From the category archives:

Re-Excision

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Second time in OR, I feel like a pro, familiar with the routines of the ambulatory surgery unit.  The prep-nurse and I exchange recipes and talk adult children. While we chat,  Dr. Guru flies by the open drapery, grins,  and gives me a half baked wave. He looks a bit like the cat who ate the canary. Suddenly, I feel silly. I  been prepared for both of us to be haughty and stand-offish, still irritated with each other. Unlike me, he obviously has many more important things to stew about than our mini-battle.

Minutes later Dr Guru is back. He slumps in the visitor’s chair opposite my gurney, legs stretched out across the floor. He is in his comfort zone. I, on the other hand, am not, covered only by my thin, ill-fitting cotton gown.

“So tell me about this business with that radiologist,” he says.

Naturally, he wants  to talk about how the re-excision reared its ugly head.  All I want to talk about is my post-operative treatments.  I drone on about Tamoxifen versus Arimidex. I tell him I liked the professor who said no to chemo therapy.

“See,  if you shop for doctors long enough, you get exactly want you want,” Dr. Guru says. Before I can protest and reach the pillow behind me to throw at him, he is on his feet and gone. The curtain sways behind him.

Just as well. Why pick a fight with the guy who will wield the knife while you’re in twilight?

In OR, I jump up on the cot, stretch my arms on the cross. The OR is emptier and quieter than the first time. A re-excision obviously does not hold enough drama for the student body.

I wake up with a blue tent still over my head. I  hear people talk and laugh, instruments rattle, water is running. I scoot over to the gurney on my own. Actually, I could just have walked out of there, but they insist on wheeling me out.

That afternoon, my oldest daughter comes over with wild flowers from Gloria’s garden and a Get Well balloon. My son comes around around three with a nice bottle of red wine. My friend Cecilia shows up with a bunch of gossip magazines, a couple of Valrona cupcakes, and a bouquet of dark red roses.

In a letter, my youngest daughter writes:

“Difficult events don’t build character, they reveal character. This same thing can be said for you in this terrible scare – your spirit remains bright and strong.”

My husband runs to the store and comes back to prepare deviled turkey and a cheese platter for the visitors. They have wine. I have water. Everyone relaxes in the living room reading, chatting, and now and then looking up to grab a snack. Like after my lumpectomy, it feels like Boxing Day. Around 7 PM, my sister-in-law and my niece come over with chicken and green beans to make dinner for us.  Afterward, as after lumpectomy, we all play cards, Spite & Malice. My niece wins.  A perfectly pleasant end to a procedure I had wondered about, fought and waited for so long.

As soon as I am heeled, I will be off to radiation.

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This is the week Dr. Guru promised to do my re-excision.  But not a word from his office or from his assistant, Joy,  who  supposedly is “arranging the details.” No explanation. No apology. No  follow up.

Meanwhile I am obsessed with my research, trying to figure out the dangers of putting off radiation. Everything I have read says it should ideally be within four weeks of the lumpectomy,  no more than eight weeks.

I find a Breast Society Journal that confirms what I suspect:  2nd incision not good for the breast, tunnel syndrome etc. Dr. Guru himself has written something in this journal.

And how will Dr. Guru know where to carve again, now that my breast, presumably, has heeled?

“Will remove lateral margin with aid of frozen section. My assistant arranging details. Thanks,” reads Dr. Guru’s email in response to mine. But he gives no hint of exact date for my re-excision although “next week”  is right now.

I call Dr. Alpha, my radiation oncologist,and ask him  if a two week wait is OK.  ” Not ideal, but OK,” he says.

Pissed, I call Dr. Guru’s office.

“I am supposed to have surgery this week, but I have no idea which day he means,” I tell his assistant.

She has no idea either.

“These small procedures are so hard to fit into his schedule,” she laments.

“I am already aware of how terribly insignificant my procedure is , but I cannot go on with my radiation and hormone  treatments without the re-excision.”

”Oh no,  that is not what I mean.”

“Can another surgeon do it?” I ask realizing I sound ridiculous.

“Oh no, then you are a new patient and have to start all over again. How about  the 15th?

“That is TWO weeks away. Two months since my first surgery.”

Briefly, I am put on hold. She comes back to tell me they have no openings this week. None.

“Maybe the 7th. I will call you back if we have a cancellation. Promise.”

“He usually does these small procedures on Fridays,” she says. “But this Friday he has a 10-hour procedure scheduled.”

I don’t give a rat’s tail anymore.

“How about my little one before the big one on Friday?”

We keep wrestling over the phone, both of us digging in our heels, but neither of us loosing our cool.

“I am going over to the hospital this afternoon,” she finally concedes. “I will ask him to call you if he can do something about it. Some times he sees thing I don’t.”

“Have him call me either way,” I tell her. “I want it straight from Dr. Guru’s mouth to my ear why he told me he was going to do it this week and suddenly he can’t. I want to hear him say it.”

Around 3 PM,  Dr. Guru’s assistant calls. She sounds relieved. “You have pre-op  on Thursday at 10.45 AM. Your  re-excision is on Friday, 1 PM.

I immediately feel guilty. What melanoma patient has been pushed off the table to make room for me? What woman with advanced breast cancer, a double mastectomy with reconstruction may have been pushed off the OR table? What person needing a 10-hour surgery is now in a complete funk because of me?

“Bullshit,” says my friend Cecilia.  “He just canceled his golf game, that was his 10-hour procedure. Don’t kid yourself.”

But I am not convinced, just relieved to know it will finally be done.

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Dr. Guru Agrees to Re-Excision

January 22, 2010

Twenty minutes after Professor Oncology nixes chemo therapy, five minutes after Dr. Alpha, the radiation oncologist, calls to tell me that I need a re-excision to get clear margins (you are supposed to have 2 mm) I am sitting in my friend’s garden sipping tea from her bone china cup. I am “in the moment” […]

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Re-Excision After All

January 17, 2010

Three distinguished physicians, all cancer specialists,  seem lukewarm – or indifferent – to the merits of chemo therapy, in my case. I feel as light as a swallow, and just as fast, as I leave the Magnolia Cancer Center. I tip the valet $10, but before I can drive away, my cell phone buzzes. “Charlie […]

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