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I had a my yearly mammo having had recurrent ...
I had a my yearly mammo having had recurrent breast cancer on the left. They saw a 'benign' something in the right breast, was told to wait and see, then finally got a biopsy 8 months later which showed an invasive tumor. I was given a treatment plan where they wanted to do a mastectomy on the right but I asked for an MRI on both as I had a history of cancer on the left but they refused. So I called the surgeon who had saved my life on two other occasions, he was now head of a breast center which was a 9 hour drive from my home.
His nurse navigator got my records assembled then set me up for a condensed week of testing and pre-surgery workups because they knew I was a long way from home and needed to get this over with quick. I decided instead of full on reconstruction I just wanted to leave some tissue if I could get good margins and arrange it into a small breast because I didn't want all the extra risk and surgery that reconstruction entails. I also wanted to leave enough breast tissue to monitor with mammography. I had enough breast to remove the tumor and match the other small breast in which I’d had several segmental mastectomies in the past. It still looked like a breast even though the nipple was gone and I would be happy if I could get two small breasts that matched. I had been with this awesome surgeon for 15 years and was happy to do it with him again but he recommended we do it with a plastic surgeon in Newport Beach named Nirav Savalia.
I looked at some photos of his work, mostly augmentations, facelifts, etc. saw his website and read some literature where he talks about himself in glowing terms, emphasizing his compassion and concern for the emotional well being of his patients. When I met with him prior to surgery, after waiting for over an hour, he told me as he walked through the door “you have the honor of being my last patient for the day” and then went on to say he wouldn't be able to do much for me because "this country doesn't hold doctors in high enough esteem and you don’t pay us enough for what we do. Americans pay football quarterbacks millions of dollars, give them free cars but you pay doctors so little for saving lives."
I told him I didn't watch football and thought my other surgeon was amazing and I was grateful that he worked hard to save my life a couple times already, he accepted me as his patient and money was never part of our discussion. I was kind of at a loss for how else to respond, then he asked me what my expectations were. I asked him what my options were and his response was very condescending and noncommittal, saying he could only do the very basics. I asked about reconstructing my nipple or doing a little fat grafting to fill in a scar (as my other Dr. suggested) but he said that he wouldn’t be able to do that. So I said, “OK, how about you just do the best job you possibly can.”
I left his office feeling as if I were walking to the gallows to go into surgery with him. I knew he wasn't a cancer doctor per se, and I didn't feel his vibe was so much about compassion or saving lives as much as he was about image and money. Unfortunately my insurance is medicare and I live in a poor, rural county 9 hours north of Newport Beach so my only guess is he thought I was out of my caste.
I called a girlfriend that night and discussed the conversation with her and we both agreed I should talk to my other Dr and tell him what transpired and to get someone different for my plastic surgeon. As it turned out, the next day I had an MRI and a tumor was found in the other breast so my treatment plan changed, our conversation was that I needed another biopsy and we had to jump through some more hoops to get me IORT by starting a clinical trial. Things were changing from one minute to the next, I was never able to express my concerns about Savalia because everything was moving fast and furious and I didn't want to sound ungrateful. But I had high anxiety about Savalia doing a botch job on top of the whole intensifying cancer situation and I was there alone. I had already dodged one doctor who was going to amputate one breast and leave the other one full of cancer, my head was spinning and I wasn't able to find the right situation to discuss my concerns. So I went into surgery praying that enough people would be watching that he couldn't do too much harm.
As soon as I was able to take the bandages off I knew that the job was botched. I decided after I got home to wait until the swelling went down to make a judgment but after going to my 6 week follow up, my Dr. stared at my right breast, looking somewhat bewildered and kept saying "I'm not loving this ." I tried to be stoic and told him how grateful I was that my margins were so good and I’m lucky to be alive, that I was feeling great and healing well. But he just kept staring at the right breast and saying how disappointed he was, that he’d expected a much better outcome.
I left his office feeling sick, like I had Stockholm Syndrome and was covering for Savalias botch job. Why couldn't I just be honest and say what had really happened? So I flew home and anguished over it for the rest of the week and then sent him a letter telling him what really happened and why I wasn't able to express myself. I told him that basically he told me I was a low value patient and as a result of that I knew I would probably get a poor quality outcome but wasn’t in a situation to discuss it, that I just accepted what was done was not going to change so I should try to live with it.
I got an immediate response from my Dr, he was very concerned and asked my permission to discuss it further with his colleagues, to try to figure out where to go from here. I told him I don't want to get drawn into any more controversy. As it is, I’m very distressed to think someone could harm me while I am under anesthesia and I just want to face the truth and get this behind me.
Now I am also wondering if I should have said anything at all, maybe I’ll be shunned by the people and the institution who just saved my life and what if I need them again in the future. All the doctors and healthcare workers there did such a great job, went above and beyond for me. It's hard to know I should have handled this better, I should have said something before the fact, but I didn't so should I have said anything after the fact?
So that is my experience with Nirav Savalia and if it helps to prevent this happening to someone else no matter where it is, please trust your instincts and try to advocate for yourself. These are difficult situations and predators surface when you are most vulnerable and least expect them. What I know today is that overall I got excellent care and I'm not going to let one sociopath ruin my life when so many people worked so hard to save my life.
His nurse navigator got my records assembled then set me up for a condensed week of testing and pre-surgery workups because they knew I was a long way from home and needed to get this over with quick. I decided instead of full on reconstruction I just wanted to leave some tissue if I could get good margins and arrange it into a small breast because I didn't want all the extra risk and surgery that reconstruction entails. I also wanted to leave enough breast tissue to monitor with mammography. I had enough breast to remove the tumor and match the other small breast in which I’d had several segmental mastectomies in the past. It still looked like a breast even though the nipple was gone and I would be happy if I could get two small breasts that matched. I had been with this awesome surgeon for 15 years and was happy to do it with him again but he recommended we do it with a plastic surgeon in Newport Beach named Nirav Savalia.
I looked at some photos of his work, mostly augmentations, facelifts, etc. saw his website and read some literature where he talks about himself in glowing terms, emphasizing his compassion and concern for the emotional well being of his patients. When I met with him prior to surgery, after waiting for over an hour, he told me as he walked through the door “you have the honor of being my last patient for the day” and then went on to say he wouldn't be able to do much for me because "this country doesn't hold doctors in high enough esteem and you don’t pay us enough for what we do. Americans pay football quarterbacks millions of dollars, give them free cars but you pay doctors so little for saving lives."
I told him I didn't watch football and thought my other surgeon was amazing and I was grateful that he worked hard to save my life a couple times already, he accepted me as his patient and money was never part of our discussion. I was kind of at a loss for how else to respond, then he asked me what my expectations were. I asked him what my options were and his response was very condescending and noncommittal, saying he could only do the very basics. I asked about reconstructing my nipple or doing a little fat grafting to fill in a scar (as my other Dr. suggested) but he said that he wouldn’t be able to do that. So I said, “OK, how about you just do the best job you possibly can.”
I left his office feeling as if I were walking to the gallows to go into surgery with him. I knew he wasn't a cancer doctor per se, and I didn't feel his vibe was so much about compassion or saving lives as much as he was about image and money. Unfortunately my insurance is medicare and I live in a poor, rural county 9 hours north of Newport Beach so my only guess is he thought I was out of my caste.
I called a girlfriend that night and discussed the conversation with her and we both agreed I should talk to my other Dr and tell him what transpired and to get someone different for my plastic surgeon. As it turned out, the next day I had an MRI and a tumor was found in the other breast so my treatment plan changed, our conversation was that I needed another biopsy and we had to jump through some more hoops to get me IORT by starting a clinical trial. Things were changing from one minute to the next, I was never able to express my concerns about Savalia because everything was moving fast and furious and I didn't want to sound ungrateful. But I had high anxiety about Savalia doing a botch job on top of the whole intensifying cancer situation and I was there alone. I had already dodged one doctor who was going to amputate one breast and leave the other one full of cancer, my head was spinning and I wasn't able to find the right situation to discuss my concerns. So I went into surgery praying that enough people would be watching that he couldn't do too much harm.
As soon as I was able to take the bandages off I knew that the job was botched. I decided after I got home to wait until the swelling went down to make a judgment but after going to my 6 week follow up, my Dr. stared at my right breast, looking somewhat bewildered and kept saying "I'm not loving this ." I tried to be stoic and told him how grateful I was that my margins were so good and I’m lucky to be alive, that I was feeling great and healing well. But he just kept staring at the right breast and saying how disappointed he was, that he’d expected a much better outcome.
I left his office feeling sick, like I had Stockholm Syndrome and was covering for Savalias botch job. Why couldn't I just be honest and say what had really happened? So I flew home and anguished over it for the rest of the week and then sent him a letter telling him what really happened and why I wasn't able to express myself. I told him that basically he told me I was a low value patient and as a result of that I knew I would probably get a poor quality outcome but wasn’t in a situation to discuss it, that I just accepted what was done was not going to change so I should try to live with it.
I got an immediate response from my Dr, he was very concerned and asked my permission to discuss it further with his colleagues, to try to figure out where to go from here. I told him I don't want to get drawn into any more controversy. As it is, I’m very distressed to think someone could harm me while I am under anesthesia and I just want to face the truth and get this behind me.
Now I am also wondering if I should have said anything at all, maybe I’ll be shunned by the people and the institution who just saved my life and what if I need them again in the future. All the doctors and healthcare workers there did such a great job, went above and beyond for me. It's hard to know I should have handled this better, I should have said something before the fact, but I didn't so should I have said anything after the fact?
So that is my experience with Nirav Savalia and if it helps to prevent this happening to someone else no matter where it is, please trust your instincts and try to advocate for yourself. These are difficult situations and predators surface when you are most vulnerable and least expect them. What I know today is that overall I got excellent care and I'm not going to let one sociopath ruin my life when so many people worked so hard to save my life.
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