Miscellaneous notes from Mom Fabjance

I am so proud of the way Judy has investigated all of her options, weighed her choices, recognized her needs, and made her decisions. This is a strange & frightening new territory she is exploring which use a foreign language all it's own. The process she has used and is using to maneuver her way through it has been impressive.

She came full circle on the reconstruction issue and decided on the implants rather than on using her own tissue. The reasons that led her to this choice were: 1) The reconstruction process will be started immediately although it will be many months before the finished product is seen. 2) The incision to her abdomen if she were to use her own tissue would prevent her from lifting Daphne and holding Daphne on her lap during the healing process. 3) Using her own tissue would leave her with a very large abdominal scar. I think her friend Elizabeth's insights helped her when she commented that it sounded like she would be damaging one part of her body to make another part of her body better.

She decided to stay with the first plastic surgeon, even though personality wise he was definitely not her favorite. Choosing the second plastic surgeon who was on staff at another hospital would have required finding another general surgeon at this same hospital, which would have slowed down the whole process. Also she has been assured by many people (people ranging from the Oncologist to previous patients of his) that the first plastic surgeon has excellent surgical skills with good outcomes. He also is in her insurance network where the second plastic surgeon was not, so financially he is a better option (which wouldn't matter if he were not a good surgeon).

We were initially very concerned about the late date of the surgery, given the fact that she had been told by the general surgeon and by the oncologist that she needed to have her surgery by this week. After talking with the Breast Health Specialist and the General Surgeon at Good Shepherd, we were assured that there is no danger in waiting until 12/23. They always give patients a target deadline because if they didn't, people would delay indefinitely making decisions and arranging surgery. Since Judy's tumor is hormone receptor positive, this means that is a less aggressive tumor and therefore more slow to grow and spread.

The genetic testing has been put on hold for now since the company that performs the test (and there is only one company), requires an advance payment of $1600.00 before they run the test. This $1600.00 is equal to Judy's deductible of $1300 + $300 which is the portion of the test (after the deductible) which her insurance does not pay. She decided to wait until her 2009 deductible has been met, which should happen some time in Jan or Feb after radiation therapy/chemo are started. She needs to have the genetic testing done, but the results will not impact anything immediately, so she can wait.