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Dec 7, 2017 11:34AM
DagnyT, so sorry you had a less than optimal, putting it mildly, encounter with the breast surgeon. Given you told them up front you have a bleeding history, it is annoying that she delegated your biopsy to a nurse, instead of doing it herself so she would be there just in case there was something in her expertise above that of the nurse that could have minimized the bleeding (maybe it would have, maybe it would not have). It was inappropriate in any event of the nurse to joke and laugh about all the bleeding you had, probably nervous "oopsie" laughter because she did not take you seriously when you told her, instead time she should have just apologized and made sure you were ok and told you she would note it in the chart so extra care could be taken next. Next time you go, I would ask them to put in writing into your chart that you bleed easily, and persist in making sure it is there every time you see a doctor. Assuming you are not on aspirin, non-steroidals, some herbals, or other meds that make people bleed easily, and you have a normal platelet count and coagulation profile (did they even check?), this may be relevant to how they plan your upcoming surgery, or they may even want to investigate your coagulation profiles more pre-op.
I am also an easy bleeder and easy bruiser (due to my prednisone therapy for my autoimmune problems) and warn them repeatedly.
A medical oncologist should generally be able to talk to you more about your options and answer your questions, as they are in charge of the big picture and not just the cutting, but it is sad that this surgeon did not even give you an outline, which I understand most do to some degree, of basic pros and cons of LX vs MX. Because, as you point out, knowledge can make a difference in your decision whether to do a lumpectomy or mastectomy, and the timing thereof, it is critical to have those conversations. I had talked to an awesome medical oncologist on the phone about 10 minutes before I saw her at all weeks later (referred by my primary care, the MOC had called me to talk almost immediately, it was the end of a day), then saw the surgeon the MOC strongly recommended as being among the best in the area (she is not on my insurance plan, so insurance only pays a part of her fee, but often you get what you pay for and if I am paying extra , non-preferred providers know they have to offer something extra to patients or no one will bother seeing them, with their higher fees ). The surgeon then outlined options, meanwhile I was doing all my reading, and then, well-informed, we went ahead with the LX (I still had issues with the anesthesiology pre-op, but that is another story). I keep seeing the BS for wound follow-up, but the big plan is now in the hands of the MOC, whom I have met and like. I am happy that she is a person who thinks outside the box and is not just a systems robot trying to push me into just following a standard one size fits all algorithm, she is treating me as an individual with a complicated past medical history that makes decisions not so simple. She went over all my questions, looked at all my notes, seemed to be thinking hard, and spoke frankly about unknowns, showed me papers on her iPhone that addressed specific questions and I took down the citations to read on my own.
Dagny, I hope your next visit with the next BS goes better, that you see a MOC, and that you also keep your psychiatrist appointment to get early input on setting up a plan of mental health care for you.
After a decade of autoimmune problems, Dx 10/2017 at age 63, IDC, Left, 9mm, Oncotype 13, Stage IA, Grade 1, 0/5 nodes, ER+/PR+, HER2-, 11/22/2017 Lumpectomy, Arimidex. Declined radiation.