Tuesday, April 8, 2014

DCIS, the breast treatment, who's the boss?

 One medical group in my part of the country is considered the "go- to guys" for cancer.  They have a big public presence, get interviewed, and quoted.  They have "a team" for you.

By contrast, my doctor in California knew everyone, knew who was the best in our area for a problem.  When I couldn't deal with one doctor he chose, his second choice was very skilled and sympathetic to me.

 My doctor was worried about the spine surgeon and his prescribed rehab being so far from friends.  But I stuck with the surgeon, because my doctor considered him the best.

Now in TX, a stranger and called back for more mammograms, I had to go on instinct.  My instinct or my fear said the "go-to guys" would regiment me, would "team up on me."  

I stayed with the hospital breast unit people, who paid attention to me and my fears.  When a kind DO there told me I needed the biopsy, I even met the biopsy doctor before I agreed.   

After the biopsy results, I used the surgeon they recommended.     He is kind, calm, and patient person.  And did a great job on the lumpectomy. Then he recommended I see a certain radiation oncologist and medical oncologist.  It was up to me. 

I was uncomfortable with one oncologist.   But I stayed with her because I got support from others in her unit, and because he had said he would go to her if he needed radiation.  Research of major hospitals has convinced me she gave me the best, latest, and least severe treatment.

The late Bernard Virshup, MD, of California, wrote  How to Cope With Your Doctor.  In his book, he tells of a general in WW2 whose grand strategy was to take a certain island.  But one colonel got reports that no enemy was sighted on the island, so he kept moving forward and arrived at the island to discover the enemy was leaving by boat. 

Dr. Virshup was convinced it's not the grand strategy that counts in medicine; ". . . it's the guy who knows the right move to make next." 

 In The Patient From Hell, Stephen Schneider found many reasons to help decide the right next move .  In DCIS, I'm incredibly grateful that I found doctors who knew, but let me decide whether to go with "the right move to make next."

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