What to say so i dont get fobbed off

[kicka]

I need some good facts as to why the gyne i have wont go on its own, i seem to keep getting fobbed off for 6 months at a time yet ive had gyne full blown for 3 years now so how they think this will help ill never no.

next wednesday i want to say look.........

i am going to point out how ive used tamoxifen for 4 months now with no major effect

[kicka]

thanks for the reply my gp actually wants me to have this surgery and at one point when we thought i was getting the op already  wrote and tryed to get me prioritised.

the problem lies with the consultant surgeon who right from the word go seems to not want to do this (proably due to bonuses for knocking people back!) first she said oh youll just have scars then when i didnt go for that she started on about concave nipples, i need some hard facts and the rest about my life being ruined is all true

I had a light case of gyne since i was 12 now its alot worse at 29 what diference a few months will make over 17 years ill never no

[phantom]

Hello Kicka

First off, no medical practitioner in the UK is EVER incentivised not to treat patients, but I understand the point you are making.

There could be all sorts of reasons why your surgeon has been reluctant to work with you.  She may not regard you as a high enough priority over, say mastectomy patients that have cancer or she may regard your condition as cosmetic rather than corrective.  It might be that she has little experience of male chest reconstruction and does not want to admit she is not up to the job.

Secondly, you probably know by now that the end result of any cosmetic or corrective procedure cannot be guaranteed.  So if she says "There's risk of significant scarring."  My response would be "I am well aware of the types and extent of scars that can be made by this surgery.  I am also aware that modern techniques in reconstructive surgery minimise the risks of obvious scaring.  For example, a crescent shaped incision around the areola is a very discreet way of hiding potential scars" (and produce a picture of a before and after that you have ripped off from this website!)

A concave chest?  My response "It is not my expectation for any surgeon to achieve a perfect result.  The outcome is down to my personal expectations and how well you [the surgeon] manages that expectation.  I also know it comes down to the skill, experience and confidence of the the surgeon that is to perform the work.  What confidence do you have in your ability to carry out this kind of work, or is there another surgeon you believe I might be more suited to?"

Be polite, patient and understanding with your surgeon.  Show her you know your stuff that you are not afraid to ask her tough questions.

It might be worth going back to this surgeon and find out if she is a) up to the job and b) prepared to cross refer you to another surgeon for a second opinion WHICH YOU ARE ENTITLED TO!  Never EVER let anyone fob you off.  You have the backing of your GP and now that you are 'in the loop' as it were, you have every chance to reach the end-point you seek.

Hope that helps.

[kicka]

thanks phantom it does help as your words fill me with confidence which i need to speak out at these meetings instead of just sitting there thinking i already no all this .

[phantom]

Look through the UK threads that show other guys' surgical experiences.  It will give you the knowledge you need to back up what you want.

If at your next meeting with the surgeon, she is still stand offish, then tell her that you are determined to go through with this surgery, but have to feel confident that the person performing the surgery is keen to do the work in the first place.  Get her to commit one way or the other.  My opinion is that if you have any doubts or don't feel confident in her, go back to your GP and ask for another referral to another surgeon.  This is a very sad aspect of NHS surgery for this condition.  Stay positive and determined.  You will get there.  Please let us know how you get on, even if there is limited progress for several months.

Best wishes.

[outertrial]

I wouldnt attempt to persuade them to do the surgery. If they say you'll have concave nips and scarring and they're talking about them doing the op then Id listen to them and go and find another surgeon who's happy to do the OP. If this means going private then unfortunately thats the reality of the NHS.

The best thats likely to happen with an unconfident inexperienced surgeon is theyll remove so little you wont notice any effect.

I mean if you took your car to a mechanic and he was like "Ooh well, if I do anything Ill probably wreck the engine and scratch all the paintwork" you'd go somewhere else til you found someone who said "Yes this is routine, Ill do this this and this and itll be sorted", wouldnt you?

[kicka]

Well she made these coments very flipantly
youl really have to take my word for it that it just seemed as if she was trying to scare me away from this op from the outset. Oh i also mentioned in an earlier post i have hepetitus, well she even then later made a coment of her not wanting to put a surgeon at risk of hep!! i mean dont they treat every one as though they are contagious. What diference does that make?
Next time i go back i will ask her how many gynecomastia ops she has done.i will even say that i feel she is trying to deflect me from this.
My dotor said he has seen a lad who she did at his surgery and he had good results.
I no what you mean about not getting the op done if i dont trust the doc but surely there is a doc out there who is up to it who i am entitled to see!? i pay me bloody stamp every week for gods sake! whats up with this country

[phantom]

What you are experiencing is very common within the NHS, where often the surgeon tries to put the patient off.  Whilst your surgeon needs to be aware of your hepatitis status, I think I would be seriously offended if it was used as an argument not to do surgery.  It would follow that surgeons would be reluctant to do any kind of surgery if they were are risk of such infections, which again does not really follow with good medical ethics.

I take you are hep B positive because this means you have the potential to remain infectious.  Otherwise with hep A, once you have had it, you don't remain infectious.

It sounds as though you mind is made up.  Stay in touch with your GP to keep their support and who knows, on your next meeting with the surgeon, if she can see that you are determined to go through with it, she will be happy that mentally you are prepared and happy to proceed.

Best wishes.

[kicka]

Well i just went to the hospital and guess what ive been fobbed off!! another 3 months now lies ahead of me!! im really disapointed in myself as i didnt get to say alot of what i wanted however they make the conversation go in such a way as to you never get the oportunity to bring any of it up and when you do you are going so off topic that even i was left thinking where did i just drag that up from.

This woman however was abit better than the one i normally see and did mention stuff about lypo and actually grabbed my nipple and said which parts were gland and fat something i felt the other woman was avoiding (i already new which parts were gland and fat just good to hear it being admitted)

So i ended up saying if i go on a fat free diet then should it mostly of gone, so next time i go im going to cut right down just to show them exactly what is gland and that i want it removing.

I raised the fact i was on tamoxifen and that withough it i was in alot of pain and wouldnt be able to do my job properly. She asked how long id been on it. (5 months) she said that should of been long enough and to stop it now and the pain shouldnt return.

I did ask what if it does return and i couldnt come back for 3 months she said to write to them and theyd see me quicker.
Not to pleased about that set up

I am going to write to them over this 3 months and express all my views and my wish for surgery. Stating that i no it wont be a 100% perfect chest and highlighting points such as phantom mentioned in posts above.

I could see that alot of this came down to the fact i may not be mentally prepared which i am i just havent expressed it very well when ive had appointments with them, in my letter it should become alot clearer to them.
phantom you were right there my friend.

Good news came in today i no longer have hepetitus!!
it was hep c but ive also had hep b as well and ive beaten them both! so great

At least one good thing happened

[phantom]

Overall I think you having a reasonable experience considering you are going via NHS.  It's very rare it goes according to plan.  It seems to take between one to two years to get the surgery for most guys (though some have managed it in a matter of a few months).  Surgery dates being set back is very, very common so even when you get your next official date, DON'T get your hopes up too much.  It will just take one urgent case to come up, or the surgeon gets flu and your booking will be put back again for a few weeks.

To prevent not being able to say what you want to say, write down a brief set of notes and questions BEFORE you see anyone next time.  This means that no matter how much the conversation steers away from what you want to talk about, at the end of the meeting you can say "I just want to check we have covered everything."  Then proceed to ask any remaining questions.

Best wishes and keep us informed!

[kicka]

Yes i was amazed this woman spoke about revision and lypo!  whether ill be lucky enough to see her again i dont no.

When she was saying about my chest she squoze the bit i always mess with (the gland) and said there you only have a small breast bud so i dont think youd benifit TO MUCH of surgery and then mentioned the scars, Well it is this breast bud whether tiny or not that im not happy about so i will point out i shouldnt have a breast bud at all im a man!
scars i can deal with they add character

[SOAD]

For men scars > breasts.

Clearly this changes for women though