Compromising Positions
My breast surgeon arranged for me to meet with a gynecologist today, one who works in partnership with the UCSF breast care center. Her concern was that if ovarian cancer might run in my family (I'm not sure) she wanted me to be screened. The gynecologist's office asked that I bring the results of my last PAP smear with me. Toward that end, I faxed a request for my medical records to my regular doctor's office last week, letting them know that I would come by this morning to pick them up and to call me if there were any problems.
You just know this didn't work out, don't you?
As I started driving into San Francisco, I called the medical records department to confirm that they records were ready. The person I spoke with indignantly exclaimed that they couldn't possibly provide me with those records on such short notice. They need several weeks advance notice.
Why then, did no one call me? Well, it turns out that they don't actually read the requests that are faxed to them. They give the faxes to a service that retrieves and copies the records and then mails them to the patient. No one looks over the nature of the request, reads the name of the doctor, nothing. I was shocked - what if this was urgent? How hard is it to say, "Sorry, we can't do this in this timeframe." Or tell me what I do need to do? AURGH!
When I explained that all I needed was the PAP smear results, they admitted that they could fax just that to my gynecologist. (And yes, I gave them the doctor's info in the fax that they didn't read.) I have no idea if they actually did that today, but they said they would. Whatever - I don't suppose it is urgent.
At the gynecologist's office, I waited in my gown, swinging my legs as they dangled from the exam table. It's never comfortable to sit on those tables. I tried unsuccessfully to distract myself from the rash on my leg. I've had this rash for a couple of weeks, but I've been so distracted by having breast cancer that I didn't really register how weird it was until I thought about seeing a gynecologist. You know, getting into a compromising position like that can make you suddenly very aware of everything from the waist down. Having a rash that runs in a straight line from the back of my knee to my buttock, looking for all the world like an insane spider ran along my skin biting me repeatedly, made me pretty self-conscious. She is bound to notice it. How do I explain that I'm not exactly sure when it showed up?
When the doctor started examining me, of course I had to call attention to the embarrassingly weird rash. It's my way. I showed her how I also had a similar rash on my arm, on the same side of my body. She agreed that it is very strange and asked me to see a dermatologist before my surgery. Hmmm, yeah, I am a mutant, just as I thought.
I must say, though, this doctor made an especially good impression on me. Of all the people I've met with so far on the breast cancer journey (outside of my PCP) she is the most compassionate and the most interested in my quality of life issues. She asked about what kind of emotional support I have, offering to refer me to someone who specializes in cancer patients. She also told me about an organization that she is part of, one that supplies funding to patients for complementary medicine, since it is often not covered by insurance.
Her questions were all thoughtful and she listened to my answers carefully. I felt calmed by this. She had a lot of information for me on hormonal treatment as it related to my issues and the genetic testing. I told her about my concern regarding the recent study showing false negative results for some patients who undergo BRCA1 and BRCA2 testing . It turns out that she part of ... oh, not sure what it's called, but the group within the Breast Care Center that deals with genetic testing issues, and she just came from a meeting discussing that study. Interesting stuff.
She wants me to get a pelvic ultrasound as soon as possible to screen for ovarian cancer and is also doing a blood draw to test levels of CA-125. I'm supposed to come back in six months, and if I go on Tamoxifen (anti-estrogen drug for premenopausal women) later, she'll help manage how I do on that. So, woo-hoo, more tests! Just what I wanted.
I think I'll go take a nap now.
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