From the category archives:

Surgery

Surgeon at Work

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” trying not to mull over all the “what ifs.”   The insufficient margin frustration is behind me. Well,  almost.  My new bosom buddy, the radiation oncologist, took charge of the incomprehensible pathology report. He even called a day earlier than promised to let me know that I , indeed, need a second surgery!

Suddenly, my cell phone buzzes. A Magnolia Cancer Center number.

The way Dr. Guru, my surgeon, puts it to me, one might think that he himself had called  my radiation oncologist, to tell him to hold off radiation,  not the other way around.

“I am still not convinced you really need this,” Dr. Guru says. “But maybe it is not such a bad idea, after all.” Then in what seems like a vague apology he adds:  “I know you are very busy and all and this will be a bit of an inconvenience for you, but we might as well go ahead and put it behind us. “

“Might as well. But when?”

“Next week.” Dr. Guru does not hesitate. “We will schedule this for next week. Joy will call you to arrange the details.”

I feel stupid for being so happy. How much happier could I not have been  had  I been wrong about the re-excision, and able to start radiation right away? Is it not childish to be happy about being vindicated? After all, I am the one who will be the most inconvenienced, just like Dr. Guru admitted. Also, I feel mildly irritated that Dr. Alpha has to tell me not to hurt Dr. Guru’s feelings by “not rubbing his nose in it.” What other profession is filled with egos so fragile that they need to be perpetually wrapped in velvet and praise? A master surgeon is never to be reminded of a mistake, however slight or insignificant.

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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)

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Totally in a Funk

October 22, 2009

My husband and I are both stuck in the glue of our gloom, unable to reach out to each other. I am restless, crabby, scarred, impatient, and distracted both at home and at work. I cannot concentrate on anything. All I do is obsess about a second surgery. It is not the surgery that scares […]

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Queen For a Day: Participating in My Own Wake

September 13, 2009

Dr. Guru meets with my family in the waiting room. Big grin, face mask dangling around his neck, arms raised, two fingers on each hand formed into the V for victory signs.  No cancer in frozen lymph node section. So far everyone agrees. Big wide margins. Some  heard only “wide” margins, but not “big wide” […]

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Lumpectomy At Last!

August 26, 2009

My surgery is expected to take two and half to three hours. Dr. Guru promises that he himself will do the whole procedure. “Won’t even let a second year student help,” he says. He will make a slit in the twelve o’clock position on my right breast,  a slit under my right arm, and a […]

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Dr. Guru Super Star

August 23, 2009

Suddenly, a flurry of activity, like when trees and leaves are set in motion by an approaching storm. The curtains, surrounding my gurney, open and flap, close and flap, as doctors, nurses, and technicians come and go. Doctor Guru’s wife, my anesthesiologist, arrives along with her second in command (or perhaps a resident in training)  […]

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The Mysterious Wire Procedure

August 21, 2009

Ever since my surgeon and his assistant started to babble about a “procedure with a wire” I assumed my tumor would be removed with a wire, as opposed to carved out by a razor blade or an exacto knife.  As silly as it sounds, I have been mentally stuck on the image  of a wire […]

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Uncertain Destinies in the Waiting Room

August 20, 2009

In the waiting area, before receiving my mysterious “wire,”  I immediately set eyes on a young woman, at the most 25 years old, too young to be wearing a hideous hospital gown and a plastic ID bracelet at the Magnolia Cancer Center. The middle-aged woman next to her is fully dressed. I feel emotional as […]

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Surgery Day Hurray

August 15, 2009

The day I have worried about, fought for, and pushed for, is finally here. Last time I had surgery, 26 years ago,  two healthy full-term babies, a boy and a girl, were removed from my body. This time the surgeon will remove a specimen of malignant neoplastic tissue, surrounded, I suppose, by normal grizzle and […]

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Full Circle In One Month

August 12, 2009

In the morning, as soon as Dr. Guru’s office opens,  I call to nail down my surgery date. “We can not plan anything until we have your MRI results,” his assistant sounds tired. “We don’t know what we’re dealing with yet. Yes, you can have a lumpectomy next Tuesday.  Anything more involved, requiring more time, […]

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