Lisa's cough is a bit worse, and her chest discomfort and higher heart rate are back...  we called the oncologist and they're coordinating with the cardiologist.

Update 4pm:  The oncologist's office couldn't get the EKG taken early January from the cardiologists office, because the cardiologist's office fax machine wasn't working.  OK, so what does the oncologist say through his nurse?  "You need to take up the fast heart rate issue with your cardiologist."  Sure... and this is at 3:30 on a Friday afternoon.  Actually, even though the cardiologist's office was already closed, the cardiologist himself was still working at one of the local hospitals and called us back when we left a message through his answering service.  He said that since the EKG and echo-cardiogram were normal a month ago, it is very unlikely that they've changed, and that the heart is almost certainly still fine and merely responding to other things going on in the body (such as the chemo, or the tumor nearby touching nearby nerves).  He offered that we could come in on Monday for another echo-cardiogram anyway if we wish.  He said (speaking of the oncologists office), "It's not helpful for them to be pointing you to things that aren't your problem."  He's going to call the oncologist, and I suppose tell him the same thing.  The oncologist is supposed to be calling us back, and we'll see what he says.  Each of these specialists have their narrow area of interest, and it sometimes feels like no single doctor acts as an overall "advocate", even though it seems that the oncologist would be that person.

Update 6pm:  The oncologist, Dr. Waples, called us back (6pm on a Friday evening... that scores points!) and we're feeling better about it all.  He doesn't fully agree with the cardiologist.  Even though the heart is probably "fine", having fluid build up around the heart is not particularly uncommon in lung cancer patients, and such things can change very quickly and it is worth checking out since the related symptoms have worsened since it was last done in early January when we didn't know about the cancer.  We'll have the echo-c done on Monday, but not at that cardiologist's office, but one that the cancer center works with closely and is perhaps more in tune with how cancer affects heart function and treats it accordingly rather than just with "the cancer is doing it" or "the chemo treatment is doing it".

In trying to best understand who does what, Dr. Waples described himself as "the quarterback" in making sure that Lisa gets every possible advantage in this fight.  Sometimes he'll run with the ball himself, sometimes he'll pass it, but he is responsible for making sure we have the best possible outcome as things progress and circumstances change.  

Michael