Monday, February 20, 2012

After recieving my results I was home by 4:30 so decided to jump in with both feet. Just before closing Thurs. I reached the surgeon's office. This fella came highly recommended by family and friends so we thought we would begin that part of my journey by heading South.  We were amazed that he agreed to see us over his lunch hour today!

As you read this please remember I am a nurse. My background is 18 years of critical care and about three years in longterm care with some homecare mixed in. I think like a nurse and have many experiences dealing with doctors in a wide variety of  situations. I also have had 5 major surgeries myself along with several minor ones. I have had multiple family members critically and chronically ill who I have cared for and followed through serious illness and even rehab. I am not new to how the medical profession operates.Therefore I think more critically about these things when weighing my options.

First was our meet and greet and my physical exam. Next came his review of my records. We were impressed to this point.Very compassionate and thorough, not in a hurry. Next he started through my records one at a time.

1.  Mammogram-he stated he wanted to repeat mine because he wanted more magnification in the views. I have had sooo many views up to this point I did not feel the need, expecially since I had seen mine and it seemed very clear to me untrained in that area, however I realized he would be looking much more critically than I so we agreed to that.
2.  He wanted an MRI.  Good deal!  I was told to expect that and I wouldn't have it any other way. This was just more confirmation but also would look at the other breast in a different way.
3. He reviewed my biopsy results/pathology report. This was where I began to question. He read them and told us that he was not convinced I had DCIS. I was speechless. My radiologist prepped me for the news with just the mammo but explained obviously it was not definitive until a biopsy was optained. My general surgeon had reviewed the films and confirmed, and the biopsy was straight forward.  He lost Brad here. From now and for the next two hours my husband was thinking there was some hope I didn't have cancer but rather the atypical hyperplasia cells. The Dr. further explained that if that was the case I would just need oral chemo and radiation. Hmmm.  I just continued to listen.
4. More on the pathology report. He wanted to actually have his pathologist view the slides and give his opinion. We didn't have a big problem with that as it was a second opinion but again it didn't really seem necessary.
5. The biopsy itself- He said he was pretty sure he would even like to repeat the biopsy. He then further explained his entire rationale. He said that there have been mastectomies when there was no cancer and that he just told a woman who thought she had cancer that she didn't.

If there is one thing any medical professional knows it is do everything with the utmost care, be on your toes so as not to make mistakes, and triple check everything!!!  And sometimes, because we are all human, mistakes still get made. For now I decided to go to the repeat mammo and  get theMRI and think on the rest. The really stressful part was trying to explain to my husband to put most of what he had just heard out of his mind because it was clear I have cancer. Brad already knows that I feel strongly that if in doubt the breast is gone! Therefore even if by the odd chance it was all hyperplasia I would personally settle for nothing less than a mastectomy. My stress level was going up exponentially.

At the repeat mammo the tech could sense my frustrations. She was a sweetheart!  I began to vent to her and she assured me this is standard practice to repeat everything with this doctor. She then shared her personal story. She was super supportive to my way of thinking but of course could only share her personal story not her opinions. She took the views he ordered then came and said the radiologist wanted more views to "see just how involved this all is."  That told me he saw what my radiologist saw, diffuse calcifications as well.

Our third and last meeting with the surgeon for the day. He showed us the films. The extra magnification had me lost. I could not even see my original areas without him pointing them out, and I couldn't see the calcifications at all. Brad couldn't see any of it even when it was pointed out. Very perplexing when my original films were so clear to me. Now he jumped back to mastectomy as my plan confirming the two areas of duct in question and the calcifications.  OK, cool!  But, he still wanted to review pathology and likely repeat the biopsy. At this point Brad was getting upset.  That's when he kicked back and said to me "When we get home can you explain this in layman's terms so I understand it?"  I said sure and the Dr. jumped right in and offered to go over it again. My husband in all his witt stated, "I am a construction engineer. I build bridges I don't do boobs!"  That was the moment of laughter I needed! By the time we left the office he was repeating everything except the biopsy. I opted to not agree to that or even discuss my thoughts until I slept on it and was feeling less frustrated.

Brad and I both just weren't sure. We liked the guy but it seemed if he had just come into the office and been straight up by explaining that it is his policy to repeat everything with his equipment and with the assistance of his partners it would have been much more honest and less confusing. To take it so far as to say he doesn't want to remove a non-cancerous breast and in fact he needs to know I have cancer did nothing but upset us both.

Now it was time to focus on the positive aspects.
1. He worked us in quickly over his lunch hour which originally helped decrease our stress level
2. He got me in for the mammo while I was there so as not to make a second trip
3. He was very thorough and we could appreciate that
4. We liked how everything was right on campus and so easy to access etc.
Time to take a break and step back before making a decision.