Process Makes Perfect.

In the past 2 weeks, I’ve found out I’m relatively normal! Just a serious genetic mutation and a history of melanoma to get in the way. But otherwise, normal. In medical terms, I’d rather normal, than abnormal. So, normal is feeling pretty good. For a moment, I considered researching how society defines normal, implications for personality and other associated interpretations. But that was a rabbit hole distraction I decided not to pursue. I’m not attached to normal in any other way right now than normal = cancer free.

  • 2nd Genetic Test: Awaiting results next week (with a big diagnosis, a 2nd opinion in our minds is warranted before I consider major surgeries. They were able to test for just the single mutation I tested positive for at the end of May and my out-of-pocket was “only” $475.)
  • Breast MRI to check for breast cancer: Normal
  • Regular Gyno appt: Normal
  • CA125 Blood Test to check for ovarian cancer: Normal
  • Vaginal Ultrasound to check ovaries: Normal
  • Quarterly Skin Cancer Check: Normal

What next? Surgeon authorizations: A process. My primary care physician (PCP) is absolutely fabulous and supportive and available. But with a combo HMO/PPO (POS plan) there is protocol. I’ve researched a bunch of doctors from recommendations over the past month. A lot of emails and conversations and looking for online reviews. It’s a lot of work. And a lot of psychic energy. There are so many women with varying experiences and tragic family histories. I’m realizing that 9 cancers among 5 of us in my immediate family is not so unusual after all. A pretty startling realization, actually. And it’s hard not to carry everyone’s pain. So sometimes, I have to turn off the process. Which means, for all of you who have so generously offered time and introductions, please know, it’s a process. I’ll get to you and your loved ones. And I thank you for your support and patience.

I don’t have cancer so I don’t have an urgency with the process. I am so very fortunate to have some time on my hands. I can be more “perfect” in my doctor choosing while still fitting in my “normal” life of long work days, time with my husband and friends, and exercise and food planning. But it’s hard not to reflect on the fact that with a BRCA mutation, it is a bit like a ticking time bomb. The reality is that I will face a diagnosis of breast and/or ovarian cancer at some point if I don’t take preventative action and I’d like to avoid that possibility. Even with our already and still evolving healthy lifestyle.

So the process continues. I’ve emailed my PCP a list. Luckily, many of the docs I’m researching are on the HMO part of my plan which means less out-of-pocket costs. However, I want to see multiple docs to check for fit– for me, fit = expertise and instills a sense of confidence in me. Some docs are in the same office, others of the same type are in different offices and you can’t get authorizations for two offices in different locations. A process. One surgeon is out of network, but I’m waiting to find out if he’s covered through my PPO. If he is, I’ll probably set up a consult, check for fit and get diagnostic codes. My insurance can help figure out what my out-of-pocket could be– I’m interested in this doc but there’s another with the same specialty that is on my HMO. So, my comfort level in either doc’s results is important aesthetically and monetarily.

What’s the plan? I’m setting up round one of appointments with oncology gynecologists, oncology breast surgeons, and reconstruction plastic surgeons… We’ll ask all of the questions. We’ll get informed. I may feel a fit right away with my first choice doctors, or I may have to continue the process. And then I’ll get closer to deciding next steps.

I don’t want to wait too long. And I’m the kind of person who likes to take care of things and move on. Not to mention, the fact that I’m healthy bodes really really well for my recovery! I’ve read many stories of how difficult and stressful the process is when complicated by a cancer diagnosis and the fear that comes with that. I’m grateful and I feel fortunate that I can take a bit of time to do what feels right. So, onward with the process.

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