My type A personality kicked into high gear. I copied two sets every piece of medical record information I had accumulated since June 1st. I kept a neatly organized copy for myself and the other set was placed into a labeled, two-prong manilla folder. My business card was attached to the front of the folder. This would be Dr. Singhal's copy. (And yes, I am using this doctor's actual name, not some random initial to represent her last name. She saved my life and I'm proud to call her my doctor. You will see I also use my plastic surgeon's last name. He is a professional, talented and exceptionally kind man.)
Her office was in Mountain View, which is about 2 hours south & west of Sacramento. I didn't mind the drive that Friday afternoon. It was the day before my 35th birthday and I couldn't have asked for a better present than to have been given a consultation appointment with this highly esteemed surgical oncologist. As had been requested of me, I brought along the pathology slides from my previous surgeon. Dr. Singhal wanted to have her pathologist personally review the slides and results.
Driver Craig parked the car, we each popped a mint and I applied fresh lipstick. I approached the receptionist's desk and the kind lady asked if she could be of any help.
"I'm here to see Doctor Singhal," I said. Actually, I told her I was there to see Doctor sing gall. She politely informed me it was pronounced like single. Dr. Singhal would be with me shortly. I paid via personal check the $300 consultation fee. My insurance carrier would not cover this consultation, seeing as Dr. Singhal was "out of network".
Meanwhile, a confident and smiling woman of Indian descent walked past me into the office area. Five minutes later, as I sat in the exam room, I realized this woman was the amazing Dr. Singhal.
After introductions and polite, casual small talk, we got down to business. Our discussion covered the entire spectrum of treatment options, concerns, possibilities, etc. She asked me questions and listened to my answers. I asked her questions and she thoroughly, kindly, professionally and warmly offered me answers. She was impressed, I admit, by the manilla folder full of details. She knew I was a type A personality right off the bat. Well, I like to think she was impressed; she just laughed, really.
She did a physical exam and was not impressed by what she found. She shook her head and pulled up the straps of my tank top.
"So, what do you think I should do now?" I asked Dr. Singhal.
"Well, honestly, it's entirely your decision, as it's your body, your life. But, my opinion would be definite mastectomy followed by chemotherapy possibly and hormone therapy," she told me. "My job is to make sure you are alive as long as possible. I'm of the opinion that aggressive treatment is the best way to ensure you are here 40, maybe 50 years from now," she continued.
I agreed. I reiterated to her that my main concern in all this was to be alive to see the kids grow up. I didn't need breasts to do that. I didn't need hair, if it came to that, either. I loved that she was honest, direct and yet, all the while, kind, professional, and quite humorous. She laughed a lot. I felt at ease with her. She agreed that I had been lost in the medical system in my area and it was unfortunate that my unique case hadn't been attended to by more highly trained and specialized doctors.
"Dr. Fazilat, the plastic surgeon, will have his office call you to talk about reconstruction options," she added. (Side note: Dr. Fazilat himself called me that evening. He was incredibly kind, understanding and sympathetic to my situation. I instantly felt as sure of him as I was of Dr. Singhal. I knew I would be in good hands. I mean, really, how many plastic surgeons would call a potential new patient personally, having just finished surgery?)
"Oh, and you should have someone up there take a look at your thyroid," Dr. Singhal mentioned to me. What? My thyroid? Why?
"Didn't anyone tell you? The chest scan you had done showed a few small nodules on your thyroid that should be checked out," she said. Nope, nobody had bothered to mention that to me until now. Thank goodness Dr. Singhal had requested copies of all my test results as well as the pathology slides. Damn, she was thorough!
I knew she was the doctor I wanted and needed to help save my life. She gave me a feeling of peace and comfort. She was going to lead me out of the maze. She would be the captain of my ship. She would be the one who saved my life.
On September 24th, I had a follow-up appointment scheduled with Dr. F. He had no additional information for me, but I had some for him. I handed him the sheet of paper I had printed out that listed the names, contact information and my official request to be treated by Doctors Singhal and Fazilat. He simply shrugged his shoulders and tossed the paper into my medical record file.
"Okay, I'll submit the request, but you should know they are going to deny it," he stated very dismissively. Honestly, I don't think he could have cared one iota less about me, my cancer, my treatment than he did at that moment.
"Why would they deny it?" I naively asked of him.
"They just will. Those doctors are out of network and you could have Dr. L do the mastectomy here," he continued. "So, what are you going to do when they deny it?"
I firmly and repeatedly responded by telling him, "I'm going to fight it until they approve it!"
"That's fine, but they will deny it again," he somewhat proudly told me.
"I'll fight it," I told him. "I will fight it and fight it more until they realize they need to approve this and let me be treated by the doctors I choose and whom I know will give me the best chances of survival! I will fight!"
I was a warrior prepared for battle ... against breast cancer and now against this doctor and insurance company who were standing in my way of being treated. The way I saw it, these doctors had their chance to rid my body of breast cancer and they failed. They failed and left me to wander the medical maze on my own. They had no plan for me, no sense of concern or compassion for this 34-year old, no, wait, now 35-year old, young woman with bilateral breast cancer. Instead, they butchered me in an unnecessary surgery and left cancer in my chest muscle.
Yeah, you'd better believe I was prepared to fight for the best medical treatment I could get. I would fight and fight for my team of Dr. Singhal and Dr. Fazilat. I was a warrior prepared for battle. And battle I did ...
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