Kudva.

It is not an elective surgery when the alternative is cancer. -Unknown

Dr. Kudva. What an incredible woman. As I had previously shared, I was not comfortable with the first general surgeon that I met with. I expressed that to my plastic surgeon who then referred me to a new general surgeon who he said I would absolutely love. I attempted to make an appointment but she was completely booked. I was told that I would be placed on a waiting list, but the very next day I received a phone call, she had an opening two days later, January 26th. So, I took the appointment despite having to miss class.

Honestly, I was extremely nervous going into this appointment. I knew very little about Dr. Kudva. All I knew is that my plastic surgeon highly recommended her and that she could potentially say no. I have heard of doctors that did not feel comfortable doing a prophylactic mastectomy on younger women, so naturally, I feared the worst. I was early to my appointment (despite missing my exit in Otay Mesa and having to turn around at the Mexican border, oops). Dr. Kudva was running late. I sat in the exam room for about 45 minutes before she finally knocked on the door and entered. What a surprise! She was immediately warm and comforting. She did not sugar coat anything but made me feel at ease and ultimately agreed with my decision; I made a wise decision. My nerves subsided almost immediately. We talked about the process and I expressed my fears. She assured me that she would do her best to keep my incisions as small as possible and that she could actually leave a little more tissue than I had previously thought. All good news.

Then we talked about the reconstruction. I learned a lot more about the process and I had a change of heart.  Assuming that my plastic surgeon will agree to it, and I am sure he will, I am going to have immediate reconstruction. That means I will have the mastectomy and in the same surgery, my plastic surgeon will insert my tissue expanders. The risk of infection and tissue death is higher, but it must be noted that a lot of the statistics are with regard to patients who have cancer and are not in good health. Dr. Kudva assured me that I would be more than okay as far as pain is concerned and that most of my troubles would potentially be emotional ones. Having the tissue expanders already in place when I wake up from the mastectomy will make the process a bit easier to handle. She then went on to ask me about my medical history, my lifestyle, and my relationship status among other things. It felt good to finally speak to a female doctor about this. I felt as though Dr. Sinow understood why good results are so important to me, but unless you are a woman, I don't think you could ever fully understand. I expressed to Dr. Kudva that yes, losing my breasts will be difficult because I have always felt that they make me a woman and honestly I love mine, but they are just not worth the risk. And then she said something that really resonated with me. She stopped me and said "your breasts do not make you a woman, they do not define you" and then she pointed to her heart and said "this is what makes you a woman and that is all you need". Now typically I am not very outwardly emotional, at least not with people I am unfamiliar with, but I could not help but tear up. She was right. And I needed to hear that. I will carry those words with me throughout this process and on into the future.

We ended the appointment after about 30-45 minutes and I left feeling extremely positive and far more comfortable than before. She ultimately agreed to do my surgery, she agreed to work with my plastic surgeon in scheduling a date that works with their schedules but also with mine so that I will not have to miss school, and she assured me that I am making a wise decision, especially with my family history.

So what's the next step? I will be getting a breast MRI shortly and assuming that the scans are clear, a final surgery date will be set and I will proceed with the rest of my pre-op appointments. I am really looking forward to seeing my plastic surgeon and discussing more specifics regarding my reconstruction: size, type, etc. I could not be more grateful for the team of amazing doctors that Kaiser Permanente has provided me with. Everything is falling into place and as each day passes, this decision becomes more real and I find myself feeling upbeat and positive about it.