Sunday, March 22, 2009

2 Years - Part I

Two years ago I was diagnosed with breast cancer. Three days ago I went for my two year scan.

It was a lesson in the benefits of private healthcare, which I was lucky enough to be on at the time of diagnosis, over the disadvantages of the unwieldy, creaking old behemoth that is our National Health Service.

The breast specialist who originally diagnosed me (and went on to operate on and treat me), Professor Kefah Mokbel, also happens to have an NHS clinic he runs at St Georges Hospital in Tooting. Which also happens to be just down the road from where my flat is in Earlsfield.

So when I discussed with him the prospect of how to retain some continuity in my follow up care (not essential but beneficial - as understanding the difference between the pre and post operative breast state is quite important) he said he'd be very happy to see me at his NHS clinic at this hospital. All I needed to do once I relinquised the private healtcare ticket through my job at DCH, was to get my GP to refer me to him at said clinic about two months before i wanted the appointment.

I had last year's 'one year' scan on March 19th, and passed with flying colours, getting all the scans (mammogram, ultrasound), blood tests, and clinical exams (a quick prod and a grope) done the same afternoon with the consultation and results delivered personally by the Professor moments after my ultrasound.

So my two year scan was a bit of a letdown.

Firstly, despite getting my doctor to refer me all the way back in January, having booked my March 16th flight home from Uganda about a year ago, the hospital made noises about 'not necessarily' being able to give me an appointment when I needed and wanted one.

My father then took on the phone campaign on my behalf to save me from bankruptcy caused by excessive phone calls between East Africa and SW19, speaking to a man named Igor (yes, really) and was given an appointment time of 3pm and told I would definitely get all my scans done the same day, but, just to note, the Professor would himself not be there.

Now, I don't begrudge the man a holiday, but it suddenly seemed rather silly that I had constructed this delicately balanced plan for the continuity in my own personal healthcare and yet events had conspired against me to make this effort entirely redundant.

Ah well, at least i'd get seen, scanned, and given an answer.

Or so I thought.

I got seen, got a clinical, got a broad thumbs up but was sent to radiology with a yellow form to get the mammogram appointment. When I was bold enough to suggest I may want to be seen the same day a lady who clearly spent more on cigarettes than she did on shampoo nasally intoned "We don't do afternoon appointments".

But lo, a radiologist took pity on me and an afternoon appointment was obtained there and then.

And as my left boob was squeezed between two perspex plates, I was advised by the radiologist that the doctor would write to me with the results of today's mammogram, but if I hadn't heard anything within a month, I should get in touch.

A month?

Apparently it takes a week to report the scan (I presume this means look at the films and enter the results into a computer), another week to dictate the letter to the patient, and another two weeks to allow the British Postal System time to find its arse from its elbow.

Thankfully my doctor knew I was flying back to Uganda on 1st April and advised me to call her next Wednesday between 1-2pm.

But then there's the Ultrasound. Not something they normally do in NHS follow ups apparently, but something I was very clear was instrumental in my original diagnosis and was used in follow up scans when i was private. Try as I might, I still can't see any sign of a 'mass' in my original mammogram from 29th March 2007, but I can't miss the reading of the ultrasound - it's a super-obvious massive black hole, which sounds more like a title for a Muse album.

But I have a bit of thickened tissue, 99.9% likely to be scar tissue from the radiotherapy, just under the original tumour bed area which I pointed out to the Doctor. Apparently it's nothing to worry about, but it does give me permission to badger them into giving me an Ultrasound. But this could have either have been next Wednesday, when I would be in the middle of a relaxed week at my parents about 150 miles west of the hospital, or on the Wednesday morning of the day we fly back to Uganda.

So I gamefully opted for the day we fly back. Which also means I get to see the Professor who will be back by then. Which will be nice. A friendly face.

So, this is follow up in stages. I have one set of thumbs up on the physical, am awaiting the mammogram results (due next week) and then will be going in for the final piece of the puzzle come the day I'm due to go home. Of course, going home will be a damn sight harder to do if the result is not a good one, but it's highly unlikely.

Either way, it makes me all extremely glad I had private healthcare when it actually mattered. Way back then, I was diagnosed within nine hours of visiting my GP with a suspicious lump, and operated on a mere 48 hours later. I was in chemo before most people would have got their written mammogram results.

And for that, I will always be thankful.

God bless Standard Life.


Dr Jude said...

Good luck with the ultrasound - hope it goes smoothly and swimmingly. It's amazing how the same hospital can do something in an afternoon when you're on private health care and take a month otherwise. The implications of that never cease to astound me. So much for hoping a similar sort of "socialist" system could ever work here. On the other hand, I've been in and out of the breast center here, for no apparent reason at all. Maybe they just like to take money off my insurance company??

Anne-Marie Weeden said...

Hey hon, sorry to hear you have health professionals manhandling your assets as well - it's never fun - even if there is no apparent reason (and lets hope it remains that way). I hear you guys are having a tough time with all the fall out - saw Dave last night and he updated me - been meaning to get to your blogs for a while and now feel v v v bad for not being up to date. Hope the visa shenanigans improve, and long may your assets remain merely a reason for insurance claims...