My second appointment with Dr Mikael was on Tue 4 Oct 2022.
This was going to be a very tiring week. I have 3 appointments with each of my doctor and unfortunately, they all can't be done on the same day. NUH now seems like my "second home".
After dropping Lil Pumpkin at school, the boy and I went to have breakfast at Kaffe & Toast, NUH Medical Centre.
I find the kopi there pretty good, and the boy agrees too. Decided to indulge in a calorie-dense {i.e. fatty and unhealthy!} kaya & butter toast set since I haven't had it for a while and have been thinking about it every time I get kopi from there before my appointments.
I haven't been as strict in my diet recently or been keeping count of my daily calories as much, although I do still try to eat more high-protein and low-carb food, as I keep thinking that once my chemo treatment starts, my selection of approved food will be pretty limited. So... might as well eat what I can when I can now haha.
I registered for my appointment once online registration opened in OneNUHS app about 8am, an hour before my actual appointment, while we had breakfast. We went up to NUH Breast Care Centre about 8.45am and although I've been there a few times already, it was the first time I realised that I needed to go to the registration counter immediately if I registered via OneNUHS to let them know I was there physically, and not wait for my number to be called.
Dr Mikael was late and we went into his office about 9.35am. Not too bad as I had to wait more than an hour past my appointment time to see him the last time.
This time, Dr Mikael seemed more relax and talkative. Perhaps less stress from having to tell me bad news?
He asked how I was and I told him that I've mostly processed the news and calmed down, which is true... did not even cry during our appointment.
Then, he proceeded to briefly explain how Colour Enhanced Mammogram and PET-CT scans work, show us my scan images and explain the results of both scans.
Basically, the scans show that the cancer is only in my left breast and has not spread to other parts of my body, which is good. I was worried that it might have spread to my brain as I sometimes get frequent headaches so this was a relief to hear but after thinking about it, I wonder if the brain activity colours masked the cancer activity in the scans?? Forgot to ask during our appointment and shall do so when we see Dr Samuel, my oncologist on Thursday.
Dr Mikael asked me what Dr Jane, my aesthetics surgery doctor, told me and I told him that based on my lifestyle and body type, she recommends implants for breast reconstruction. However, it does come with risks such as lymphoma.
He said that as my doctor, she was obliged to tell me about the risks, however, it is a low risk and I need not worry about it. It put my mind at ease hearing that.. as I really was worried about getting cancer from breast implants and going through all this again.
I am prepared to go for double mastectomy, but we shall wait for my genetic testing results to be out before we decide on that. Dr Mikael thinks I have just a 15% chance of a positive result for gene mutation... which seems low, but then I've been told that 10-20% of biopsies have positive cancer results, and only 20% of breast cancers are the aggressive HER2-positive kind so..... yah.
It seems like I tend to fall into the unlucky "low possibility" region. Oh well.
We talked a bit more about the surgery itself - like I've to stay maybe 1-2 nights in the hospital, he will make a long incision next to the nipple and one on top of the breast, he will try to save the nipple and breast skin but I will likely lose sensation in my breast after the mastectomy etc.
Dr Mikael will be going on leave 6-17 Oct and I will probably not see him again until my surgery, which is likely going to be in late Oct.
Dr Mikael 2nd visit cost: S$108.05
Before mastectomy and breast reconstruction surgeries
After mastectomy and breast reconstruction surgeries
Adjuvant Chemotherapy and Herceptin Injections
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