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Medical Forum / Diseases and Disorders / Prostate Cancer / January 2004

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John Trujillo and his post-op pathology results

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Debbie Trujillo - 24 Jan 2004 02:29 GMT
Some of you may recall that when I took my husband John to have his
staples removed a week after his surgery last July, I got angry and
upset at his doctor for not giving me an opportunity to hear the
pathology report with John.  We had arrived 20 minutes early so I
could go to the ladies room before his appointment.   However, to the
surprise of both of us, John was immediately called in before I got
back five minutes later, and his doctor was right there and
immediately started talking to him without even asking where I was.

A half hour later John came into the lobby to get me and said he was
finished.  I immediately wanted to get out of the doctor's office
because I was angry at not being included.  However, I made him repeat
to me in the building's lobby what the doctor said, and he drew me a
diagram.  I had thought at the time that he told me the doctor said
his margins were clear but that one of the two lymph nodes removed was
infected.  John recently told me that he didn't say that and that the
doctor told him the lymph node was clear.  John also didn't recall
drawing that diagram.  When John told me this, I got angry all over
again at not being included when the doctor gave him his path report.

I therefore asked John this morning if he would sign a letter to his
doctor requesting a written report of the pathology results.  John
asked me if I was crazy so I told him that I feel I have been getting
conflicting reports from him and that I wanted some straight answers,
dammit.  John then told me to write the letter and he'd sign it.
johng - 24 Jan 2004 02:38 GMT
> I therefore asked John this morning if he would sign a letter to his
> doctor requesting a written report of the pathology results.  John
> asked me if I was crazy so I told him that I feel I have been getting
> conflicting reports from him and that I wanted some straight answers,
> dammit.  John then told me to write the letter and he'd sign it.

That is not an unreasonable request.   My surgeon put his pathology
results in writing, gave me a copy, and also sent a copy to my regular
physician and to the urologist who did my initial diagnosis.   He did this
for each visit, including (I think) the pre-surgery visit I made to get a
2nd opinion.   It looks like it is standard operating procedure for
him.    Today when I went to my regular physician for my annual checkup,
he offered me a copy of the latest report my surgeon had provided.   I
told him I already had a copy.   Maybe he wasn't used to a surgeon
providing that information to a patient.  But in case you had any doubt,
such things ARE done.

JohnG
olfart - 24 Jan 2004 02:38 GMT
> Some of you may recall that when I took my husband John to have his
> staples removed a week after his surgery last July, I got angry and
[quoted text clipped - 21 lines]
> conflicting reports from him and that I wanted some straight answers,
> dammit.  John then told me to write the letter and he'd sign it.

I hope I understand you correctly - you have been angry over this for 6 months
??
Age - 67
8/12/02 - PSA 3.7
10/13/03 - PSA  4.69
11/11/03 - PSA 4.8
11/18/03 - Biopsy - 10 cores
one core-25% of core-Gleason 4+4=8
all other cores benign tissue
12/10/03 - Consult - Oncologist
12/16/03 - Consult -  Radiation Oncologist
Treatment Plan -
HT - started 12/17/03 - Eulixen & Lupron
Radiation - IMRT to begin 3/14/04 - for 5 wweks
Theraseed implant after Radiation completed
Debbie Trujillo - 26 Jan 2004 16:28 GMT
> > Some of you may recall that when I took my husband John to have his
> > staples removed a week after his surgery last July, I got angry and
[quoted text clipped - 37 lines]
> Radiation - IMRT to begin 3/14/04 - for 5 wweks
> Theraseed implant after Radiation completed

No.  I was angry at the time and then got angry again when John told
me recently that what  I remembered his telling me was not what he
told me.
c palmer - 24 Jan 2004 03:03 GMT
hi debbie - i had a hard copy in my hand at the time of checkout at the
hospital.  i still read from time to time, and some of the things on the
report i didn't remember seeing before.  i know they didn't just jump on
the paper.  

what i'm trying to say is that you husband may have been in shell shock
when the doctor talked to him and he only remembered what he wanted to
remember.  it may have been too much information at one time too.

getting a copy of the path report is not out of line.  he needs it too.
it will give you both a chance to see - in black and white- what you are
up against - good or bad.   this way, there is no second guessing.

hang in there.

~ curtis

knowledge is power - growing old is mandatory - growing wise is optional
Wakeley Purple - 24 Jan 2004 03:05 GMT
...
> I therefore asked John this morning if he would sign a letter to his
> doctor requesting a written report of the pathology results.  John
> asked me if I was crazy so I told him that I feel I have been getting
> conflicting reports from him and that I wanted some straight answers,
> dammit.  John then told me to write the letter and he'd sign it.

As a typical male, I also tend to shrug off scary things like pathology
reports. I also have a (typical?) wife who insists on written reports about
almost *everything*, and who would have been just as upset as you in the
same situation.

I think it's perfectly reasonable to request a written report. Most people
are pretty nervous about the post-op report, and it sounds like a good idea
to have a written copy to go over later when you're more calm and can
understand what's in it.

My wife and I have had some difficulties along this same line. It sounds
like you are working through them as we have.

Here's hoping the report says "not involved"!

Signature

Wake

Age 58
PSA 3.8
Biopsy positive 5% in 1 of 10 cores
Gleason 3+3
T1c
RRP 1/12/04
Pathology agrees with biopsy
Negative margins

Robert Austin - 24 Jan 2004 04:43 GMT
Hi Debbie and all -

Something that I have not seen discussed on this, or any other forum
is the punishment that our brain takes while our bodies are undergoing
surgery.  So far as I know, most times it is not very noticeable,
other times it is more severe and sometimes the brain never recovers
completely.

Please cut John a little slack. In addition to his surgery, he very
well may have partially freaked out when the doctor dropped another
problem in his lap. It may be that whatever he says about the
conversation with his doctor may or may not be true. If his doctor is
worth a grain of salt he will be glad to fill you in his findings.

>Some of you may recall that when I took my husband John to have his
>staples removed a week after his surgery last July, I got angry and
[quoted text clipped - 21 lines]
>conflicting reports from him and that I wanted some straight answers,
>dammit.  John then told me to write the letter and he'd sign it.

Bob Austin

Age 74
PSA 7 Free PSA 12
1st round of biopsies clear, 2nd. 2 positives
Gleason 9
Cryosurgery 03/11/03
Post Op PSA's .04 & .01
RobertBob.Austin@NoSpam.Att.Net
Steve Kramer - 24 Jan 2004 10:22 GMT
I'm not taking sides, but under all the circumstances you report, I
think....

1.  The doc legitimately assumed John was alone and wished to be that way.

2.  John was understandably inattentive to his pathology and maybe even
prognosis.

3.  The best way to resolve it is to get the thing in writing so you both
know what you're up against now that the initial emotions are out of the
way.

I was in partial denial for well over a year after diagnosis and much of
what I was told during that year I did not "hear" until the denial was over.
I wasn't in complete denial, but partial denial can screw you up on little
things like lymph nodes, etc.  Especially, if you don't know the
significance of lymph node involvement.

Don't be mad, just get the report and plan your actions around it.  Don't
look back and get angry until you know you have a lot of time to look
forward.

Signature

Prostate Cancer Survivor (so far), not a doctor
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000
PSA  .1  .1  .1  .3  .4  .8
EBRT 05-07/2002 @ 47
PSA  .3 .2  .2  .2 .3
Erection 05/12/2003 @ 48
HTbegins 07/21/2003 @ 48
PSA  .1
Lupron 7/03, 8/03, 12/03

> Some of you may recall that when I took my husband John to have his
> staples removed a week after his surgery last July, I got angry and
[quoted text clipped - 21 lines]
> conflicting reports from him and that I wanted some straight answers,
> dammit.  John then told me to write the letter and he'd sign it.
Debbie Trujillo - 26 Jan 2004 16:36 GMT
> I'm not taking sides, but under all the circumstances you report, I
> think....
>
> 1.  The doc legitimately assumed John was alone and wished to be that way.

When John went to hear the results of his biopsy, he did ask have me
come with him (I guess because he was in denial).  We had both hoped
it would be good news and assumed that because his appointment was 2
weeks after the biopsy that that was the case.  However, when John
went to see the doctor after the biopsy, the first thing the doctor
asked him was where his wife was.  That was another reason I couldn't
understand why the doctor didn't ask where I was when he gave John the
path report.  I think he should have asked John rather than assuming
but then I work in a law office and have learned from my experience in
law not to assume anything.

> 2.  John was understandably inattentive to his pathology and maybe even
> prognosis.

Another reason i should have been with him.
Debbie Trujillo - 26 Jan 2004 22:33 GMT
CORRECTION:  What I meant to say was that when John went to hear the
resuls of his biopsy, he did NOT ask me to go with him.  I didn't
question this because I guess we were both in denial at the time and
were thinking that the doc would have wanted to see him sooner if he'd
found cancer. We were wrong.  Anyway, John has agreed to sign the
letter.  We will also be getting our new computer this week so it
won't take me so long to respond to the posts.  I am currently reading
and responding at work through the google site.

> > I'm not taking sides, but under all the circumstances you report, I
> > think....
[quoted text clipped - 16 lines]
>
> Another reason i should have been with him.
Steve Kramer - 26 Jan 2004 23:20 GMT
> > 2.  John was understandably inattentive to his pathology and maybe even
> > prognosis.
>
> Another reason i should have been with him.

No argument.  I wonder how many docs realize the state of their patients
during that time.  I know I never told my doc.  Maybe I should.
Debbie Trujillo - 26 Jan 2004 22:40 GMT
> I'm not taking sides, but under all the circumstances you report, I
> think....
>
> 1.  The doc legitimately assumed John was alone and wished to be that way.

John was still wearing his catheter then so there was no way he could
have come alone since somebody needed to drive him.  That somebody was
me.

> > Some of you may recall that when I took my husband John to have his
> > staples removed a week after his surgery last July, I got angry and
[quoted text clipped - 21 lines]
> > conflicting reports from him and that I wanted some straight answers,
> > dammit.  John then told me to write the letter and he'd sign it.
Steve Kramer - 27 Jan 2004 22:13 GMT
> > I'm not taking sides, but under all the circumstances you report, I
> > think....
[quoted text clipped - 4 lines]
> have come alone since somebody needed to drive him.  That somebody was
> me.

O.K.  You're right.  Hanging is too good for the SOB.
Debbie Trujillo - 28 Jan 2004 01:52 GMT
> > "Steve Kramer" <skramer@cinci.rr.com> wrote in message
>  news:<kHrQb.51130$f97.10399@fe3.columbus.rr.com>...
[quoted text clipped - 9 lines]
>
> O.K.  You're right.  Hanging is too good for the SOB.

Ha ha!  We sent the letter out today.  I don't anticipate having any
problems with getting a response.  The doc may call John first as a
CYA since all medical establishments are so paranoid about HIPAA.
Steve Kramer - 28 Jan 2004 18:48 GMT
> Ha ha!  We sent the letter out today.  I don't anticipate having any
> problems with getting a response.  The doc may call John first as a
> CYA since all medical establishments are so paranoid about HIPAA.

HIPAA.  What a crock!  I can think of only a very few people who would worry
so much about their records that they thinc the incursion of such a huge
bureacracy is justified for their 'privacy.'

I, for one, tell the whole world.

Signature

Prostate Cancer Survivor (so far), not a doctor
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000
PSA  .1  .1  .1  .3  .4  .8
EBRT 05-07/2002 @ 47
PSA  .3 .2  .2  .2 .3
Erection 05/12/2003 @ 48
HTbegins 07/21/2003 @ 48
PSA  .1
Lupron 7/03, 8/03, 12/03

Debbie Trujillo - 29 Jan 2004 16:18 GMT
> > Ha ha!  We sent the letter out today.  I don't anticipate having any
> > problems with getting a response.  The doc may call John first as a
[quoted text clipped - 5 lines]
>
> I, for one, tell the whole world.

Every medical office that I have dealt with since that became the law
has been concerned about that and asked us to sign that special form.
It's the same way at the pharmacies.
Sandy - 24 Jan 2004 20:48 GMT
> Some of you may recall that when I took my husband John to have his
> staples removed a week after his surgery last July, I got angry and
[quoted text clipped - 21 lines]
> conflicting reports from him and that I wanted some straight answers,
> dammit.  John then told me to write the letter and he'd sign it.

Debbie,

As another wife, I totally understand your frustration.  It is a
difficult time for both of you and I'm sure you both are trying to
deal with it the best way you know how.  This journey we are all
taking includes the wife as much as the husband and you have a right
to know.

I have copies of everything done on my husband from day one including
biopsy reports, all blood work, surgical report, History and physical,
discharge summary, pathology report and so on.  I've integrated all
these reports into a notebook for future reference. My husband really
has relied on me to help decipher treatment options, etc. and it helps
to have your medical information in front of you.  Those medical
records are yours and you have every right to have them in your
possession.  Even now, every time my husband goes to the urologist or
oncologist, I ask for copies of consultation reports, psa's, etc.  So,
don't be shy about asking the physician and/or hospital for his
medical records!!

Sandi
Ernest Gudath - 25 Jan 2004 16:07 GMT
Soon after I was diagnosed, I returned to the office and asked to see my
complete chart. The nurse I spoke to had me sign a release, and said that
she would have to discuss it with the doctor. For a nominal fee, they made a
copy of the whole thing. Ever since then, the doctor has furnished me with
copies of anything I've asked for. He has done so graciously, and seems
happy that I am taking such an interest in the technical aspects of my case.

Having my own chart is one of the best investments I've ever made. I went to
Kinko's and made several copies, and I took one with me when I saw other
doctors. It has its own section in my "PCa Project Manual."

By the way, as soon as I was diagnosed, I got a manila folder and set up a
project file. Everything went into this: telephone notes, newsgroup items,
internet downloads, insurance stuff, and of course the chart. This soon
became unwieldly, so I got a ring binder and a 3-hole punch. Thus was
created  the "PCa Project Manual."

Dealing with prostate cancer involves, among many other things, having to
organize and assimilate a huge amount of information. My "PCa Project
Manual" was a useful tool and I recommend its use highly.

Finally, if you have a doctor who is reluctant or unwilling to share
information with you, that is a serious issue and should be discussed with
the doctor. If the issue can not be resolved, then find a doctor you can
work with.

Ernie Gudath 65
PSA 4.3 3/03; 5.6 5/03
Biopsy 1 5/14/03 ambiguous
Biopsy 2 9/18/03 T1c Gleason 6 (3+3)
Scans Negative
RRP 12/11/03
Gleason 6, w/slight marginal, other tissues negative
Alan Meyer - 26 Jan 2004 20:10 GMT
Debbie,

A diagnosis of cancer is a terrible psychological blow to both
a husband and wife.  There is a danger that each person in the
relationship can become focussed on his own issues and
problems and feel angry at, or hurt by, the other.  But of course
that makes things much worse.  Instead of just dealing with the
horrible disease, you are now dealing with horrible disease plus
interpersonal problems.

I'd like to propose that you and John not worry too much about
these issues.  Resolve to work them out.  Don't let them stand
in the way of your love for each other and your support for each
other in this terrible time.  Give as much love and strength and
support to each other as you can.  I suspect you are both strong
and intelligent people and have a lot to give to each other.

You may know a counselor or clergyman or just a close friend
who can help you discuss these issues and resolve them to both
your's and John's satisfaction.

Best of luck to both of you.

   Alan

> Some of you may recall that when I took my husband John to have his
> staples removed a week after his surgery last July, I got angry and
[quoted text clipped - 21 lines]
> conflicting reports from him and that I wanted some straight answers,
> dammit.  John then told me to write the letter and he'd sign it.
Fernando Navarro - 26 Jan 2004 22:02 GMT
Hi Debbie,

I suggest you go to the hospital with John and request a copy of the
pathology report. It took me 5 minutes to get mine at Kaiser.

> Some of you may recall that when I took my husband John to have his
> staples removed a week after his surgery last July, I got angry and
[quoted text clipped - 21 lines]
> conflicting reports from him and that I wanted some straight answers,
> dammit.  John then told me to write the letter and he'd sign it.
 
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