General Non-Fiction posted October 8, 2017


Exceptional
This work has reached the exceptional level
For women and the men who love one

Don't give it another thought

by B.B. Rose

1991

My phone rang Wednesday morning at eight-thirty -- not early in my small rural town where folks have been up and at it for hours. But when I answered, it was an unknown woman’s voice asking for me.

“I’m calling about the mammogram you had Monday. The radiologist would like to see you again as soon as possible.”

My legs went weak. “What for?” I was a healthy 49-year-old and it had been my first mammogram.

Her voice oozed alarming sincerity and concern. “The doctor thinks there’s something on the film.”

Barely able to whisper, I scheduled an appointment for Friday.

I meandered through the morning’s chores in a daze, trying to envision my demise. Honestly, I couldn’t picture myself not in the picture. The human species has a massive blind spot when it comes to facing the inevitable.

On the other hand, one of my best friends had died of breast cancer. Even if death wasn’t in the picture yet, I knew the miserable inconveniences and accommodations following a cancer diagnosis. I’d done my best to help, but was mostly a shoulder to cry on. Our town was sixty miles from the nearest big hospital. This meant endless hours to, from, and in that hospital’s waiting rooms, doctors’ offices and labs. I’d listened to her descriptions of painful tests and treatments, mind-dulling medicines, her missing breasts. I’d seen her relationships change as family and friends reacted to the new person she had become – sometimes for better, sometimes not. Invariably though, everyone wanted the original person back, not the new version.  Underlying those struggles was the added stress of mountains of paperwork and towering expense…. And oh, God, no hair.

I spent several hours the next day at the library. The few books on hand about breast cancer veered from maddening clinical neutrality to New Age baloney. I came away slightly better informed, but no better off emotionally. I learned the five-year survival rate for early-detected breast cancer was good. Unfortunately, one of the classic characteristic of small-town life is how, in its microscopic universe, statistical averages get skewed. The studies may say “good,” but in the past five years, I’d known three women, in addition to my friend, who’s been diagnosed with breast cancer. Now, each was dead.

After two nights of uneasy sleep, I returned for the new test. Though I had felt perfectly fine before the phone call, my right breast had ached for two days afterward. I wasn’t surprised when the technician squished the right one into place for the mammogram.

“Do you think that….” I started to ask.

“Hold your breath! Don’t move! Okay, that’ll do it.” And she left the room.

I got dressed, sat gazing at the drab wallpaper for an achingly-long ten minutes.

The tech reappeared. “Everything looks fine.”

“Huh?” I stared at her stupidly. “It does? How can you be sure? I thought….”

The radiologist, a young doctor in casual clothes, stuck her head in the room. “I just read your mammogram. It’s fine. Everything’s great.”

“But, but…I thought you had found something on the film.”

“We did.” She smiled. “A fingerprint. Now go home and don’t give it another thought.”

Yeah. Sure.

2010
I’d like to say I began getting annual mammograms in honor of my late friend, but I’ll come clean. I’d been scared. Still, from then on, every October during National Breast Cancer Awareness Month, I developed the routine of what I jokingly referred to as getting booby-trapped.

Near the end of October in 2010, I received a pink envelope stamped “confidential” in the mail.  After twenty years of testing, I assumed it was the usual form letter telling me everything was fine. I set it aside.

Except it wasn’t the usual letter. When I got around to opening it, I was asked to schedule a return visit for a diagnostic mammogram. My test had “detected a mass of unusual density.”

Two days later, in the mammogram imaging room I awaited the latest results. This time, there wasn’t the blissful news, “Nothing to worry about.” 

 “You need to take another test,” said the tech. “Can you do it now?”

This was getting scary. I nodded okay.

She took me down several hallways to a tiny room for an ultrasound -- that same test where babies have their first pictures taken.

A cheery technician slathered me with gel and ran the transducer around my right breast. Nothing. He ran the transducer around my breast again. “Ah, ha! There’s the little bugger.” Taking my hand, he pressed my fingers into a gel-slicked spot on my right breast, halfway between my nipple and armpit. “Feel that? That’s it.”

“I can’t feel it. How big is it anyway?”

“It’s small. I see these every day. I’d say, about ninety percent of the time these are just benign calcifications.” He wiped the goo off me, told me to get dressed and head on home. “And, if I were you, I wouldn’t worry a bit.”

Music to my ears, but then again....

I was allowed three days off to fret at home before going back for yet another procedure, a core needle biopsy. On the appointed day, I found my way back to the ultrasound closet and the same cheery tech. Another fellow introduced himself as the radiologist who would do the biopsy. “I’m going to insert a hollow needle into your breast and extract tissue from the lump. Then we’ll send the sample off for a final determination. “

I didn’t know which was worse, my breast being stabbed with a very long needle or the angst of having to wait for another result.

Mercifully numbed up, I listened to the men chat as they worked. They were having the casual, “How’re-the-wife-and kids-conversation.”  Then the doctor extracted the needle and he and the tech examined the contents. Conversation stopped. They had seen this kind of tissue before. I knew by their silence I had cancer.

Problematically, I was now diagnosed with cancer in the age of the Internet. If I thought the information available to me in 1991 was not particularly useful, now I faced sorting through an avalanche of web results. These ranged from hundreds of jargon-filled clinical studies to improbable home remedies bordering on witchcraft.

Fortunately, I happened on the website for the National Comprehensive Cancer Network (NCCN.org). A consortium of the top twenty-seven cancer treatment centers in the nation, NCCN experts had developed checklists of steps to take in the wake of any kind of cancer diagnosis. I counted my blessings every day for years at finding those checklists. They were were both informative and reassuring.

The Monday after Thanksgiving that year, I underwent “lumpectomy” surgery to remove a small cancer on my right breast. My breast stayed intact. Tests showed no cancer cells had escaped to my lymph nodes where it would spread to other areas.

Three months later, after healing from the surgery, I underwent six weeks of radiation, five days a week. Piece of cake, until about week four when my skin became noticeably irritated. By week five my nipple began suppurating clear fluid. But then, week six, and it was over. I tested several drugs prescribed by my doctor to prevent the return of my cancer until I found one I could tolerate. After five years I stopped taking that medication as well.

October 14, 2016
My oncologist pronounced me cured of breast cancer.




This is an amended note. In 2015, the American Cancer Society updated its guidelines on breast cancer. At that time it announced that self exams and even manual breast exams given by a healthcare professional were no longer recommended.
Mammogram screening has proven wonderfully effective at finding cancers at extremely small stages. Self exams only find those that are larger and, by that time, require more severe treatment.  
 


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