Posts Tagged ‘mammogram’

My last post was about breast cancer biopsy (the bruising is completely gone now). I told my brother that I wasn’t surprised by the outcome because doctors have “tells” in their speech and mannerisms. I am, however, disappointed in that I am now a statistic. A lucky one, at that.

Had I not been referred for a bone density scan, I would not have called the radiology lab at the local hospital. Had I not called, I could easily have ignored the referral for a mammogram. I still could have ignored that referral but I decided to just go with it despite my previous painful experiences. I still don’t know what the bone density scan showed, but I sure as heck know what the mammogram revealed and the subsequent needle-poking of the biopsy proved.

Emotions tend to run high at the mere hint of the word, “cancer”. I’ve had several basal cell carcinomas removed from my face and a couple pre-cancerous lesions. Nobody freaks about that although those areas were much larger than the carcinoma discovered in my left breast. It’s so tiny, it can’t be felt by a routine self-exam. It’s considered an “invasive carcinoma” which merely means that it has invaded my breast tissue.

The word “metastatic” was not written in the report nor has it been mentioned by anyone. So, calm down everyone: it’s tiny. It most likely has not moved into the lymph nodes. All my markers are good. I’m not freaked out.

I’m irritated at the timing, worried about how friends and family have reacted, and not real thrilled with all the upcoming tests and surgery and follow-up, especially (irritation) during the height of garden season. my list of questions for the oncologist had more to do with the timeline of care and recovery than “Am I going to die? Will it recur? How scary is this?!” I still have no definitive answers on the timeline, but there is an outline of a game plan, and it does NOT involve chemotherapy, mastectomy, or even a whole lot of radiation.

The number of friends, family, and acquaintances I know who have already been down this road have been diagnosed with Stage 3 or 4 cancers, some metastatic and some highly aggressive. the living ones (sadly, I have lost friends, acquaintances, and family to this scourge) have either told their stories publicly or I have known them well enough to have watched them endure the weeks and months and even years of recovery. We all know those stories. I think that is where the fear comes in.

The doctors I have spoken to have gone out of their way to be kind and considerate. My own PCP (Julia) left a voice message that if I “needed to talk…” she would be there. The oncologists office was cheerful and upbeat in a true effort to make the whole process less frightening for cancer patients. Everywhere I have turned so far, it seems like I am being handled with kid gloves, as if my emotions are going to just spiral out of control.

I was referred to CompassOncology which has several offices in the Portland Metro area, the closest of which is 20 miles away, right off of I-5, and very reminiscent of my commute for at least 10 years. My oncologist is a Dr. D who is tiny, funny, sincere, and caring. She’s also very thorough. And she’s on vacation all this coming week.

Which is OK because I have to have an MRI a week from today. A mammogram only catches 50% of cancers. An MRI catches 97%. They want to know if the mammogram caught the entire picture of what is happening in my body and only the MRI can do that. My husband and support person whispered, “If that’s the case, why don’t they just do a routine MRI for breast cancer?” (Answer: insurance companies don’t want to have to write off that expense.) He also offered to take me to breakfast after the MRI even though I might be a bit loopy (I’m claustrophobic and will need a little sedative to get into that tube face down for 20 minutes).

Check that: MRI on April 30.

I also need to see a hematologist. This is because I had a DVT (blood clot) in my left leg a year ago and there was no obvious reason. No surgery, no bumps to the leg, nothing out of the normal and my blood pressure and heart beat all tested out relatively normal. this came as no surprise to me: Julia had mentioned it last year saying that we could rule out a clotting disorder if I saw a hematologist. We need to rule out a clotting disorder before I go into surgery.

The fun part about this upcoming appointment is that it is at 4PM. I’ll be driving home in high traffic. It’s OK, I’ve done this commute before, too many times to count. I told my husband he is not allowed to come with because I don’t want him to be in the car with me when traffic comes to a dead stop. And starts again. And stops again. he’s not good company in heavy traffic.

I do know the surgery will most likely be a simple lumpectomy and that one lymph node under my left arm will be removed for testing. I was advised Saturday by a cancer survivor that the injection of dye into the breast is the worst of it that no one tells you about. So yay for implanting that bit of knowledge into my nervous system.

Telling friends and family has been … interesting. A lot of “I’m so sorry you are going through this” comments and virtual hugs. I don’t want anyone to feel sorry for me. I am going to be okay. Two friends broke down and cried. But I still made summer plans with one of them. My family… Well, my brother made jokes (I love that guy). I know they are all there for me, if I need them. But I am still making summer plans with some of them. I’ve heard privately from other dear friends, encouraging me. All the same people who reached out when our son died.

This has been a lot more serious than I intended it to be. I was planning on making jokes all the way through. I’m not far enough into the process to make this journey humorous, but – trust me – I will find a way.

The photos I am using were sent to me by a very dear friend shortly after my last post. She said they were the first images she saw after she read (and deciphered) my last post. They are of the Oregon Coast. They are proof that I am blessed. Very blessed.

Please do not feel sorry for me. This is just a little stumbling block. I’m in good spirits. I’m hopeful. I am grounded.

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Liar, Liar, Pants on Fire!

Today was Biopsy Day. I’m recording this, not because I am afraid I will be diagnosed with the dreaded breast cancer, but because I think women should know. And men who are married to women or in a relationship with a woman or have a woman in their life that they care dearly about.

First, they did a second ultrasound so they could mark my left breast for the incision. Promised me that I would be injected with lidocaine and that would be the worst of it. I know all about lidocaine and the pain of that injection. Definitely was not looking forward to that injection. I have been to the dentist too many times in my life to even think it wouldn’t be painless (and dentists use lidocaine’s cousin, novocaine). Besides, all of this entails a very large needle inserted into my body.

I do not do needles. I close my eyes at the dentist’s office and I turn my head when they draw blood at the doctor’s office. I cringe when I get a vaccination. The only Vax I ever got that didn’t hurt was Covid #1 and Covid #2. True story. I didn’t even bleed either time which befuddled the paramedic giving them out who was ready to put a bandage on the injection site. No blood, no mark.

Otherwise I bruise and turn purple. It’s just a fact. You mention the word “bruise” in a medical office and my skin immediately turns purple.

They mentioned the word “bruise” today. I haven’t been able to peek under the bandage, but I’m pretty certain I turned purple.

All the prep went well, we were on schedule, the radiologist was a pleasant person, and then came the big needle. Oh – did I mention the ultrasound imaging was right in front of my face so I could watch the needle being inserted into the fattty tissue? And that I don’t do needles? There it was, in front of my nose, long and silvery, and then came the sting of lidocaine. And more. And more.

I neglected to advise the radiologist that I usually need extra novocaine when I have the dentist work on a cavity in my teeth. OOPS.

That first biopsy was a searing fire-hit needle into my breast and beyond. My eyes watered. I almost cried out. I certainly gripped the handles of the guerny. DAMN! So – more lidocaine. But not enough. SHIT! More lidocaine. Third times the charm.

BUT – during the pre-biopsy ultrasound, they discovered another “suspicious” mass they wanted to biopsy. “Not a real concern, but we’d have to monitor it every six months…” and my brain screamed: you mean the smash-smash-smoosh-smoosh EVERY SIX MONTHS?!” Nope, nope, nope. I just went over fifteen years since the last one and now I’m being subjected to more torture. NO. Biopsy the bastard.

So the first needle went in and it stung like a bee sting. I lied and said I felt nothing. JUST GET IT OVER. The second needle hit my nerves like a yellow jacket with purpose. My breast will never be the same. The third shot… well, the numbing medication went into effect and I felt nothing. Heavy sigh.

But- but, but, but – they aren’t finished yet. Because now there is a “light pressure” mammogram on the plate to make certain the little metal markers inserted are where they need to be.

Oh, did I fail to mention that part? They insert little metal markers with cute little names into the position of the suspicious mass so they know what they biopsied. Site A gets one marker and site B gets another marker. They are different shapes. Site A has an oval marker and site B has what they names “infinity” but it isn’t actually an infinity symbol. Someone flunked math. It’s more of a corkscrew and I would have named it the “Wine Marker”.

The light pressure mammogram was exactly that: at least they didn’t lie about that. But I had to wait with a little sticky ice pack on my breast while the radiologist reviewed my files. Can’t risk swelling.

I am home now. Ice on every 20 minutes and off every 20 minutes. I can feel the incision and the path of the needles through my fatty tissue. Can’t remove the bloody bandages for 76 hours. No lifting, no planting flowers in the garden during these exceptionally warm April days, and sit still. I’m excited.

I get the results in two to three business days (Tuesday or Wednesday next week). I’m leaning toward they will be benign and all this hoopla will be for nothing because that is my medical history: all panic in the foreground and nothing to worry about after the tests are done. I hope this for every woman (or man) who has to undergo this kind of scrutiny/injections/biopsies.

I will post updates next week. Until then, scrunch up your battle face and do the mammogram. ‘Kay?

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If you don’t know what that is, you are most likely a male of the homo sapiens. It is a sadistic medical procedure women put up with (at least some women do) annually or every other year. I did it twice in my mid to late thirties. That was, um… a while ago. Quite a few grandchildren ago. I mean, I raised my kids, saw them grow up and start their own lives after that last mammogram in the 1900’s. Yes, that is correct: back in the 1900’s. Like a century ago. Last century, anyway.

(I hear my son making some snarky comment about my age and my close relationship to Moses. Damn, I miss that kid’s snark.)

I have dodged every mere suggestion of a repeat of that last Smash-Smash-Smush-Smush because that was *exactly* what it was. The tech was a sadist. I only went in for that second one because the first tech was kind and gentle and didn’t attempt to smash my 32A breasts to nothing. The second tech didn’t care anything about my pain. She screwed the plates down hard and taut and then took her sweet time taking the images while I bit my tongue. I swore I would never – NEVER – endure pain like that again unless I was somehow placed in an internement camp and set up for torture.

I am not unsympathetic to breast cancer survivors. I know a few and have known a few who survived for a few years. But I had tiny little bumps on my chest and they were easy enough to do a routine, monthly, self exam. No cancer history that I know of in my immediate family. And a healthy respect for Erma Bombeck’s description of the procedure. Erma was a breast cancer survivor and knew what she was writing about when she described a mammogram in detail. Do yourself a favor and “google” “Erma Bombeck Breast Cancer.”

Erma was far funnier than I can aspire to be.

I know a group of women in my prayer circle who refuse to do the procedure. They dodge it as skillfully as an athlete in a dodge-ball game. Me, I’m more the kid who gets hit with the ball and leaves the game with a big bruise on my belly from the impact. Still, I managed to dodge that ball for a couple of decades. I just forgot I had a referral.

I had enough other medical issues to deal with that seemed much more important. A bleeding kidney that turned out to be nothing at all and which suddenly ceased bleeding after three years of medical tests and questions and procedures. Some skin cancer that had to be scraped off. A broken foot that revealed I have thin bones and needed to go onto medication to try to rebuild the bone and strengthen my skeleton. A little this, a little that. Always something that turned out to be nothing at all or something highly treatable. Last year’s heart scare (which was probably more about a broken heart than any actual physical issue). High blood pressure which is currently under control. A wounded rotator cuff that just sucked eight weeks of my life into physical therapy.

Okay, the PT wasn’t all that bad. I started with a shoulder so frozen that I couldn’t raise my arm over my head and I graduated eight weeks later with almost full motion restored. I still have a lot of exercising to do, but I reached my personal goals of being able to life and reach and GARDEN (if only the rain gods would relent and allow me to get my fingernails dirty).

My Primary care Giver (PCP) is a wonderful person. She has four children, same as my daughter: three boys, one girl. She sets me up with referrals that I don’t always follow through on and forget about until we meet the following year: “Mammogram? Oh, gee. I didn’t do that.” But she got me this year.

I have to have bone density tests every couple of years in follow up to that painful instep break I managed to do to myself a number of years ago. I fractured two metatarsal bones in my right foot by slamming my foot into a bed post in the dark. I climbed into bed and cried until I fell asleep. Only when I woke up and needed to get up and pee did I know how badly I’d mangled my foot. The pain was not pretty. Let me give birth to a ten pound baby before I have to step on a broken foot again. (For the record, I did give birth to a ten pound plus baby and it really was *not* as painful as trying to put weight on a broken foot.)

Besides, the baby had certain rewards that came with his birth. A broken foot only precludes you from jury duty, driving a car, and running a marathon. The baby came with a certain sense of snark, sticky fingers, and a penchant for making me laugh whenever I was angry at him.

I saw my PCP in January. She ran the usual tests and we talked about the usual things (“have you had a mammogram recently?” “Nope.”) and she sent out some referrals. One was to physical therapy and two were to the local hospital for imaging. I figured I could do the bone density test and sneak away without a mammogram yet again. Score!

It didn’t work out that way. I called the hospital to set up the bone scan, but the bone scan is done in the same department as mammograms and the scheduler had both referrals in front of her. I wasn’t prepared with a good excuse so allowed her to schedule both tests on the same day, just 30 minutes apart. I thought I might buy a bottle of wine in celebration after – or I could hope that the sadist was an anomaly and I’d get a sympathetic tech like my first mammogram tech. Worth a hope, anyway.

The bone scan was easy. I still have a lot of work to do to rebuild bone density.

I have gained a lot of weight during retirement/Covid. My breasts are no longer mere 34A, but are more 36B. Fat has its benefits. Muffin tops are not something to be proud of, but that’s where I am in this stage of life. I even had to hold some of my fat out of the mammogram. Literally. I’m 25 pounds over what I used to be and it’s all settled on my waist and above. It used to settle in my butt. I don’t know which I prefer. Well, I do: I prefer to be 25 pounds lighter than I am now.

Probably too much information, but I am at a stage in life where I really don’t give a flying flip. This is what women go through: body shaming, fat shaming, breast shaming, butt shaming. Age rounds our faces and adds wrinkles. We lose our upper arm strength and musculature. We get thinning hair. Unwanted whiskers grow on our chins and out of our moles. (I understand men go through similar physical changes. I can’t speak to that. I am not unsympathetic.) Sometimes we get benefits: I no longer grow hair under my arms or on my legs. I haven’t needed to shave in a decade. Benefit.

The mammogram tech was very kind and gentle. Everything went painlessly. Then I got the results: asymmetry in one breast. Well, no surprise: my breasts have always been asymmetrical. One larger and the other smaller, and neither one lines up like my eyebrows or my ears. It’s like the angels who worked to create my body didn’t communicate. It’s probably why I make weird sculptures. What is perfect and symmetrical, anyway? Nothing of Nature.

Here’s the kicker: if you don’t have regular mammograms, your old results “disappear” after ten or so years. There’s no “baseline” anymore. The techs don’t know what your mammograms looked like before. It has been a lot more than ten years for me, so – no “baseline” for comparison. I could tell them that dense breasts are my baseline, but they don’t have that data. That data died during Y2K. Just kidding – it was probably still available for a few years after that supposed “crash” of the Interwebs. But it definitely died in the mid 2010’s. They need you to come back in to establish a “baseline” for the results.

Another Smash-Smash-Smush-Smush. And this one was not as nice as the former. I will say that the tech today was not a sadist. She tried very hard to not put me in pain and she hurried to take the images so I wouldn’t scream in pain while she did it. Then she ushered me to the ultrasound tech. My poor bruised breast complained as the tech ran the ultrasound over the smashed and bruised flesh of the breast in question. I practiced breathing techniques and meditation.

The result is a .5 x .5 x .8mm “something” in breast that has never had anything show up on a mammogram. At least not 20 years ago. But it is there now. I have to go back for a biopsy.

I am a little surprised: nothing ever amounts to anything for me, medically speaking. The radiologist said it was probably a very recent growth given the size. I find myself running through “worst case scenarios” and none of them are that bad. But it is certainly a wake up call to myself and my group of friends who are mammogram deniers. Maybe we should test at least every five years and insist that the tech be extra gentle with our tender bosoms.

And a note to mammogram techs: a little empathy goes a long way. I will probably never forgive that —tech— from years ago. She was a sadist.

I am not particularly worried. It’s just another thing the 2020’s has thrown at me. Another irritation as of this writing. If it is something, it is still another irritation. But – perhaps – i should not be so cavalier about mammograms. I owe my breast cancer surviving friends and relatives an apology for poo-poo-ing this sadistic procedure. The medical industry owes us a better way to examine breasts.

End of the story: I have a biopsy on Friday. No results until next week. I have daily plans next week that I will not renege on.

Until I know…

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