“As part of a regular ongoing effort to provide quality patient care,” reads the letter from the Breast “Care” Center. “We encourage annual follow up care.” It then goes on to say that they would greatly appreciate receiving information concerning my health status since last treated there.
Really?
This is the Breast Care Center where I had mammograms for ten years without ever receiving a bi-rad score, and where they could no detect a hazel nut sized, slow growing, tumor from one year to the next. I was the one who discovered my tumor when it was T1C-almost Stage 2.
This is the Breast Care Center where the radiologist, as she measured my ominous lump on the computer screen during my biopsy, said: Oh, we saw that last year. But we did not know what it was. How about finding out? Is that not what radiologists are supposed to do? Are they not supposed to investigate a lump seen on a mammogram? Is that not why women have them?
This is the Breast Care Center where I was sent me home after a biopsy with detailed instructions on how to apply an ice pack on my breast every fifteen minutes. They told me not to have vigorous activity for 24 hours. Told me, that if I had a large area of redness or fever, I were to call them immediately. But there was not one word what I should do in the unfortunate event the biopsy was not what they had hoped. No instructions at all how I should proceed if my biopsy was positive for cancer.
This is a letter from the Breast Care Center where its own radiologists calls me at work and tells me: You have cancer. Any questions? And hangs up on me when I, too stunned to even understand what she just told me, answers: No, no questions.
Click.
This is a Breast Care Center where a major overhaul of both procedures and training of staff is needed – an overhaul of everything from how to communicate with a patient, how to read an x-ray, what to do when a radiologist sees something “she does not know what it means.” How about consulting with another doctor? How about calling the patient back for additional x-rays? How about a biopsy?
And as part of the general over haul, this Breast Care Center should consider some new magazine subscriptions.
Most women no longer crochet doilies or make many casseroles. At least no one I know.
I will write them back and let them know my status: I will never set foot there, ever, again. The letter came with a stamped return enevelope.
![iStock_000002471597XSmall[1]](http://cancerboob.com/wp-content/uploads/2009/08/iStock_000002471597XSmall1-300x282.jpg "iStock_000002471597XSmall[1]")
Ever since my surgeon and his assistant started to babble about a “procedure with a wire” I assumed my tumor would be removed with a wire, as opposed to carved out by a razor blade or an exacto knife. As silly as it sounds, I have been mentally stuck on the image of a wire lasso slung around my lump.
Children often get stuck on words that will, in their immature minds, take on strange and incomprehensible meanings. Yet children usually do not ask for clarification, they just conjure up these bizarre images in their heads. And apparently, so do 60-year olds.
The scene playing out in my head has been this: the surgeon makes a slit in my breast, of the kind I do when I want to stuff a prune into a pork roast. ![iStock_000000844923XSmall[1]](http://cancerboob.com/wp-content/uploads/2009/08/iStock_000000844923XSmall11-225x300.jpg "iStock_000000844923XSmall[1]")
He then proceeds to take a thin wire and shapes it into a lasso around my lump before he pulls the tumor out, roots and all, like a radish pulled up from its garden bed.
The mysterious wire procedure (needle localization) turns out to be a procedure where a wire is inserted in each breast before surgery to later guide the surgeon to the right place during the operation. It is important to have the “wire guide” where tissue is to be removed from lesions that cannot be felt, or perhaps not even seen seen by the naked eye. The exact spot where the wire needs to be is identified on a computer monitor, hooked up to either a mammogram or an ultrasound machine, and the wire insertion is preceded by the insertion of a hollow needle.
Before the needle is plunged into my breast,the skin is cleaned and numbed. The doctor and the technician checks a computer screen to make sure the needle is in the right place before a thin wire is pushed down to replace the needle.
Doctor Competent and her nurse, two middle aged women, are both jovial and seem to enjoy working as a team. They banter and tease as would two sisters on good terms, or two old childhood friends. Like a well choreographed dance troupe, they anticipate each others every move. They respond to each other before a word is ever spoken. And they giggle and laugh a lot while still maintaining their professional aura.
Despite their pleasantries, the procedure hurts, especially when they try to stick the wire right down in the tumor site.“But of course,” says Dr. Competent, smiling. “It is only natural that it will hurt you more in that area.” It also tickles when the nurse puts her hands on me and tries to adjust my position in the machine. I squirm and the nurse shouts: “You moved!”
“She moved again?” asks Dr. Competent.
They both laugh although they have to start the whole thing over.
Finally, I end up with a bopping extra-terrestrial antenna sticking out of each breast. The nurse bends them down and tapes them to my breast before I shuffle back to my gurney to wait for the “real” procedure.
