UCSF is Not Making Me Feel Confident

Someone from UCSF called today to give me the appointment times for my surgery and pre-op appointment (though she called the pre-op appointment the "preparing" appointment - who trains these people?).

She told me that I need to report to room such-and-such at 10 am for the needle localization. I had that done on both breasts last year - that's where the radiologist put a guide wire into each breast to guide the surgeon to the surgical location. Thing is, they use the core needle biopsy equipment for this...you know, the same equipment that the radiologist said couldn't detect my microcalcifications.

I brought up the obvious question: How can they insert a guide wire into a place they can't see? The person who called babbled on a bit, making it clear she knew nothing about the procedure. I repeated the question and said that they were not able to do the biopsy with the equipment, so how can they do the needle localization?

Finally, she said, "You can ask the person you meet with for your preparing appointment; she can explain to you how we do it at UCSF."

I tried not to grit my teeth as I answered, "I know how you do needle localizations at UCSF; I had it done twice there last year. That's why I am concerned."

She rambled on some more, saying nothing, not offering to get the question answered for me. I gave up on her, making a note to try to reach the radiologist (which is hard, because I think at UCSF they don't want you to reach anyone).

Then she said that the surgery would take about an hour, that it was an in-and-out thing and I'd be ready to leave quickly, but I should have someone drive me because I might feel groggy. She couldn't see my eyes narrow suspiciously as I asked, "Exactly what type of anesthesia is this listed as?"

She paused as she rifled through papers and then said, "It is MAC."

Right. MAC. The type of anesthesia that I told the surgeon's assistant and the scheduler last week that I could not have. TWICE I've been told it was switched to general. I took a deep breath and explained again that I did not want MAC, as I had a bad reaction to it. It needs to be switched to general.

Slowly, she responded, "And the reason would be...what? Because you had a bad reaction?"

"YES!" I managed not to make a strangled, "aurgh" sound. I finished up the call quickly after that, as it was clear that she couldn't provide me with any information. I hung up the phone feeling much more unsettled than I was before.

Here's my issue: I understand that the people calling with scheduling information can't be trained on the actual procedures. But they can be trained with how to properly escalate questions and issues to an expert who can answer them. All she did was make me nervous.

Do I have confidence that my anesthesia has been correctly recorded as general anesthesia? After having to tell this to three people, no way! I'm pretty sure that two days before surgery, I'll have to state this all over again. Who knows what will be given to me on the day of surgery.

I'm going to go beat my head against the wall for a while.

Update: I called the radiology department and talked to a radiologist about whether or not they could do the wire localization. He said it was an excellent question. After looking up my file, he said what they might be able to do is use slightly different equipment and more compression (ouch!) and accomplish it that way, but they won't know what would work until they tried it. Okay, that kind of answer I can live with. At least it sounds honest.

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