A couple of weeks after my routine mammogram I received a letter to say that the results needed checking out: a quick scan and biopsy, then followed by results and consultation about what would happen and the options for surgery. All these appointments were on time and conducted in a friendly and calm professional manner, which helped reduce the initial scariness. Mr Paul Thirulchelvam recommended that I had wide local excision and sentinel node biopsy, and a wise pattern mammoplasty, with a symmetrisation surgery at the same time. Although this increases the risks and makes for a more complex operation, I preferred the idea of getting this done 'in one go'. A date was fixed straight away for the operation [so I knew that and didn't have to wait for one which is very helpful in forward planning] and I was marked up for the surgery by Paul, who also took photos for the record and preparation. His positive and straightforward approach made this decidedly comfortable and made me understand better what would happen and decision making seem easy, removing any worries. He outlined the risks and what he proposed to do. Since this was to remove the cancer by taking a wide margin, it would entail re-sizing both breasts in the same operation. He booked Mr Leff at the same time. The day of the operation was a bit nerve-racking, since there was a courier failure to deliver the hospital radioactive isotopes and a long wait for them [the dye is needed during the operation to pick up the cancer/nodes?], and hence delay in operating - but this has nothing to do with the excellence of the surgeons! Despite this, I was massively cheered by the arrival of PT in nuclear medicine, deciding to save time by pre-operation marking which kept me distracted and also reassured me the op was not going to be postponed! No bandages, liquid skin and self absorbing stitches, and a longish time for healing which is still underway. No real pain either - what I had/have is mild and tolerable. I was visited late that operating day 10 pm or so, and again the next morning when the drain was removed. Both reassuring and cheering. Since the operation I have had a further consultation and will now 'move on' to the oncology stage, an appointment is expected soon. Throughout so far it has been a very positive experience, healing seems to be going well, and I have always felt confidence in what needed to be done and who was doing it . I could have done better myself on finding out about post surgery bras, how to judge sizes etc but have actually managed very well with friends and common sense. I found many of the downloadable booklets useful but some rather long and not terribly good reading - and what about exercises? I still have a lot to find out on the next stage.
Gone are the days of white-coated pomposity among senior medics, if Paul and his team are anything to go by. For a living, I train people to have difficult conversations in the workplace more easily, so I'm picky about these things; Paul got everything right from the word go. At our first meeting, confirming that my biopsy was indeed cancerous - and throughout the op day and followup appointment - he hit exactly the right balance between being human and being professional. He puts medical terminology into laywoman's language without a hint of impatience or condescension. He is a great listener (rare, especially among busy people). He inspires confidence, yet is straightforward about any chances of negative consequences from any part of the process. Following the emotional freefall I had experienced while awaiting news of the first biopsy, this kind of simple clarity about best and worst probabilities was an absolute lifeline. One small but important thing that put our initial conversation straight onto the right track was that he introduced himself to me by his first name. I am very comfortable with first-name terms in most contexts, but get privately irritated by medics who assume they can address me by my first name, and then tell me they are 'Dr So-and-So'. (This did happen with one or two of the many I met along the way as part of the wider process; it might be an idea explicitly to discourage this in the hospital at large - or at least for doctors to ask the patient how they prefer to be addressed and stick to the same protocol themselves.) If I may make one other tiny observation: at our second meeting, I was expecting Paul to give me an 'examination'. What I hadn't quite expected was that this meant being thoroughly 'marked up' with a felt tip pen! This didn't worry me in the least - I was just a bit surprised when he began drawing on me! - but others might appreciate a tad more explication by way of forewarning (for one thing, don't wear your best bra/top as it tends to rub off on the inside afterwards and is hard to get clean!) On the other hand, my guess is that if you're the type to find that idea worrying, you would receive sensitive reassurance from Paul and the nurse (who stays present throughout). I needed a lumpectomy with a lymph node biopsy to be taken during the surgery, and opted to have the other breast adjusted at the same time to even up my shape (by Paul's colleague, Daniel Leff). I didn't meet Daniel pre-surgery, so was particularly impressed and grateful that Paul made a point of bringing him to meet me in the evening following my op, more than 12 hours after the beginning of the working day for them, and that Paul was back in to check on me the following morning. So I'm in awe of his stamina, as well as his skills - ditto Daniel's - which I believe stems from a true passion for their work and compassion for those upon whom they practise it. Although I have radiotherapy to come, my lumpectomy has been a complete success, and I can only reiterate here what I told Paul face to face - I can't thank him and his team enough. If you're about to go through something similar, you couldn't be in safer hands.
I was diagnosed with breast cancer a few months ago and from my first appointment with Dr. Paul I felt I was being cared for. He explained everything that would happen and had the patience to answer all my questions. While talking to me I felt I had his attention and his honest and caring personality made me trust him completely. I wouldn't want any other doctor. Dr. Paul made me feel a person, not only another patient.
I was fortunate to be under the care of Paul Thiruchelvam at Charing Cross for my breast treatment. He was a calming presence from the first meeting when he explained, in a clear manner, the procedure that was to be carried out, allowing time for me to process the information and to ask questions. To be told that I required an operation was a shock, but I did feel very reassured that I was being dealt with by a competent and considerate surgeon. This was a routine appointment for him, but at no time did he make me feel as if I was just another patient. On the morning of the operation Paul Thiruchelvam came to talk to me on my arrival on the ward, then just before the operation, and later, in the second recovery room after the operation. The following morning he called me to check on how I was doing. I was impressed by this exceptional level of care and attention.Though it was such a worrying time for me, it was a very positive experience overall, thanks to the excellent care provided by Paul Thiruchelvam and all the Breast Care team at Charing Cross Hospital. Thank you.
Paul is an incredibly caring surgeon. The operation he performed initially had a superb outcome. He gives the impression that he worries about you as an individual finding time to answer questions and talk about your case. He never rushes you out but gives you all the time you need. He makes himself available and will always reply to an email (day or night) particularly if you are asking a question. He is also completely honest and does not seek to placate you with false optimism. You know where you stand at all times. Considering the number of issues in my case, the pace was maintained throughout. Paul's surgery skills are amazing and the outcome superb. Unfortunately I needed a follow up operation to remove further lymph nodes. This was undertaken swiftly and efficiently. Paul explained clearly that this was necessary because the cancer needed to be removed. In retrospect I think it would be useful to record where the radiologist takes the initial biopsy of the lymph nodes as a guide to the surgeon so if it was positive (or negative) in terms of cancerous cells that area could found again at a later stage. It may avoid taking out lymph nodes unnecessarily. However Paul and his team were quite simply superb throughout my surgery and the aftercare was exemplary and I would recommend Charing Cross to anyone as a centre of excellence which supported me through this immensely difficult time.
Short link to review Mr Paul Thiruchelvam: http://iwgc.net/eftdn