Breast surgeon appointment

Discussion in 'The Watercooler' started by Marguerite, Feb 16, 2010.

  1. Marguerite

    Marguerite Active Member

    We saw the breast cancer surgeon today. We already had appointments today for difficult child 3, it would have been possible to do both but it would have been a tight schedule and we didn't know what was likely to be happening, so when one of the difficult child 3 appointments rang yesterday to postpone, I cancelled the other one too. So we left difficult child 3 at home and took ourselves out "to the mainland".

    I also had the hassle of having to deliver some new welfare paperwork, and I tried to do it beforehand but didn't have enough time.

    I didn't know what to expect, so I took a packed bag, hoping I wouldn't need it but also ensuring that we wouldn't be too inconvenienced if I suddenly found myself admitted to hospital.

    The surgeon has a great reputation, plus she is the same doctor my friend has, my friend who had a really nasty case of breast cancer that none of us thought she could survive. She is still cancer-free after ten years. So I felt very confident even before I met her.

    Then I realised - I HAVE met her, she was the doctor at the clinic last Thursday who did my breast examination (and couldn't feel anything). She didn't touch me today, because she already had. She answered the few questions I had and also told me exactly what she is doing.

    I asked why this diagnosis is INVASIVE ductal carcinoma, and she explained exactly why - because the core biopsy sample happened to cross the margin of the tumour into what should have been healthy breast tissue - only it wasn't healthy, not completely. She said that for a few more millimetres, the cancer cells have moved beyond the duct. She said that it's very small so it's most unlikely it's gone any further - yet. But she wants to move fast to keep it that way. This tumour, she said, is about as small as you can get and still be detectable. Even when she knew where it was, she couldn't feel it when she examined me. And that is really, really good. We caught it early. Very early.

    So what is in store for me?
    Surgery is booked for Friday 26 February. That's exactly 10 days away. It's the earliest she could fit me in but she thinks it should be plenty early enough. I have to go private to get in that early, but if I went as a public patient (ie national health insurance) I think it would still only be a couple of months at the most.

    It will be done as day surgery. She said she has a full surgery list but is tucking me in at the end of the day, so it will be about 4 pm before I get operated on, but she said the surgery in my case will be very minor, very quick. I'll have to be nil by mouth from 6 am and probably have to arrive at the hospital about the same time.

    Next I have to have another ultrasound. This will show up any changes in the three weeks, and they will also use the ultrasound to insert a wire that goes right down to the tumour. Apparently tumour tissue looks too much like normal breast tissue, to make it easy to just operate without any other assistance. So the wire is inserted under ultrasound guidance, because the ultrasound really shows up the tumour site. Then at the same time the tumour gets injected with a radioactive tracer and also a dye. That way she will be able to easily find it with both a gamma probe and also the naked eye. The wire makes it more specific. The whole lot means that minimal cutting has to be done of healthy tissue, only the tumour gets targeted and they can spare as much of the healthy tissue as possible.

    The doctor said they will do it under general anaesthetic, will go in and remove the lump as well as a wide margin around it, to make sure they get it all. They then use the gamma probe to find the most radioactive lymph node under my armpit (ie the one that got the most drainage from the tumour site) and will remove that node. While I'm still under anaesthetic, they send that nose to pathology for frozen section. If the node is free of cancer cells, they close up and when I've come round, they send me home. If the node is positive, they remove ALL the lymph nodes in that armpit and keep me in overnight because they put a drain in to ensure a better recovery. They then send me home to daily dressings etc change under supervision of the district nurse.

    Next - when the wound is healed, I begin 5 weeks of radiotherapy. Monday to Friday for 5 weeks. We have to go to the same hospital for it, it's halfway to the centre of Sydney so it will mean almost an hour each way every day for five weeks. husband said he will take the time off work (he has long service leave owing) but when I talked to my friend's husband tonight, he said that our church friends would make sure I get help with transport to and from hospital.

    The doctor said the radiotherapy is just to make extra sure.

    And if pathology finds that I have positive nodes, and/or they don't get all the tumour, we will re-visit the situation but only then would they be suggesting chemotherapy. It will depend on the pathology results, basically. But because this tumour is so small (thumbnail sized) she is definite - "prognosis is excellent," she assured us.

    Good enough for me.

    As we were driving there this morning I noticed a little bit of apprehension in my, but not much. I realised - I feel more comfortable about this, even when I was seriously preparing myself to have it done under local anaesthetic, than I do about going to the dentist.

    So I'm OK. Really. I slept moderately well last night even though I didn't take anything and even though I was half-expecting to be put into hospital today.

    Sis-in-law will be arriving ten days after my surgery, which I estimate to be close to the beginning of my radiotherapy. husband will be available to help drive me there, plus having sis-in-law there means we won't be needed quite so much for mother in law at tat time.

    Because I didn't have to go in to hospital, we were able to go do a bit of shopping, drop in to Centrelink and get the paperwork sorted out (hopefully that will now be the lot) and then collect difficult child 3 from the ferry to take him to drama class this evening. Because we had left dinner for mother in law, we took a night off ourselves and had a quiet and quick Chinese meal (some gow gee and soup) while difficult child 3 sat in the car outside enjoying his pizza. Nothing wrong with that boy's appetite - he bought a family-sized pizza and I think has already eaten most of it by himself.

    One funny thing - I noticed this morning, to my relief, that at last my weight has begun to slowly drop again. I had been getting concerned that my weight was beginning to climb - well, for the last week it's stopped climbing and I've begun to drop at last. I told husband. By now he realises I'm not stressing about the cancer, especially after the doctor reassured us today.
    So he said - "You're losing weight? Why are you so surprised? You do have cancer, after all!"

    He wouldn't have said that if he was still worried, or if he thought there was the slightest chance that I was still worried.

    So hopefully that will reassure you all.

    I'll be OK.

    Thanks, guys.

  2. timer lady

    timer lady Queen of Hearts

    Marg, thanks for the update. The situation sounds less "dire" (for lack of a better word this morning) now that you know all the facts.

    Please slow down during this time & take care of YOU. Will be keeping you in my prayers during this time.

    We love you here, so do what the doctors tell you to do. I want to make a trip to your little island & paint with you.
  3. Marg,

    It's good to read your update. Your surgeon sounds wonderful; and it is especially good to hear that you can be worked into the schedule so quickly. Your plan of treatment sounds exactly like the plan of treatment that my Mom had. Her tumour was also very small and detected very early on. That's the beauty of mammograms , despite the current controversy.

    It's also so wonderful to hear about the way your family and friends are rallying around you. Their loving assistance will make all of the difference in the world. Marg, you continue to be in my thoughts and my prayers.

    Take care,

  4. WhymeMom?

    WhymeMom? No real answers to life..

    Thanks for the update and the plan sounds great..... hope it goes smoothly and they need to remove only one node....... please take care of yourself and let us know how you are.........
  5. Fran

    Fran Former desparate mom

    Marge, if you and husband aren't worried then I won't worry either. I'm sure you will just get on with the business of living and dealing with another health issue instead of being enveloped in a health issue to the detriment of your regular life activities.
    Good luck.
  6. Lothlorien

    Lothlorien Active Member Staff Member

    Sounds like the doctors are really on top of this and are moving quite quickly. That's really awesome. When my friend was diagnosis'd with breast CA, she was told she couldn't get into on surgeon for several months (hers was a very aggressive cancer too). She finally did find someone, but didn't get in for three weeks. I'm very impressed that they are moving so quickly. That's reassurring.
  7. hearts and roses

    hearts and roses Mind Reader

    Hey Marg, your surgeon sounds wonderful and calm. I am so glad she was able to explain everything in detail to you and H and assure you that things will progress easily.

    Ditto taking it easy, however - you need to remain stress free. I'm glad you have supportive family and friends. hugs~
  8. TerryJ2

    TerryJ2 Well-Known Member

    Marg, that sounds very much like what I went through, with-the exception that mine was intraductal. But the procedures are the same.
    You are going to get so sick of doctors appts!
    But it will all be over soon enough. I'm so glad you are able to move quickly with-this.
    Many hugs.
  9. witzend

    witzend Well-Known Member

    Marg - thank you for keeping us so well informed on your progress. I'm wondering about difficult child 3 during your recovery time. How is he handling this? Will husband be able to take some time off of work to help?
    Last edited: Feb 18, 2010
  10. maril

    maril New Member

    I imagine it is very reassuring - both that you are in good hands and that you will be getting started soon to tackle this. As others have mentioned, take care of you and kudos to your wonderful family.

    Best of luck in the coming weeks with the treatments and all the traveling; it seems you have the patience of a saint. :angel3:
  11. klmno

    klmno Active Member

    Thanks for keeping us up-to-date; I have been thinking of you. I, too, am impressed and thankful that they are dealing with this quickly. ((HUGS))
  12. gcvmom

    gcvmom Here we go again!

    What a great and hopeful report! It's all very encouraging and you sound like you are rolling with this situation very well. :D I will continue to hope for the absolute best possible outcome, and that this ordeal will soon be far behind you!
  13. SearchingForRainbows

    SearchingForRainbows Active Member


    As others have already said, I'm so glad you have a wonderful surgeon, an excellent prognosis, and that the surgery is scheduled so soon. I'm glad you have support from a loving family and caring friends.

    Keeping you in my thoughts as you begin your journey on the road to recovery. SFR
  14. Mattsmom277

    Mattsmom277 Active Member

    I am glad you were able to do the private thing rather than waiting a few months for national health insurance to get you moving on this path. the surgeon indeed sounds terrific. You've explained each step to us all so well, i am betting she was terrific in explaining to you and your husband as well. that can be a real barrier for many patients, surgeons without that ability to communicate effectively to patients.

    you are a heck of a strong woman marg. I am betting your family are very proud to be related to a woman who just keeps plugging away and has an attitude of gratitude as well as level headedness. Those traits are serving you well right now. *clap clap clap*

    Thanks for the update and just remember that if you have a "bad day" and feel less than confident, no need to feel anybody will think less of you for any reason. Please turn to us all if you need our ears through this.

    PS. Totally jealous of your chinese meal!!! I'm on my way ;)
  15. Estherfromjerusalem

    Estherfromjerusalem Well-Known Member

    Marg, thank you for that detailed report. I had been thinking about you.

    Your medical services in Australia sound wonderful. I'm pleased you don't have to wait a long nerve-racking time, but will get the surgery over and done with. The doctor sounds so good, and the explanations of the procedure so clear.

    Best of luck with everything.

    Love, Esther
  16. KTMom91

    KTMom91 Well-Known Member

    Thank you for the positive update. I'll be keeping you in my prayers.
  17. Marguerite

    Marguerite Active Member

    I think I've been lucky in getting this surgeon. It's funny - I was berating myself for stepping outside the system last Friday and going to see my GP for the results instead of the clinic surgeon. But when I met her yesterday (the private doctor my GP referred me to), I discovered it is the SAME clinic doctor who did the breast exam on me! So it's the same person the clinic would have had me see on Friday anyway!

    So even though I've chosen to go private, I'm back in the "routine", the carefullyset up system with BreastScreen designed to ensure fast treatment.

    In Australia, our health care system on a national level is funded by the Federal Government from a tax levy on every person who earns over about A$20,000. The levy is something like 1.5% of gross income. It covers all doctors, all medical procedures, all hospital. It doesn't cover things like dental, physio, chiropractic etc but a new system under our national health system means that if the GP orders a Care Plan for the patient, even these things can be covered. The price for the extra cover is that all your medical details are on file and shared with everybody, including the government's Health Insurance Commission if they want to check up and make sure your doctors aren't ripping off the system. It also means that each participant in the Care Plan is fully aware of what everyone else is doing; the main reason for this is to feed it all back to the GP and frankly, it's what I prefer in my health care. It keeps everyone in the loop. Patient confidentiality is still respected when it comes to anyone outside that Care Plan.

    Private health insurance steps in for extra help with private hospital admission. Public hospitals have much longer waiting lists. Some specialists only operate in private hospitals, although the standard of treatment you get in public hospital is just as good. Because we have private insurance as well, we have the option of saying to the doctor, "if the waiting list is shorter for the private hospital, let's go there."

    As a general rule, if I have an emergency medical problem that requires an ambulance, I'll be taken to the public hospital. I may even get admitted and treated in a public hospital. mother in law has Gold Card medical because she is a war widow. Gold Card means she gets all her health care, including the full extent of private insurance's extras and more, paid willingly and enthusiastically by the Federal government.

    Even though the public component if our health insurance is federally funded, at the moment it's administered state by state. I live in NSW. My brother with prostate cancer lives in Queensland. And the Queensland public health system is considered to be one of the worst. I know in my brother's case, he is poor and can't afford any private health insurance. Plus he got mucked around a lot more than I think is usual - when he was diagnosed with prostate cancer, he had to wait about 18 months for urgent surgery. As a result, by the time they got in there they had to take a lot more than they would have if they'd operated within a month of diagnosis. He's got a lot of problems and he tells me his cancer has now returned (according to rising PSA levels). He's a darling bloke, a bit of a difficult child in that he won't fight for himself as he should.

    it's because of problems like this (and other problems to do with long waiting lists and desperate need for upgrades in other states' public hospitals) that the Federal Government is threatening to take over administration of the state-based health care.

    Someone asked how difficult child 3 is coping with this - we thought he was doing OK until last night, he came in and said, "I've not been able to get my schoolwork done, I just can't concentrate on it. I think it's because I've just been too worried to think straight."
    That is information I need to pass back to the school so they won't get too demanding for a while about getting the work back to them.

    Now I know what is happening with the treatment timetable, I can start organising various other appointments that I have had to put on hold. A few emails have come in concerning another acting job I hot involved in with easy child 2/difficult child 2, there are bad problems brewing which I COULD step in and help sort out, but this time I'm going to sit on my hands and do nothing. In some ways a rescue job could be very good for me professionally, but the personalities involved are volatile and I think I could do without it. As it is, rehearsals will be scheduled during the latter part of my radiotherapy, so I'm not telling them anything except I'm having a "day surgery procedure" a few days before the first rehearsal. If and when I need to tell them anything, I'll tell them as little as possible. I've been burned before from sharing even need-to-know info on health problems with an acting troupe - of all professions, they are the most superstitious, the most paranoid and the most rejecting of anybody, when it comes to health problems. Like the other minor cast members I have about three or four small roles, each of them only for about five minutes on stage. easy child 2/difficult child 2 has one of the more important roles plus a couple of others. I really want her to stay involved, it's more important for her career-wise. Me - I just want to work towards voice-over work, I don't need to be physically in the limelight.

    Whatever I can do income-wise, it needs me to be working from home and with control of my own hours.

    I need to go and settle difficult child 3 and get him to do some work. I've not been able to be home with him during the school day as much as he needs, that could be a factor as well. When I'm here, he works better. I'm also here for him to see, touch and feel reassured by. If I'm not here and he knows I'm seeing doctors about cancer, he worries about what he doesn't know.

    I'll keep you all updated.

  18. susiestar

    susiestar Roll With It

    Thanks for the update. Sounds very promising. It is awesome that the doctor is one you really like and she is getting you in quickly.

    When the radiotherapy starts you might try keeping some diaper rash ointment like the soft desitin around. I have an older relative who had some problems with burns about a year ago. I had her try this after a treatment and it helped quite a lot. I have a good friend who does this as her career and it is what she suggests also.

    Anyway, many hugs and prayers!
  19. Marguerite

    Marguerite Active Member

    Thanks for that tip. I had a lot of phone calls today, I'll have the breast care nurses involved apparently, I meet them the day of the surgery and from then on, they're in my life in a big way.

    I have to be careful with petroleum-based oils and creams, also anything with preservatives. So I might have to concoct my own herbal ointment. If I work on the theory of needing treatment for burnt and inflamed skin, then I'll probably use a combination of vegetable oil and aloe vera gel cut fresh from the inside of the leaf. I have lots of this growing in the garden, I'll have a plentiful supply. Plus there's a huge clump of it in the local park, if I begin to run short of it.

    I'll be comparing notes with other patients, too. One thing we're looking at, is husband dropping me off for radiotherapy and then going to work for a few hours, travelling by train. He then comes back to the hospital by train, collects me (and maybe difficult child 3) and we then drive home. They said they have lots of lounging around space at the oncology unit and I'll be OK to hang around there all day if I want. It could buy me some relax time (and keep me off the internet to talk to you guys as much!).

    Apparently there is a waiting list for radiotherapy, it could be six weeks before the course begins. But tat will give my skin time to heal. Also, the doctor said that in my case, the radiotherapy is just a precaution.

  20. ctmom05

    ctmom05 Member


    You are so darn graceful about all of this. What a blessing that is.