Tuesday, February 7, 2012

Don't Be Alarmed

My mom and my sister are breast cancer survivors. I am not naive about my own risk given this family history but I don’t obsess about it until my annual mammogram is scheduled. I never like getting a mammogram--what woman does? But the procedure itself, while slightly uncomfortable, isn’t what gets me, it’s the waiting to find out if the scans are clear. Typically it takes 3 or 4 days before you get the letter in the mail. You want the letter. The letter tells you that your mammogram was clear and to come back in a year. You don’t want a phone call. Phone calls mean the radiologist sees something and you need to have more imaging.

This year I delayed getting my annual screening. I was due in November but my dad passed away, the holidays hit with a vengeance and then my husband had a heart procedure. I knew that there was way too much on my plate and gave myself permission to wait until the new year. As January started to wane, I reluctantly scheduled the appointment, which happened a couple of weeks ago.

I have always gone to the same hospital for my mammogram and the same woman, Donna, has always been my technician. Donna’s sister and mother are both breast cancer survivors, too. She understands the extra sensitivity I have about getting the procedure. So when Donna came out to bring me back to the imaging room, I was relieved to see her; somehow this consistency is comforting. After taking the pictures Donna gave me the usual info, “if the radiologist sees something you will be called back and might require more pictures.” Then she looked at me, shook her head slightly, as if to say “no” and told me that nothing “popped out at her.” I rubbed her arm in appreciation. “Of course,’ she continued, “the radiologist compares your previous films and has greater magnification...”

I left the hospital and took Donna’s “nothing popped out at me” and held it close. I held it with all my might. The next day I felt anxious; more so than usual. The phone rang and my heart started racing. I nervously checked the caller i.d. and saw it was a market research company. Relieved, I decided to keep busy outside of the house to avoid obsessing about the phone. That evening when my husband came home from work I told him how nervous I’d been all day about the phone and how I’d purposely avoided hanging out there. I had even completed a small writing job at the local coffee shop rather than stay home by the phone. Gary tried to reassure me that if they had seen something I probably would have heard today. I added that to Donna’s “nothing popped out at me” and held really tight. As Thursday progressed, I thought I was feeling less anxious. Until the phone rang. It was my sister, Lisa. “Don’t call me on the home phone,” I said, “I’m so scared it is going to be the hospital.” She apologized and we continued chatting. Then I heard the beep of call waiting. “Oh God,” I whined, “hold on.” I glanced at caller i.d. It was the hospital.

Panic consumed me. “Oh my God it’s the hospital!” Lisa put on her best calm and comforting voice and said, “Ok, answer it. I will wait here on the other line.”

I clicked over. A perfectly nice lady somewhat clumsily asked me if I’d received any information or instructions. Huh? No, I hadn’t. “Well this is regarding your mammogram and the radiologist would like you to come back for some additional screening.” My heart pounded. Oh Donna, why have you forsaken me? “OK, I said.” She asked me if I could come in on the following Tuesday at 8 am. She asked me as if she were inviting me to tea. “Tuesday?” I practically shrieked. “You don’t understand, I am not OK and I will not make it until Tuesday not knowing anything.” She went over the schedule and did her best but could not fit me in any sooner.

I felt completely out of control at that moment. I was shaking violently. Odd, adrenaline-soaked thoughts bombarded me: The boys, Gary and I had tickets to see a favorite comedian on Friday. How would I enjoy it now? I was going to ruin the fun night for my family. Freddie only has one year left of high school. If I am undergoing treatment he might get really stressed because he tends to suppress his feelings and maybe he won’t graduate! I will not look good bald. I don’t want to die.

Both my mom and my sister did their best to reassure me. Going back doesn’t mean you have cancer. It just means they see a difference from last year which could be nothing. It could be a cyst. My mother did her very best “I’m not worried at all” imitation that was painfully and obviously not the case. I understood. I’m a mom, too.

I called Gary and he came home. I stood in my kitchen not able to do anything but tremble.

I decided to call the radiology department back and ask them to recheck for a cancellation. A no-nonsense woman named Betty answered. I explained the situation and asked if perhaps I could go to another Providence hospital (there are several) to have the imaging done sooner. Betty pulled my report and offered to read it to me to perhaps assuage some fears. Fat chance, Betty, but go for it. “Possible new or developing nodule in right breast.” All I heard was “nodule” which sounded ominous but then I took a breath and tried comforting myself with “possible.” “Possible” was my new security blanket since “nothing popped out at me” was clearly out the window. Betty explained that it’s quite common to be called back and that there were many things that could be construed as a nodule, which really is a very generic term and that it could actually be nothing. Betty must have heard my heart beating through the phone so she offered to make some calls to see if she could get me in sooner.

Betty called me back and told me that I could go to Providence in Portland the next day. That they were squeezing me in and might have to wait but to check in at 11:00 am. I love Betty and I told her so.

That evening we had martinis, joined some friends for dinner and had wine, came home and had more wine. I was self-medicating. I slept a bit that night. I actually had pleasant dreams but when I would wake up I would remember where I was going in a few hours and start to shake again. Then I’d breathe, stop the shaking and invite the good dreams to soothe me.

Gary took the day off so he could take me to the appointment. He was understanding, loving, kind and gentle. That’s who he is. I asked him if he was worried and I appreciate that he honestly answered yes. If he’d said no I wouldn’t have believed him or I would have thought he didn’t care. He said that whatever happens that we’d be OK and that he would be with me.

We checked in at the Ruth J. Spear Breast Center at Providence St. Vincent. The woman at the front desk gave me a form to fill out and I told her that I wanted my husband with me for the mammogram. She told me that unfortunately no one can be in the room due to radiation exposure and that the waiting lounge is for women only. This was hard for both of us but Gary had no choice but to sit and watch me go alone through the doors to the women’s lounge.

A nice young woman gave me what I must say was a very attractive robe. It was a lovely aqua color which is a very flattering on me. The fabric was quite nice, too. I stopped shaking. I joined a small lounge where several other aqua-robed women sat reading magazines and newspapers. If a stranger was transported to the lounge not knowing what it was, she might have guessed a spa. I wish it was a spa.

I picked up a magazine and flipped through it. I did not see a single picture or word on any page. I placed it back on the table and surrendered to my own thoughts. Another woman offered me part of the newspaper. I declined. I knew I wouldn’t be able to concentrate enough to read. A woman came from one of the procedure rooms, stopped and gave a “thumbs-up” to newspaper lady and practically bolted out of the lounge to freedom. Newspaper lady explained to the room that thumbs-up woman had to come back for more imaging. “I’m glad she’s ok, she said.” I want to be thumbs up lady.

I said, “I am here for re-takes, too.” This made me laugh slightly because re-take sounds innocuous, like when your school picture doesn’t turn out. The woman next to me looked up and said, “I am, too, and I’m freaking out.” I squeezed her arm and admitted that I was also panicking.  I felt slightly better at this point. I didn’t feel alone. These women were with me. We were together.

My name was called and a lady named Suzie took me back to do the additional mammography on my right breast. Suzies live in your neighborhood and bake really yummy things like zucchini muffins with chocolate chips which are amazing especially since you don’t even like zucchini. Suzies don’t tell people they have cancer. I filed this next to “possible.” I didn’t let it go anywhere near “nodule.”

Suzie explained that she would be taking different images at various angles to give the radiologist a better view of the tissue. She said that this would be more uncomfortable than regular mammograms because they were focusing on a particular area. Each time she pressed my breast in the machine I had to hold my breath and stay completely still. She took several images and told me there would just be a couple more. She compressed my breast tissue between the plates again when suddenly a very loud alarm sounded. “Don’t be alarmed by that, don’t be alarmed by that, “ she insisted, as the alarming alarm sounded. For a brief second, I thought it was some sort of cancer alarm. That when something insidious is found it sounds an alert. Of course I knew this was ridiculous. Mostly. I asked her what it was. Slightly less frightening than “cancer alarm” was her answer, “it’s the fire alarm.” “If this freakin’ hospital burns down before I know what is going on with my boob I am going to have a total nervous breakdown,” I thought, not caring at all about any of the other patients or people in the building, which I feel a little guilty about now. Just a little. Eventually the alarm stopped and we were informed it had been a drill.

Suzie finished up and told me that I was to wait back in the lounge while the radiologist looked at my new films and then I would probably be sent for an ultrasound. I asked if I could wait with my husband. She agreed and wrapped a warm blanket around me. I sat with Gary for just a few minutes before I was called back to the ultrasound room. This time he could join me.

A very sweet young woman named Katrina introduced herself as my ultrasound tech and asked me how I was. “Scared out of my freaking mind, “ I replied. She told me that I would have some answers soon and that hopefully everything would be fine. She took me to a dark room and asked me to lie on the bed. She covered me in another warmed blanket and told me that most of what shows up on the ultrasound is not concerning. She told me that she was going to squeeze some warm gel on my breast. “Is that what they’re calling warm these days?” I asked, trying to sound funny and nonchalant, as the rather cool gel hit my recently compressed flesh. I knew better than to look up at the screen because I knew that I would see things I didn’t understand and decide that they were bad things. When she was finished she said she was going to show the images to the radiologist and that he might come in to do more ultrasound himself or perhaps just explain what was found. She told me that we would wait in this room because it offered more privacy.

Privacy. This didn’t sound good. I suddenly missed the other ladies in aqua.

Mercifully only a few minutes passed, maybe 10, and Katrina came back in. I was glad it wasn’t the doctor. Doctors tell you scary things. Katrina, with her pretty brown eyes, white smile and fashionable glasses, doesn’t give bad news. Please don’t give me bad news, Katrina.

“OK,” she said, “the doctor found a couple of things.” She started to say something else and then saw my stricken face and backed up. “First, there is nothing concerning.” Nothing concerning. Nothing concerning. I love Katrina. And I told her so.

She showed me some captured images from the ultrasound. I have a couple of small, fluid filled cysts. I also have a fibrous growth that is benign and common. Because they are so cautious and because of my family history they recommend that I have another ultrasound in 6 months just to observe and look for changes. I can deal with that. I started to cry, tears of relief. I kept trying to hold Katrina’s hand and she offered a hug. I took it.

That night we went to the comedy show and I laughed. A lot.