From the category archives:

Mammogram

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My friend Elise, who had breast cancer more than 30 years ago, sends me an email. Back when she had her first breast cancer bout, she was a law student with two young children. She had a mastectomy. No implants. No chemo therapy. No radiation. Now she has discovered something in the breast she has left.

Right away I pick up the phone to call her.

“ I went over to the Magnolia Cancer Center to get a diagnostic mammogram and to see Dr. Guru,” she says.  “He is not overly concerned but wants me to have a biopsy. Told me it would be the medically prudent thing to do.”

She pauses. I am looking for the right words because I can tell she is more worried than she lets on.

“I must admit I am a bit rattled,” says Elise. “Although Guru seems to think it is highly unlikely this is cancer.”

“So did he look you straight in the eye when he told you it is nothing,” I ask Elise. “Or did he avoid eye contact, shuffle the papers or glance at the cell phone as he spoke? Did he say it was “nothing ” or “probably nothing?”

Elise and I speculate over the phone, like two high school girl friends speculating about some boy. Did he really say he likes me? Do you think he will call? Except Elise and I are now two middle-aged women, not two loved-crazed teenagers. And our speculations are not about a boy one of us fancies. It is about the surgeon oncologist we both share. And we are not trying to read tea leaves about love, but about biopsy results before they are in.

We analyze Dr. Guru’s every gesture as he talked to Elise. Every nuance of his demeanor, of his tone of voice, of the words and how he weighed them. Finally, I conclude: Well, Elise, if that is what guru said and if that is the way he said it, then it is from God’s mouth to your ear. Of course you will be OK. He would never say it that way if he wasn’t sure, I tell her.

Elise sounds relieved. I am relived too. I believe what I just told her. But then again – even if I didn’t – I would have told her that  she would be all right. Just as I would have assured her if she had asked: Do you think he will call? Like any   real friend, I would have said: Of course, he will call you. And then if the call never came: “He didn’t call you? How strange. Maybe he lost your number? Maybe he dialed the wrong number, could he have read your 4 as a 9? You write your fours like nines some time. Maybe he is too shy?”

What is even more typical in my friend Elise’s situation, she would speculate with a friend rather than turn to an expert. Her husband is a doctor, he works with guru, and they are practically neighbors. The most logical step, perhaps, would have been to ask her husband to ask Guru if he really thought it was “nothing” or if he was more concerned than he let on. But no, Elise mulls all these scary details over with someone, me, who is probably the least qualified in the world, medically speaking, to give advice. But I will say what she wants to hear.

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“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.

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The Mysterious Wire Procedure

August 21, 2009

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 […]

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“Ask an Expert” – It May Save Your Life

August 1, 2009

You don’t understand your doctor’s mumbo-jumbo, or have doubts?  You are confused about the correctness of your diagnosis or your pathology report? You are too scared to wait six months to find out what may lurk inside your boob?  You have a family member, or a friend, with breast cancer and you want to figure […]

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Seven Sick Reasons Not to Check Your Breasts

July 27, 2009

I. Nobody in my family has breast cancer. But: Eighty percent of  post-menopausal breast cancer patients do not have a family history. II. I need to wait until my son’s wedding, my husbands 50th birthday, our 20th anniversary trip/my daughter’s high school graduation/until after my high school reunion. But: What could have a higher importance […]

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My Medical History Is…Lost

July 22, 2009

My medical records have evaporated. Buried in some nuclear waste site? My “health file” at home contains a brochure regarding an ancient, and expired, insurance plan. Not a single piece of paper refers to past doctor’s visits or mammograms. Not a single reference to the benign findings of my earlier biopsy. Certainly no pathology report. […]

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Another Scary Mammogram

July 14, 2009

As I enter the semi-dark room for my third mammogram in a month,  I notice two large X-rays mounted on a back lit panel. One shows a breast with two lumps and a calcified area, all clearly circled in red. I assume this is the view of  my right breast and freak out at the […]

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Finally – First Meeting with the Surgical Oncologist

July 5, 2009

Finally, I meet with Dr. Guru, my surgeon oncologist, after a two week wait. It seems like ten light years. The waiting room is enormous, empty except for an elderly couple. I notice that they do not carry an over-sized,  brown x-ray envelope, like I do. The staff in the reception  is slow and overweight, […]

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Retrieving My X-Rays from the Breast “Care” Center

June 29, 2009

Friday afternoon. I drive back to the Breast Care Center for the fourth time in less than a month to retrieve my mammograms. I need to give them to my surgeon when I see him. Again, I ruminate  over the hopeless, pointless, and completely unanswerable question: Why did they not find my lump last year, […]

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Announcing to Extended Family: Onset of Anxiety

June 29, 2009

Sunday dinner with extended family: Sister- and brother-in-law celebrating the return of a lost son. He is now home after two years in Japan, teaching and one year in Vietnam, doing what? We are about to find out. Luke is sensitive, intelligent, and well-informed, I can’t wait to hear about his Asian adventures. Yet on […]

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