I was most definitely leaning in the direction of Florida Hospital in the beginning of this crazy process. I had both of my children at Florida Hospital, my father and my aunt were well taken care of there too, so I have always felt very comfortable there. So I began by seeing doctors who practice at F.H., and although each one was very nice, I was pushed (thank you Jennifer - I love you!!) to get second opinions at MD Anderson Cancer Center, and, in the end I chose all 3 of my doctors from there. I have included a link to the hospital's breast cancer page.
http://www.orlandohealth.com/mdanderson/CancerInformation/BreastCancer.aspx?pid=2740
My surgeon and oncologist are on the same floor and the plastic surgeon is right upstairs. They, by all accounts, work as a team, and I have already seen evidence of this when Dr. Smith told me he had already spoken to Dr. Shah about my case. Everyone, from receptionists to nurses to "schedulers" to the doctors, has been incredibly kind, compassionate and positive without showing the least bit of pity. I feel very valued, heard, and well cared for which makes me feel very confident.
Dr. Smith - He will do what is called a "skin sparring" bilateral (both) mastectomy. During surgery via microscope/various pathology methods, my lymphnodes will be evaluated for "involvement" by checking the "sentinel node." If there is cancer present, most of the other nodes will be removed during surgery. How they determine how many lymph nodes and which ones to take I have no idea, but that is a good question that I will need to ask Dr. Smith. Dr. Lee will consult with him about where and what should be cut. Dr. Shah will also be recommending that he put in a "port" at the same time. A port is used to administer chemotherapy, which I will more than likely need based on the size of my tumor. After surgery I will only stay in the hospital for 1 night (is that not unbelievable??) given there are no complications.
Dr. Lee - He will do what is called Deep Inferior Epigastric Perforator (DIEP) flap surgery 5 days later. The reason for waiting the 5 days will be to see the pathology report. The pathology will determine the treatment protocol, and therefore may impact the type of reconstruction I can have. But based on the idea I won't need radiation and that all else goes well, I will be able to have the DIEP surgery. This is reconstruction where my own tissue (aka fat from my belly) will be used to make new boobs. It will enable me to keep my abdomen muscles - a major benefit to getting out of bed in the morning! (In a TRAM flap surgery - one of the reconstruction options - the ab muscle is sacrificed and used as the blood flow source for the breast.) Blood vessels in the skin and other places will be connected microscopically to the vessels in my existing skin of the breast, which will then act as the blood source for the new boobs. My tummy will then be stitched back together pulling everything in tighter/flatter. I will be in the hospital for 5 to 7 days with recovery being 4 to 6 weeks. I am a candidate for this surgery because: a. I'm young (I confirmed this with Dr. Lee, as all my students not to mention my own children think I'm old); b. I haven't had major abdominal surgery (some how my 2 c-sections don't count!!!!); c. I don't smoke; d. I'm in good health (aside from the cancer and all); and e. I have family and friends around to take care of me while I recuperate (right??!!).
Dr. Shah - She is amazing!! Competent, professional, smart, and caring all at once! She will see me 2 weeks after surgery (I'm hoping she makes house calls but I don't think so) and by then she will have the results of the path. report and will have an idea for a treatment plan. She has already called me to tell my my basic blood work looks great except, apparently, I am iron deficient - so I started on the iron supplement she suggested (I have to take it with oj). Yes, she also suggested a stool softener - lucky me - and wouldn't you friggin' know that at the drug store, on that specific item, I didn't get the $3 off like I was supposed to, so the clerk had to get the manager to fix the dilemma!! Seriously??!!
Although doctor shopping is over, now the tests ensue! I have been scheduled for 3 different scans: a bone scan, a ct scan, and a ct angio. I'm not up to speed yet on what those are so, mercifully for you, I can't explain them. Next time...
OK - Bottom line - I have a team of AWESOME doctors, I feel good, and no surgery date yet!!
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