I saw Dr. Bar-Natan at Weill-Cornell. She had reviewed my file well. She agreed with MSK on most stuff. The differences:

1. She thinks it’s likely one disease i.e. the eosinophilia and myeloproliferative neoplasm (MPN) are connected. MSK thinks it is two separate things at the moment. It doesn’t really matter for treatment whether they are connected or not right now.
2. She did not define the type of MPN (ET vs MF) and said it will become clearer as time passes. MSK also didn’t 100% define it but the diagnosis is “MPN most consistent with ET.” My platelets continue to be just slightly high (430-460 with the high threshold being 400).
3. She doesn’t think there can be a causal relationship determined as to whether the eosinophilia is caused by the asthma or the asthma is caused by the eosinophilia based on the data. MSK thinks it is asthma driving the eosinophilia. But this also doesn’t really matter, as both need to be treated and monitored no matter what is causing what.
4. When I asked her my life expectancy question (Do you think my life expectancy could be affected?) she said yes. Dr. Goldberg brushed off that question and said there would be new advances in treatment in my lifespan so I shouldn’t worry about that.

I really value transparency in communication with in my doctor. From the published medical research I’ve read about MPNs, the data on the life expectancy question is clear that it could be affected. To me, the confirmation of that from the doctor is not shocking because this is the reality-based response. I appreciated that answer. Javi was there and described her overall as more straightforward which I cosign.

The visit was relatively speedy and smooth while Dr. Bar-Natan took her time talking to me. One thing that was very noticeable was facilities were clearly lower grade than the swanky MSK Koch Pavilion I go to. It was more like a normal NY hospital. Also, I’ve mentioned how great the MSK patient portal and mobile app are. The Weill-Cornell patient portal is through MyChart which is kind of clunky.

I’ve asked for some opinions on what to do from friends and family. I’ve also asked for opinions on the MPN forums I’m on. Some are saying follow your gut on the doctor you trust. Some are saying stay with MSK for the facilities/resources. Some are saying Weill-Cornell is amazing and the Silver MPN Center is one of a kind in the U.S.

I also saw Dr. Ullah at Brooklyn Cancer Center the day after Dr. Bar-Natan because his office kept calling on his behalf for me to see him. He gave me a fist bump, was excited my eosinophilia has decreased, and breezed out of the room leaving his assistant to finish with me. I had wanted to ask his opinion but I was not feeling the vibe.

Ideally would like to push off the decision since I have less experience with Weill-Cornell. But that’s not realistic. My insurance is going to come get me any time since I have been seeing THREE hematologist/oncologists. I recognize I am so privileged to have this problem.

No matter where I go, I have to go every 4-6 weeks for the time being to see what my blood is doing. Brooklyn Cancer Center would be the best for that convenience-wise, but Dr. Ullah is not an MPN specialist so he’s out based on that alone. MSK and Weill-Cornell are both on the East River at 74th and 70th respectively and the Q subway stop is 72th. That is exactly the same commute.

In the short-term, I’m going to experiment with a few things with Weill-Cornell like trying to reschedule my next appointment and sending the doctor a message to see how that goes as well in comparison to MSK.

Of course I’m having some social anxiety about breaking up with the doctors. 😹

What would you do?