Inevitability, part 2

April 29, 9am. I realized I was starving, bundle of nerves notwithstanding, and since I was incredibly early for my appointment, I checked around for restaurants in the vicinity that served breakfast. My only choice was Waffle House, so I had a waffle and coffee to kill time. It’s amazing how much my nerves stopped jumping once I was no longer hungry.

I was probably about half-calm, overall. I had worked hard the past week to not freak out, and to keep my reactions and thoughts positive. I kept in touch with my friend B, the breast cancer survivor, and she thought I was being amazingly calm. It helped that I had been through this back in the mid-80s… that made it easier to convince myself that this would have a positive outcome, as well. And if it didn’t? I would deal with that when I needed to. No sense borrowing trouble, I told myself.

 I did call another friend, one night when the doubts were getting the better of me. We talked about it, and I told her that 95% of the time, I was ok, and I knew it would all be ok. But that other 5% was killing me, when it would kick up. She told me she would believe for the other 5%.  :-)

We talked about what I was expecting on Friday, and I told her that while I knew they couldn’t know anything for sure until the lab results, I was hoping they could give me their best guess when we were done, so I knew whether I needed to worry or not. I figured it would be 3 business days before we got the lab results back, which meant it might be as late as the following Wed before I knew anything, because of the weekend. I didn’t want to spend another 5 days fighting the doubts.

Breathing deeply, I entered the clinic. I had come prepared to wait this time, remembering to bring in my reading glasses so I wouldn’t have to strain my eyes to read the paper or magazines in the waiting room. No sooner had I gotten comfortable then they called my name for the in-take procedure. We went through all the identification process again, verifying insurance, etc., and I managed to keep the in-take counselor giggling throughout.

I had made it my personal goal to be as friendly and cheerful as I could, and to try and make everyone I saw there smile, or even laugh, if I could. In my mind, I could still see Mom telling jokes to the anesthesiologist as they wheeled her away for her bladder surgery.  I figured that was a pretty good model to follow. And I figured that the other ladies who were  there for exams  were nervous too, and if I could get them to chuckle, it might make it more bearable for them, as well.

After the in-take process, I settled myself in the waiting room again and picked up a magazine. No sooner had I found an intriguing article then they called my name again. Follow the nurse into her office, talk about the process, verify which breast was involved – normally they have you write the word “yes” on the breast that’s being tested. Since they were doing both of mine, it wouldn’t be necessary.

Follow her across the hallway to the waiting lounge, change into the white gown (it fits better than the blue one), and wait some more. I had forgotten that I was allowed to bring my own bathrobe – I might do that next time, just for the comfort factor.

Again, just as I found an interesting magazine article, they came for me. I had the same ultrasound tech as the previous week, which was comforting to me. She remembered my face, but not my name – understandable, since they see so many patients a day. She also remembered how I had fallen through the cracks, and apologized to me for my having to wait so long the last time.

She ushered me into her room, and onto her table. We didn’t have to wait very long for the radiologist, either. This was all moving at the speed of light, it seemed. Certainly quicker than I had ever seen any clinic process patients. Maybe it was only seeming to go so quickly because I was wishing I could postpone it, but I don’t think so. I think it really was that quick.

So there we were in the room together. The radiologist and his harem. His harem was me, the ultrasound tech, and the nurse. He explained the process to me again. It sounded simple, but I was still apprehensive, just because it was unknown, and it was happening to me, not some anonymous patient.

First he would do my left breast. That way, when they shifted me over to do my right breast, the nurse would be able to keep pressure on the entry point in the left breast without being in his way. This meant I would be able to watch the first procedure, because I’d be facing the monitor. He would begin with a local anesthetic (hooray!). If I needed more, I was to speak up, and they’d give me more. It wasn’t supposed to be painful, except for the initial sting of the lydocaine. Then he would insert a small tube in my breast, to use as a guide for the biopsy needle. Once the tube was in place, he would insert the biopsy needle through it, push a button that made a sound like a staple gun, and the needle would pierce the node and retract, bringing with it a tissue sample. It’s similar to the concept of taking core samples when drilling for oil. They’d take 3-4 samples from each breast, but only from one node each. Then I would be given icepacks to keep the swelling down, and I was to refrain from heavy lifting for 24 hours. We reached a mutual definition of heavy lifting (my laptop was ok, but my laptop case was probably too much), and I took a deep breath. It began.

I rolled onto my right side, kept there by towels propped against my back, and watched the monitor as he inserted the needle for the local. I was prepared for the sting, but there wasn’t any. It was the most painless injection I’d had since I don’t know when, and I complimented him on his technique. As he injected the lydocaine, I could see it on the monitor – a dark fluid spreading around the needle point.

The tube showed as a line in my breast, ending before it reached the node they were sampling. They warned me about the sound (it really did sound like a staple gun), and I watched a small harpoon shoot out of the tube, pierce through to the other side of the node, and then retract. No one had ever called it a harpoon before, they told me. I insisted that it reminded me of a harpoon or a spear gun, and while they could see my point, they said they would continue to call it a staple gun to their other patients. By the 4^th time, the novelty had worn off, and I was glad when he said he was done with that side.

Now I was facing away from him, unable to watch the proceedings. This time, the needle with the lydocaine stung going in. Other than that, it was the same as the first, and in a remarkably short time, he was done. As they were cleaning up, I asked him what came next.

 Wait for the lab results, he said. If it’s benign, then just come back in 6 months for another mammogram with ultrasound. Basically, I’ll always have an ultrasound with my mammograms, so I should just get used to it.

 I asked what his opinion was of what he’d seen, explaining that I knew nothing was official until the lab results came back. He said he as 95% certain that what I had were benign, fibro adenomas. The quantity of them, and the nature of them, all suggested fibro adenomas rather than cancer.

 They said I would probably hear from them on Tuesday, if not sooner, because their lab was pretty quick about things like this, but that I shouldn’t worry overmuch.

 So I got dressed, got my ice packs from the nurse, made sure they had my cell phone number with permission to leave me a message, and headed back to work.

 Probably the one mistake I made the entire day was thinking I’d be able to work after the procedure. Oh, I could have, if there’d been anything there to keep my attention. But the ice packs in my bra were distracting (as well as cold), and I was a little light-headed, so after an hour or so spent catching up on my emails, I gave up and went home.

 On Sunday, I flew to

California

for a business trip, and on Monday afternoon while I was preparing my classroom, the phone rang. It was the nurse from the clinic, calling to tell me that the lab results were negative, and I was fine, just as they’d expected to hear.

So now I’m on a six-month schedule for mammograms, and can expect to have an ultrasound with every exam. Compared with the alternative, it doesn’t seem like an inconvenience to me.