The definition of “IST” can be India Standard Time. It could be Ireland Standard Time or Israel Standard Time. According to cancer patients, it has a much different definition to time zones.
Prior to being diagnosed with MM, I was like most middle-aged women. I had a few ISTs in my life. By this, I mean, how many doctors does one need? I had a gynecologist, a dentist, and an internist. I was healthy. Maybe some of you have a cardiologist at this point in your life, the older you get. A few of you probably have a gastroenterologist and a therapist. When you are assigned or pick an oncologist, the entire American Medical Association opens up to you now. Not that this is such a good thing, but in reality it is. Welcome to cancer, welcome to the new ISTs!
Now instead of three or four physicians, you now are allocated to the following:
- Oncologist: Concentrates on your specific type of cancer.
- Hematologist: Accompanies oncologist when dealing with blood cancers.
- Pulmonologist: Tests you in order to withstand a SCT.
- Cardiologist: Also test you in order to withstand a SCT.
- Ophthalmologist: People’s eyesight goes downhill with certain therapies …
- Nephrologist: Depending on what type of cancer, kidney function is a priority.
- Gastroenterologist: Side effect dependent.
- Rheumatologist: Immune suppressed disease.
- Neurologist: Side effect of meds as well as pain management.
- Internist: The doc that gets all of the reports.
- Dentist: If you are on Zometa, (bisphosphonates), need healthy gums and teeth.
- Gynecologist: Every female needs one, yearly tests needed.
- Dermatologist: Dependent on side effects or additional type of cancer.
- Radiologist: Every scan needs to be read, scans are your new normal.
- Psychiatrist: Therapists are a necessity for some of us that need extra support.
Each clinician serves a specific purpose now. Whom you start with may not be whom you end up. It mostly as, you know, stems from the potential side effects that each medication has. So how do we keep track? Take their cards and put into a contact book? Who is in charge of the day-to-day communication necessary for all of these docs? Patient? Transplant Coordinator? Nurse Navigators?
This gets even more difficult if you have second opinion myeloma specialists. You could have this list times two! Most of this depends on the status of your diagnosis and treatment selected. Many of these you can meet once and move on prior to your SCT. The rest could be part of your journey ongoing. The goal is to stay healthy so that you do not need many of these. If not, trying to stay organized should help. Perhaps keep their cards stapled to your cancer journal, or a date book. I tend to have everything on my outlook calendar so I do not miss any appointments.
Can we have favorites? I certainly do. I really like my oncologist/hematologist. He is willing to work with me in developing my individual plan for treatment. Pain management and the neurologist have also won me over. They have prescribed the magic cocktail for Chemo Induced Peripheral Neuropathy (CIPN). I am a huge fan! Finally, after two years significant improvement and pain-free but still numb feet. Should we alphabetize them? Perhaps we color-code them? It is kind of like being in an elevator and trying to remember what floor, you are parked. So bottom line, who is your favorite IST? Were you overwhelmed with the choices? The appointments? The confusion of each department? Do they operate in silos of care? That is an entire other blog. Are they all necessary? Feel free to chat about your favorite IST, and how it is going. Whom you can’t live without? No pun intended …
Best,
Cathy