Dr. Knockout

I decided I wanted a new OB/GYN in this post-cancer period.  Since it is inadvisable for me to have more children (since my cancer was hormone positive), my new OB/GYN will only be my GYN.

Upon hearing this news initially, Brad and I had the same reaction.  “It’s okay; we just want to raise the two beauties we already have.”

Up until March 2012, I was satisfied with my OB/GYN practice, of which I’d been a patient for 10 years.  However.  They did miss my breast cancer, which the doctors believe started between the ages of 22 and 27.  In hindsight, and as a super-duper-educated about breast cancer person, I had some (a few) warning signs and I think that someone along the way should have said, “You should have a mammogram (or MRI) just to be sure.”  So, I wanted a clean start in the OB/GYN department.  I wouldn’t say I have animosity or bitterness towards my old practice, but I am ready to start fresh.

I asked Dr. Wonderful for an OB/GYN recommendation, and he did not have a go-to name, which I found a little surprising.

I asked Dr. Awesome, and she paused to give it some honest reflection.  Then she said, “For you, I think Dr. Knockout would be a great fit.”  I nodded, happy to have a name, and Dr. Awesome continued, “She’ll give you a really thorough assessment and look at the whole picture.”

I had my first appointment with Dr. Knockout this week, and I liked her a LOT.  Dr. Awesome was absolutely right: she’s the perfect OB/GYN for me.  We spent about 30 minutes together, and Dr. Knockout did look at the whole picture.  On one side there is my normal, healthy 32-year-old self (who delivers 8 lb. 9 oz. and 10 lb. 8 oz. babies in under five minutes thank-you-very-much.)  On the other side there is the hairy scary cancer at a young age.  It’s a big picture to wrap one’s brain around, and I definitely like doctors who take both sides into consideration when making medical decisions.

After we finished my medical history and exam, it became even more apparent as to why Dr. Awesome had matched us.  Dr. Knockout told me that she is BRCA positive.

BRCA Education:  BRCA stands for Breast Cancer Genes.  (In the breast cancer world, we refer to them as the “bracka” genes.)  At this point in history there have been two genes that have been proven to have a correlation with the development of breast cancer (and ovarian cancer, incidentally).  BRCA1 is the first breast cancer gene that was identified, BRCA2 is the second gene identified.  Women who have strong family history and/or other high risk factors (age, etc.) are often BRCA tested to see if they have one of these genes.  Whether positive or negative, the results are insightful in making decisions about current and future medical procedures.  If you are BRCA1 or BRCA2 positive (meaning you have one of the genes), then you have up to an 80% chance of developing breast cancer in your lifetime.  All of the breast surgeons I know recommend prophylactic mastectomies for patients that are BRCA positive because of the high risk: if you don’t have breasts, you can’t get breast cancer.

Dr. Knockout went on to tell me her story.  Based on family history, she consulted Dr. Awesome right after she finished her med school residency, and she opted for prophylactic mastectomies based on her family history alone.  Later she found out she was BRCA positive, and says of the mastectomies, “It was the best medical decision I ever made for myself.”  Further, because of the associated risk of BRCA and ovarian cancer, she also had prophylactic oophorectomies (ovaries removed), but she waited until after she was done having her own children to have that invasive procedure done.

I was able to ask her questions about all of it, and I loved that she was able to give me both medical and personal experience when she was giving her answers.  She developed a plan of care for me, and, while it is pretty basic, it does include increased monitoring of my ovaries.  I am BRCA negative, but given my young age at diagnosis, she feels it would be prudent to keep an eye on the whole picture.  Like I said, I’m a fan of the whole picture and being really thorough.

I feel so blessed that I am constantly wowed by these doctors and their treatment.  I’m even more impressed that when I left Dr. Knockout’s office, I felt like I’d just had coffee with a new friend.  “She gets me,” I thought.  And she opened the door to herself enough for me to say, “I like her.”  Angels on earth.  Gifted healers.  Love these doctors.