We have a plan!

I visited the physician who may become my new primary care provider (PCP in medical notes lingo) on Wednesday, July 29, 2015. Dr. Golnosh Sharefsaleh, a young, attractive, astute Iranian-American physician, is with the Wake Forest Baptist Health System and a member of a multi-physician family practice located right here in beautiful downtown Lewisville. She is unassuming, warm and enjoys sharing personal stories of her own that are pertinent to the conversation. She doesn't come off as a know-it-all which is refreshing in a profession that attempts to monopolize that personal attribute.

I think it may take a couple more visits for me to fully assess my comfort level with her as my PCP, who would coordinate my general care with Dr. Wiggy (aka Weston Saunders) at Robinhood Integrative Health. My plan is to use Dr. S. to do my annual physical and someone I can go to for aches, pains, colds, flu, etc - you know, those periodic maladies that require attention but aren't life-threatening. Dr. Wiggy will continue to be my 'feel-good' doc who chases numbers to ensure my overall well-being and vitality.

I learned about Dr. S. from a large "Welcome to Our Practice" postcard from WFBH that came in the mail several months ago. The postcard said she specializes in geriatrics and I think I'm pushing that boundary. I visited the WFBH website with a video of her discussing her reason for choosing medicine and geriatrics. I was impressed by her description of how Iranian families (who aren't terrorists attempting to make a nuke to blow up the middle east or the entire world!) take care of each other, even into the later years, even unto death. I infer that they don't farm their elder family members out to elder care facilities to eat crappy, tasteless food and die a slow death among strangers and staff who could give a shit less whether you lived or died in the first place. Here's a link to the video of Dr. S.

Dr. Golnosh Sharafsaleh

I sent email inquiries last week to Holly with the UVa Medical Center (Dr. Loughran, aka the LGLL guru) and Dr. Ellis with WFBH Hematology and Oncology asking about being under their care during the asymptomatic observation period. Holly explained that Dr. Loughran would always welcome an asymptomatic patient who has been diagnosed with LGLL and that being under his care would be completely separate than being in the national LGLL registry that is administered there at UVa. I discovered that the UVa Medical Center is an in-network provider under my BCBSNC insurance plan so that's a piece of good news. No sense enriching the medical-care industrial complex anymore than I already do.

Dr. Ellis responded to my email inquiry stating that she would also take me under her care during the observation period and put me on the same kind of lab/office consult schedule that Dr. Paschold had suggested. Apparently that is the nationally accepted treatment/non-treatment regimen for LGLL patients who are asymptomatic. I would be able to get my quarterly blood draws and labs at the Lewisville Family Practice office (Dr. S.) and then my semi-annual labs and office consults with Dr. Ellis at WFBH Hematology and Oncology Center. Dr. Ellis also agreed to assist me with sending in any required paperwork and labs to join the national LGLL registry at UVa. That is the plan that Mari Jo and I discussed and agreed would be the most advantageous going forward, until treatment time comes. All bets are off when that happens. Maybe by that time Yoda will have returned from Jedi Valhalla and will use the Force to exorcise my demon lymphocytes.

In addition to using the services of Dr. Ellis and the WFBH system, we are going to schedule an appointment with Dr. L. sometime between the first quarterly lab in October and first semi-annual consult with Dr. Ellis in January 2016. We are doing this just to have an opportunity to speak to the LGLL guru and get his opinion of how this blood disorder will progress over the next several months and years. I hope my unruly lymphocytes behave when we visit the distinguished and internationally renowned LGLL guru. Conversely, maybe they should act out instead to give him an idea of just what the hell is going on inside my bone marrow and thymus. In fact, the more LGLs in my blood the lower the $/LGL for the trip up the Charlottesville. I'm sure the wonderful folks at Blue Cross that write the checks will be pleased with that accounting sleight-of-hand! My guess is that the only lab Dr. L. will do is a CBC (complete blood count) just to see what my lymphocyte and neutrophil counts are when he sees me. In the meantime, I'll be sending all of my past CBC lab results along with the flow cytometery and PCR results to the registry.

Here's the email I sent to Dr. Ellis notifying her that she had won the Turner LGLL lottery.

Dr. Ellis,

I had an outstanding visit and it was my first of many, I gather, to your clinic. All the staff there were affable, professional, courteous and helpful. My unruly LG lymphocytes approve.

My wife and I have chosen to place my future care for LGLL into your capable hands during this asymptomatic observation period and beyond. We feel that as my LGLL progresses it would be most advantageous to already have all my medical records within the WFBH system when we start talking about treatment options. We also feel WFBH will provide more cutting-edge treatment options when that time comes. Plus, I want to do my part to help pay for that spiffy new Comprehensive Cancer Center! Seriously, it is an amazing care facility and I'm sure you all enjoy all the new amenities it offers.

Should I go ahead and schedule the next lab work and office visit/lab work appointments? Three months from my first visit would be around October 21. Six months out would be around January 21. I'll schedule the quarterly lab work at my local clinic in Lewisville and the semi-annual lab work/office visit there at the WFBH H & O clinic. Is that an acceptable plan going forward?

Despite sounding slightly macabre, I look forward to seeing you again.

Wayne