I decided to dress up a little for my meeting with the surgeon today. I figured that dressing professionally would put us at more of an even playing field, espeically after the smoothie incident with the surgeon yesterday. I think it worked - she was much more talkative this time around. This appointment was again at Abbott and Lisa came with me. My mom wanted to come, but she had already made plans to volunteer at my kids' school at that time. Again, they put a hospital wristband on me. Why? Were they afraid thay would do the consultation on the wrong person? Hospital protocol, I guess.
The nurse called us in to an exam room and went over all of the test results. The MRI was clean - no new lesions. Yay! Also the progesterone and estrogen receptor test on the biopsy came back - positive for both. She gave us a large folder filled with all sorts of breast cancer-related material. It weighs 1.75 pounds - I weighed it at work! No subject was left uncovered - there was even an article about how cancer can affect your sex life. She also recommended the Susan Love Breast Book, which must weigh like 3 pounds. Since I love to shop, especially for books, I'll be buying that book in the near future. Great beach reading for Hawaii, right?
The cool thing about the Piper Breast Center is that they have a ton of resources, ranging from the the straightforward medical stuff to support groups to an entire center that concentrates on alternative cancer theapies (like nutrition, acupuncture, etc.). She said we can use any of these resources as we wish. I think I also get a free life coach and a consultation with a psychologist. I need to look through everything more closely. It just struck me how medicine has changed in the past 1-2 decades. The patient is more informed, for one thing (thanks to the internet), and docs are more open about the various treatment options and the risks/benefits of each. The patient gets to make her own decision about treatment, with the guidance of the doctor, of course. They even gave us copies of the MRI and final path report without us even requesting them.
The surgeon was much more tan than the last time I saw her (remember, she was on vacation last week), and also less rushed. She went over the lumpectomy procedure, and then started talking about the other option - full mastectomy. She was describing implants and tissue expanders until I finally stopped her said that mastectomy wasn't even an option ofr me at this time. Statistically, the survival time with DCIS is the same with mastectomy as it is with lumpectomy plus radiation (a good prognosis either way).
I scheduled the lumpectomy for May 2 and plan to be back at work on May 3. I can't run for about a week after the surgery. Sometime in the next month or so I will also meet with an oncologist and a radiation oncologist. Starting a few weeks after surgery, I will have daily radiation for 5-6 weeks. I am also a candidate for Tamoxifen (an estrogen inhibitor) since my tumor does have estrogen receptors. I am not sure I want to take that drug because it would send me into a pseudomenopause and I'm not quite ready for that yet! I'll discuss it with the oncologist.
The surgeon also told me that because I was under 45 when diagnosed, I am at increased risk of having a BRCA 1 or BRCA 2 gene mutation, which could make me more likely to develop ovarian cancer. So I also get to meet with a genetic counselor to discuss getting tested for that. Wow! A whole lot of stuff, don't you think?
I started getting a little cavalier when talking to the doctor, asking her what sort of suture material she used, etc. I felt like I could, being that I was dressed better than she was, you know. Turns out, she prefers the kind I use on animals! So as a joke I plan to bring a pack of suture to my surgery and ask for a discount on the hospital supply fee for providing my own suture material. Ha ha! Finally, although the surgeon mention doing a quick exam, and there was a hospital gown waiting for me on the table, it never happened. That's two appointments in a row where my breasts were not handled! Yeah!
I did follow through with my plan to give the radiologist a thank you card. She wasn't there so I gave it to a nurse to put in her box. Hopefully she'll be the radiologist on when I have surgery (because again a radiologist needs to impant a radioactive seed first).
One thing the nurse did say was that telling people you have breast cancer is a lot like telling people you're pregnant. I'll get all sorts of unsolicited advice and I will hear many stories - some good and some bad, and to make sure that I keep in mind that everyone's disease is different. I've already been getting lots of advice and I will say that I am happy with my medical team and the treatment choices that I've made so far.
I think you should get the BRCA 1 and 2 test as well. It is a simple blood test. I had it done almost 4 years ago..because my mother had breast cancer in her 30's. I don't have the gene mutation, but feel more powerful knowing the information!
ReplyDeleteGood for you Jami! Sounds like you're comfortable with the medical team but also know the reality of people wanting to help. I had a bunch of genetic testing with my infertility and found out some things I would have never known. Not bad, just interesting in a geeky medical sort of way. It led to full cardiac work-up and an MRI to make sure my aorta wasn't going to explode. I was fine. BTW - loving the scale in Hawaii!
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