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02-24-2007, 05:35 PM
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#1
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Senior Member
Join Date: Feb 2006
Location: Southern, CA
Posts: 2,511
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Pushed off on NP?
Many of you know this nightmare I have been having with my onc not examing me or anwswering my questions. Plus I have been *literally forced* to stay with this onc rather I like it or not. I am not allowed to change. Now not only does my onc refuse to exam me, her newest thing is to push me off on the NP. The NP is nice...but she does NOT have the knowledge or yrs of experience in onc as a real oncologist. I don't feel its right to *make* me see the NP and have to pay a co-pay of $30.00 dollars. Techically she is not a doctor yet.
I found a message on my machine yesterday saying my onc wants me to see the NP this Tues. I am not going to pay $30.00 for the NP again! My onc pulls me off my hormonal protection...now she pushes me off on the NP...I don't think this is right! The NP doesn't do anything for me...legally do we HAVE to see a NP? I sure would NOT think so. If my onc is TOO BUSY to see me...then WHY can't I change onc? I am beyond frustrated. Why is there NO help out there for me to straighten this out? (No one deserves this!)
Chelee
__________________
DX: 12-20-05 - Stage IIIA, Her2/Neu, 3+++,Er & Pr weakly positive, 5 of 16 pos nodes.
Rt. MRM on 1-3-06 -- No Rads due to compromised lungs.
Chemo started 2-7-06 -- TCH - - Finished 6-12-06
Finished yr of wkly herceptin 3-19-07
3-15-07 Lt side prophylactic simple mastectomy. -- Ooph 4-05-07
9-21-09 PET/CT "Recurrence" to Rt. axllia, Rt. femur, ilium. Possible Sacrum & liver? Now stage IV.
9-28-09 Loading dose of Herceptin & started Zometa
9-29-09 Power Port Placement
10-24-09 Mass 6.4 x 4.7 cm on Rt. femur head.
11-19-09 RT. Femur surgery - Rod placed
12-7-09 Navelbine added to Herceptin/Zometa.
3-23-10 Ten days of rads to RT femur. Completed.
4-05-10 Quit Navelbine--Herceptin/Zometa alone.
5-4-10 Appt. with Dr. Slamon to see what is next? Waiting on FISH results from femur biopsy.
Results to FISH was unsuccessful--this happens less then 2% of the time.
7-7-10 Recurrence to RT axilla again. Back to UCLA for options.
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02-24-2007, 05:44 PM
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#2
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Senior Member
Join Date: Aug 2003
Location: Morris, IL
Posts: 3,507
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Chelee
Where in Southern Ca do you live? Is it an insurance issue that you can't change and go somewhere else? I am delegated to where I can go and what Dr.s if I want to use the PPO insurance, but there are many on my list....I myself would not want to be examined by a NP for cancer treatment...if the Dr. wasn't seeing me also! Can you switch clinics/hospitals altogether? My brother works for Kaiser out there and he said they have alot of good BC onc. and surgeons...let me know if I can help...I hate to see you go through this added stress! You don't deserve this treatment!
__________________
"Be kinder than necessary, for everyone you meet is fighting some kind of battle."
Hugs & Blessings
Sheila
Diagnosed at age 49.99999 2/21/2002 via Mammography (Calcifications)
Core Biopsy 2/22/02
L. Mastectomy 2/25/2002
Stage 1, 0.7cm IDC, Node Neg from 19 nodes Her2+++ ER PR Neg
6/2003 Reconstruction W/ Tissue Expander, Silicone Implant
9/2003 Stage IV with Mets to Supraclavicular nodes
9/2003 Began Herceptin every 3 weeks
3/2006 Xeloda 2500mg/Herceptin for recurrence to neck nodes
3/2007 Added back the Xeloda with Herceptin for continued mets to nodes
5/2007 Taken Off Xeloda, no longer working
6/14/07 Taxol/Herceptin/Avastin
3/26 - 5/28/08 Taxol Holiday Whopeeeeeeeee
5/29 2008 Back on Taxol w Herceptin q 2 weeks
4/2009 Progression on Taxol & Paralyzed L Vocal Cord from Nodes Pressing on Nerve
5/2009 Begin Rx with Navelbine/Herceptin
11/09 Progression on Navelbine
Fought for and started Tykerb/Herceptin...nodes are melting!!!!!
2/2010 Back to Avastin/Herceptin
5/2010 Switched to Metronomic Chemo with Herceptin...Cytoxan and Methotrexate
Pericardial Window Surgery to Drain Pericardial Effusion
7/2010 Back to walking a mile a day...YEAH!!!!
9/2010 Nodes are back with a vengence in neck
Qualified for TDM-1 EAP
10/6/10 Begin my miracle drug, TDM-1
Mixed response, shrinking internal nodes, progression skin mets after 3 treatments
12/6/10 Started Halaven (Eribulen) /Herceptin excellent results in 2 treatments
2/2011 I CELEBRATE my 9 YEAR MARK!!!!!!!!!!!!!
7/5/11 begin Gemzar /Herceptin for node progression
2/8/2012 Gemzar stopped, Continue Herceptin
2/20/2012 Begin Tomo Radiation to Neck Nodes
2/21/2012 I CELEBRATE 10 YEARS
5/12/2012 BeganTaxotere/ Herceptin is my next miracle for new node progression
6/28/12 Stopped Taxotere due to pregression, Started Perjeta/Herceptin
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02-24-2007, 06:10 PM
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#3
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Senior Member
Join Date: Jun 2006
Location: San Antonio, TX
Posts: 2,357
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Hi Chelee!
How can someone prescribe for you (or not) if they don't see you? Sounds like she has a problem. I think Sheila is right. You could at least pursue another option. It makes me so mad to hear how some of the group is treated. I've been so well treated and cared for with such kindness and love, and I am so grateful, but I get so sad to hear that others receive less than the best care. I don't have your answer, but listen to those who know what to suggest. You don't need more stress, but less stress. I've decided for me that eating as well as I can make myself eat, exercise, and most importantly, delete stress as much as possible from my life is incredibly important to my living a longer, happier life. Hope you'll find the information you need to fight for your own peace and good treatment. Those people make me mad! Love to you, ma
__________________
MA in TX.
Grateful for each and every day....
Diag. 12/05 at age 60
Stage II, Grade 3, 4.5 cm primary tumor
ER/PR- Her2 +3 strongly positive
Her2 by FISH 7.7 amplified
vascular invasion
Ki67 20% borderline
Jan - March '06 Taxotere/Adriamycin X 3 to try to shrink tumor - it grew
April '06 Rt Modified Radical Mas, 7 of 9 nodes positive
April - Aug. '06 Herceptin/Taxol/Carboplatin X 8 (dose dense)
Sept - Dec. '06 Navelbine/Herceptin x 8 (dose dense)
Radiation & Herceptin Jan. 22 - March 1, 2007
Finished Herceptin Dec. 10 '08! One extra year.
Port removed August, 2012.
8 1/2 years since diagnosis! 5 1/2 Years NED!
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02-24-2007, 06:10 PM
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#4
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Senior Member
Join Date: Sep 2005
Posts: 312
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Hi Shiela
I think it is a matter of an HMO. The problem reads like a Robin Cook novel. Too bad it is not just a book instead real people inolved.
Chelee, in my experience, sometimes you can get more help from an NP than from a doctor. They may order more tests and are more thorough than the doctor in some ways just because they are not doctors. Have you seen this one? Often they have more time and can listen to you. If they have been doing this a long time, they maybe fairly competent--and I am not one to like NP's for the same reason as you. She also maybe in the postion to get the doctor's attention should she think there is something wrong where the doctor may just brush your concerns, off. But I do hope you can just change doctors.
Janet/FL
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02-24-2007, 06:14 PM
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#5
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Webmaster
Join Date: Feb 2005
Location: Home of the "Flying Tomato"
Carlsbad, CA
Posts: 2,036
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Chelee,
You may wish to contact the Cancer Legal Resource Center in LA:
http://www.lls.edu/academics/candp/clrc.html
They will host our next teleconference in April
Regards
Joe
__________________
A Proud webmaster to the internet's most informed, educated, COMPASSIONATE and caring group of breast cancer survivors.
Illegitimi non carborundum
My Album
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02-24-2007, 06:31 PM
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#6
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Senior Member
Join Date: Feb 2005
Location: Norridgewock, Maine
Posts: 778
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In the past I have seen a P.A. rather than an oncologist while I am stable. If I have a question she can not answer she will tell me before I leave she will get an answer from the head oncologist. At first I didn't like the idea but than figured if I am stable why not. I see the head oncologist once a month so to cover all bases. I love my P.A. and she is so kind, caring and compassionate has plenty of time to see me and so I am glad I gave her the chance. However, if you are not comfortable seeing the NP then you shouldn't and they should listen to your needs. I think Joe has directed you in the right direction and Sheila can help as well. Wishing you well with your journey it sure has been a stressful one for you. Senind you a big hug, Sandy
__________________
Dx. 03/01, Rt. IBC
AC/Taxatere
Rt. MRM-with graft Lt. simple
5 rads-skin mets
Herceptin, taxol, carboplatin (taxol seem to be the magic drug)
Navelbine & xeloda (did not work)
topical miltex for skin mets
Tykerb/xeloda
thoracentesis x 2 left lung fluid shows cancer cells
Port removal (4 years) with power port replacement
Doxil
Updated 05-07 Scans show no bone or organ involvement we shall see!
I shall not pass this way again. Any good I can do or any kindness that I can show let me not defer or neglect it for I shall not pass this way again.
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02-24-2007, 07:23 PM
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#7
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Senior Member
Join Date: Feb 2006
Location: Southern, CA
Posts: 2,511
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Janet, You are right. Its a matter of being *stuck* in a HMO group. Once you choose a group at open enrollment...you can't change until the next year. They dictate the little group of doctors you see & what hospital you will use. Janet..as to an NP..yes I have agreed to see her a few times. I wasn't happy with her. She is *nice*, but thats about it.
Legally I find this hard to believe. However my HMO grievance Dept pretty much said unless & until its proven I'm injuried or dead...there is nothing I can do. (She seems to be RIGHT!) I have been so nice down there its not funny! The only thing I've done wrong is file a grievance to change onc. (Which I have a right too.) People change doc's/onc's in groups all the time...but I can't! I am being retaliated against and its so obvious. They say they can't retaliate against you for filing a complaint...but don't anyone of you believe it! The system is set-up through the HMO so they can MAKE you THINK they are there to help...when really they are only there to head any problems off that could cause them or the group any problems. As for the patient...too bad...so sad!
__________________
DX: 12-20-05 - Stage IIIA, Her2/Neu, 3+++,Er & Pr weakly positive, 5 of 16 pos nodes.
Rt. MRM on 1-3-06 -- No Rads due to compromised lungs.
Chemo started 2-7-06 -- TCH - - Finished 6-12-06
Finished yr of wkly herceptin 3-19-07
3-15-07 Lt side prophylactic simple mastectomy. -- Ooph 4-05-07
9-21-09 PET/CT "Recurrence" to Rt. axllia, Rt. femur, ilium. Possible Sacrum & liver? Now stage IV.
9-28-09 Loading dose of Herceptin & started Zometa
9-29-09 Power Port Placement
10-24-09 Mass 6.4 x 4.7 cm on Rt. femur head.
11-19-09 RT. Femur surgery - Rod placed
12-7-09 Navelbine added to Herceptin/Zometa.
3-23-10 Ten days of rads to RT femur. Completed.
4-05-10 Quit Navelbine--Herceptin/Zometa alone.
5-4-10 Appt. with Dr. Slamon to see what is next? Waiting on FISH results from femur biopsy.
Results to FISH was unsuccessful--this happens less then 2% of the time.
7-7-10 Recurrence to RT axilla again. Back to UCLA for options.
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02-24-2007, 08:06 PM
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#8
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Senior Member
Join Date: Feb 2006
Location: Southern, CA
Posts: 2,511
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Joe, I did contact the Cancer Legal Resource Center in LA. They did what they call an intake on my problem...& a week or so later they got back to me & gave me phone #s of places that might be able to help. The numbers they gave me I have already called with the exception of two. Which was the Orange County State Bar Association, & the Calif. State Bar. All these places tell me the same thing...there is nothing *they* can do. However, they all listen to whats happened and tell me its awful. One attorney told me he was just appalled at what their doing. But its a catch 22. (I swear, this is going to kill me before my bc does!)
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Shelia, I am in Orange County, CA. Your brother is right...there are some "fantastic" bc onc and surgeons here. In fact I made them a offer to let me go to one place that is within reasonable driving distance. They have top of the line bc onc, surgeons...plus top rated hospital. They won't let me. They will only agree to let me go to the *only* place I told them I could NOT drive that far too. Its 98 miles round trip...I can't do that. Its impossible for me. If I recur...there is no way I can go back and forth that far 2 or 3 times a week & they know it. (Not on the CA freeways!) I would be lucky to get home by 10:00 PM.
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Just the fact that she won't exam me and I now have proof via her progress notes. Her notes also prove she doesn't like me asking questions. Then she takes me off all hormonal meds and offers nothing. Now pushes me off on the NP every chance she gets. The documents I got back from the HMO shows where they were having my infusion nurse write up all my orders to ship me off to the other cancer center. They didn't even tell me this. I found out through these notes. So I may be thrown out on the streets soon. No wonder the HMO kept asking if I was in "active" trt. Once your aren't...they can toss you. Cancer patients do *not* have rights.(Again, unless you prove your injured or you die.) Then hubby can and will go after them...but that doesn't help me now.
Chelee
__________________
DX: 12-20-05 - Stage IIIA, Her2/Neu, 3+++,Er & Pr weakly positive, 5 of 16 pos nodes.
Rt. MRM on 1-3-06 -- No Rads due to compromised lungs.
Chemo started 2-7-06 -- TCH - - Finished 6-12-06
Finished yr of wkly herceptin 3-19-07
3-15-07 Lt side prophylactic simple mastectomy. -- Ooph 4-05-07
9-21-09 PET/CT "Recurrence" to Rt. axllia, Rt. femur, ilium. Possible Sacrum & liver? Now stage IV.
9-28-09 Loading dose of Herceptin & started Zometa
9-29-09 Power Port Placement
10-24-09 Mass 6.4 x 4.7 cm on Rt. femur head.
11-19-09 RT. Femur surgery - Rod placed
12-7-09 Navelbine added to Herceptin/Zometa.
3-23-10 Ten days of rads to RT femur. Completed.
4-05-10 Quit Navelbine--Herceptin/Zometa alone.
5-4-10 Appt. with Dr. Slamon to see what is next? Waiting on FISH results from femur biopsy.
Results to FISH was unsuccessful--this happens less then 2% of the time.
7-7-10 Recurrence to RT axilla again. Back to UCLA for options.
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02-25-2007, 04:22 AM
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#9
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Senior Member
Join Date: Feb 2006
Location: Acworth, GA
Posts: 2,104
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Chelee,
When I first started down this long road, I saw my oncologist everytime I went to the office. I now only see my oncologist once every three months, but I do see the NP every time I go to the office. At first I didn't like seeing the NP but I have found that she will answer all my questions and if she can't then she will get in touch with the oncologist and call me back. Also, the NP will order any tests that I request. I know that she runs my requests by the oncologist first. I was resentful of paying a co-pay to see a NP but now I have adjusted. Have you thought about going out of network even though you would have to pay for it out of pocket?
__________________
Kate
Stage IIIC Diagnosed Oct 25, 2005 (age 58)
ER/PR-, HER2+++, grade 3, Ploidy/DNA index: Aneuploid/1.61, S-phase: 24.2%
Neoadjunct chemo: 4 A/C; 4 Taxatore
Bilateral mastectomy June 8, 2006
14 of 26 nodes positive
Herceptin June 22, 2006 - April 20, 2007
Radiation (X35) July 24-September 11, 2006
BRCA1/BRCA2 negative
Stage IV lung mets July 13, 2007 - TCH
Single brain met - August 6, 2007 -CyberKnife
Oct 2007 - clear brain MRI and lung mets shrinking.
March 2008 lung met progression, brain still clear - begin Tykerb/Xeloda/Ixempra
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02-25-2007, 05:53 AM
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#10
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Senior Member
Join Date: Aug 2003
Location: Morris, IL
Posts: 3,507
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Chelee
It might be worth 1 trip to the other place...you may find you like the onc. there, and if so the miles will fly by. I know what you are talking about...I choose to drive to Chicago for treatment as I want the best, the latest and greatest....there is a brand new cancer center 6 blocks from my house...I could walk there, but instead I drive 141 miles round trip in Chicago traffic, spend hours...actually all day, but in the end it is worth it because I am comfortable in the onc., hospital and oncology dept. This week I go twice, once for treatment & Onc. appt., and once for bone scan and Brain MRI....I always go alone...it is a time to reflect and be alone for a day....wish I had time to shop on my trips...I go by several nice malls!
__________________
"Be kinder than necessary, for everyone you meet is fighting some kind of battle."
Hugs & Blessings
Sheila
Diagnosed at age 49.99999 2/21/2002 via Mammography (Calcifications)
Core Biopsy 2/22/02
L. Mastectomy 2/25/2002
Stage 1, 0.7cm IDC, Node Neg from 19 nodes Her2+++ ER PR Neg
6/2003 Reconstruction W/ Tissue Expander, Silicone Implant
9/2003 Stage IV with Mets to Supraclavicular nodes
9/2003 Began Herceptin every 3 weeks
3/2006 Xeloda 2500mg/Herceptin for recurrence to neck nodes
3/2007 Added back the Xeloda with Herceptin for continued mets to nodes
5/2007 Taken Off Xeloda, no longer working
6/14/07 Taxol/Herceptin/Avastin
3/26 - 5/28/08 Taxol Holiday Whopeeeeeeeee
5/29 2008 Back on Taxol w Herceptin q 2 weeks
4/2009 Progression on Taxol & Paralyzed L Vocal Cord from Nodes Pressing on Nerve
5/2009 Begin Rx with Navelbine/Herceptin
11/09 Progression on Navelbine
Fought for and started Tykerb/Herceptin...nodes are melting!!!!!
2/2010 Back to Avastin/Herceptin
5/2010 Switched to Metronomic Chemo with Herceptin...Cytoxan and Methotrexate
Pericardial Window Surgery to Drain Pericardial Effusion
7/2010 Back to walking a mile a day...YEAH!!!!
9/2010 Nodes are back with a vengence in neck
Qualified for TDM-1 EAP
10/6/10 Begin my miracle drug, TDM-1
Mixed response, shrinking internal nodes, progression skin mets after 3 treatments
12/6/10 Started Halaven (Eribulen) /Herceptin excellent results in 2 treatments
2/2011 I CELEBRATE my 9 YEAR MARK!!!!!!!!!!!!!
7/5/11 begin Gemzar /Herceptin for node progression
2/8/2012 Gemzar stopped, Continue Herceptin
2/20/2012 Begin Tomo Radiation to Neck Nodes
2/21/2012 I CELEBRATE 10 YEARS
5/12/2012 BeganTaxotere/ Herceptin is my next miracle for new node progression
6/28/12 Stopped Taxotere due to pregression, Started Perjeta/Herceptin
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02-25-2007, 07:29 AM
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#11
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Senior Member
Join Date: Jun 2006
Location: San Antonio, TX
Posts: 2,357
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Hi Again Chelee!
I go to a clinic 3 1/2 hours away in San Antonio, while there is one 45 minutes away in Corpus Christi. But I love the care I get! I sure do hear your frustration. You will figure it out. God Bless.
__________________
MA in TX.
Grateful for each and every day....
Diag. 12/05 at age 60
Stage II, Grade 3, 4.5 cm primary tumor
ER/PR- Her2 +3 strongly positive
Her2 by FISH 7.7 amplified
vascular invasion
Ki67 20% borderline
Jan - March '06 Taxotere/Adriamycin X 3 to try to shrink tumor - it grew
April '06 Rt Modified Radical Mas, 7 of 9 nodes positive
April - Aug. '06 Herceptin/Taxol/Carboplatin X 8 (dose dense)
Sept - Dec. '06 Navelbine/Herceptin x 8 (dose dense)
Radiation & Herceptin Jan. 22 - March 1, 2007
Finished Herceptin Dec. 10 '08! One extra year.
Port removed August, 2012.
8 1/2 years since diagnosis! 5 1/2 Years NED!
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02-25-2007, 09:17 AM
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#12
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Senior Member
Join Date: Sep 2005
Location: Stockton, NJ
Posts: 4,179
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Chelee
This is obviously not working for you but if you have to make it work, maybe the NP will be more kind. I have found that at my gyn office, the NP is better than the doctors. It may be the personality that makes some people become nurses or NPs vs the personality of a doctor (especially an oncologist's personality which I find different than other doctors). This NP can be a "start over" too and she may give you an examination as well.
If this doesn't work, I would find a new place. Although I love my onc (my second one who happened to be partners with my first one), I wish I had gone to another place (just because the first one acts like such a baby when he sees me which is not as often now as when I was still on Herceptin). Although I got great care, I did go there because it was close to home versus the other places I visited that were farther away. Lesson learned.
Take care
__________________
Kind regards
Becky
Found lump via BSE
Diagnosed 8/04 at age 45
1.9cm tumor, ER+PR-, Her2 3+(rt side)
2 micromets to sentinel node
Stage 2A
left 3mm DCIS - low grade ER+PR+Her2 neg
lumpectomies 9/7/04
4DD AC followed by 4 DD taxol
Used Leukine instead of Neulasta
35 rads on right side only
4/05 started Tamoxifen
Started Herceptin 4 months after last Taxol due to
trial results and 2005 ASCO meeting & recommendations
Oophorectomy 8/05
Started Arimidex 9/05
Finished Herceptin (16 months) 9/06
Arimidex Only
Prolia every 6 months for osteopenia
NED 18 years!
Said Christopher Robin to Pooh: "You must remember this: You're braver than you believe and stronger than you seem and smarter than you think"
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02-25-2007, 04:23 PM
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#13
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Senior Member
Join Date: Feb 2006
Location: Southern, CA
Posts: 2,511
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I agree with all of you about seeing the NP. But if you look at the "big picture", this is where things changed. Everything *was* fine till I filed a grievance to change onc. Everything changed! BEFORE the grievance I saw the NP and she was so nice, spent time with me and really tried hard to answer my questions. Fast forward to AFTER my grievance. Now SHE is UNDER orders from my onc as to what to do with me rather she likes it or not. She has totally changed. I am being retaliated against by the onc, & people above her due to my complaint to switch onc. (Its just too much to fully explain here...that I understand.) They just want me gone because you should NOT file grievances. (This is my payback!)
I would love to go some place else...but they have to be reasonable. I was already disabled *before* bc. I have severe scoliosis which is curvature of the spine. It causes extreme back pain which makes it impossible for me to spend hrs on the road each wk driving 100 miles round trip & they know it. My disablilty is well documented LONG before my bc. I am not capable of driving or sitting that long by myself and my husband has to work or he would gladly take me. These are not excuses...I did not ask to have scoliosis. Its very painful. I offered to go to one cancer center that is still far...but close enough I could drive to it. But they want to be ridiculous and send me to the one I can't get too even if I wanted too.
All this makes me angry because I do have severe back problems...it limits me as to where I go. I would of NEVER choose this place for bc. I would do anything to go to UCLA, Cedars, or the likes of if I could. They "HMO" original said I would be able to see a onc at UCLA & that onc would work with one at my cancer center. Saving me from driving back & forth. That would of been great. Everything they promised and told me changed. I know there are so many people driving much farther then I mentioned...some very ill. But due to the problems I have its impossible and *they* (group & HMO) know it. They just like making me misrable since I filed that request to change onc. O'well...I guess there is nothing I can do. So much for all the promises the HMO made me! I was looking forward to going to UCLA and having an onc there work with one at this place. They lied to me. There *suppose* to have my best interest at heart but they don't. (Message to all...again, NEVER file a grievance!)
Chelee
__________________
DX: 12-20-05 - Stage IIIA, Her2/Neu, 3+++,Er & Pr weakly positive, 5 of 16 pos nodes.
Rt. MRM on 1-3-06 -- No Rads due to compromised lungs.
Chemo started 2-7-06 -- TCH - - Finished 6-12-06
Finished yr of wkly herceptin 3-19-07
3-15-07 Lt side prophylactic simple mastectomy. -- Ooph 4-05-07
9-21-09 PET/CT "Recurrence" to Rt. axllia, Rt. femur, ilium. Possible Sacrum & liver? Now stage IV.
9-28-09 Loading dose of Herceptin & started Zometa
9-29-09 Power Port Placement
10-24-09 Mass 6.4 x 4.7 cm on Rt. femur head.
11-19-09 RT. Femur surgery - Rod placed
12-7-09 Navelbine added to Herceptin/Zometa.
3-23-10 Ten days of rads to RT femur. Completed.
4-05-10 Quit Navelbine--Herceptin/Zometa alone.
5-4-10 Appt. with Dr. Slamon to see what is next? Waiting on FISH results from femur biopsy.
Results to FISH was unsuccessful--this happens less then 2% of the time.
7-7-10 Recurrence to RT axilla again. Back to UCLA for options.
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