Mixed feelings after first consultation with surgeon

[Marla13]

Hi lovely ladies-I am in two minds about my choice of hospital (note: not surgeon per-se).

 

I am sure I am not unique in that I started off on the NHS-had 2 consults then (pre-MRI, and post MRI) but moved to private once I chose the surgeon I wanted to have operate on me (they work at both the NHS hospital & the private one).

 

So yesterday was my 1st appt. with the surgeon at their private hospital (I saw their colleague on the NHS but they are all part of one team). So this was my first appt. with my operating surgeon. 

 

I didn’t come away from my appt. yesterday having learned anything new-it felt it was much more of a meet & greet and my whole experience felt disappointing for a few reasons. 

 

The hospital itself (a private one-one I’ve not had treatment at before) felt chaotic. Specifically the BC floor-when I arrived, befor I even sat down, the BC nurse came out of nowhere and introduced herself to me and started chatting away, when all I really wanted to do was just sit down and gather myself after a long journey to get there and difficulty finding the place. I *was* admittedly in a “faf” when I arrived. I saw the consultant which was all fine, and then the nurse took me into a small waiting room after my consultation, gave me some more booklets (I had been given some on the NHS), the phone # for the plastic surgeon (I am having a DIEP) and gave me more info. re-what questions I should ask re-cost for my insurance company, etc. She then left me in the room and said she’d be back…20 mins. later she returned, apologizing for taking long-she went back into clinic! Presumably with another patient. It felt so “conveyor belt” like and I actually chose to go private because I thought it would be a bit more personal, etc.

I actually found the whole experience at my NHS hospital more “calming” and I don’t know about you ladies, but “calm” is what I need right now. I know this is going to sound “personal” and it’s not meant to, but the BC nurse speaks very quickly and it feels to me she is always in a rush. This isn’t calming at all:). 

 

So a concern of mine is “what will the experience be like on the ward once I’ve had my operation”? Will it be as chaotic? I know that when we have treatment on the NHS we don’t get to “choose” and once we committ to a private facility we don’t either, but I’m sure I’m not alone here in thinking “is this the best BC nurse for me”? given the important role they will be playing in my treatment. Of course, clinical skill is more important than “manner” but to be honest, I’ve not known her long enough to comment on skill. It would be something else to say “she amazing at what she does but just doesn’t have a good beside manner” but I don’t know how amazing she is cause it was only my 1st appt. So that’s that issue:). And as a preface I’d like to say that I am fully aware I may be judging prematurely, but it was my first appointment and this is how I felt coming away from it. 

 

This is not my first hospital experience as I’ve had 3 surgeries in the past (not BC but all three were done by the same consultant, at 3 other private hospitals) and all three were + experiences…my consultant (same one each time) used to see me at his consulting rooms-separate from the hospital…just me and him-no nurses in the room…it felt more personal. My experience of BC so far is that you are *never* alone with your consultant. Why is this? I don’t feel I need to have a nurse with me. Am I alone in feeling this way? 

 

It feels much more (with BC) that they throw info. at you but don’t have much time to go through your Q’s with you. Also, with the other procedure I’ve had (3 times)…my consultant would show me my scan results/on the screen and show me the “X” on the scan that he was going to remove. He showed me stuff-he made sure I saw what the abnormality was, etc. Re-my BC…I’ve not seen my MRI results-the only imaging/scans I have been shown were by the very first screening mammographer (at a separate location altogether)-she showed me my cancer on her computer-she said “you’re an intelligent lady so here…have a look”-she could tell I was interested and wanted to see. And this is how I feel about the MRI-I want to see what’s going on! I am the kind of patient who wants all of the clinical info and I want it explained to me. Surely I am not alone here:). 

 

I want someone to sit with me and show me my scans/MRI’s before they start carving away on my boob:)!

 

Another Q. I have is: *when* will my consultant sit me down and go through what will happen at surgery? I assume I will have a pre-op appt? Presumably yesterday was not my pre-op appointment?  

 

I suppose because I’m now paying privately (through my insurance) I am questioning the purpose of the appt. yesterday…I assumed I’d have come away with some new info. 

 

All I’ve come away with is next steps: contact the plastic surgeon and make an appt. to see them, find out costs and then contact my insurance co. I could have done that on the phone:).

 

I’d value some feedback as to how important are these concerns of mine or should I just tolerate the issues I’m having because I have chosen this particular surgeon.

 

xxxxx

 

[pinklily]

Hello marla13
I’m sorry to hear you had a bit of a rough experience so far, from my own experience so far, having an lumpectomy and three lymph nodes removed on the NHS, my experience has not been much better than yours.
Most of what I’ve learned about the operation and advise, has been from the wonderful people on this site and the internet. In fact, I would go so far as to say, my bcn, is as much use as a chocolate teapot.
She has only been in once with me when I was first diagnosed and saw the consultant, the other times it was someone else and she failed to confirm I had an infection, even though I had pus coming out from the wound under my arm.
I can only say that my friend has also gone private, through her husband company insurance and she has not had reason to complain at all.
Maybe you could phone someone and ask for a different nurse, or just tell your consultants secretary, you are not happy with the lack of information.
I’m sure there will be other ladies who will be able to give you better advice than me, but after 12 other major ops and now breast cancer, I don’t depend on any of the medical body to keep me informed or give me info, I just do loads of research and ask others in my position for help and advice.
Hope you get things sorted, this journey is bad enough without having to sort things out like I have.
Good luck and keep us informed of how you get on. xx

[ann-m]

Hi Marla,
I think loads of us have had similar experiences, although I never really gave it much thought!
Overall, I was quite happy with my experience on the NHS & just went with the flow.
For me, I found it helpful that the bcn’s were in the appointment with the consultant as they clarified things afterwards.
Now you’ve had time to reflect on it, maybe just view it as clarifying what you want moving forward & ask for what you need, as you say.
ann x

[Appletree]

Hello Marla

 

I have only ever been treated by the NHS but, on more than one occasion, have had experience of surgery in a private hospital under the NHS. In all honesty, I would say the treatment is just as good in both, if not better in the NHS. You are getting the same consultants who work for both, who were trained under the NHS, and who are applying the same knowledge, skills and procedures in both sectors. New knowledge flows from the public sector to the private.

 

Nurses in the private sector have trained under the NHS, even if they currently work only for a private company. They are unlikely to be any more skilled than their NHS counterparts and, quite possibly, less so, and less compassionate. Most NHS staff nurses/specialist nurses/sisters I’ve encountered have been very caring and compassionate as well as being very knowledgeable, despite the pressures they are under. It’s been the ones in private hospitals who have tended to be counting the cost of everything and referring to the CE of the hospital rather than the surgeon for, e.g., the need for an extra night in hospital.

 

It is a fallacy to assume that private medical treatment is better than that on the NHS - it might mean you are seen more quickly, only with breast cancer NHS England fast tracks patients anyway. In private care, you are likely to be given a room to yourself with en suite shower room, and the food might be better, but otherwise the medical care is likely to be the same, or even of a lower standard. From posts across this forum, it seems that NHS hospitals vary in the quality of their treatment. Some are excellent and could not/are not bettered by the private sector; these are more likely to be the big teaching hospitals. There are many possible explanations for the differences.

 

I would say to anyone, wherever you are treated, you as the patient need to be pro-active in your care, i.e. by asking questions, making requests, making phone calls and ensuring that you are given the information  you want. For instance, if your consultant doesn’t offer to show you your scans, you can ask to see them and ask for an explanation. Some patients want to see their results, others don’t, so surgeons and other specialists need some lead from the patient as they cannot read minds. This applies to both the private and public sectors.

 

The reason for having a nurse present during consultations and examinations is, I suspect, largely to chaperone the surgeon/consultant, especially if physical examinations are likely. We live in a very litigious society and some patients make accusations at the drop of a hat. I’m not suggesting you would, but some do, and breast cancer is a very emotive topic. Another reason is to assist the patient to present their own concerns and worries; nurses tend to be better skilled in communication than surgeons and are involved, to some extent, to represent the patient’s side of things.

 

You ask when you are going to be told what. This is my experience in a big NHS teaching hospital.

 

About a week after my investigation (examination, mammogram, ultrasound and core biopsies), I was given an appointment with a Consultant Breast Surgeon in which the diagnosis of breast cancer was given, with a specialist Breast Care Nurse present. Both were introduced to me and I was assured the same BCN would be available to me throughout my treatments. I was shown the results of the mammogram and ultra sound and these and the biopsy results were explained. The surgeon discussed with me the surgical options, explained the procedures in detail and answered my questions openly and considerately. Then I had a session with the BCN on her own, in which she gave me several booklets, contact numbers for support and information (includng her own) and talked me through aspects of treatment. I had already produced a brief account of my medical history with relevant problems, dates, treatments and medications, and gave her a copy which aided our discussion about my concerns. She couldn’t have been kinder or more helpful.

 

Soon after my diagnosis, I was sent a date for surgery which fell within 4 weeks of the diagnosis. I was also given an appointment for a pre-op assessment for a week or so before the surgery, and details of the procedures to be followed. On the day of surgery, the surgeon came to see me in the morning to talk through the agreed procedure and to obtain my signature. A little later, the anaesthetist came to see me to discuss anaesthetics and analgesics; she couldn’t have been kinder or more informative.

 

The surgical ward was equally well run with kindness and compassion, and personal attention when I needed it. Everyone, including the tea lady, was considerate, cheerful and informative. And I’m talking about the NHS.

 

No treatment from any establishment is going to be perfect, which is why we have to be prepared to manage our own health and take some responsibility for how we are being treated. It is worth remembering that the private health sector is there for the financial gain of its investors and not as an altruistic service to those in need. It cherry picks the most lucrative aspects of care and leaves the NHS to pick up the tab for more complex, more expensive and more time-consuming treatments.

 

Whether or not we still have the NHS in a couple of years time is anybody’s guess.

 

All the best to you and I hope your treatment runs smoothly.