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mifis

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      mifis
      Participant

        Thank you both very much!

        mifis
        Participant

          Thank you both very much!

          mifis
          Participant

            Thanks for your replies. I will call the doctor and get it checked out again. He didn't really have a very close look at it on Friday, just a quick glance. I will also photograpf it. Thanks for your suggestions and support, Jennifer

            mifis
            Participant

              Thanks for your replies. I will call the doctor and get it checked out again. He didn't really have a very close look at it on Friday, just a quick glance. I will also photograpf it. Thanks for your suggestions and support, Jennifer

              mifis
              Participant

                Thanks for all your encouragement and support. I will probably not go back to Sloan Kettering for the surgery because it will be out of network and very expensive and it is also 4.5 hours awat from home. I sopke to the wonderful specailist I saw there, Dr Charlotte Ariyan and she also felt it wouldn't be necessary as it isn't really a complicated surgery. My primary has referred me to a new dermatologist and I met with him today. we spoke for over an hour and I felt in very safe hands, felt really listened to and respected for my tenacity in seeking the best care and folowing my intuition, rather than dismissed and condescended to. The new derm is going to hook me up with another plastic surgeon and the plan is to finally take sufficient margins to excise all the melanoma. I have already asked where the slides will be read and have insisted I get a sexond read from the Sloan Kettering pathologists. I am not looking forward to another cut, but hopefully it will be my last!

                That said, I do understand that pathologists have different opinions about melanoma and that is very scary. I also understand that doctors will have different opinions and that they may not agree with their patients either, but ultimately they might better practice some humility and remember that they are, after all, in the service industry. I don't think my plastic surgeon was ever unsure of the diagnosis. He made up his mind before he even cut me the first time that there would be atypical melanocytes and was too arrogant to consider another opinion, especially mine.

                Brandi, I really appreciate hearing your wisdom from the other side!

                Wish me luck and I hope all  works out well for all of you too,

                 

                Jennifer

                mifis
                Participant

                  Thanks for all your encouragement and support. I will probably not go back to Sloan Kettering for the surgery because it will be out of network and very expensive and it is also 4.5 hours awat from home. I sopke to the wonderful specailist I saw there, Dr Charlotte Ariyan and she also felt it wouldn't be necessary as it isn't really a complicated surgery. My primary has referred me to a new dermatologist and I met with him today. we spoke for over an hour and I felt in very safe hands, felt really listened to and respected for my tenacity in seeking the best care and folowing my intuition, rather than dismissed and condescended to. The new derm is going to hook me up with another plastic surgeon and the plan is to finally take sufficient margins to excise all the melanoma. I have already asked where the slides will be read and have insisted I get a sexond read from the Sloan Kettering pathologists. I am not looking forward to another cut, but hopefully it will be my last!

                  That said, I do understand that pathologists have different opinions about melanoma and that is very scary. I also understand that doctors will have different opinions and that they may not agree with their patients either, but ultimately they might better practice some humility and remember that they are, after all, in the service industry. I don't think my plastic surgeon was ever unsure of the diagnosis. He made up his mind before he even cut me the first time that there would be atypical melanocytes and was too arrogant to consider another opinion, especially mine.

                  Brandi, I really appreciate hearing your wisdom from the other side!

                  Wish me luck and I hope all  works out well for all of you too,

                   

                  Jennifer

                  mifis
                  Participant

                    Thanks Janner,

                    That certainly complicates things! I specifically asked the plastic surgeon if a type of melanoma had been diagnosed and he said that at the in situ stage there are no types. He went on to say that the various types are only diagnosed once the melanoma is invasive. That is very different from what you are saying and also very different from what I had read.

                    I only have the first 2 pathology reports so far. On neither of those is there a mention of the degree of atypia (or type of melanoma). The original biopsy report states "there is a residual proliferation of atypical melanocytes noted along the deraml-epidermal junction". The first wider excision states "in block 3, the residual proliferation of melanocytes is virtually transected at a lateral margin".  I have asked for the 3rd patho report to be sent to me and am waiting for it. All three of the reports were prepared by Cleveland Skin Pathology lab in Ohio and I was told that the doctors there are dermopathologists.

                    Thanks for your response. Any other experiences with something like this out there?

                     

                    Jennifer

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