香港乳腺科醫生 - 點先可以快D睇?
讀者來函:我想找一個好嘅香港乳腺科醫生睇,上網尋找,嘗試打電話問一問,診金昂貴之餘,現在已經排期到兩個月後!搵私家醫生,本來就係想快靚正,但睇黎我係想得太簡單。如果搵政府,我估排期時間應該會好長。究竟點先可以快D見到醫生?呢篇教你「源頭減廢」⋯⋯
乳腺科醫生未見你個人,先見你封信。要快D見到醫生,就要令到醫生睇完你封信後想快D見你。
「我知點做!我咁靚,等我貼自己張相落去咪得囉~」
現實係冇人會貼自己張靚相落轉介信度,咁點樣先可以喺云云轉介信中突圍而出?
唔通要好似大陸咁比紅封包?
你並唔需要好似前廉政專員湯顯明咁送禮酬酢,你需要嘅係同醫生好好合作,做到「源頭減廢」。
源頭減廢
「咩係源頭減廢?係咪好似政府高官咁,一個一個咁落台,就係源頭減廢?」
源頭減廢即係由你封轉介信做起,盡量做到言簡意賅,重點/賣點清晰分明,資料要足/報告要齊,最重要記得唔好鬼劃符。
「我封信D字真係幾潦草,雖然我唔睇唔明,可能乳腺科醫生睇得明呢~」
封信黎到我度,面對住轉介醫生嘅草書,我連你D英文字母都睇唔到,就算我係醫學活字典都冇用啦。我係唔應該/冇責任/冇動力去估轉介醫生寫D乜。而唔知你轉介信寫乜,我真係唔會知你咩事黎睇乳腺科/急唔急,好自然你見醫生個期就會被安排到隊尾。如果後來唔好彩出咗事,你都唔怪得人/追究唔到。
「死啦,我封信真係鬼劃符,點算?」
有錢嘅,搵過第二個醫生再寫。冇錢嘅,禮貌地要求醫生用電腦打過,都廿一世紀啦,仲唔用電腦,阿公阿婆都用智能手機/「鴨舌」啦。
「慘~個醫生唔肯寫過/打過⋯⋯」
你如果唔好彩遇著嗰醫生唔肯寫,你只要比佢知道,佢寫過/打過封信仲快過同你糾纏,我想信醫生最終都會寫/打比你。實際點操作,請發揮你嘅創意。
「好野,我攞到封睇得到英文字母嘅轉介信喇,等我即刻去遞信先⋯⋯」
唔好咁心急住,封信睇得到,並唔代表寫得好。仲記唔記得我上面講重點/賣點要清晰分明?乳腺科醫生而家睇得到你封信,咁下一步就係斷定你急定唔急。呢個時候就要睇你個轉介醫生嘅功力:
如果佢寫得出你有患乳癌嘅高危因素(女性/年紀大/曾患乳癌/重家族病史)或者乳癌症狀(越黎越大硬塊/腫塊、血色分泌物、乳頭凹陷、皮膚凹陷、橙皮紋),甚或至已經抽咗針確咗診(乳癌/非典型乳腺增生/乳房葉狀腫瘤)嘅,我地會好快睇。
但係如果佢將個重點放落低危因素(男性/年紀輕)或非乳癌症狀(乳房痛楚/怕自己生野),甚或至已經抽咗針確咗診良性嘅(乳房纖維瘤/乳腺增生),好簡單,排隊尾囉。
「封信醫生寫,佢寫咩我控制唔到㗎喎~」
你真係認為你控制唔到佢寫咩?諗真D,並唔係~
醫生寫信嘅資料來源咪你度黎,你重點放係廢野(乳房痛楚)度,封信咪廢囉。你清楚知道並講比醫生聽你既乳癌高危因素或者乳癌症狀,封信咪突圍有力囉。唔係教你講大話,但避重就輕係人生必需學嘅一課,所以記住源頭(你自己)減廢(話/料)。
資源回收
「你話資料要足/報告要齊,報告我係有啊,不過係你上一篇所講嘅廢報告,我準備掉咗去」
唔好咁衝動,我地做好源頭減廢,下一步就要做資源回收。報告係廢,不過「廢」係由乳腺科醫生角度出發,因為要由頭做過晒/做多次檢查。不過由你嘅角度呢,廢嘅報告都有佢嘅用途,尤其係用黎寫轉介信時。
「廢都有用?此話何解?」
報告廢,係廢在「模棱兩可」,你正正就係要利用佢嘅「模棱兩可」。「模棱兩可」可以令到乳腺科醫生都唔能夠肯定你真有事定假有事,只好比個「快期」你。如果好彩,有時可能仲有個「特快期」添。
點先可以快D睇香港乳腺科醫生?
「我已經做好晒自己本份,絕對係源頭減廢,自問重點/賣點清晰分明,資料足/報告齊,但返黎個期都係好遲,仲有冇咩方法可以快D?」
睇私家同睇公立有唔同處理方法。
睇私家,同你接頭嘅係接待處嘅姑娘,佢地做又三十六,唔做又三十六,唔做仲可以收早啲,你死求佢都冇用,佢只會答你:「X醫生好忙,最快睇都要兩個月。」消費者只可以做最簡單嘅事,貨比三間用腳投票。
睇公立呢,你可以試吓搵多幾個唔同嘅醫生寫信,一封唔得就兩封,兩封唔得就三封,就好似D家長搵學校扣門咁日日寫信比校長,實行以「誠意」去打動醫生。
「咦,真係得喎,唔通醫生都比我感動咗?」
要知道點解呢招得,咁我地就要解拆吓公立醫院專科門診,究竟係點樣分流?
點樣分流?
公立醫院專科門診,一般由櫃位文員收信,之後交比姑娘/護士長睇信。第一浸姑娘佢地睇咗先,由佢地決定比個咩期你,由「特快期」、「快期」到「唔快期」不等。你個病情係真急定假急,同佢地比咩期你唔係一個正比例關係。最決於好多因素,佢有冇經驗/醒唔醒目/多唔多野做/精神集唔集中/你封信喺咪鬼劃符/報告齊唔齊/轉介信嘅內容。
係,你冇睇錯,轉介信嘅內容只係眾多因數之一。
如果姑娘冇經驗/唔醒目/好多野做/精神唔集中/你封信鬼劃符/報告唔齊,話之你轉介信內容寫到識飛,病人名叫梁振英都冇用,因為鬼掩眼根本睇唔到。
「可惜嗰個落雨嘅晚上,嗰條濕滑嘅公路,嗰個粗心大意嘅司機 ,令我唔可以趕到嚟呢間咖啡室,親口對你講一句『我愛你』」
問題係點解個司機唔用愛膚堅呢?
「可惜嗰個落班嘅下午,嗰條濕濟嘅熱線,嗰個粗心大意嘅姑娘,令我唔可以趕到嚟呢間專科門診,親口對醫生講一句『我怕癌』」
你交多幾次信,就係希望自己唔好咁黑仔,盡量避免不利因素。睇吓交第二封信第三封信嗰日,會唔會撞到個姑娘有經驗/好醒目/精神集中,懂得欣賞你封信/報告嘅內容,從而比個「快期」你。
好喇,假設你過左姑娘第一關。係,冇錯,打咗咁多字先過咗第一關。嗰時文員就會通知你幾時睇。如果你不幸地比姑娘判咗做「唔快」類別,2017。2017?係,又係冇錯,就係D人好天真以為可以普選特首嘅一年。唔快嘅專科門診期係斷年計嘅。
「喂,咁唔掂㗎喎,睇相佬批我冇咩民主命,有生之年都唔會見到普選特首,2017我死咗喇喎,到時黎唔到,又打唔到黎比你取消,浪費你地D期,真係好對唔住。」
為咗唔好比你死住,所以會有第二關。已分好晒期嘅信會交到去高級醫生手上,再睇下有冇嚴重錯漏,明明急,錯判咗唔急嘅,就call返黎快D睇。如果冇大問題嘅,就一切依時跟次序睇。
「咁點解遞多幾封信有可能可以早D有得睇呢?唔通醫生都比我感動咗?」
分流個醫生一日睇幾十封信,睇信都睇到麻木晒,點會比你感動到吖。
「唔明,我感動唔到醫生,醫生仲咩對我咁好比快期我?」
點解咁神奇?可能性如下:
1)第二次遇著個醫生有經驗/好醒目/精神集中。冇錯,醫生同姑娘都係一樣,大家都係人。
2)就算遇著同一個分流醫生,假設以上所有因素都一樣,個分流醫生面對幾封同行唔同時間寫黎嘅信,姑娘仲比2017,係咪自己睇漏野?仔細睇多次/睇多幾次先。用多D時間係你封信度,自然大D機會睇到你要求早D睇嘅賣點。
3)幾封轉介信互相補足,令到醫生了解你更多。
衞道之士實會衝出黎鬧我:「嘩,乜你咁教人濫用公立醫院服務㗎~」
始終最尾決定比快期定慢期嘅,都係負責分流嘅高級醫生。如果醫生唔把好關,你又點可以怪冇專業知識嘅病人濫用呢?
咩話,你封封信都資料唔齊/鬼劃符/冇賣點?
圖片來源:互聯網
咁你只可以等民建聯幫你「成功爭取2017睇醫生」。
諗深一層,你自問已經做好晒源頭減廢、資源回收,但醫生都仲比2017年嘅期你,即係你已經係低危中嘅低危,醫生覺得你冇事。其實未睇醫生,已經睇咗醫生,應該可以放心。
下一次,教你點樣「醫乳癌公私營合作 - 教你點保障自己」⋯⋯
The epithelial cells exhibit mild nuclear atypical. Comedo necrosis is not seen. Invasive carcinoma is not seen. Microcalcification are present. The overall features show profliferative fibrocystic disease with focal atypical Ductal hyperplasia . The atypical ductal hyperplasia measures up to 0.1 cm in size.
This is the report conclusion of my wife test. Doctor suggested her to take checking in twelve months but she is very much worry whether it is safe since there is symptom of the bad cells can turn to cancer tumour.
Kindly assist to comments what next should be doing in a better safe way. Thanks
要睇返個報告atypical duct all hyperplasia (ADH)嗰度切清未,例如有冇寫clear margin。如果已經切清,第一次可以半年至九個月再照,穩定後先照疏D。如果未切清,就做多次手術切清佢。
妳好、我在廣州幾間醫院做咗檢查、做埋抽針活檢,已確診為三陰性乳癌,現想回港睇醫生,因為右胸個瘤好大,似我這種情況可以在公立醫院睇快啲嗎?還有我在大陸醫院做的檢查在香港醫院承認嗎?需不需要重新再做所有檢查?
確診癌症公立醫院一定盡快睇。大陸檢查承唔承認就視乎報告質素同一間間醫院做法。
Hi, my mother had a left mastectomy last Monday and the doctor said that he only removed ONE lymph node and didn’t see cancer in it. Do you think he should remove more lymph nodes to check ?? I didn’t ask him because I was too nervous at that time. But I saw lots of women had about 10 lymph nodes removed to see which one is infected. I’m still waiting for the pathology report from the hospital but I just want to hear from a professional like you what stage does it sound like to you ?? and if cancer did not spread to lymph nodes, does it mean cancer did not spread to other parts of her body as well or there’s a chance that other parts of her body might have cancer. She didn’t do any scan yet so we don’t know. Please kindly reply so I can be less nervous. Thanks
如果係做前哨淋巴,一粒可以接受。如果唔係做前哨淋巴,一粒唔可以接受。
第幾期要睇埋腫瘤大細,其他器官有冇受影響,冇得就咁估。
淋巴冇受影響,唔等如其他器官「一定冇」受影響,只可以話機會相對「淋巴有受影響」的病人細。
Thank you for such QUICK REPLY. I learn so much from your site 🙂 My mom’s biopsy report said the lump is 1.7 cm but the doctor said the actual size can be bigger or smaller after the surgery. But he didn’t tell me whether the lymph node he removed is 前哨淋巴 or not. He just told me he only removed one and there’s no cancer in it and told me not to worry that most likely her cancer is only stage 1 or 2 but I’m still worried that the pathology report came out differently and do you think she needs to have a MRI or Pet scan soon to find out whether it’s in her other parts of her body too ?? She’s going back next week and do you think she should ask for a scan to make sure ??
淨MRI就唔洗(唔係講PET-MRI),係呢個情況係冇用嘅。
PET Scan 就睇情況,如果第一第二期A都唔洗,第二期B或以上就可以考慮。
Hi Breast HK, I have pretty good news. My mom ( 67 years old ) went back to the surgeon to look at her pathology report saying that her cancer is Stage 1 here’s what the report said so I wonder if she still needs to do chemo, radiation, oral pills, ect ?? I asked the surgeon if she needs a CT scan but he said wait for the oncologist to decide and her appointment is in 3 weeks. Do you think I should push to have a CT SCAN sooner than that ?? I’m afraid there might be cancer in other parts of her body Thank you for helping out 🙂
– NO TUMOR IDENTIFIED IN SENTINEL LYMPH NODE
– NO MICROMETASTASIS IDENTIFIED
– INVASIVE DUCTAL CARCINOMA, POORLY DIFFERENETIATED, GRADE 3 OF 3
– MAXIMUM TUMOR DIMENTSION 2.1 CM
-SMALL FOCI OF DUCTAL CARCINOMA IN SITU OF THE COMEDO, SOLID AND CRIBRIFORM TYPE.
– RESECTION MARGINS CLEAR
– ADDITIONAL DEEP MARGIN ( NO TUMOR IDENTIFIED )
媽媽情況不是第一期,是第二期A(pT2N0(sn)),洗唔洗化療/荷爾蒙治療要視乎ER/PR/HER2 status。CT scan就唔洗push。
Thanks for such quick reply. Maybe the surgeon didn’t look carefully or in his opinion, this is stage 1. Is there a big difference between stage 1 and stage 2A ?? I found her ER/PR/HER2 status from the biopsy report, cannot find in the hospital pathology report. Don’t know if that’s accurate from biopsy report. Do you think it’s best to get the complete treament such as chemo, radiation, oral pills , ect ? how many rounds of chemo do you think she needs because she’s very afraid of side effects 🙁
ER – POSITIVE 80%
PR POSITIVE 30 %
HER2 – POSITIVE 3+
分別就係stage 2A差過stage 1。佢係Stage 2A HER2型乳癌,如果情況許可,醫生係會建議化療加標靶,例如TTCHx6。之後要吊足一年Herceptin同食5-10年抗荷爾蒙藥。
乳癌標靶治療 - 乳癌HER2型點樣揀?
Hi Breast HK, I asked you a few questions couple months ago regarding my mother’s case, she’s stage2A HER2 positive with no lymph node involvement and PET SCAN shows no evidence of cancer before she starts chemo . She’s undergone chemotherapy with Taxotere and Cytoxan 4 times and tomorrow is her last chemo. I wonder how do I know if chemo works for her ??? and whether she should have another scan after she finished chemo ?? She’ll have herceptin for one year and oral medication for a few years. Do you know what’s the recurrence rate for cases like hers ?? She is 67 years old and I’m still worry if cancer will be back in other parts of her body. Thanks for answering my questions.
第二期術後輔助化療係唔會知work唔work,一切講個信字。
化療後唔需要再scan。
HER2 型乳癌暫時無計數機計復發率。
你好。已经在私家做完切除手术。想去政府排期做化疗,想问问应该去乳腺专科,还是肿瘤科?谢谢
腫瘤科。
想請問點樣可以同一間醫院交多幾份referral letter去專科門診?但佢電腦唔係會有record?定你指可以遞交唔同的醫院?
同埋如果已經抽埋針證實係癌症 係咪會比個最快的期我?
去同一間醫院多交幾次信,佢係有record,但你嗰幾封信係唔同版本。
癌症係最快的期。
健康院醫生手摸後,係轉介信上寫疑似乳癌,係未乳癌機會大?
好難就咁推斷。