Thursday, February 5, 2009

THE BREAST PSYCHOLOGIST



I went to see the 'breast psychologist', Dr Karen Applebaum today. I had to see Karen so she can write an assessment of my mental state prior to surgery. This is for medical aid and legal purposes.

I was expecting her to be quite antagonistic towards me because more allopathic medicine focused practitioners generally are when they find out I studied homeopathy.

I explained my journey from diagnosis, breast duct removal, sentinel lymph node biopsy, core needle biopsy, my estrogen history, Chinese herbal medicine, supplements, trip to Germany to see if another country held a form of treatment that South Africa did not, diet, medical intuitive, energy healer, Neuro Linguistic Programming, Psych-K mind programming, positive affirmations, Caroline Myss, oxygen + mineral +vitamin drips, live blood analysis, to now. Shoo!

I must admit that just seeing all these practitioners saps my energy!

At the end of all of this, Karen said my cancer could just be random with no specific cause, and certainly not something I have done to get it.

She said I am a 'driver' type meaning I like to find the cause and be part of the healing versus a 'passenger' type who just believes it just happened to them and does what the doctor tells them.

Karen questioned me a great deal about why I have opted to have a double mastectomy and not a single. She said if someone has DCIS in one breast, the chances of the other breast getting it are 1 in 8. All women have a 1 in 8 chance of getting breast cancer. In the case of DCIS, my healthy breast has the same chance as any other woman of getting breast cancer ie. 1 in 8.

If the cancer was LCIS (lobular carcinoma in situ) meaning it had spread to the breast lobules as well, my healthy breast would have a higher chance of getting LCIS in the future. This would be more motivation for a double mastectomy. But I don't have LCIS according to the needle biopsy.

I told Karen that I had thought about this long and hard, spoken to many people, including women who had had mastectomies for breast cancer. I want to have a double mastectomy for safety and cosmetic reasons.

The chance of breast cancer returning after a double mastectomy is 1%. I don't not want this cancer to recur. I am not a candidate for radiation or chemotherapy.

Karen then tried to convince me to have just the right/affected breast removed. After a certain time period, I could then decide whether or not I wanted to do the other breast. This doesn't appeal to me because I would have to go for 2 anesthetics, 2 sets of post surgery antibiotics (and I hallucinate on antibiotics!), 2 sets of post surgery down time and recovery, 2 separate breast drains (to drain liquid left in the wound after surgery) for 7 days each, and the process would be too drawn out. I want to get on with my life!

The plastic surgeon is better able to reconstruct and achieve symmetry, shape and sizes similarities if done together. Splitting the op may also cost more in the long run. Also, the medical aid is more likely to pay if both breasts are done together. If the op is split, the medical aid may see the 2nd breast as purely cosmetic.

The next issue we spoke about was about me being upset that I could not have the mastectomy done in the luteal phase of the menstrual cycle. Studies done in the USA are showing that there is a higher chance of recurrence of the breast cancer if the operation is done from 1-14 of the cycle.

Seeing as I am doing a double mastectomy as a precaution, I don't want to have opted for this radical approach only for it to be negated by having the surgery at the incorrect time in my cycle.

Both the breast surgeon and the plastic surgeon are fully booked until the time I enter the first half of my cycle again. I am now faced with the question: do I wait until the following month's luteal phase (3.3.09) or do I request to be slotted in during the luteal phase of this cycle (9 + 10.2.09) instead of the date booked (17.2.09).

Karen is going to investigate moving my surgery date a week earlier, as well as a single vs double mastectomy.

I told her I know am one of those pesky patients but what if this new research has just filtered down to mainstream circles yet?? These kinds of things need pioneers to push them towards mainstream.

We parted on very good terms, having both enjoyed each other's view points. I expressed that I felt the medical team of breast surgeon, plastic surgeon, radiologist, mammographer, pathologist, and psychologist, needed a lifestyle/alternative/complimentary medicine opinion as well.

I believe women with breast cancer should have these lifestyle and complimentary medicine options made available to them so they don't just see surgery, radiation and chemo as the start and end of their treatment.



Links for the research about surgery in the luteal phase of the menstrual cycle:

http://www.ncbi.nlm.nih.gov/pubmed/8907825?dopt=Abstract

http://www.cbcrp.org/RESEARCH/PageGrant.asp?grant_id=241

http://www.pslgroup.com/dg/7c31a.htm

http://www.breastcancerchoices.org/FAQSurgery.html

http://www.scienceblog.com/community/older/1998/B/199801344.html

LiveHeidi

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