Re-Excision Me, Re-Excision Me Not….

by Maggan

in Breast Cancer Treatment,Physicians,Surgery

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“Sometimes when I consider the tremendous consequences that come from little things, I am tempted to think there are no little things.” – Bruce Barton

-When will you have your re-excision? my sister-in-law wants to know.

I tell her that I believe Dr. Guru when he says my margins are clear. He says that I don’t need a second surgery despite a pathology report  which seems to indicate a margin of less than 2 mm.

I tell my sister in law that my real worry is the prospects of chemo therapy. Of course, no oncology appointment has been scheduled yet. Somehow I am under the impression that Dr. Guru’s office will set it up.

-You need a second opinion,  my sister-in-law says firmly. I will call Doctor Weary to schedule an appointment. Now.

My sister-in-law’s friend died from breast cancer. Her margins were never clear despite several surgeries. But her situation was different from mine. She was much younger than me, by a decade or so. Her cancer was, sadly,  more aggressive. Her prognosis was more “unfavorable” from the outset.

I tell my sister-in-law that a new surgeon can not possibly figure out margins from an old surgery, now healed. But she will have none of it.  She calls me back with two appointments, less than a week out: one with Dr. A, her friend’s surgeon, one with Dr. Weary , a well known oncologist at the hospital that was feuding with my insurance company at the time of my diagnosis. But the feud is over. They will accept my insurance.

Although I cannot for the life of me understand how a second surgeon could possibly tell my margins, I feel relieved.  Someone, other than me, is doing the heavy lifting. A mill stone rolls off my shoulders.  Appointments have been set for me, whether they make sense or not. I realize how wonderful it feels to have been removed from the decision making process and able to just follow someone’s command

Energized, I decide to also ask the University Medical Center to send my pathology report along with a sample to Vanderbilt University for a second opinion.

Maybe it is not a bad idea to find out more about my cancer cells, given that both the Breast “Care” Center and the University Hospital says my cells are moderately to well differentiated and slow growing. Yet the OncoDX test indicates that they may not be quite as benevolent.

You, too, can send your pathology results to Vanderbilt for a second opinion. Check information below or go to www.breastconsults.com. In most cases, insurance will pay. If not, their fee is quite reasonable.

Q: How do I arrange for my slides to get to Vanderbilt (VUMC) for consultation?

A: Patients wishing to have their slides shipped to Vanderbilt should contact the originating pathology department and tell them you are requesting a second opinion from the Breast Consultation Service at Vanderbilt University (aka. David Page, MD and Associates). Request that they send the pathology slides and all reports corresponding to those slides. Also, ask them to include a face sheet of your demographics and billing information for billing purposes. The address to send the consults to is as follows:

David Page, MD
Vanderbilt University Medical Center
Department of Pathology
C3321 Medical Center North
1161 21st Ave. South
Nashville, TN 37232-2561
615-343-0072 (Phone)
615-343-5137 (Fax)

{ 1 comment… read it below or add one }

JMartin November 9, 2009 at 5:12 pm

To be at some doctor’s mercy or be saddled (at your most vulnerable) with the burden of serving as your own doctor: what a choice. But what do I know? I was shocked when my SIL’s search for a s.o. required her to schlep her own glass slides.

You are screwed in this world, without smart people who love you. (Bumper- sticker rights pending.)

Surely soon in this recounting you’ll switch Dr. Guru’s nom-de-blog for something more appropriate? Contest!

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