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So, you want a second opinion??


Recently I had an abnormal test result come back.  I’ll withhold the details, so those who are squeamish don’t stop reading.  Suffice to say it is a test that only women need to have done, it is done as an early detection test for cancer, and no woman enjoys it.

The abnormal result is not one you want, and means you need further tests to confirm the findings, to work out if any treatment is needed and importantly to make sure there is no cancer.  So, my fabulous GP, Penny, did a referral and off I toddled to a surgeon for more tests.

In the surgeon’s office the additional tests undertaken where inconclusive, that is, there was nothing bad found but he also couldn’t see all the bits he needed to be able to see to say that everything was definitely OK.  His recommendation at this stage was a very reasonable one, and one that many surgeons in the same position would have given.  The recommendation was to do a “biopsy’ and send it off to the lab for further analysis.  To call this recommendation a “biopsy”, somewhat underplays the procedure.  It kind of makes you think of just a little sample of tissue.  But no, this was 3-5cm long by 0.5 cm deep, bloody big “biopsy”.  That’s not a biopsy in my books, that’s removal of almost an entire organ.  It meant I needed admission to hospital, a general anaesthetic and time off to recover post procedure.

I knew the risks of the abnormal cells turning into cancer, IF they were there, and I knew I didn’t want cancer.  I therefore agreed to the procedure but made the booking date long enough in the future (6 weeks), so that I could do some research and think about my options.

From here I read around the issue.  I’m very lucky that working in this area I have access to a lot of information.  I am also fortunate that I can understand and interpret medical information.  However, the more I read, the less happy I was with the bloody big “biopsy” option.  I wanted to find the least invasive way I could to get a diagnosis BEFORE I had to have surgery, not have the surgery to get a diagnosis.  Surely, I thought, in this day and age that should be possible?

Again, I am thankful for knowing health professionals who specialise in this area, and I could make a quick phone call and pick their brains.  I got more information, and this really helped me to work out what I wanted to do.  I wanted a second opinion.

I sent an email to my amazing GP, Penny, explaining why I wasn’t comfortable with the original recommendation and asking for another referral for a second opinion from a specialist who was highly skilled in this area of medicine.  Penny did not hesitate; the referral was sent through within the hour.  There was no making me feel guilty, no questioning my thought processes, no defending the recommendations of the surgeon.

So now I am off for my second opinion.  More tests, and this surgeon, because he specialises in more difficult cases was able to see all the bits he needed to see.  Unfortunately, though, some of the bits he could see looked abnormal, so multiple biopsies were sent off to the lab.  These biopsies though were just little samples of tissue and not the bloody big “biopsy” originally recommended.  The biopsy results were not so great, and it seemed I would need to have surgery.

The interesting thing though was the surgery which was now being recommended was in a different area to the original recommendation.  This meant had I gone with the first recommendation I would have had a bloody big “biopsy” of a normal area, and the abnormal area would have been left behind….with the potential for cancer to develop.  That would not have been a great outcome in my books.

I now had a choice of having the surgery I needed in a hospital under general anaesthetic or in the clinic rooms under local anaesthetic.  Of course, I opted for the clinic rooms and local anaesthetic.  When I said “I have discharged against medical advice twice and own a home health service.  You can pretty safely assume I will do almost anything to avoid being admitted to hospital,” the surgeon laughed and laughed and asked if he could write that in my notes!

A booking was made, and I was comfortable with this decision.  A week later I am at the clinic for surgery.  However, when the surgeon goes to perform the procedure the abnormal area has disappeared.  My little old immune system had kicked in and the abnormal cells had vanished!!

Yay immune system.  Yay (reasonably) healthy eating.  Yay yin yoga. Yay meditation. Yay me.

He took some of the small kind of biopsies again anyway, just to make sure all was good, but the actual surgical procedure was cancelled. It was lucky I hadn’t opted for the hospital option instead, as by the time they worked out I didn’t need the surgical procedure I would have already been anaesthetised.

I had gone from needing a rather invasive procedure involving a bloody big “biopsy”, hospital admission and a general anaesthetic to needing NO TREATMENT!  I cannot tell you how damn ecstatic I am that I got that second opinion.  How glad I am I trusted my instincts.  How glad I am that I knew my body well.  How glad I am that my GP supported me.

I also know how lucky I am.  Not everyone has the level of access to medical information that I have.  Not everyone has the same level of understanding of health issues that I have.  Not everyone feels brave enough to ask for a second opinion. Sometimes, they are even made to feel guilty for daring to consider it.

At a time when you are worried or sick, it can be difficult to find your voice and ask for a second opinion, even if you want one.  Cancer patients find it especially difficult, as they fear that any delays may decrease their chance of survival.  But I have sat in many 100s of “team meetings” where patients treatment options are discussed.  I know that sometimes there are different opinions on what the recommended option is.  It is not always black and white, there can be a good deal of grey.

So, I encourage you to speak up, ask questions, be strong, make decisions that you and your family are comfortable with.  ASK FOR A SECOND OPINION, IF YOU FEEL YOU NEED ONE.

Lastly, big shout out to all the wonderful GPs who support their patients in getting a second opinion, especially my GP, Penny.  You rock Penny.  And another shout out to all the Specialists who see second opinion patients (because not all do).  Your sensitivity and fairness are appreciated.

Julie

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