Preparation

In no particular order:

Make sure you are comfortable with your surgeons and trust them. If you need to get second and third opinions, do it.

One of the things that helped me deal with my fear when facing a 10-12 hour-long surgery was listening to "Preparing for Surgery" by Martin Rossman MD every day for at least 2 weeks prior to my surgery.... and then for several weeks afterwards:
http://www.thehealingmind.org/products/index.php?main_page=product_info&products_id=11

Another was learning everything I could possibly learn--what to expect, how to prepare for what I'd need at home for my recovery, etc--from my doctors and also from patients who had undergone this type of surgery. My surgeon put me in touch with a couple of his patients and that was very helpful.

Physically, you would need to consult with your doctor so that you get an answer tailored to your particular situation.

Bottom line, make lists of questions and don't be afraid to ask them.

Best of luck to you! Preparing for any type of surgery, let alone a surgery that will alter your physical appearance can be overwhelming. You did not mention the type of surgery you will be having, so I am not sure if my answer will be appropriate for you. I had a double mastectomy with tissue expanders. My preparation was simplistic. Picking the right surgeons was of prime importance to me. Once this was done, I communicated to them my anxiety about waking up having a part of me….. for lack of a better word, amputated. I needed to understand exactly what they were going to be doing, and how I would look and feel after the surgery. Fortunately, with a sense of confidence, they were able to explain in detail how the procedures were going to be done which gave me inner strength to put my faith in them. Don’t be afraid to ask questions. I feel nothing is going to take away the thoughts of fear, but I tried to think of the surgery as a positive, not a negative---the cancer was being TAKEN from my body, and in its place, I would have new and improved parts. Perhaps an odd way to think about surgery, but it worked for me. I am a physically fit person already, so recovery was rather easy for me. I did however, ask the doctors what type of exercises they suggest after the surgery. I made sure that I practiced them before the surgery, so I was better able to do them after the surgery. I do wish you all the best for your surgery and a speedy recovery!

Write down your questions, make sure you get all of them addressed and take someone with you. A second set of ears is always helpful! There is no question that when physicians have more in-depth, personalized discussions with their patients and encourage them to take an active role in their health, both doctor and patient feel more confident that they have reached a correct diagnosis and a good treatment path.

A doctor’s approach to the patient is key. Taking the time to examine every piece of a person’s medical history, and then applying his/her expertise to the patient’s particular condition is critical to making the correct diagnosis.

The first piece of advice I would offer a patient is to ask questions, and to keep asking until they’re satisfied with the answers. It’s all too easy to be referred to a specialist and start treatment without having all of your questions answered, or having your doctor ask – and answer – the right questions in the first place.

For example, if you have a test, don't assume that no news is good news. Ask about your results. Also, treatment recommendations based on the latest scientific evidence are available from the National Guidelines Clearinghouse™ at www.guideline.gov. Ask the doctor if your treatment is based on the latest evidence.

A recent study in Israel (http://tinyurl.com/3wehvcw) determined that examining patients and taking a medical history are more useful to hospital doctors in diagnosing patients than high-tech scans. The study showed that patient history alone or history plus a physical exam were most important to a doctor's correct diagnosis in almost 60 percent of cases. When basic tests were included, they were the basis of more than 90 percent of correct diagnoses along with history and exams.

According to Dr. Jerome Groopman, one of the world’s foremost researchers on how doctors think (he’s written the definitive book on it http://tinyurl.com/28pom7), doctors desperately need patients and their families and friends to help them think. Asking questions won’t just make the patient comfortable – it can disrupt a doctor’s thought process and make him think about a case in a way that may save a life.

While we urge patients to be their own advocate, it’s also smart to have a family member or friend with you at doctor’s visits, someone who can help get things done and speak up for you if you can't.

Also, I can’t stress enough the importance of researching and compiling a family medical history. BreastCancer.org reports that a woman’s risk of breast cancer approximately doubles if she has a first-degree relative (mother, sister, or daughter) who has been diagnosed with the same, and about 20-30 percent of women diagnosed with breast cancer have a family history of it. A Cleveland Clinic study (http://tinyurl.com/25azwa8) shows that a family history may be a better predictor of disease than even genetic testing. Find out about your family’s medical history, write it down (the Surgeon General has a good on-line tool to help you do this http://tinyurl.com/a675nl), and make sure your doctor knows about it.

Even if you do have charts dating back to childhood, however, don't assume your physician has digested or will remember everything. Adam Dickler, M.D., a radiation oncologist in Evergreen, Ill., says,"There really isn't enough time. If your doctor flips open your file while entering the exam room, it may be the first time she's looking at it, so be ready with a recap. A full recap.”

Great question, Murray! We would suggest making sure you know why you're going to a specific doctor and what you hope to accomplish at the appointment, and going from there. Our feature article, "The 'Handoff': Your Roadmap to a New Doctor's Care" (http://www.preparedpatientforum.org/organizing/handoff.cfm) offers some tips for planning and navigating a visit to a new doctor's office. The article recommends that patients take these steps:

Bring a list of all your medications, including herbal and over-the-counter remedies, to your first appointment with your new doctor.

Repeat back any instructions your new doctor gives you, to make sure you've understood them correctly.

Ask your doctor to demonstrate the use of any new devices he or she may prescribe for you.

If you have a family member or friend who helps take care of your health, bring them to your appointment.

Before you leave, ask about your next steps. Do you need to make other appointments? Do you need to share any information with your primary care doctor?

There may also be other medical records or information you need or want to have on hand, which you may want to consider ahead of time. There are also some general steps that are good to take before a visit to any doctor's office. Some general resources for preparing for doctors' visits can be found here: http://www.preparedpatientforum.org/patient411/communicate.cfm#Preparing

You may also find it helpful to review our article, "Your Doctor's Office, Demystified," which provides information about the different kinds of medical professionals found in many doctors' offices: http://www.preparedpatientforum.org/organizing/droffice.cfm

Great question, Murray! We would suggest making sure you know why you're going to a specific doctor and what you hope to accomplish at the appointment, and going from there. Our feature article, "The 'Handoff': Your Roadmap to a New Doctor's Care" (http://www.preparedpatientforum.org/organizing/handoff.cfm) offers some tips for planning and navigating a visit to a new doctor's office. The article recommends that patients take these steps:

Bring a list of all your medications, including herbal and over-the-counter remedies, to your first appointment with your new doctor.

Repeat back any instructions your new doctor gives you, to make sure you've understood them correctly.

Ask your doctor to demonstrate the use of any new devices he or she may prescribe for you.

If you have a family member or friend who helps take care of your health, bring them to your appointment.

Before you leave, ask about your next steps. Do you need to make other appointments? Do you need to share any information with your primary care doctor?

There may also be other medical records or information you need or want to have on hand, which you may want to consider ahead of time. There are also some general steps that are good to take before a visit to any doctor's office. Some general resources for preparing for doctors' visits can be found here: http://www.preparedpatientforum.org/patient411/communicate.cfm#Preparing

You may also find it helpful to review our article, "Your Doctor's Office, Demystified," which provides information about the different kinds of medical professionals found in many doctors' offices: http://www.preparedpatientforum.org/organizing/droffice.cfm

1.Office Contact information: Obtain phone and fax numbers, office hours, web address, e-mail policy, hours of operation.

2.Office Location: Get the address, locate public transportation, and learn about parking options including whether and how much you have to pay to park or if there is free parking (perhaps a parking ticket will need to be stamped by the doctor's office).

3.Making Appointments: What are the hours to call for appointments? Are there no-show policies? Can they provide estimates of waiting times (both for an appointment and when waiting to see the doctor after arriving)?

4.Medical record: Ask about any instructions for bringing a summary of your medical history, current health status and recent test results or if referral documentation is needed (especially important for specialists and testing).

5.Special needs: Inquire if and how the provider can accommodate any unique or special needs (such as physical navigation, hearing or visual impairments, translation services, etc.) and how to arrange for assistance if needed.

6.Payment: Inquire about the health insurance documentation and/or payment process required for receiving care. Get the contact information for staff administrator or the billing manager.

7.Tests and test results: Request a description of what types of tests are commonly conducted in the practice, by an external provider (with names and contact numbers for commonly used laboratories and radiology facilities), and the practice policy about patient notification of test results.

8.After-hours and emergency care: Inquire about when to seek, who to call and where to go for after-hours and emergency care.

9.Prescriptions: Obtain instructions for securing prescription refills, reporting adverse side effects and decisions to discontinue medication or change any agreed-upon treatment plans.

10.Care companion: Notify your physician group if you would like to bring a companion along with you to visits.

For more information check out the Prepared Patient 411
ttp://www.preparedpatientforum.org/patient411 1.Office Contact information: Obtain phone and fax numbers, office hours, web address, e-mail policy, hours of operation.

2.Office Location: Get the address, locate public transportation, and learn about parking options including whether and how much you have to pay to park or if there is free parking (perhaps a parking ticket will need to be stamped by the doctor's office).

3.Making Appointments: What are the hours to call for appointments? Are there no-show policies? Can they provide estimates of waiting times (both for an appointment and when waiting to see the doctor after arriving)?

4.Medical record: Ask about any instructions for bringing a summary of your medical history, current health status and recent test results or if referral documentation is needed (especially important for specialists and testing).

5.Special needs: Inquire if and how the provider can accommodate any unique or special needs (such as physical navigation, hearing or visual impairments, translation services, etc.) and how to arrange for assistance if needed.

6.Payment: Inquire about the health insurance documentation and/or payment process required for receiving care. Get the contact information for staff administrator or the billing manager.

7.Tests and test results: Request a description of what types of tests are commonly conducted in the practice, by an external provider (with names and contact numbers for commonly used laboratories and radiology facilities), and the practice policy about patient notification of test results.

8.After-hours and emergency care: Inquire about when to seek, who to call and where to go for after-hours and emergency care.

9.Prescriptions: Obtain instructions for securing prescription refills, reporting adverse side effects and decisions to discontinue medication or change any agreed-upon treatment plans.

10.Care companion: Notify your physician group if you would like to bring a companion along with you to visits.

For more information check out the Prepared Patient 411
ttp://www.preparedpatientforum.org/patient411

If there is just one piece of advice I can give you, it is to always have an advocate with you at appointments...a spouse, friend, relative or a coach. When faced with a cancer dianosis even the most brilliant and medically knowledgable person can become overwhelmed with the information given.
Today cancer patients have many options. It is critical that you find the best treatment plan and team for you and your cancer. I have written a few blogs on this and if you can, please view:
http://elynjacobs.blogspot.com/2011/05/empowerment-is-key-to-successful.html
http://elynjacobs.blogspot.com/2011/05/cancer-find-right-team.html The first thing that needs to happen is a series of tests and analyses, and potentially biopsy and surgery to learn more about the breast cancer. Breast cancer is different for everyone, and as much information as possible must be gathered in order to determine treatment options. These tests likely will take a week or two to perform and analyze the results. In the meantime, do whatever works for you to relax and not worry, whether that is pampering yourself, taking a trip, exercising, shopping, etc.

When you receive the results of the tests, make sure that you have copies of all your medical records (mammograms, test results and pathology slides, etc.) so you can have them for future consultations and appointments. You can get this information at any time, all you need to do is ask for it.

It is also recommended that you get a second opinion, or even a third or fourth, to help you feel more comfortable with your options. This will also help you to begin selecting your medical team. You will get a feel for the physicians that are the best fit for you and that will listen and spend time with you.

After you evaluate the test results and discuss your options with your medical team, the next step will be to decide on your treatment plan. The good news is that there will more than likely be quite a few options to choose from. There will be a lot of information to understand. The medical team and your personal support team will be helpful during this process. Make sure to ask a lot of questions.

Breathe, that's the first thing. Remember, your cancer has likely been growing for quite some time, so it is important not to rush when making decisions as to treatment.
Tanya is right, you must bring along an advocate, it is far too much to expect to process all that is said to you. Be sure to bring along a list of questions and do not leave if these questions are not answered. Be prepared to fire a doctor if you do not feel comfortable with his recommendations or personality. Please, get a second opinon, if nothing else, hearing the same information twice may make it easier to digest the treatment plan. Remember, it's your body, your life and there is life after cancer; find the team that is best for you and your cancer. I'd like to share with you a blog I posted:
http://elynjacobs.blogspot.com/2011/05/cancer-find-right-team.html" target=_blank>http://elynjacobs.blogspot.com/2011/05/cancer-find-right-team.html
To view another great post on this topic, please view:
http://bit.ly/mu0LVB Breathe, that's the first thing. Remember, your cancer has likely been growing for quite some time, so it is important not to rush when making decisions as to treatment.
Tanya is right, you must bring along an advocate, it is far too much to expect to process all that is said to you. Be sure to bring along a list of questions and do not leave if these questions are not answered. Be prepared to fire a doctor if you do not feel comfortable with his recommendations or personality. Please, get a second opinon, if nothing else, hearing the same information twice may make it easier to digest the treatment plan. Remember, it's your body, your life and there is life after cancer; find the team that is best for you and your cancer. I'd like to share with you a blog I posted:
http://elynjacobs.blogspot.com/2011/05/cancer-find-right-team.html" target=_blank>http://elynjacobs.blogspot.com/2011/05/cancer-find-right-team.html
To view another great post on this topic, please view:
http://bit.ly/mu0LVB