Tuesday, September 6, 2011

Baring it all for my new doctor!

Today was the day. I thought it seemed so far away and it was finally here. I was nervous all morning. Sweating even. I felt great about the guy. New practice at Christie Clinic. From Mayo. Recommended by other doctors, etc. My primary, Dr. Marty said to be confident with him, ask lots of questions, tell him what I wanted and needed, listen lots, and be firm. I had to be proactive. Perhaps thats why I was nervous. I'm really good at being bold. I'm stellar at talking. Not as great at listening but I'm working on it. And those who know me know I'm very confident- at most things in my life. But not this cancer thing. I'd thrown me off my rocker. All my insecurities have come out and while I know I have to be proactive, finding the words and saying the with confidence had me freaking.

I saw Dr. Youse's new poster on the wall at Christie and read it three times while I waited to be called. He was cute. I don't need a cute doctor but nice looking people are easier to look at than ugly ones, lets me honest. He has kids and a wife. I can relate to him. His specialty is cancer-DONE! You had me at Cancer!

I stripped down to my undies and put on the gown ( left open in the back as instructed) and had a big ass sheet around my legs. Doc walks in and says, "so you've got some Squamous!" with a smile. I smiled back. Sense of humor. Like him. He introduced himself and while I was trying to be the new, more professional Katie that has cancer and is trying to keep her shit together, here's how I responded after we shook hands...
"Well, Doctor. YOu are going to like me. I'm cute and fun, I'm detailed and a very good patient. I will take notes, do as I'm told and listen. You are not going to like me because I'm super dramatic, too detailed at times, and I'm going to ask a million questions. And I'm going to expect you to answer them all and be patient with me while you do." Holy shit! Did I really just say all that to my new doctor I'm supposed to be impressing. Screw it. I'm done. I'm me. Take it or leave it. Luckily he responded with a laugh, " lets get started then, Katie".

So, we talked about the thing on my chest...I'll call in CANCER! The damn robe was pissing me off. I was trying to show him my chest and not my full rack but it wasn't working well. The robe kept slipping. Annoying. I showed him pictures of what it looked like before. We talked about the different types. I told him what I had learned about it. I told him I was concerned about the cancer cells attaching to the bone. He pinched and proded and rubbed and jiggled the area. He said that if cancer attached to the bone in that area where there is very little fat, you would be able to feel the lesion and it wouldn't wiggle and giggle but feel connected. Never have I been so happy to wiggle and jiggle.

I told him I was worried about my boobs. Where does chest tissue end and breast tissue end? Could this squamous cell that is in my tissue spread to the nearby breast tissue. "yes" he said and I caught my breath. But it would spread to your lymph nodes first. He felt my armpits over and over and said they felt great. Deep breath.

We then talked about surgery. I told him I was scheduled with Plastic Surgery at Carle on Sept 22nd and I wanted to go with him instead but it would have to be before the 22nd. he had no idea what his schedule looked like but wanted to talk me through the procedure he uses, called MohsSurgery. Its the most highly effective surgical treatment of skin cancer. Instead of cutting deep and wide and then sending the tissue to pathology for results, you take the least amount you possibly can outside of the margins of concern, and then do Pathology on the spot. Right there. if Pathology comes back and all margins are clean, you are done. if not, then they can go back and take more tissue right there. They are able to evaluate the margins and get 100% clean rate each time. Sounds amazing- sign me up!

So we talked about the procedure and the scarring. He starts feeling on my scar and pinching the skin. Then kinda marking it with his fingers to show me how big of an area he would take. No mirror to hold. I asked if we could go to the mirror on the wall. So, I headed to the mirror with that damn robe on and the sheet around my booty and he stood next to me while I pulled down the robe to show my chest. Robe falls down. Crap. I pull it up. While I'm pulling up the robe, the sheet falls down. CRAP! It was pissing me off. I was trying to concentrate on the mirror and my scar and didn't care about my ass or my boobs so- I just let them fall and appologized to the doc, even though I wasn't really sorry. He laughed again and said he was glad I was so focused on this procedure and getting as much info as possible. He ended up drawing on me. he uses as "S" cut instead of a straight across line. He drew around the current scar and said that would be the amount he would start with. Probably only 10-12 stitches. Then he drew a bigger "S" around that to indicate what the next cut would be if the first margins didn't come back clean. The first one looked little. WAY littler than expected. The second one looked big. But not too big. I liked him. I liked the idea of this technology- something Carle is not using right now. We talked about recovery, if Carle did it or he did it. He said I would only be down for a day or two and would be pretty sore but would be able to do all the things I had done before immediately, except lifting. Ideally, he said he would want me not to lift anything heavy for 2-3 weeks. When I looked at him in disgust, he said "I know better than to tell a Momma she can't hold her babies- you just need to be careful. its not for the cancer, its for the scarring- you do not want to pull those stitches at all- they need to stay really tight"
He wrote on a request sheet for me to bring to the schedule that I would need it ASAP. I felt great. Not on to the full body exam....he started on the arms. Touches and rubbing the skin. I said to him, "I'm so glad you are touching me." He responded, "Excuse me?" I then explained that the PA I went to a year ago, never touched my skin one time and I was really pissed about it. He said that touching the skin and looking at each mole or irratation is the only way to really access the skin. I AGREE, DOC! He looked at everything and asked if I had concerns in the areas covered by my undies or bra. I did. I showed him the pitch black mole I have on my hip ( I call it my side ass). He immediately circled it. I told him after looking at cancer posters for 20 minutes I knew the black ones were concern for Melanoma. I asked if I should be concerned. He just said, we are going to take it, put 2-3 stitches in, and evaluate. No worries now. DAMN- can I get a break, please! He asked if I wanted it gone now or on the day of the surgery. Thinking the surgery would be next week, I said we'd wait.

We talked for a few more minutes and he brought me a pamphlet on Mohs Surgery to help make my decision.

I headed to scheduling and told the chick I needed to schedule a surgery. First available, OCTOBER 6th!!!!!!!!!!!!!!!! SHIT!!!!!!!!!!!!!! That's 14 days after the one I have now. NOW WHAT??????? I start sweating again. DAMN IT!!! I ask if there is anything sooner and show her that the paper says ASAP. She says she saw it. Then I tell her to make the appointment but I may cancel if I decide to use my Plastic Surgery Appt at Carle instead.

The lady says, "is this for skin cancer?"

" yes" I reply
"Carle doesnt use Mohs. You want Mohs. Its the best"

"I'm sure it is, I say, "but I am freaking out with this on my chest and need it gone"

" I know but regular surgery doesn't always get it all. This will.

"I know. "

So, I have some decisions to make. September 22nd with Plastic Surgery and a stranger doctor I'll meet that morning or October 6th with Dr. Youse who laughed at me when I introduced myself, told me he like my inhabitions when I dropped the sheet, and the guy who didn't think I was harassing him when I told him I was glad he was touching me.

I'm thinking. I know it sounds like an easy call but its not for me. 14 days is alot.

I'm grateful however that I was true to me....not really classy or professional but kinda silly and awkward and just me.


Jill said...

Go with Christie it is worth the extra wait to know that they will get it all and that you trust your doctor. even Dr. Jacobsen has to send it in to make sure she gets it all and that the margins are clear. So that is my two cents worth and when are you coming to ST. Matts to see us? also even though Pete had a skin cancer removed no one has mentioned to him to go in for a full body scan. perhaps I should suggest that to him. Jill

Lisa said...

There's a lot to be said for continuity of care; then again, there's a lot to be said for "Get this out of me NOW!" I'll be praying for your decision. Much love.

Laura T. said...

My friend, Corry did Mohs (in California) for a basal cell carcinoma on her forehead. They had to go back and back and back, and it turned into an all day process (...but they got it all, and everything went great!) My dad did Mohs for a squamous cell on his bald head and had to go back once if at all. His incision healed up really beautifully. At the time we didn't shop around much, but it was pretty compelling that Mohs was the way to go. So, 2 positive experiences (although slightly different) to throw in the hat. Thinking of you as you decide! Hang in there!