Wednesday, June 17, 2009
Follow Up Post About the Lady Doctor
7:29 PM | 
Posted by
Heather Warren
First and foremost, thank you for the sweet comments about my mama. For those of you that haven't read my blog long, my mom was diagnosed in August/Sept 08, she chose to have a double mastectomy before Thanksgiving. Luckily, the cancer was Stage 1, nothing in any of her lymph nodes they removed. Thank you GOD! She is awaiting her reconstructive surgery which she postponed until after the summer since she'll be laid up for quite some time.
She doesn't have to do any radiation or chemo, we were very lucky.
Breast Cancer runs in my family, my maternal grandmother and my mom both have had it. My mom took the BRACA and tested negative for it. I asked my doctor if I should take it. She said that she didn't think I should because if I tested positive they would want me to immediately have a double mastectomy and hysterectomy and I would have insurance issues for the rest of my life. I could be a carrier and got it from my biological father, and it doesn't mean I will get cancer. Ovarian cancer does not run in my family. Also my grandmother we believe got cancer post-menopausal and my mom pre-menopausal, so even though it runs in my family, it doesn't necessarily mean we pass the gene.
OMG its so confusing and scary to think about....
I started talking to her about my mom and how I don't think I now how to do a proper breast exam. I told her that prior to my mom's surgery she asked if I wanted to feel it. I couldn't really feel anything... CUE THE TEARS... they started flowing and the Dr. didn't really comfort me at all. I even glanced over to the box of tissues in the corner of the room thinking she'd offer one...ummm... no. Instead this cute, middle aged, southern, blond, Dr showed me how to do a proper exam and assured me that its much harder to feel a growth on someone else other than yourself.
I then asked her, "How do you know if you have dense breasts?" She told me that I have smooth breast... yeah go me... she told me most young women won't have dense breasts and that some women's feel like they have popcorn in them.... Huh? Which makes it even harder to feel for growths.
We discussed my fears of breast cancer, worrying about my ability to get pregnant, worrying about getting off the pill and having to live with my ridiculously horrid cramps, and a little bit of everything else.
She told me to start taking folic acid at least 2 months prior to trying to have a baby. She also wanted to me to check with a general practice physician to determine if I need any vaccinations. Has anyone had vaccinations before getting pregnant? I don't think I've received a vaccination since going into college.
So that was my emotional visit to the Dr. I swear whenever I have to talk about my family medical history I cry. Its this uncontrollable thing... the eye doctor, my general physician, and the gyno... yeah I can't control it.
My mom is great... she's cancer free and we're just awaiting her reconstructive surgery. I adore my mama but I have inherited all her issues... migraines, bad eye sight, painful menstrual cramps,and my ugly lil toes. But I love her just the same...
She doesn't have to do any radiation or chemo, we were very lucky.
Breast Cancer runs in my family, my maternal grandmother and my mom both have had it. My mom took the BRACA and tested negative for it. I asked my doctor if I should take it. She said that she didn't think I should because if I tested positive they would want me to immediately have a double mastectomy and hysterectomy and I would have insurance issues for the rest of my life. I could be a carrier and got it from my biological father, and it doesn't mean I will get cancer. Ovarian cancer does not run in my family. Also my grandmother we believe got cancer post-menopausal and my mom pre-menopausal, so even though it runs in my family, it doesn't necessarily mean we pass the gene.
OMG its so confusing and scary to think about....
I started talking to her about my mom and how I don't think I now how to do a proper breast exam. I told her that prior to my mom's surgery she asked if I wanted to feel it. I couldn't really feel anything... CUE THE TEARS... they started flowing and the Dr. didn't really comfort me at all. I even glanced over to the box of tissues in the corner of the room thinking she'd offer one...ummm... no. Instead this cute, middle aged, southern, blond, Dr showed me how to do a proper exam and assured me that its much harder to feel a growth on someone else other than yourself.
I then asked her, "How do you know if you have dense breasts?" She told me that I have smooth breast... yeah go me... she told me most young women won't have dense breasts and that some women's feel like they have popcorn in them.... Huh? Which makes it even harder to feel for growths.
We discussed my fears of breast cancer, worrying about my ability to get pregnant, worrying about getting off the pill and having to live with my ridiculously horrid cramps, and a little bit of everything else.
She told me to start taking folic acid at least 2 months prior to trying to have a baby. She also wanted to me to check with a general practice physician to determine if I need any vaccinations. Has anyone had vaccinations before getting pregnant? I don't think I've received a vaccination since going into college.
So that was my emotional visit to the Dr. I swear whenever I have to talk about my family medical history I cry. Its this uncontrollable thing... the eye doctor, my general physician, and the gyno... yeah I can't control it.
My mom is great... she's cancer free and we're just awaiting her reconstructive surgery. I adore my mama but I have inherited all her issues... migraines, bad eye sight, painful menstrual cramps,and my ugly lil toes. But I love her just the same...
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20 comments:
Bless your heart! Sorry about the crappy Dr. They really need to have a class called "Bedside Manner 101" in med school. Don't try to convince me otherwise. I'm glad your Mom is doing well and no worries, everything will be okay.
-A Faithful Reader and Jetplane's Fan
Oh I hadn't even thought about the insurance nightmares that it would cause...so true!! All of my friends have told me (as did my doctor when I asked this winter at my annual exam) that I need to be on a prenatal vitamin a few months before even trying. What is it going to hurt, I guess. My doc also told me if I can't choke down the big prenatal pill, or if they were too expensive, to take two chewable kiddo vitamins. :)
That was a lot to digest in one appointment, huh? I hope it doesn't feel so overwhelming in the next few days as it all settles.
After reading your family history and seeing that your mom's BRACA test was negative, personally, I would not take it. You know that it is a possibility that you can get it BUT so does everyone. You just need to be more careful with your family history and do regular exams (which honestly, I am bad at doing them too). Jumping to the conclusion of a double mastectomy and hysterectomy just is crazy to me and I know that a lot of women do that! I don't know anything about having a baby (we aren't there yet) but I wish you all the luck in the world!
I recently saw my doctor and she said that a woman's daily vitamin is fine (assuming it has folic acid). She said the amount in that is plenty unless your family has a history of spina bifida. Also, while I was there, they did bloodwork to see if I had the rubella/German measles vaccine. I think most people get this when they are young - I think they call it the MMR (mumps, measles & rubella) vaccine. Apparently, if you don't have it, it can cause birth defects. She didn't mention any other vaccines that are needed. Hope this helps and I'm so sorry you had to deal with a crappy/insensitive doctor.
What a crappy doc, she doesn't sound nice at all! From an insurance perspective, you can always have the test run and pay for it out of pocket and use a fake name. It happens often with genetic testing. I know it's a personal decision and I have no idea what I'd do, but you do have options. Best of luck!
It is so great that you are being proactive! Talking about such sensitive issues is really tough and it is natural to get upset. I am sorry your doctor was not comforting at all!
Don't you just love how "lady dr's" are always so gentle and understanding? Or not. Mine has the same facial expression everytime I see her, no matter what I tell her...
Oh that is unreal that she wasn't even sympathetic. You poor thing. Like I said before, it's certainly NOT a fun appt, let alone when there are sensitive issues broached. Glad that everything is ok though.
So sorry to hear that your doctor was so insensitive! I sometimes lose my marbles and cry at my doctors appointments, too. Definitely do not think you are alone there...I am so happy to hear that your mom is cancer free now. What a blessing.
Our family had a scare with cancer last summer... my little sister (at 21 years old) found out she had melanoma (which is very hereditary)...After surgery she is cancer free, but has to routinely be checked every few months in the event it comes back. Needless to say, my days in the sun are no longer. Cancer in the family completely changes your outlook on life.
So glad to hear that everything turned out okay with your situation. :)
My mom was diagnosed last May (08) with stage III, had a double mast chemo and radiation, and is waiting until after the summer for her reconstruction. My maternal grandmother and several great aunts also had it. Like you, my mom tested negative for both BRCA genes, which is fantastic, and I had the same conversation with my lady doctor two weeks ago. I pretty much knew what to expect, though, because I had had a detailed discussion over the gene testing with my mom's oncologist prior to this. My stepmother also had breast cancer, and for my stepsisters sake I learned as much as I could about it. Basically the conclusion was if they don't have the gene, then it's not likely that you have the gene. However, if it runs in your family it's not "technically" more likely that you will get it--but it happens often (??), I think mostly because it's 1 in 8 women. My mom's doctor was the top oncologist in all the metropolitan area here, and said that I shouldn't be tested until after I'm done having children and I am at a job that I feel I will continue in until retirement, as insurances will not take you if you test positive for either BRCA gene as a pre-existing condition. The only thing the lady doctor really said to me was that because it runs in my family, my breast films would start some 13 years earlier than most women--so 27/28ish. It sounds like we're kind of on the same page with the disease, so you if you have any questions or anything feel free to email me :) Glad your mom is doing well!
I imagine this can be pretty stressful for you! My husband is in med school and is very adamant about me starting pre-natal vitamins a couple of months before we start trying. (We aren't there yet.) I think being proactive is a great thing and it sounds like you are doing everything that you can to prevent and be aware of any cancer.
I haven't been reading long enough to know what your mama went through, but I'm happy to hear that she's doing well!
I think that your doctor should have in some way tried to comfort you, but sometimes they can be very "no nonsense" people. I'm glad that she gave you good facts, though, and it sounds like you are not currently in any danger!
If you aren't currently taking a multivitamin, now is a good time to start. You can buy prenatals over the counter for cheap. You do not need to buy an expensive brand- they're all the same per FDA regulation. The most important thing to note is that there should be 100% folic acid in them. Also, increasing your green, leafy vegetable intake will help.
As for immunizations, basically you should make sure that you had all your childhood vaccines (most colleges require this, so you should be fine). If you don't already have your hep B series, you may want to consider getting this. I would talk to your physician to see if she/he thinks it is necessary.
It is such a wonderful thing that you are thinking about, and it's hard to have anything negative associated with it. Do know tht breastfeeding decreases your chance of breast cancer, so definitely consider it. I'm not promising that breastfeeding is stronger than family history (which I also have :( ) but any little thing helps, right? Also, if you don't love your ob/gyn, consider changing prior to getting pregnant. You will spend a LOT of time with the practice during your pregnancy, and the best thing possible is for you to feel comfortable. Best of luck and lots of hugs, sweet thing!
Bless your heart! I do the exact same thing though...it is like I don't want to face the truth about my family's medical history. I think I cry everytime I go to the doctor!
I do not envy you! We are not close to the baby stage yet. I'm already freaked out by doctor's visits, etc. Good luck with all this! I'll be thinking of you. Speaking of this, do you go on base? or do you get to go off base? Because I have to tell you that left a little to be desired on my last visit for reasons I won't get into on a blog. :) It was awful!
This must be so hard for you! Trust in your doctor's advice. Wait. Get the test down the road if you find that you need it.
just read this from last night (too busy consumed by this new site that i've over hyped... ahhh death) but, stinks that it was a rough day, but glad you figured it out and worked through some stuff! :) Sorry the dr. wasn't the best, but I'm also very glad your mom is doing better! xoxo
Thanks for sharing about your mom. I'm so sorry you and your family have had to endure that.
Isn't it infuriating that we have to make decisions, like whether to take the BRACA tset, based in part off of insurance potentially giving us problems?
Oh, and the folic acid and immunization bits are true, or so my GYN told me. And yes, it is so annoying that even most lady OB-GYNs are so coldly efficient; part of their job is to have a bedside manner, in my opinion.
Now I don't feel so bad. I have horrible eyesight and cry every time I go to the eye doctor. I also have horrible cramps and endometriosis.
Hey, girl!! I've neglected my blogging duties lately and am catching back up. Thought I'd throw in my 2 cents....
A. Before you start trying to get pregnant talk to your doctor about the HPV vaccine - Gardisil. Even though there is no history of ovarian cancer in my family I got the vaccine and feel super happy about it. It is just a series of 3 shots and insurance should pay for it.
B. Yes, take a multi-vitamin and folic acid if you are planning on starting a family soon. My multi-vitamin has 400 mcg of Folic Acid so I take another 400 mcg pill of Folic Acid to get 800 mcg of Folic Acid total... which is the recommended amount for future mamas!
C. Don't worry about not getting pregnant! Easier said than done I know. Just know that it might not happen right away and that is okay. Every body is different.
D. Although lots of women seem to get pregnant 'by accident' while on the pill, I would consider dropping the pill a few months before you start trying. It can take your body a while to adjust.
That is all just advice from my personal experience and reading. Everyone is different and I'm sure everyone will tell you something different. Do what is comfortable for you.
Then get ready for the best part of the whole process - the baby making!! :)
So when will we see a little Jet Plane??