Blumenthal. I saw a few patients with Mrs. Blumenthal and then sat in on another brief conference within the clinic with Dr. graham, where he was able to check on the status’ of different patients belonging to each PA. After everyone dispersed, Mrs. Blumenthal received a phone call indicating that AR’s PET scan had come in. From my 5 days working with her so far, I have not seen her as shocked as she was when opening AR’s PET scan. She first showed me the scan and told me that every part of her spine that had a glowing yellow color, indicated the cancer had spread to those places. Even I was shocked as that color traveled up her whole spine. Her and Dr. Graham explained to me that a CTC (circulating tumor cell test) detects how aggressive a cancer is. Ideally they would want everyone’s number to be 0 (or no cancer). When the numbers are around 5-100, the cancer is slightly aggressive (depending where on the spectrum it is). When the numbers are above 100, the cancer is extremely aggressive and requires significantly aggressive and immediate treatment as well. AR’s CTC number was in the 300’s: very aggressive.

It’s extremely disheartening to know what a wonderful person AR is and what she’s going through (especially after Dr. Graham tells her the news later today). When I met her for the first time, she was so kind and in so much pain. Her partner is so supportive of her and I cannot imagine what he’s going through as well.

I was thrilled to have attended the medical conference at REX today but on the other hand it’s truly difficult to hear about the demise in AR’s health; I have learned however, that this is what oncology is about: dealing with the unfortunate truth by getting over it and helping people live as long as they possibly can.

Continue reading Day 5

Today was the last day of my first week working here at Waverly Hematology Oncology. It was a fairly relaxed day. I only saw a few patients today because at 10AM Dr. Graham had to catch a flight to Chicago. Before he left he told me what kinds of things would be discussed at the medical conference that I will be attending Tuesday morning (concerning AR).

Once Dr. Graham left, I saw a few patients with Mrs. Blumenthal. The first patient had some knee problems and Mrs. Blumenthal explained the process of receiving elective surgery. Another patient was very young (21) and was suffering from blood clots in her lungs. The patients were pretty spread out today so I had a lot of downtime. I used this time to go around the clinic asking different people what they did. I had more interactions with another pharmacy technician, some nurses, and some administrative figures.

I’m glad to have taken a break from all the emotional cases I was exposed to for the past few days. I will be reviewing the notes I took on AR during her bone marrow biopsy and X-ray examination in order to be well-prepared for the medical conference at REX Cancer Center on Tuesday!

My third day at the clinic was… pretty sad. Remember the patient I talked about from my first day, AR? Well her results from pathology came back. The results indicated that a small mass found in her breast (which doctors initially thought had been from a trauma), was actually cancer. Not only that, but the bone marrow biopsy (which I witnessed on my first day), indicated that the same kind of cancer was found on her bones. Dr. Graham and Mrs. Blumenthal explained to me that this actually wasn’t bone cancer; rather, the cancer found in AR’s breast had spread down to that area, making the cancer metastatic (or able to spread). I had no idea that a cancer found in her breast could travel down to her bones especially when the mass was so small. In fact, it was so small that doctors couldn’t spot it the first time they reviewed it. Anyways, with the confirmation that AR did in fact have cancer, I sat in on the meeting where Mrs. Blumenthal explained to her and her partner what the situation was. It was truly disheartening to see her attitude change the second she heard the word “cancer.” However, Mrs. Blumenthal explained to AR the same thing she explained to me on my first day at the clinic: when patients hear the word “cancer,” their first thought is that they are going to die. That’s a horrible mindset to be in; while cancer is a really serious disease (no matter where it’s found), most kinds are treatable and have great survival rates. The second Mrs. Blumenthal told AR that her kind of cancer was treatable, AR was relieved. However, we would only know the severity of the treatment after further scans.

After the session with RA, Dr. Graham had introduced me to other patients dealing with breast, lung, and prostate cancer. He also told me that next week he was going to be a part of a conference at REX hospital to converse about RA’s cancer and he wanted me to join him! I was incredibly excited when he told me that I would get to be a part of a real medical conference and I cannot wait to participate!

Today was quite different from my first day working at Waverly Hematology Oncology. Instead of starting my day with patients, I was able to shadow the pharmacy technician, Emily. It was extremely interesting to watch Emily because her job was to mix individualized medicinal solutions for different patients depending on how severe the patients’ diseases were. Through her mixing process, she walked me through step by step the mathematics that went behind calculating how much of each substance was used. It was also helpful to hear about her pharmacy technician school process (how long it was and what kinds of things she learned.

Working with Emily on the medicinal solutions didn’t take all day; in fact, during the afternoon, I worked with Dr. Graham (the head of the clinic) as he met with the rest of his patients. I was introduced to GR who was in her late 30’s. It was unfortunate that she had breast cancer as she was very young. I sat in on Dr. Graham explaining to her the pros and cons of getting a lumpectomy versus a mastectomy. I could tell that GR was getting rather emotional (as expected) while Dr. Graham was talking, but she felt much better knowing that she was working with an expert like him. He made a list for her to take home which explained that through a lumpectomy, GR would be able to keep her “God-given anatomy.” However, the downside to that process would result in a 1 in 7 chance of the cancer reoccurring. In the case of the other process, the mastectomy, she would lose this “God-given anatomy” but the risk of her cancer reoccurring would be 1 in 40. While most come to the conclusion that you would want to pick the path that yields the best security, Dr. Graham explained to me that this is a patient’s life we are talking about and we can’t make assumptions as to what their best interest is.

Overall, my second day at Waverly Oncology was just as interesting as my first. I was able to experience a new outlook of medicine which I now have more interest in (in terms of professions) and I was able to continue my patient-interactions which I enjoy.

Though it was only my first day, working at Waverly Oncology was extremely interesting. I was immediately integrated into the clinic lifestyle; the first PA I was working with, Susan Blumenthal, had brought me along to see each of her patients. Initially it was quite difficult for me to be exposed to each individual cancer patient, as it was an emotional experience for everyone involved.

For privacy issues, I am required to code all the patients with their initials. The first patient I visited, SJ, had a breast tumor that resembled a marble. Fortunately for this visit, her tumor had shrunk to a point where it was almost impossible to feel. Another patient, KW, had colon cancer and his blood had been tested to see if he would be able to participate in clinical trials. While his results came up with a mutation, he was still given the opportunity to participate. The most interesting patient I witnessed had come in with severe back and breast pain. Dr. Graham had asked Mrs. Blumenthal to perform a bone marrow biopsy which I was luckily able to witness. While it was difficult to watch the patient, AR, in “the most excruciating pain [she] had ever felt,” it was truly an interesting process. After the patient’s lower back was injected with lidocaine (a numbing medication), a small incision was made in the spot. After that, a huge needle resting in a tube-like tool was manually drilled through her back muscle and fat till it reached her bone. The lack of blood that came from the other end of the tube indicated that she most likely had some kind of cancer around her bones. The bone marrow was collected and sent to pathology for a confirmation. After witnessing the biopsy, Dr. Graham took me into another room and pulled up AR’s X-rays. He turned the lights off and guided me trough what normal bone matter, liver matter, and breast matter looks like versus what the patient’s had looked like. After close examination of the X-rays, Dr. Graham was able to explicate certain areas in the liver, breasts, and bones that raised red flags pertaining to AR’s health.

Through patient-interactions, being able to watch the biopsy, and Dr. Graham’s lectures, my first day at Waverly Oncology was extremely eventful. I can now say without a doubt that working with the associates at Waverly Oncology has made me more interested in pursuing an occupation in the cancer field whether it be through research, or patient care.