Thinking of traveling for my reconstruction surgery

I had an appointment yesterday to meet with the plastic surgeon I met with in December. Unfortunately, I arrived late for my appointment (somehow I wrote the time down wrong) and I had to reschedule. I managed to snag an appointment for a week later, but my heart is really making me think that maybe this was a sign for me to really search for a surgeon I feel better about.

Although this particular plastic surgeon comes highly recommended by my oncologist and my first general surgeon... I'm really not digging her. At. All.

It took a few weeks for me to realize that the procedure I had researched on line, and had gone to the initial consultation to discuss, she never offered me. At the time, I didn't pay a lot of attention to the fact that we were discussing the TRAM flap procedure versus the DIEP procedure. But now that I have more time to think and reflect, I realize that I was about to settle for a procedure I don't really want to have.

That makes me a little angry, ya know?

I'll tell you why. Its one thing if I am told that, for medical reasons, I cannot have a particular procedure or medication. I can accept that. My body is unique and everything just won't work for everybody. However, it is a totally different thing to be told (or rather NOT TOLD that there are other options for your care) because the doctor does not have the ability to perform them.

Both procedures take tissue (fat, skin, etc.) from your abdomen area and use that to construct a breast mound. The TRAM flap is an older procedure and it cuts through your muscle in your abdomen. The DIEP procedure does pretty much the same thing, but it doesn't require that the muscle be cut which means that you heal faster and you're less likely to lose core strength (or develop a hernia). However, the DIEP procedure does require a lot more micro-surgery on the blood vessels. There aren't very many doctors in the country who perform this procedure.

I was just watching a video on-line of the DIEP procedure being done (and yes, it was GROSS) but watching it made me realize that no matter what procedure I choose to have, I'm going to go through a really major surgery. If I'm going to put myself in a situation where I'm risking so much, I really need to go for exactly what I want.

I'm starting to realize -- as frightening as learning breast cancer is -- I really could have (and probably should have) slowed down a lot in accepting my treatments and my surgery options. I don't know if they would have been different had I waited a little while and researched a little more. But I do know that I might not feel like second-guessing whether I've done the right things so far. I'm really second-guessing a lot right now. (the mild swelling in my left arm is really making me take notice that I still have a responsibility to myself to make sure that I take an active role in my treatment)

So, the missed appointment on Thursday gave me lots of free time to think about whether or not I really want to have this lady cut on me. I have not had a good experience yet in dealing with her office and I found her less than personable and far from friendly. Not that either of those personality traits reflect on her surgical abilities. But (maybe its me)... I want to LIKE the people who are treating my body. Cancer is invasive enough, do I have to feel further removed from feeling "whole-ness" by dealing with medical staff that I don't like?

At any rate... one of my "pink ribbon sisters" on facebook, recently wrote a blog entry about her most recent surgery experience. She has an implant and had to have it removed/replaced because of an infection or something. She traveled to Louisiana to have the surgery. And as I read that, I had to wonder would I be willing to do the same. In the early days of my diagnosis, I had many people recommend the Cancer Treatment Centers of America to me. (They do have some powerful commercials) But as I looked into it, I immediately dismissed it because the closest center to me is in Philadelphia, PA. I didn't want to travel every week, or every other week to Philly for treatments. Especially not when I knew there were very good hospitals here in the DC metro area that I could go to. But... this surgery presents a real challenge for me.

There is ONE doctor in this area who performs this surgery. And he's at Georgetown University. I have put a call in to his office (today in fact) to try to schedule a consultation -- but I haven't gotten through yet. I will go to the appointment with the cranky lady next week. But I am crossing my fingers (and asking you to do the same) that I can get in with this Georgetown doctor. If not, I will be looking for plastic surgeons around the nation who can perform this procedure.

Traveling for medical care. Hmph. Never thought it would come to this but if this is what it takes for me to get back to feeling whole... I'm going to have to get with it. I have no idea how I'm going to afford this. Guess I need to get on my knees... and quickly.

[Video of DIEP breast reconstruction procedure]

...of course, I just read something that suggests that the DIEP procedure might not be better than the TRAM procedure. Grr....

Why isn't there a blueprint for all of this stuff? Which way do I go?

DIEP Flap info[DIEP Flap information]



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