Friday, January 15, 2010

A Long Five Minutes

Last Tuesday, I went for my routine annual screening mammogram. Even people (women under 40 and men) who have never had a mammogram understand that this process ranks up there in the category of highly undesirable but necessary medical procedures. For me, it is in third place; closely behind dental procedures requiring Novocaine and well behind number one, ye olde "slide down and put your feet in the stirrups, please".
As a general rule, I've never had too much discomfort during the mammogram procedure, especially the routine screening. Perhaps being small-breasted is a blessing here, or, it could be my relatively high pain tolerance level in action. In any case, other than not particularly enjoying the process as who really wants to stand in an air conditioned room with your top off while a (usually brisk and efficient) woman turns you this way and that, shoves you up against a cold and heavy machine while manipulating your breasts for a righteous squishing?
I had my first mammogram at age 39 1/2, right before I headed off to Italy for six weeks. I discovered right off the bat that one is not supposed to wear any sort of talc or deodorant on the day of the appointment as it can cause a false positive (tiny particles of deodorant can masquerade as the potential of nasty tumors). Unfortunately, this was back when it took several weeks to get results so by the time they had mine, I was wandering around Verona, Italy, searching for my lost suitcase. I made the mistake one afternoon shortly after arriving to check my home voice mail where there was a message from the radiology nurse telling me they'd found something on one of my films and I needed to come back RIGHT AWAY for another screening. As I was in Italy and had no intention of leaving before I was scheduled to, it was in the back of my mind the entire time that this might be my final hooray; playing Camille a bit, as it were (if only with myself as I never told anyone). Upon my return to California, I dutifully went immediately back for the screening and, of course, it was deodorant, not cancer.
Fast forward. Over the past years since then, the vast majority of my screenings have been normal although I was called back in 2007 because the radiologist thought they saw "something" in my right breast. Within the Duke Medical System here in Durham, if you are called back for another mammogram, you have to go to the HOSPITAL, not one of the clinics. I remember that this was the day before Thanksgiving and I made the awful mistake of scheduling an afternoon appointment. One of the readers had called in sick (home with her butterball, perhaps) so they were REALLY backed up. I can tell you, there were a lot of grumbling, grouchy ladies sitting in that waiting room that day (all of us decked out in those oh so fashionable robes that are standard size 3 XXX). I was there over 3 hours that afternoon but the good news was all was fine; turns out the screening picked up a small mole on the outside of the breast. They put a pretty pink sticker on it, screened again; yep, no bad boy cancer. BUT, although the routine screenings don't normally bother me, this one HURT because they were really squishing the breast. Thankfully, it was just two pictures.
So, last Tuesday was the routine screening, as I said. I was very pleased with the procedure; I got there a few minutes before my appointment, they took me back right away, and we were done within 15 minutes.
The following Monday, as in, this past Monday (as I mentioned, results come in a lot faster these days), I got a call from Duke telling me they needed to take more pictures of BOTH breasts. The nurse on the phone was cheerfully non-committal; "Oh, microcalcs in your left which is really common but they want to take a closer look and your right breast, let me see, why do thy want to see you for this breast? Oh, because it's asymmetrical". Me: What does that mean? Her: It's a weird shape (yes, after I hung up I did go into the bathroom and pull up my shirt to see if it looked oddly shaped but it looked the same as it always has). I made an appointment for the following Wednesday; then, got to thinking I didn't want to wallow in fear any longer than I had to so called back and was able to get in yesterday at 8:20 am. I'm sure Mr. B was thankful I rescheduled it for an early day as I was likely awful enough to deal with from Monday through yesterday (that Camille thing again).
So, back to the hospital, back to that same waiting room and those awful robes. At least this time there were hardly any other women there. I ended up initially with a very cheerful technician who talked a mile a minute but thoroughly explained WHY they wanted to see me again. Apparently, the vast majority of women have/will have microcalcs (micro calcium deposits) in their breasts at some point in their lives. 90% of them are nothing to worry about; 10% MAY be precursors to the nasty C. So, they pay attention to them when they first appear. She said I might have to have mammograms every six months for two years to keep a check on them. My right breast, well, I have extremely dense tissue and some of it seemed to be wadded up and so they needed to un-wad it and get a better picture. "So, she said, if you deck me while I'm doing your right breast, I'll completely understand". Uh-oh.
The tech was almost giddy about the new digital machine she had (which take far superior images than the other machines) plus, they are much faster to process (minutes) so I'd have my results that day. She then proceeded to tell me, "No matter what happens, don't freak out, ok? Even if they want to do an ultrasound, just stay CALM!" My mind was racing a bit, but, frankly, I was thinking more how my insurance company was going to FREAK OUT (that is, assuming they will pay for all of this).
So, she did the left one first, congratulating me all along on what a great, compliant patient I was (she was probably happy I hadn't "decked" her). After six or eight images, she started on the right. Ok, this one DID hurt but it wasn't as bad as I was led to believe.
I went back out to the waiting room and then was called back again by another tech for more pictures of the right. I didn't like her quite so much, probably because she wasn't as friendly and was quite a bit rougher (I did grimace a few times under her care; she's lucky I didn't deck HER).
Back out to the waiting room for just a few minutes before the not-so-friendly tech came back to tell me I was done, I could get dressed BUT the doctor did want to talk to me.
Crap. This had never happened before. Usually, they give you a letter of a clean bill of health and send you on your merry way.
So, I got dressed; she took me to some small waiting room AWAY from the main area of action. She told me the doctor would be there shortly and closed the door.
The first thing I noticed was a box of Kleenex on the table next to the chair I was sitting in. Not a good sign; they expect crying, then (as a former HR person, I understand the box of Kleenex thing). I had the newspaper and a book with me, but, I didn't take them out. I sat there staring at the wall trying not to think too much but still managing to think about more than I wanted to. It's amazing how, when faced with something potentially dire, our minds (at least mine) flip into action planning and contingency mode; or, maybe that is a defense against the dark side of slipping into despair.
It was a long five minutes.
I was in the middle of pondering if I'd have to reschedule my Florida trip and who would get my hope chest if I died when the doctor came in, along with a medical student.
She (the doctor) looked about as old as my stepdaughter but the fact that she had a medical student in tow, although annoying, was surprisingly comforting because, I quickly reasoned, she wouldn't be giving me BAD news with this big bumbling looking oaf of a student along side her, would she?
No, she wouldn't. She immediately told me everything was fine (thank you thank you thank you) and the reason she wanted to talk to me was to explain WHY they'd called me back, what they saw and show me, if I wanted to see (yes I did).
Upshot. The microcalcs ARE microcalcs. They are, apparently, fluid and moving around (hence all the pictures; would different angles and positioning cause them to move....yes, they did). As for the right, the Nazi tech managed to get the tissue unwadded (dewadded?) so that they were able to see it was just tissue there, no lumps or bumps (thank you, Nurse Ratchet).
I left the hospital feeling considerably lighter in mood. An added bonus; the parking lot cashier, as I pulled up, said to me, "Good morning, young lady". He then looked at me again and added, "PRETTY young lady".
Today, I've got a pair of sore ta-tas, to be sure and my chest and arm muscles are also none too comfy. BUT, hell, who wouldn't take this over the alternative? Had it been cancer, I would have had a 95% chance of still being alive 5 years later because it would have been detected early. And, yet, this government panel a few weeks ago is suggesting women a) don't need screening mammograms until 50 (and not after 70) and b) that there is no point to doing BSEs (breast self-exams). Why? Because the statistics show (simply stated) that there are more false positives, leading to expensive testing (such as what I endured yesterday) than are warranted for the small number of women in this category who actually end up having breast cancer.
One woman is too much. We all, likely, have known and loved one such woman or women.
And, excuse me, but, I don't want to be included in this "small number" this idiotic panel talks about; not having it detected, and thus drastically reducing my survival rate. I don't want anyone I know; not my sisters, not my sisters in law, not my cousins, not my friends; not my stepdaughter and nieces (when their time comes) to be part of this sad statistic.
Do you?
Mrs. B

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