Monday, July 9, 2007

A Fish Ate My Homework

Max had his follow up MRI today along with a visit to Endocrinology; all to see how things are progressing. As Max had done the MRI three months ago without sedation, we scheduled this one without sedation but had him fast since 4:30 am just in case he couldn't make it through the scan without staying still. Having stayed in the scanning room with him last time, I knew to bring a book and not bring my typical laptop, PDA, and other electronic gadgetry as I had to leave it all outside the room anyway. Thinking thin I had taken only the paperwork that I needed, a pad of paper, and my new paperback that I had purchased last night and placed it on the fish tank. That kind of preparation paid off handsomely as the entire bundle still sits atop my fish tank keeping the fish entertained while I'm here trying to explain to everyone that I really do have all the paperwork (referrals, prescriptions, test results, etc.) but I just forgot to bring it. I'd have thought I was beyond the old "… the fish ate my homework …" but alas, it just isn't so.

In spite of my incompetence, things so far had gone very well. We didn't hit any traffic at all so we arrived at the hospital early around 11:00 am. We weren't supposed to arrive until noon and then start the scan at 1:00 pm but with the early arrive and some sweet timing with everything else we were done with the MRI at 1:22 pm. Our next appointment wasn't scheduled until 3:00 pm so we had time to hit McDonald's as a reward for Max because, in his words, "I faced my fears so maybe I deserve McDonald's". His fear, of course, is NOT needles, being trapped in the MRI tunnel, or suffering a terrible fate from the truly caustic chemicals that are pumped into him weekly. No, the fear that faced was that of wearing a band aid. Oh - he's also terrified of rain - really.

When we got to the registration desk at the endocrine office I knew I was in trouble. I must have tucked away in the back of my mind just how afraid I am of these women and their ruthless pursuit of all paperwork. All is in my best interest, so that I don't end up stuck with bills that otherwise would be covered by insurance, but somehow I never seem to get it all right when we visit the endocrine office. Today, as you've already learned, was not going well paperwork wise so when she finished with most of the check-in questions and asked, "Do you have a referral?" I replied, "Yes" and held my breath while looking at my feet. When I realized the silence was a little too long and looked up I found that she was staring up at me between her glasses and slightly furled eye brow. When she saw my eyes were looking at her she said, " … and I will have this … ?" I pleaded, "Yes, I know, I'm an idiot. I called my wife as soon as I realized I had left it at home. She called the doctors to get test results faxed down but now that I'm here I realize that I didn't ask her to get the referral faxed down. I really do have it at home and I'm sure it has been filed but the pediatrician's office might already be closed - is it okay if I fax it tomorrow?" She was very kind and pointed to the fax number on the wall in a way that told me I wasn't the only lummox that did this on a somewhat regular basis.

We weren't there very long before they called Max back to see the nurse practioner for his doctor. Unfortunately, it took only a few minutes to realize that we were seeing her based on another doctor's schedule and she was afraid that our doctor might have left. She hurried off to try and get him to wait if he hadn't already left. Things sort of worked out in that she found but he did have to leave so we tried to hurry through the visit. Unfortunately Max was in a very talkative and silly mood so it did take longer than normal. Essentially we have learned that Max grew about 1.3 cm, maintained weight, still showed normal hormone levels for his age and actually had lower than normal growth factors since our visit 2 months ago. He said that the lower than normal growth levels just need to be watched. Alone they don't mean too much but if the trend continues in 3 months they'll need to re-evaluate the growth suppression drug as the tumor may have changed and is no longer impacting his growth hormones the same way. I was surprised that he was happy with Max's growth because it is a little rapid but he said that it might actually be a way for his chronological age to catch his bone age. The more I think about that now, several hours later, I'm a little confused but will simply trust that the news was essentially good and will not worry myself about my trying to figure it out right now. His shots will continue, we'll get more labs in 3 months and see them again in January 2008.

Max has chemo tomorrow at Lehigh Valley. Yes, this could've been done at CHOP today but he looks forward to seeing everyone at Lehigh Valley and we felt that it was worth an additional stick this week. On Thursday Max and I head back to CHOP to meet with his neuro-ophthalmologist at 8:30 am and his oncologist at 10:00 am. That is when we'll find out the results of the MRI as well as map out the road ahead.

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