Friday, August 19, 2011

Bedside "Un-Manner"

So, here is what went down since Monday.... Now, I will add as a disclosure, that I just got out of surgery 6 hours ago, so my anesthesia may still be lingering, so I'm not responsible if I sound loopy, or if I'm not making sense.  I'll have Chris proof read it when I'm done to make sure I didn't leave out random words.

I went in for Dr Garvey to check my stitches from my surgery 8/8 and see if they were ready to come out. I was a little ticked at him already because as I was in the PACU recovery room, he walked past my bed TWICE and never once popped his head in to check on me. I've never had a doctor do that to me. I know they don't always pop in on you when you're in outpatient recovery, because often times, they are in another surgery by the time you're awake. But, he walked past my bed twice and I was awake. NOTHING. I was also a little upset because of our conversation that took place at our last visit prior to that. Needless to say, he was a little on my bad side already and I was going to ask for a different surgeon after he took my stitches out. Our personalities just don't match. I think I mentioned that in my last post.

So, he decided to leave my stitches in another week because my incision had not completely healed yet, which means that I have to see him again. *eye roll* So, we get to talking and he repeated a few things that he told me at the last visit. But, here is the icing on the cake......(portions of our conversation from this Monday)

Dr G: "Yeah, it's (incision site) having a hard time healing up because your skin is just so charred from radiation. She (radiation oncologist) just burnt your skin so bad."
Me: "Yes, because SOMEONE (Dr Garvey) didn't deflate me ALL the way as requested by her, you left 300 cc's in the expander, saying it was ok, so she had to radiate me deeper to get through it."
Dr G: "Yeah, ok, so it's my fault...whatever...you can blame me, she can blame me, I can blame her, whatever. Bottom line is that your skin is destroyed"
(did he just say "whatever" to me???)

Dr G: "You need to compromise and lower your expectations!"
no response from me because what the heck does he possibly mean by that??? I think I've already compromised and lowered my expectations by dealing with Cancer! Cancer boobs are much different than "augmented" breasts, so I've already done both of those! I don't expect stripper boobs. I don't expect bikini boobs. I just want normal boobs that look good in clothes!

Dr G: "I never changed plans on you. I've said the same thing from the beginning."
Me: "No, I asked you if you'd have enough to do 2 decent size breasts with the TRAM flap and you said Yes. When I asked you if I should lose weight, you said yes. So I did, and now you are saying that my breasts are going to be triangular shaped and much smaller if I do both with the TRAM flap"
Dr G: "Ok, let me put it this way....(looks at me like I'm a dumbass and talks slower) if I take the flap and cut it in half, and use it for both breasts, they will be smaller because I'll be using 50/50 portions. If I only do one breast, I'd be using about 70% of it on one side. Does THAT make sense to you?"
Me: "I'm done!" and I hopped up off the table, threw my hands up in the air, grabbed my bra and shirt and started to get dressed.
Dr G: "Would you like me to get you in with a different doctor?"
Me: "YES!!!"
Dr G: "Ok, I will get you in with Dr Skoracki" and he left the room.

So, Tuesday, I spoke with the patient advocate and told her my story. She could not believe he said those things to me and spoke to me the way he did. She filed a copy in the advocacy file, and also with the director of Plastic surgery. I was supposed to go in to meet Dr Skoracki in the first week of September. She repeatedly apologized on MD Anderson's behalf. She said that is not the way they are trained to deal with things, and she just cannot believe it. You could tell she was stunned, and on my side. I'm so thankful they have a patient advocate!!!

Then, Wednesday, my incision started leaking. CRAP!!! See blog post below this one....

Thursday, I went in to see my PA, Marla, because I told them I didn't want to see Garvey and Skoracki is on vacation. It really sucks that all this happened while I am in the process of switching Drs. So, she tells me that she got a page about me that morning telling her what had happened. She spoke to Dr Garvey, and said that he felt awful about what happened Monday. She said he really doesn't like the way it happened, or things that were said, but she said she respected me for saying "I'm done" and walking away rather than saying something I regretted. She said He also respected me for that. She said she talked to him about describing my breasts as being triangular shaped, because they aren't gonna be triangular shaped. She doesn't know why he used that word to describe them. She said she is proud of me for standing up for myself because a lot of patients don't. They just put their tail in between their legs and say Ok. I told her "It's MY body and I'M in control of it...NOT HIM!!" She said it reminded her of a sibling argument because neither of us were backing down.

Anyways, after all of that, she said he was willing to do the surgery and recommending it because if I let if go over the weekend and wait for Dr Skoracki to return on Monday, it could be later in the week before he could do surgery and the risk of infection is so great now that I have a seroma. So, my choices were: Let Dr Garvey take my expander out......or wait for Skoracki out of hard-headedness and risk getting an infection.

I know when to let my hard-headedness go.....

But, before surgery this morning, I requested to speak to Dr Garvey before they took me back. He came in and looked at my incision, and we talked medical jargon for a bit. (He brought in a medical student with him who he is apparently mentoring) So, he said "Do you have any more questions"

hehehe

Me: "any apologies?"
Dr G: "For....?"
Me: "talking to me like I was an idiot and saying   'does THAT make sense to you?' "
Dr G: "I'm sorry for the way things turned out between us."
Me: "well, your bedside manner leaves a lot to be desired because you walked right past my bed last surgery 2 times and never popped your head in and I was awake. If you don't change your bedside manner.....I pity your patients". (yeah, probably a little over the line...I know)
Dr G: placed his hand on my thigh where he was standing, in a manner to calm me. "look, let's not go there again. Let's just get this surgery done and get you all fixed up for Dr Skoracki. I need you to have trust in your Doctor for today"
Me: "Well, that's hard to do because I lost all respect and trust in you Monday when you spoke to me the way you did. I'm very nervous about you doing my surgery today, but I don't have another choice"
Dr G: "well, you do, but it's not one I recommend."
Me: "I know.....so I either risk getting an infection, or risk you doing my surgery"
Dr G: "OK, so, I take full responsibility for what happened between us. I'm very sorry. I'm sorry. I really am Sorry."
Me: "ok. Thank you. Please be careful and give me back to my husband and kids...OK?"
Dr G: "I will" (smile)

He shook my hand and Chris' hand and left the room.

Marla came back in (because she had come in halfway through our convo and started to cry (which I was crying too). She said more of the same stuff. He's probably in the OR hanging his head in shame, he's really upset that this happened. Then she tells me I really need to get a job as a patient advocate for patients who are too scared to stand up for themselves. HAHAHA. She said I would be really good at that because I'm very stubborn.....just like Dr G, which is why we butt heads.

So, it's not really that I'm stubborn....I just am a visual person. I need to know that if I use the TRAM flap and do both sides (which I am GOING to do, even if I have to switch Dr's outside of MDA) I need to know that I have another option, maybe put some implants behind the TRAM flap in a few years, maybe get some lipo or something from somewhere and have it injected in there....something. Tell me that I have other options if I'm not happy with the results.
IF....
I may be happy with them. But, I won't know until I see them.....because I'm a visual person!!! He never would answer those questions. I got "we'll cross that bridge when we get there". That's not an answer!!!

So, I'm out of surgery. All is good. I am concave and wrinkly. He used the same incision from a week ago, rather than using my mastectomy incision. He just made it a bit bigger and ruptured my expander and pulled it out, and then used some tool to basically burn the inside of my "pocket" to help it close together so it wouldn't collect fluid. Kind of like a cauterization? Then, he placed a drain tube to help drain all fluid from the pocket. I can't wear a prosthesis for a few weeks until it's fully healed. So, they told me to use batting, (light and fluffy) since now it's VERY noticeable that I'm lopsided.

Everything should still be in tact and OK to use for reconstruction. The expander did it's job, and saved the skin that was important. It shouldn't shrink down over the next few months while I heal.

Not sure when reconstruction is going to be now. I'll update more about that after I speak with Dr Skoracki.

I have to see Dr Garvey one more time this Thursday for a follow up. I'm not sure if he will be removing my stitches, or if they will stay in until I see Dr Skoracki. He will probably remove my drain tube Thursday, depending on my level of output.

They don't want me working out for a month....except walking. BOO!!!!

I think I've answered most of the questions that people had for me on Facebook. If I haven't, ask them below, and I'll do a Q&A post soon.

Thanks for your prayers! I really felt them today.

Love you guys!!!!
Tiffany


2 comments:

  1. the conversation you had with the doc before surgery when you called him out and asked for an apology - AMAZING. You truly are a phenomenal woman. I love that you speak up for yourself not allowing this doc to minimize you/your intelligence/your experience. You really would make a powerful patient advocate (b/c if you can do it this well for yourself while you are in the thick of everything - imagine what you could do healthy and for someone else). I am so glad you and Chris have each other. I know you are weary from all this fighting. I am praying for the day when it is no longer necessary to fight and the patience to get you to that day.

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  2. Wow. I don't think I could've handled it like you did! I'm proud of how you handled it all!

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