Monday, September 10, 2012

My First Mammogram

I mentioned that rather than being solely focused on my baby girl's first day of preschool and all the emotions and activities attendant to such an event, I have been distracted.

Here's why.

On Tuesday, I went to my first Well Woman Exam since before Ella was born. Which is to say, I haven't had a proper physical since 2008, as far as I can remember.

The doctor found a lump.

She gave me the order to have a mammogram and ultrasound, and the phone number for the imaging facility at which I was to set up the tests.

I went to Target.

It's on the way home.

While I was standing in the aisle between potty seats and bouncy chairs, the doctor's office called me to confirm my contact information. A minute later, the imaging center called me to set up the appointment. My pen died as I was trying to write down the information on the back of the imaging order using the cardboard box of an activity gym as a desk. I etched the appointment time onto the paper, figuring I could remember it long enough to put it into my phone once we hung up.

I bought groceries and cleaning supplies and went home.

I told Justin. He went to pick up the car from the auto shop, and I prepared food for Ella.


The next morning, I started setting up childcare for Ella so that Justin could join me for the tests. My mom asked me where I was getting all this done, and I told her. Before we could talk more about it, I had to take another call. It occurred to me, though, that I didn't actually like the gynecologist I had just met for the first time at that appointment, and that I knew I didn't want to go to the hospital attached to the facility I had been scheduled with or even see that doctor again.

The wheels were set in motion for me to choose a different imaging center, and a different doctor with privileges at a different hospital.

And by "wheels," I mean, I spent Wednesday afternoon, Thursday morning (starting at 7 a.m), and Thursday afternoon on the phone with two local doctor's offices, two local imaging centers, and the breast health center, radiology, and medical records departments at the military hospital in San Diego where I had my surgery in 2006. Oh, and the insurance company.

One of the offices returned my call while we were taking pictures of Ella at her first preschool drop-off. I let it go to voicemail.

You know that frustrated, confused, overwhelmed feeling you get when you're sick and you're standing in front of a wall of cold medicine in the pharmacy, hoping that you're picking the right one? It felt like that, only I don't have a cold.

By Thursday evening, I had connected everyone to the right people to make it possible for me to get my images done at a hospital that I trust and then be seen by a doctor we've heard good things about. Even the insurance was approved.

The imaging center wants my old films to compare them and look for changes. San Diego needs written permission to release the documents. A fax is acceptable, an email is not. From when they receive the request to when it is completed could take 48-72 hours. Then they can FedEx the images to the imaging center, which will take another couple of business days. Or I could just stop by and pick them up.

Justin and I decided to drive to San Diego on Friday. We would make it a family adventure, and take Ella to lunch and the children's museum in Balboa Park afterward.

Comfort Food: We ate down memory lane--Urban Solace in North Park makes The Best Tomato Basil Soup and Grilled Four-Cheese Sandwich I've ever had.

How did that happen? Ella enjoyed putting the light plastic balls into the tubes, where air blew them upward until they flew out the tube into a giant funnel and then came down the other tube (pictured in the forefront of this photograph).

The fountain in front of the Natural History Museum.

Who taught her to pose that way? I mean, really? Who???
 So, as much as I would like to be tunnel focused on my health, you can see that I am happily distracted by my baby girl who started preschool last week.

Still, that didn't stop me from looking back into my files and finding what I wrote about the first time I found a lump. I'm copying part of it here--just the parts about the testing. I'll get to the surgery stuff later (the first paragraph about surgery explains that I was writing after taking two Vicodin and an anti-anxiety pill, so there's some editing to do). I don't want to get ahead of myself, either. I had forgotten, but my records and the emails I wrote after surgery reminded me that surgery sucks. Besides, I might not even need surgery this time, so why worry about it now?


21 May 2006

God in His infinite entertainment is putting little landmines in this field He's dropped me into. I suppose it is my job to see them and figure out how to choose a safe and loving route despite their presence.

Justin [then beginning his third year of medical school] was able to arrange his schedule on Thursday so that he could go to my two month check up at the Breast Health Center. Before the appointment, I, of course, did my research and made my list of questions. Because I believe the lump has changed a bit and my mom has not had breast cancer, nor my grandparents as far as our sketchy history of medical diagnosis in India in the 1950s goes, my mom's cousin had a rare form of breast cancer when she was my age and had to have a mastectomy and chemo and radiation. My conversation with Justin on the way to the hospital went like this:

"I want it taken out, if that's an option," I said.

"No, I think you're being too aggressive. It's probably nothing and there's a lot of risk in surgery." Then he rattled of his Second Year Medical Student statistics of the tens of thousands of people who die during surgery, plus the risk of infection. This, from a man who starts his surgery rotation on June 26 and might want to be a surgeon. "I don't think you should do it."

"Justin, you're not being rational. There's more of a risk of leaving it in if it is cancer and just letting it grow."

"Justin, you're being ridiculous." I started wondering whether bringing him to this appointment to distill the medical jargon was such a good idea. Maybe I should just go in on my own.

"I think you're over reacting."

"You're not talking like a doctor. If you were talking to a patient other than me, is this what you would be saying?" You could almost see the wheels turning ever so slowly in his poor little head.



"I'm the one who's supposed to have surgery. You're not supposed to have anything wrong with you. You're not supposed to have to be cut open."

"That's very cute," I held his hand, "but be realistic."

When we got to the clinic I gathered all their flyers about preparing for breast surgery while we waited for the doctor

I asked the doctor my questions:
"What exactly is it?" Subacute Mastisis

He checked it, noted that it had changed a bit in size and shape, and as I said sort of has a bump on it. (He said to look out for things that seemed like the hard end of a knuckle if you make a fist, and it seemed like that to me. (Justin isn't convinced it has changed.))

We discussed the risks of surgery--infection. I would be sedated, and they would use a local anesthetic. They would cut in at the areola so that the scar blends in and then they can move their way up to get it all out. It's called an Excisional Biopsy. The lump and surrounding tissue, so they can look at it all, in case the needle missed anything. And I get to have another ultrasound first.

So I have the ultrasound at 8 a.m. on May 30 and the appointment with him to pre-pre-op at 1:30.

The surgery will probably be around the end of June—ironically just the time I've been telling everyone not to have surgery or get sick because that's when all the newly graduated medical students, and continuing med students, and interns will have no idea what they're doing. I'm hoping for sooner, so the more experienced ones can do it, but maybe they'll have short-timers syndrome.

I have to decide how I want them to pray for this at church. Whether to just stay in the general prayer section, or be specific and have a laying on of hands. Part of me says, 9 days of prayer that I don't have cancer before I have an ultrasound that won't be conclusive anyway couldn't hurt. The more prayers, the better. The rest of me says this is such a common thing for women I should just let it lie and wait until the biopsy is over.

I don't know. I guess it will be a game time decision.

When I first found out, when I was at the doctor's office, I was all business about it. Just making the appointments, getting the blood tests, and moving on. Then I came home and was efficient about something or another. This is the girl who worked through her miscarriage, just had it right there at school, surrounded by the children of other people's wombs.

Then Friday morning I started getting really angry about it and wanted to talk to people and complain and ask for prayers.

30 May 2006

My morning began with an ultrasound, and then, since they didn't see anything new and wanted a "big picture," I got to have a mammogram, too. They start giving those to women at 40 because they don't want to expose us to too much radiation because it causes cancer. Another funny little ironic paradox.

The first part of the mammogram involved me standing against a cold plastic and metal giant vice with hemicircles drawn on it. My boob left a few circles visible, needless to say. Anyway, the thing squeezed down so hard that I could feel the skin from my chin being pulled. I am going to have a waddle by the time I turn 40 due to premature mammograming And this on a boob that is already sore from a naughty little lump! 

"How did that feel?"

"Not too bad. I could do it again." I already knew that I had to do it in the other direction, too. Did you know that if you turn your head, lift your arm up a bit, relax your shoulder back, and rest your arm over a cold piece of machinery you can squeeze from your breast bone to your armpit?

Surgery to remove the lump and surrounding tissue is scheduled for July 6--nothing unusual seen in ultrasound or mammogram, but just in case. Though they keep saying, "I don't think it's cancer."

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