My Personal Thoughts About Breast Cancer 10/20/08

I just edited my original post from 10/17 about the 3-Day Breast Cancer walk, and I added a picture Larry and I call the “Finish Line Boogie”.  You can see the big finish line behind me and I am still dancing as I continued into the crowds.

Looking at that picture reminds me of the first “Race for the Cure” I ever walked in with my friend and survivor, Nancy.  It was in Chicago and I was blown away that all those people who came to cheer us on gave us a standing ovation for being breast cancer survivors.  The closing song was “Simply the Best” by Tina Turner and there was not a dry eye in the house.

I had not met my Larry yet.  I was a 5 year survivor at that time, and it wasn’t easy to date because somewhere in the beginning stages of dating anyone, I would have to say that I had breast cancer.

Every time I have told this to a man over my entire 15 years their eyes go right to my chest.  What is it with men and breasts?  I had a real estate customer who was really into staring at me when the topic came up and I realized he assumed I was either wearing a damn good prosthesis or I had been blessed with a great reconstruction.  No, I was blessed with a great surgeon in the first place and let me tell you here he was not my first choice.

Let’s talk about that because it is a very important topic.  Here it is plain and simple, cancer or no cancer, if you are not happy with your physician in one word “CHANGE”.  Get a new doctor immediately, do not give them a second chance.  Certainly not in a critical time when time is of the essence should you be burdened with a doctor you cannot relate to or one that won’t listen to you or answer questions.

And please don’t ever say “I can’t change, it would hurt his/her feelings.”  Bull hockey.  Do you think that most physicians remember who you are as they move on to their next patient?  I am not saying you are not a memorable person, because you are, what I am saying is when they move out of the exam room they have moved on to the next chart in their hands and if you cancel your next appointment and move on do you think they are aware of this?  In a word, no.

When I was told I needed to get home and see a surgeon immediately, I went to the surgeon my internist recommended.  He was the spitting image of Randy Travis, the Country/Western singer.  He walked into the exam room and was dressed in an Armani suit and Gucci loafers.  I was not impressed.  Some patients like to see their doctor dressed well, it is a sign of monetary success.  I want to see my doctor’s sitting across from me, making eye contact with me as he/she listens and talks to me like an equal.

“Randy” had already not scored well with me but I needed a biopsy so I moved forward.  He also did not score well with me when he was performing the biopsy and hit an area of my breast that was not anesthetizedwith the Bovie wand (which is an electro-cauterizing device).  I compare it to being tasered.

Then he really hit rock bottom when he gave me a suture line that ended up with polka dots from the sutures.  He did not care that I might not have breast cancer and that now I would have this 2 inch scar with “connect the dots” on each side of it.  This man was on my sh** list.

“Randy” really lost all my respect when he picked up the phone on a Friday afternoon to tell me I did have breast cancer.  It was flipping 430PM on a Friday and he left me with a “come in and see me Monday at 10AM” and that was it.  Where was this man’s brain?  Obviously in the back pocket of his Armani suit.

That Monday he explained to me that he would schedule me for follow up surgery and he called it a quadratectomy.  I did not need a translation, I am an RN, and I could break down the word.  I had a 5x7mm ductal carcinoma in situ and he wanted to remove 1/4th of my breast.  He told me not to worry I could have an implant placed to “make me look normal again”.

I had already been doing a lot of research.  I had been in the cancer treatment business for years, and I called all the big cancer hospitals I had ever worked with in my career.  I called MD Anderson in Houston, City of Hope in Los Angeles, and I called Dr. Larry Norton at Memorial Sloan Kettering in NYC.  I had called on these doctors and clinics when I was involved in clinical trial investigation with a company that was treating cancers with hyperthermia.  All three replies were that this was overkill for the type of cancer I had.

Now what?  I needed a new surgeon and one that would be comfortable going in after a biopsy which is asking a lot of a surgeon.  I needed someone who had the confidence that he could get the remaining cancerous tissue out of someone else’s operative site.

Enter my radiation oncologist, Dr. H.  When I had my appointment with her, we talked about what “Randy” wanted to do.  She looked at me, wrote a number down and said “I am telling you this in confidence, call this office.”

I did, I made an appointment and I met the best surgeon I have ever had the pleasure of knowing.  I will call him Richard because that is his name.  Richard read all my films, all my reports, and he said he would have to talk to his other partners about me, but he was pretty sure they would not object.  This was the South, and we certainly did not want to start a surgical feud.

Long story short, Richard did my surgery.  He is an amazing surgeon, trained at Jackson Memorial in Miami, and I was just so comfortable with him.  He told me the surgery with axillary node dissection would take about 1.5 hours.  When my surgery date arrived, he met me in the holding area, and I shared with him and his staff a really cute golfing joke I had recently been told because I wanted a relaxed OR team.  It was noon on a Friday, not a day you want to have surgery.  The last thing I remember hearing was a room filled with laughter.

When I came to in the recovery room it was 500PM, and I was immediately fully awake and alert because this was 5 hours later.  I asked where Richard was and they brought him in immediately.  He sat on the side of the recovery room bed and said “Carole, since I was not your original surgeon, I spent a little more time and went a lot slower than I usually do to make sure I did the best work I could on you and by the way, your polka dots are gone for good.”  Bless him they are.

A week later when I went back for my first post op check up and to have my drain removed Richard took a couple steps back and he had tears in his eyes.  I asked him what this was all about, and he said “Here is your pathology report.  Now you can see how much of your breast I did remove.”  I read it, and I was shocked.  He had done a quadratectomy because he felt he had to since he had not done the biopsy.  I looked down and all I could see was a normal breast, same size as my other breast.  You see, Richard had taken all that time to move tissue around and then he clipped it in place with surgical clips (I can see them on every mammogram).  He told me he had hoped for these results, but you never know and that is why he had tears in his eyes. 

That is the difference between a general surgeon and a true caring general surgeon, and that is the reason I tell people all the time, if you do not feel comfortable with your doctor, get a new one.  You are the employer, they are the employee.  They are not little tin gods, they are human, and they all have different approaches to how they do things, but this is your body, your life, and your emotional situation and you owe it to yourself to feel as comfortable as you can when your life is truly upside down.

Repeat after me- “I am worthy of having physicians who listen to me, answer all my questions, validate my concerns, and take the time to make eye contact with me because the eyes are the windows to the soul.”

Don’t ever be afraid to move on, you have to work with people you trust completely!  And 15 years later I can barely see my scar and the only difference in my two breasts is I have a tiny thumb print sized indentation right at my scar line – I call it “Richard’s thumb’s up!”

Thumb’s up to Richard too.


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