Kicked off the team

Tom had his follow-up appt at the transplant clinic today. The marrow biopsy was negative - yeah! He has some signs of GVHD - elevated eosinophils, itchy skin, numbness, swelling of the feet, yadda, yadda, yadda... There is always some issue, some symptom, some concern. Whatever...

Today Tom was basically kicked off the team. As you know, from recent blog entries Tom stopped taking his medicine. The transplant doc that Tom was assigned to on day one gave Tom an eerily brief exam (throat, eyes)today, after which he told us that he was going to discharge Tom to the care of his oncologist, who is not directly affiliated with the transplant clinic. His oncologist is the doctor who diagnosed Tom with leukemia in May 07, and who he saw almost every other day during his chemotherapy that first year prior to the transplant.

This was not expected. This came out of left field. Tom was all set for a confrontation with his transplant doctor: "Tom, you MUST resume your medicine or you'll die!". "Oh yeah, doctor? Well F*** your medication and your narrow mind. Go jump in your sportscar and pick up your dry cleaning and be sure not to scratch your Italian leather dress shoes on the way!". Tom certainly wasn't expecting to be "let go".

I can understand Tom's ongoing frustration - feeling let down by the doctors, wondering if he chose the right course of action, tired of being prescribed a neverending daily cocktail of toxins. I can also understand the doctor's course of action. If Tom isn't going to follow his regimen then what's the purpose? There is no need to continue seeing Tom as a patient if he isn't cooperating.

So, next on the calendar is his visit to the neurologist. The neurologist is by far my favorite doctor of "the group". He makes us feel that he has Tom's best interests in the ongoing, everchanging plan of action. After that, the next appt will be with the oncologist, who will throw a real hissy fit when he finds out that Tom is no longer a patient of the transplant group.