Monday, August 30, 2010

Off To Meet The Wizard

Today was my consultation with the first of two general surgeons that True North, my plastic surgeon, referred me to.  This fellow would be responsible for the mastectomy portion of my surgery, and then True North will come in and work her magic on me.

Husband and I sat in the waiting room, flipping through magazines.  There was an article about artisanal cheeses from California in Wine Spectator magazine.  I could have written that article.  That has to be my next project, among several writing projects, getting my butt out there writing freelance articles for magazines.  I know I could do it.

It wasn't long before we were escorted into his office, he sat behind a large desk, and we were seated in front of him in two large leather chairs.  We started talking, I had typed up a profile of myself, with all the relevant info taken from my mammo, MRI, biopsy and PET/CT scan.  He had looked over that, as well as examined the MRI CD I brought with me.

He started asking questions about my health history, and so on.

Let me just say right up front,

I LOVED THIS GUY!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

He really does remind me of The Wizard.  He is a smaller stature man, balding with white hair, has a great smile, and a very fatherly way about him.  He is very direct and a straight shooter, but he has such a great bedside manner, voice and smile.

I felt like he cared about me.  That may sound goofy, but it makes a huge huge difference.  I felt like he was going to do the job he had to do regarding my cancer, but was also concerned about helping my plastic surgeon achieve the best cosmetic result for me.  [Exactly the opposite of a remark first surgeon made - "It will just be something to fill a cup."] We talked for some time and then he took husband and I into the exam room.  I also liked his way with Husband, very hospitable and inclusive.

In the exam room, Flopsy and Mopsy got a working over like no other.  It was the most thorough breast exam I've ever had in my life.  At one point, when he was muscularly kneading my right breast within an inch of its life, I said "Are you making focaccia"?

He laughed and slightly blushed.  I appreciated his thoroughness.  He examined both breasts thoroughly, molding them and shaping them and throwing them around like Playdough.  He also did an exam into both armpits and up into my inner arm, under my breasts, feeling all along my rib cage and along the sides.

This man was on it, and I could see his brain doing the math, like an old calculator where the paper advances forward as the accountant punches in numbers without looking at the keys.

We talked more in the exam room, and I told him about weighing the decision over keeping or removing the right breast, Mopsy.

His answer was the most concise yet.  Of course I can't give you verbatim what he said, but will give you his take on the talking points.  As I listened to him, I swear, I felt like Dorothy sitting down at the campfire with Professor Marvel, the scene where Toto steals his hot dog and Marvel convinces her not to run away.  There was something so fatherly and compassionate about this guy, I wanted to jump up and run home to Auntie Em.

These are the main points.  Even if I do a reduction on Mopsy to make her match the new Flopsy, a good portion of her will be reduced and reconstructed anyway.  I could do a mastectomy on Mopsy where he will keep the breast skin and the nipple, and just scoop the breast tissue out like a melon.

The DIEP procedure, where they do the tummy tuck to make new "breast" tissue is a one time shot.  If I just have Mopsy reduced, and at some later point, cancer occurs over there and I need a mastectomy, I'd have to put an implant in.  At that point, I'd have natural feeling tummy tissue in Flopsy, and an implant in Mopsy.

He also said the psychological factor every year when I'd be having Mopsy Mammo'd and MRI'd can be very very stressful for most women.  Also, there is a 6% chance each year of an increased risk for cancer in the right breast.  That's a 60% chance by the tenth year, and I'm young.

I told him I never want to go through this again.  He said "Well, there's your answer.  You have answered this yourself.  Why not just do the whole thing and be done with it?  I'm sure, you will also have a much better cosmetic result as well."

You mean I won't have to have mammo's and MRI's?

Nope, he said, there won't be breast tissue in there.  It will be tummy tissue.

He felt that given what he saw on the MRI, he agreed with the mastectomy for Flopsy because of the tumor size and spread to the lymph node.  He agreed the cancer was too close to the nipple to keep it, but felt he could keep the outer breast skin.  He also said he'd take a few more lymph nodes on the left side just to make sure there is a clear margin with no cancer.

I told him about the possible insurance problem with the micro surgeon, and this was his advice.  First of all, its obvious he has the utmost respect and admiration for True North and her work.  This is a very specialized procedure and you have to have someone who has done a lot of these.  True North has.  He said the micro surgeon's portion of it should not be a significant portion of the bill.  He figured the portion I'd have to pay will probably by less than what I am dreading, maybe more than I am hoping, and in the end, will probably all work out!  He said in these cases, he has often seen where the insurance company does finally rollover since the patient is not purposefully trying to go out of network.  He made me feel very hopeful.

He also said if it does turn out I can't use True North, he wants her to refer me to a new plastic surgeon, but he would be happy to give me any input I might need from him.

I left that meeting feeling so good, in his hands.  I don't even know if I'm going to keep the other appointment with the other recommended surgeon.  I just had that solid gut feeling this is the guy.  I mean, come on, I already have The Good Witch, I need a Wizard.

I left there feeling whatever happens, he would make his sound advice and help available to me however I needed it.  He was very genuine and personable and I can't say enough how much I liked him.  He shook my hand firmly and enthusiastically, and looked me straight in the eye.  This is my guy.

I meet with the micro surgeon on Wednesday, and that will start the process with my insurance company when he puts in an authorization and they see he is not in network.

At this point, I feel like True North and The Wizard are my surgery dream team.  I really do.

Pray for me, send me good thoughts and joo joo that all of the stars will line up for me, and I will be able to have these people create the new me.

I forgot to tell you, or maybe I did, chemo brain, I am tentatively scheduled for surgery on October 26, and Duncle Dody reminded me, it's my grandmother's birthday.  His and my mama's Mama, the maker of pastina.  I think that is a very good omen.

I am spending this evening visualizing myself in the operating room, with True North and The Wizard working their holy magic on me, cutting and scooping, creating, molding and stitching an even better version of moi.

Send your good thoughts and creative visualization into the Universe for me, and if you are the praying kind, or have an in with God, talk to him about me.

I am throwing the dice into the air, hoping they land on the operating table with the brains and hearts and hands of True North and The Wizard helping me find my way home.

There's no place like home, there's no place like home, there's no place like home.

Come on baby, come to Mama, Mama needs a miracle!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

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