All Is Finalised

30^th September 2009

A message had been left on my answer machine to go to the Hospital today. My consultant greeted me with her usual firm hand shake. It was explained that the plastic surgeon was on maternity leave during the 6^th and my appointment was to be shifted for the 16^th for surgery to take place at the Big C hospital. She wanted to apologise in person for the delay. I told her that I was ok with that and what difference would one week make. The facts are the surgery is booked and it has to be done.

At least my consultant took the time out of her busy schedule to speak to me in person. It could have been a letter in the post or a phone call.

The truth is I’ve been busy at the theatre doing costumes. I am trying to get things in order before the operation. I could not stand being at home any longer. Ok I can’t lift anything, but I can sew a few items. It is like nothing has happened not really. I don’t know what I was expecting really. I just hate feeling helpless.

At least I got to complete and drop one of the costumes I took home off.  Yes I was using the sewing machine last night, but it was a straight forward piece to do. The truth is if I keep myself occupied I won’t think about the operation. The four walls of my house are like a cell. Here I can chat nonsense and see faces. Everyone was concerned, but understood my reasoning to keep going.  

Letter from Big C Hospital:

Dear Dr S,

Re: Ms Sarah Mendoza – DOB: **/**/**** NHS Number: *** *** ****

      **, M*** **** Road, Northolt, Middlx, *** ***

Diagnosis: Left breast CA for skin sparing mastectomy plus immediate reconstruction

I saw this 39 year old married lady who works for a children’s theatre who was referred to me by Miss S for consideration of an immediate breast reconstruction following a mastectomy of her left breast. She is currently in 34B on right side and is happy with that. She has diet controlled diabetes and has had two caesarean sections for both pregnancies. She is on no regular medications and the only allergy is to elastoplasts. She is very fit and active and enjoys swimming, running and walking, though does not swim competitively. She is a non-smoker and drinks minimal alcohol. She lives at home with her husband.

On examination of the abdomen there is a c-section scar and some marked striae and not a large amount of abdominal tissue for flap reconstruction. On examination of her back she has very little subcutaneous fat and on examination of buttocks again she has little in the way of soft tissue for breast reconstruction. I had a long discussion with her today about various options. I suggested given her body habitus the only option would be a latissimus dorsi myocutaneous flap to reconstruct her left breast with an implant. She herself has done a lot of research about breast reconstruction and I went through the procedure with her including the risks of the procedure, the operative course, the post-operative course and the recovery. I have explained that we can implant both reconstruction but reconstruction may need to be revised over a course of time. I offered her a second visit to discuss these issues but she is very keen to get on and get her breast cancer treated and therefore declined. I will liaise with Miss S to plan her surgery to be done either here or in the ****** Hospital.

Yours sincerely

Mr H