Tykerb, Herceptin combo instead of Navelbine?

[Pam P]

It seems that seeing the ortho doc quickly and getting the surgery as soon as possible is key here in order for you to be able to move forward with the best treatment. You are such a good advocate for yourself - can you try to push for an appointment soon (develop a severe unbearable pain in your femur that needs immediate attention???). In the meantime it seems that the herceptin is being very effective according to your markers. Adding the tykerb would be good too but from other posts - Sheila - that could be a bigger challenge. I'm sorry you are having to go through this fight for attention and treatment. Pam

[Lani]

Chelee--the orthopaedic surgeon specializing in bone tumors (primary and mets) at UCLA is Jeffrey Eckhardt. Perhaps you could ask your HMO to refer you to UCLA rather than COH and ask Dr. Slamon if he or his NP could put in a call to Dr. Eckhardt's office asking them to see you prompty.

An orthopaedic opinion PROMPTLY, advising whether this needs fixing now(or perhaps even ever depending on your response to treatment), advising whether to continue Zometa (which has its effect over a MONTH after it is given if I understand it) and advising whether you should be on crutches or avoiding any other particular moves while you wait, would seem to be in order.

That way your orthopaedic and oncologic care could be coordinated. Even if you can't get your oncology care at UCLA, at Least Dr. Slamon would know
what your exact orthopaedic status is/how it might impact your oncologic care from someone he might often work with.

If this turns out not to be practical:

I looked up orthopaedics at COH because I had heard it was a small department--it is. There is only one member and here is his CV:

Dominic Femino, MD

Chief, Orthopaedic Oncology Surgery
Professional Experience

2007 - present, Associate Director, Musculoskeletal Tumor Program, City of Hope, Duarte, CA
2007 - present, Chief, Division of Orthopaedic Surgery, City of Hope, Duarte, CA
2001 - 2007, Assistant Professor of Clinical Orthopaedic Surgery, University of Southern California, Los Angeles, CA
2000 - 2001, Visiting Professor of Clinical Orthopaedic Surgery, University of Southern California, Los Angeles, CA
1998, Co-Chairman, Division of Orthopaedic Surgery, San Gabriel Valley Medical Center, San Gabriel, CA
Education and Training

1999 - 2000, Childrens Hospital Los Angeles, Fellowship, Pediatric Orthopaedics
1998 - 1999, University of Washington Medical Center, Fellowship, Orthopaedic Oncology
1994 -1996, Johns Hopkins Hospital, Residency, Orthopaedic Surgery
1991 - 1994, University of Southern California, Residency, Orthopaedic Surgery
1991, Johns Hopkins University School of Medicine, M.D.
1987, Yale University, B.S.

He seems to work with Health Volunteers Overseas so perhaps you could call his office and hypothesizing that he really is a nice guy, see if he will move your appointment up (unless, of course, he is overseas)

Hope some of this helps

[Chelee]

Pam, Due to the pain I am having...that did help to expedite matters. The case manager handling this for me called today & has me set-up to see a Ortho next wk which is quick for them. I just pray the Herceptin continues to knock down my markers till I get something going...this is stressful.

Lani, Thanks for all the information you looked up for me! I SO appreciate your time and trouble. The 1st option to go to Dr. Jeffrey Eckhardt at UCLA cannot be arranged due to my HMO. I paid out of pocket to see Dr. Slamon. I am hoping to change my insurance this Nov. so I won't have all these problems in the furture.
The case manager I called yesterday has set me up to see Dr. Dominic Femino next wk. Yes it is a small Dept which surprises me for COH...he is the only one that deals with these medical issues. The case manager that is handling this for me said that Dr. Dominic Femino tends to be very aggressive in his treatment. COH called today & has it all set-up. I hope to find out we can fix the hip later after I've completed some chemo? I will save the name of Dr. Jeffrey Eckhardt in case I need another opinion now, or in the furture. I would pay out of pocket again if need be. Thanks again for your help.

Chelee