The Surgeon

          My surgeon's office is located in the same building as the diagnostic center(turns out the whole building is a Breast Center adjacent to a hospital).  The appointment turned out to be on my husband's day off, thank goodness!  We had a very early appointment and while waiting in the lobby that same feeling of being spotlighted came over me.  No one coming through was anywhere near my age or physical health.  I was nervous but trying to be light hearted and focused on the science.  I am a science major ( Nutrition) so a clinical approach makes this whole thing a little easier sometimes.  The funny thing is that despite my best efforts my gut normally exposes the truth.  I have a stomach condition called IBS ( Irritable Bowel Syndrome).  I developed it around 19 and have worked crazy hard over the past 11 years to manage it without going on any prescription medication.  I changed my eating habits, learned more about managing stress, and discovered coping skills.  One additional side effect of this stress related condition has been some acid reflux.  If I get stressed out or my stomach is too empty, I "urp".  My co-workers nicknamed the noise that many years ago because it is not quite a burp but everyone asks if I'm going to throw up.  Well, despite my attempts at a brave face I'm waiting in the lobby and "urping" every 15 sec.  I start doing some deep breathing hoping to calm down before seeing the dr.  They call me back and want to weigh me.  Damn!  I hate being weighed by strangers!
              We finally get to see the surgeon after the nurse goes through my personal and family medical history obviously clueless about what my chart actually says.  She is one of only two surgeons in the center to have completed a fellowship in surgical oncology. Points in my book!  She is not ancient and she seems in good physical health!  Also big points!  I believe those in the health care profession should be examples of health and wellness as they know more about it than most people!!!! Duh!!!!!!
She was great.  She explained exactly what ALH was and what that means for me.  She said" Right now this is your diagnosis"  I had not really thought of it like that until she used those words.  It means that I am 3to4 times more likely to get breast cancer than the average woman.  It means that both breasts are probably affected and therefore at risk.  It means more aggressive screening and possible hormonal therapy medication to help prevent breast cancer.  She asked lots of questions about my family member's diagnosis and genetic testing.  Unfortunately, I did not have all those answers. She and I have had a strained relationship over the years and I only know the basics.  The surgeon said she wanted me to get tested for the BRCA1 and 2 genes and we would need my relative's specific information in order to get approval for the test.  She did an exam of my breasts and commented on how bruised I still was from the stereotactic.  She also said she felt a lump but because it was on the same side as the biopsy was done and she had never examined me before she could not be sure it wasn't just a hematoma.  She agreed with the Radiologist that I needed an excisional biopsy to be sure that cancer was not hiding nearby.  She seemed positive though.  She mentioned my dense breast tissue and the possibility of this all being related to fibrocystic (hormonal) changes within my breast.  We thought we would be scheduling the surgery that day and we were told, "The Dr. normally does all that on the weekend and then gives it to her nurse to call people on Mon. or Tues.".  Seriously!!!! I want this impending doom OVER!!!!!  So.....I wait.