Saturday, December 1, 2007

Dr. Rimmer

I met with Dr. Rimmer yesterday. It was the last time I will meet with him before the surgery. In fact, it was only the 3rd time I have met with him, ever. The first time being when I was just coming in for the first time with a suspect mammogram; the 2nd time after the first biopsy came back positive. I have spoken with him a few times on the phone, though, and he told me that I could come back anytime before the surgery if I felt I needed to, without an appointment.

The office was a bit crowded and harried on a Friday afternoon, but Dr. Rimmer was patient and answered all of my questions. Even though I knew the answers, I needed to hear the answers from him. Again I wanted to know why he couldn’t do the 2 lumpectomies with radiation and again he told me that I would end up with a deformed breast that I would never be happy with. He all but implied that he simply would not do it. I wanted to know if he could preserve the nipple area, and yes, he could, but I would have no feeling there and it is possible that the ductal in situ carcinoma could have spread to that area.

He showed me where and how he would cut across my breast and lymph nodes, and told me that he would use the “skin preserving” technique so that when Dr. Lickstein puts in the “expander”, I will start out with a little mound of a breast, rather than being totally flat chested.

He has a nice style for a man who cuts off women’s breasts.

His hands are warm and he unabashedly touches – touches your breasts, your hands, puts his arm around you. Ordinarily I would find this a bit off-putting, but in this situation I find it somewhat reassuring.

I had been a bit confused about the type of reconstruction I would be having – silicon implants rather than the more complicated “trans-flap” surgery where skin and tissue is moved from the abdomen to the breast. They make an effort to not influence your decision and just give you the facts, but I saw Dr. Rimmer wince when I mentioned the abdominal surgery, and the nurse later told me that she felt the expander/implant technique was a good choice.

Dr. Rimmer says that I am going into the surgery with good prospects – the DISC (ductal in situ carcinoma) is a larger area, but has supposedly not reached the invasive stage; the invasive stage cancer is small. It is possible that the lymph nodes will not have been affected.

Finally, the nurse made the final arrangements with the hospital. The mastectomy will be done at 9:30AM with the plastic surgery phase following at 11AM. Hearing these times made it all a bit more real, like this is really going to happen. I’m still scared but am getting better I think.

Next week I go to get the blood tests, chest x-rays etc. that they need before surgery.