Monday, March 21, 2022. Sparkle’s limp had returned on her right front leg. She hobbled down the back porch steps to go potty. Miah’s mental capacity for another health problem – human or dog – was dangerously close to igniting a breakdown, so I told him I would deal with Sparkle. I called her veterinarian. They didn’t have any same day appointments but could see her on Thursday. If I didn’t want to wait that long, I’d have to take her to a walk-in urgent care or emergency clinic. I had a full schedule of meetings that day and didn’t want to take time away from my job commitments, so I decided to work until 4:30 PM and then take Sparkle to the emergency vet clinic about 15 minutes away.
Miah and I tried to keep her from moving around too much, but that’s impossible with a border collie. She stared up at us with her amber eyes, wondering what would happen next. “It’s ok. I take you to the doctor soon,” I told her in the baby talk voice that she loves.
At 4:30 PM, I loaded her into my car, Oreo Starflight (I have a black Mazda CX-30 with white leather interior and gold vinyl stars on the rear exterior side panels.) and drove to the emergency vet. The parking lot was nearly empty – only one other car – so I thought we might not have to wait long. Unfortunately, the receptionist told me it would be a 5-6 hour wait, and I had to stay there the whole time to secure Sparkle’s spot in line. A veterinary technician was also in the waiting area and heard what was going on. She stepped in and recommended a different clinic within the local university system, saying, “Sometimes they can get you in within an hour or two.”
Sparkle and I said goodbye and went back out to Oreo Starflight. “They couldn’t see you, but mama will call someone else,” I told her. I googled the other clinic’s phone number and called. The receptionist checked their schedule and said if I could get there by 6 PM, they would be able to evaluate Sparkle tonight. It was just after 5 PM and rush hour traffic was in full force. “I’m heading over now,” I told her and hung up so I could focus on driving.
The Universe rolled out a red carpet of green traffic lights and perfect lane merges for Sparkle and me. Amazingly, we entered the university veterinarian clinic parking lot at exactly 6 PM. The clinic was observing social distancing policies and there were signs directing me to call for check in. Five minutes later, two young technicians, a man and woman, exited the building and headed over to us. I explained that Sparkle had been limping on and off since Christmas Day. She’d been fine for all of February and most of March until today. I really wanted her x-rayed. I had fed her before we left for the clinic, thinking I didn’t want her to go hungry. That was the exact wrong thing to do, because now they couldn’t sedate her for x-rays. They would examine her and see if they could get her to lie still enough to get some pictures anyway. I said to do whatever they thought was best and cost was not an issue. I handed over her leash, but Sparkle refused to go with them. This was a first! Normally she is curious and ready to explore. So, I walked with the technicians up to the entry door and waited until they had gotten her successfully inside. Then I went back to my car to wait.
But I wasn’t going to just wait. I was on a problem-solving mission, and this was as good a time as any for multi-tasking.
I pulled out my phone, pen, and notebook, and got to work, researching the pros and cons of double mastectomy, lumpectomy, and radiation therapy. Time flew by and before I knew it, the technicians were back, standing outside my car window.
“We were able to take x-rays, but the images weren’t great. We’re certain nothing’s broken. It looks like a soft tissue sprain. Her shoulder and paw don’t seem to bother her when we push there, but she whimpers if we touch the ankle area. In older dogs, these kinds of injuries can take longer to heal,” the young male technician explained.
We talked more about her treatment and next steps. I was relieved It was nothing serious and thanked them for seeing her so promptly. They prescribed some pain medicine for inflammation, and two other medications to keep her groggy and moving around less for a week. I waited another 30 minutes before they brought her back out to me, and then Sparkle and I waited together for 15 minutes more while they dispensed her medications. By 9:00 PM we were headed home.
Tuesday, March 22, 2022. The day was uneventful except for the need to give Sparkle her medicine doses. She eagerly chomped down every pill – some of which we had to encase in cheese. Miah decided to ice her ankle and positioned her on the couch with a cold compress Velcroed around her leg. Ears back, eyes wide, she stayed put and waited until he released her. It was kind of cute in a sad way.
I took Magic for our evening walk. He trotted along happily, enjoying being an “only dog” for his walking time. He was getting used to being walked solo, since Sparkle had been on a restricted exercise routine for months now.
When I got home, I gathered my research notes from last night and settled on the couch with my laptop. In typical Lorie-fashion, I transcribed my notes into a colorful spreadsheet. I wanted the best visual representation for my decision-making. I got kind of excited by my thorough, level-headed approach.
Whatever option I chose, I resolved, there would be no stone unturned.
Satisfied with my professional-yet-poignant chart, I converted it to PDF and downloaded a copy to my phone. I texted Childhood-BFF T, and a few other friends in my Flock, “Look what I made!” and sent an image of the file.
I returned to my laptop and opened my Facebook Messenger chat with College-Neighbor-&-Hometown-Classmate E.
“E, can I send you my decision-making pros and cons list for your review? I want to see if you think I’m missing anything in terms of the double mastectomy.”
Moments later, she replied, “Sure!”
I typed back, “I know my situation is slightly diff than yours. Ok.. its fancy formatting because that’s how I do things lol.”
To which, I received her return message, “No problem.” I uploaded and sent the file.
Next, I logged into my health system app and wrote a message to Primary-Care-Provider-Doctor A.
Subject: your thoughts - best surgery option considering my chronic pain history
Message: Hi Dr. A, I know you are busy with so many patients, but I am hoping for just a small amount of your thoughts as I am deciding which surgery to get. Dr. L will not steer me in any direction; I qualify for 2 options. You know me better than all these new doctors. Can you please review this pros/cons doc I wrote and tell me if either option jumps out to you as preferable per what you know about my pain avoidance/suffering avoidance stance?
Childhood-BFF T texted back, as did College-Neighbor-&-Hometown-Classmate E. Both were impressed with my efforts. Neither would point me in any one direction, but Childhood-BFF said it looked like the double mastectomy was winning. College-Neighbor-&-Hometown-Classmate E also pointed out something I hadn't considered as a pro for the double mastectomy - I was young and healthy now, and in the best physical condition to handle a major surgery like this.
I emailed Psychic-Healer K, “I know this is super short notice, but by chance, could you fit me in this week? I am feeling pretty good, but I now have 3 weeks until my surgery, scheduled for Wed April 13th. I have to decide between 2 surgery options. I’m doing research, pros/cons lists, and trying to figure out which option to choose.”
I was going to use facts, friends, and psychic intuition to make my choice, because that's what it felt like the Universe wanted me to do.
Wednesday, March 23, 2022. The next morning, Primary-Care-Provider-Doctor A responded, “Your chart is great what a good way to look at it. From the beginning you were hoping for a mastectomy. Small or large surgery will cause anxiety and pain. One and done! That will give you the most peace of mind. That's my instinct.”
I debated whether it’s appropriate for me to share my chart on this blog. Like my Marketing Plan in Post 5 – Diagnosis & Surgical Oncology Office Visit, I’ve decided to leap into the fear and put it on here. I might change my mind and take it down, but for now, I’m sharing the visual tool I used to make this important decision that would affect my physical body for the rest of this lifetime. Psychic-Healer K replied to my email and was able to fit me in the very next afternoon. She understood the urgency of my needs. I was grateful for the steady flow of everyone’s responsiveness, all working in my favor.
Thursday, March 23, 2022. It was time to visit Cancer-Pain-Rehab-Doctor C at clinic ground zero, Miah’s most hated location. I was the first appointment of her day. (I later learned she likes to reserve that first timeslot for new patients, to give each person plenty of her undivided time.) We waited less than two minutes after getting seated in the exam room. Cancer-Pain-Rehab-Doctor C entered and sat down. She had a slow, calm disposition as she typed her password into the computer and pulled up my medical record. I launched into my chronic pain history and explained I was worried about pain control, and I also didn’t know the best surgery to choose. Cancer-Pain-Rehab-Doctor C was more than prepared for me. She had already reviewed my pros and cons chart from the other day. Because I had emailed it to Primary-Care-Provider-Doctor A, it had been saved in my medical record, so Cancer-Pain-Rehab-Doctor C was able to view it. In addition, she’d reviewed the message I’d sent her the previous week to give her a short breakdown of my situation and why I was coming to see her.
We talked about pain medicine first and settled on a plan. She thought my go-to strong pain medicine would work for this, but I’d need to slightly increase the dose, and potentially take it every 4 hours. She also recommended Narcan be prescribed, in case of overdose. I asked if this was because of the strength of the medicine, and she explained it’s a good idea anytime there are opioids prescribed, even if they are weak ones. I asked about my tramadol and how to switch back to that. She told me to stop the tramadol completely (I had already figured this out), and only take the other medicine, which I might need for 2-3 weeks. But, near the end of those 2-3 weeks, I’d have to taper down to a lower, less frequent dose, and then switch back to tramadol. I asked, “What if I’m still in a lot of pain after 3 weeks?”
“If it gets to be 4-5 weeks and you’re still needing the stronger medicine, we’ll need to work with you to get you off it. We really don’t want patients depending on it much longer than that.”
I made a mental note to be off the strong pain medicine by 3 weeks post-op. I then asked if she could prescribe the medicine. “No, it will need to be your Primary Care Provider,” she said.
I thought this was strange. Primary-Care-Provider Doctor A had referred me to Cancer-Pain-Rehab-Doctor C to take care of my pain management. Clearly, I didn’t understand something about the arrangement. “I’ll type up notes and share the recommended dose and plan with your PCP,” Cancer-Pain-Rehab-Doctor C told me. “If she has any questions, or you find it isn’t treating your pain, I can work with her on figuring something else out.” I decided I’d have to trust the process and hope for the best.
Next, we talked about the surgery itself, and whether I should go with a double mastectomy or lumpectomy followed by radiation. I asked the question Surgical-Oncologist-Doctor L had posed – about which path seemed to cause patients the most difficulty. “They’re both similar in terms of risks for long-term issues,” she said, followed with, “It looks like per your pros and cons chart, you might be leaning toward the double mastectomy.”
She then wanted to examine my upper body and chest, shoulder, and arm strength. I took off my shirt but left my camisole and bra on – she didn’t need me fully unclothed. She remarked how I was in good physical shape, and my muscular swimmer’s upper body would benefit me if I went with the double mastectomy. I asked about my pectus excavatum – would this cause any issues post-mastectomy? “You’ve lived with it your whole life already, I don’t see why it would be a problem,” she answered.
“It seems like for you, the double mastectomy might be a better option,” she concluded, basing this on the more “one-and-done” nature of that choice. She explained I should see an occupational therapist for several months post-surgery to reclaim my shoulder and arm range of motion and help with scar tissue massage. She also told me to start doing daily chest stretches to prepare my muscles for the surgery. After all that, she offered to see me again, post-surgery, in case I needed help with any complications. Miah and I thanked her for such supportive recommendations. We returned to the waiting room where I approached the scheduling receptionist and booked my next appointment for 4 weeks post-surgery.
We drove home and retreated to our separate offices to login on our work computers and resume our normal schedules. At two o’clock, Miah knocked on my door to deliver my coffee. Every afternoon he brews a small amount for his last cup of the day. Since working from home, he’d been including me in this ritual. It was a thoughtful gesture, and I always felt a little happier as I sipped my hot beverage. At 3:50 PM, I logged off my work laptop and switched over to my personal one for my reading with Psychic-Healer K.
With the magic of Zoom, Psychic-Healer K entered my office, ready to connect to my energy. The reading was similar, but different, to the first. The double mastectomy appeared to her as a full, beautiful rose, in perfect bloom. The lumpectomy with radiation was wilted, uncertain, dark. It was obvious what I should do. At the end of the session, she offered me an extra service, at no charge. She would be willing to ground the energy – for everyone and everything involved in my surgery – the surgical oncologist, the anesthesiologist, the nurses, the surgical suite, Miah, me, the hospital, even the drive to the hospital – so everyone was at perfect neutral and in the best possible energetic state for my procedure. I was interested. I hadn’t received energy grounding quite like this before, and I wanted to hit this thing at all angles. It seemed just as relevant planning as pain management.
She asked me to email as much information as I could get – the names of the doctors, nurses, surgical suite number, etc., and said she would set up the space and do the grounding work the night before my surgery. Wow, I felt especially protected. I had a cancer-pain specialist, a surgical oncologist, a primary care provider, and a psychic healer on my team. I also had a whole flock of friends and a loving, caretaker husband. I guess maybe I could manage cancer treatment.
Friday, March 25, 2022. I was going with the double mastectomy. I called the breast center and asked them to relay my choice to Surgical-Oncologist-Doctor L. A couple hours later, Surgical-Oncologist-Doctor L called me. She had received my message and wanted to make sure I knew what I was choosing. I told her I had done extensive research and was confident, explaining I had even made a detailed chart. She pulled up my medical record, found the chart, and exclaimed, “This is very detailed!”
“Ok, I’ll book the double mastectomy. Someone will call you to setup a pre-surgery nurse appointment. You’ll meet with one of our nurses to go through the surgical drain care and everything else you need to know.”
I told her I had my pain management covered and wouldn’t need her to prescribe anything. She said, “That’s fine. I’ll do whatever you need me to do,” which I took as, she would prescribe the medicine I needed at the dose I needed, if necessary. But I wasn’t taking any chances. Primary-Care-Provider-Doctor A knew my background a lot better than her. I would stick with Primary-Care-Provider-Doctor A. I asked if she was going to prescribe antibiotics. “Not unless I have to,” she said.
“So, you don’t prescribe them preventively?” I asked.
“No, we don’t do that,” she said.
Thank goodness. I hate taking antibiotics because I find the stomach irritation so bothersome. I also asked if I needed to remove my nail polish. I felt dumb asking something so minor, but it was relevant to me. I have such dry, brittle nails, and I like to keep them polished. Again, I received the answer I wanted, “No, you don’t have to. We did that years ago, but it’s not necessary anymore.” As trivial as it seemed, that answer provided a huge relief – something I would tell several members of my Flock over the next couple days. At least while I was going through this scary, body-altering procedure, I could keep my pretty, well-manicured nails intact. I already had my next nail appointment booked for the Saturday before surgery and was glad I wouldn’t have to cancel it.
I didn’t have any more questions, so I said goodbye and hung up.
And that was that. Decision done.
End of 10 - Surgical Options