Six Months Surgical Follow-up

I had my appointment for my six month post-mastectomy follow-up with Rockstar Raja today.  Since I'm still being seen by the oncologist and plastic surgeon, I figured seeing the breast surgeon was superfluous - but I now do what doctors tell me to do.

For the most part, anyway.  My surgery was actually 7 months ago.  Time flies.

I wonder if doctors realize how much we women read into what they say and do?  Here is the examination from my point of view:

He checked out my mastectomized breast and asked me if it hurt.  He seemed amazed when I said it didn't.  

I must be really strong to not feel pain when a doctor thinks I should.

He said, "it's time to get it out of there"  meaning the expander.  Yes, I thought,  the skin is stretched tight.  I told him surgery is tentatively scheduled for June.

Then he did an exam on my remaining girl.

As he did the breast exam he looked concerned and frowned.

Is he concerned about me?  Does he feel something in my breast?

He looked at me and said, "Who is your primary care physician?"

I answered, "Dr. Q."

Dr. Q.  happens to have an office across the hall, and he used to share a practice with Dr. Raja so they know each other very well.

Why does he want to know?  Is there something that he has to talk to him about?  Does he feel a lump? Do I have cancer again?

Dr. Raja looked at the nurse and said, "Is Dr. Q in today, can we get him?"

Oh God!  Something is wrong.  He needs the doctor right now!  Why would he need him now? Does he need pre-approval for a test? He feels something!

The nurse said no, he was out of the office today.

I said, "Is something wrong, do you feel something?"

He said, "It's hard to tell.  When did you have your last mammogram?"

I told him August, when I'd been diagnosed.

Do I need another one right now?  Am I going to go through all this again, just a few weeks after finishing chemo? How can I do this to my boss again? My family?  

He said to have the surgery to get the expander out and then to call my primary care physician and schedule a mammogram for August and make sure he got a copy.

Make sure he got a copy?  Does he think he'll have to plan another surgery?  Oh no, I don't want to do this again!

"I'll see you in six months."  Unless your next mammogram shows cancer, in which case I'll see you in August.

Now, here is the same conversation from what I imagine to be Dr.Raja's perspective:

"Did you have pain with this expander?"

"No, it''s not painful, just a little uncomfortable."

"Well, it looks like it's time to get it out of there."

What has it been, 7 months?  What is the plastic surgeon waiting for, she's clearly as full as she can get.  It will be hard to do proper tests while that is there and she's almost due for her yearly checkup.

Time to do a breast exam on her remaining breast. There is some hardening that is consistent with her previous history of cysts.. 

"Who is your primary care physician?"  I need to remind her to schedule her yearly exam with him.

"Dr. Q."

Oh, Ernie.  I wonder if Ernie is around?  I wanted to talk to him about that poker game this weekend. I wonder if my nurse knows?

"Is Dr. Q in today, can we get him?"

The nurse said no, he was out of the office today.

Darn, it's his turn to bring the beer.

"Is something wrong, do you feel something?"

"It's hard to say."  

You have a history of cysts and I can't tell the difference by feel between cysts and cancer and I'm not going to guess with a patient."

"When did you have your last mammogram?"

"August."

Ah, that's right, it took her a while to be comfortable with a mastectomy as opposed to a lumpectomy.

"Have your surgery to get the expander out and then to call Dr. Q. and schedule a mammogram for August and make sure I got a copy.

Ernie's office staff always forgets to send me information for my records - maybe the patient can help me with that. 

I'll see you in six months.  

I'll see you in six months.

His way sounds so much better, doesn't it?  But, you can see the holes where he left ambiguity with a patient.  And, you can see where I didn't probe enough.  I am not sure "it's hard to tell" is an appropriate answer when it comes to "do you feel something?" but then again,  I am experienced in the ways of breast lumps and I don't feel anything..

In any event, my plan is to see Dr. Raja in November.