Monday, February 9, 2015

Of Screening Tests and Inconclusive Results - February 9, 2015

In December 2013, I went for my first official "I'm 40, time to have regular screenings" mammogram. I had had a series of mammograms when I was in my early 30s, though. This wasn't my first.

Back then, I found an odd (smooth, moveable) lump under my arm. I went for a consultation with a nurse practitioner who said "Well, it might be cancer!" I cried and also yelled. "Obviously I know that. That's why I'm worried!" She sent me for that first mammogram. The order of all the things blurs a bit because this was a few months before I got pregnant and, of course, my entire life changed after my kid was born, but there was a mammogram, an ultrasound, a meeting with a GP I'd only seen one other time (and I don't even remember why) who blanched at the results and told me "They have wonderful treatments for these things now" followed by a surgical consult and surgery (during which I was awake - by design, not by accident - it was done with local anesthesia). It was benign, a fibroadenoma. I moved on. My scar is nearly invisible now, all these years later.

Then December 2013. My supposed standard, run of the mill, get a new baseline mammogram? It came back with an abnormality. I got the call while my cat was having an EKG (he's an older cat and he has a heart murmur we now are monitoring closely). I was worried about him that day - a skittish cat with a heart murmur at the vet. I was afraid he'd have a heart attack over it. So when I remember that phone call, it's like it was underwater. I remember someone telling me they'd seen something on my mammogram, and I think I remember someone telling me to come back for more tests, but it's all with this layer of fuzzy disbelief coating it. I remember thinking "Oh, you're not the vet. You're not calling me to tell me how my cat is doing. You're...telling me something"

The timing for such things is never good, but the timing for this was particularly poor. Everything happened swiftly, without much time to plan, right around the December holidays, including while my kid was off of school, including while various doctors and specialists and pathologists were on break, and so on. The radiologist had seen calcifications, which can be normal, but they were clustered in an abnormal manner. I had a second mammogram. Then I had a surgical consult with a new surgeon (I had run from that first surgeon after he was overly alarmist about something unrelated that I got both second, third, and fourth opinions about - and it is a non issue that I have checked yearly by my GP, but I digress).

An attempt at a needle biopsy failed because of the placement of the calcifications. Lucky me - I had to schedule an actual surgical procedure. Full on (outpatient) surgery with anesthesia - and I had to be put under more fully during the procedure itself, I found out afterwards, because I had a reaction to the "twilight sleep" they tried at first. (I wish I knew more about my reaction - I had similar anesthesia during my wisdom tooth removal without issue, but I also wasn't worried that my wisdom tooth was cancer.) I was alone because my husband was home with the kid. I was left, at one point, by myself in a small back area so that someone could pick me up in a wheelchair to take me from the first part of the procedure to the second - luckily a nurse wandered by randomly and I begged her for at least a magazine I could stare at to pass the time. (If I have to do this again, I'm bringing my own damn magazines, even if I have to leave them behind as I move from place to place.)

After my surgery, I was brought back to the wrong room and for a minute the orderly couldn't find my glasses nor my clothes before they were tracked down in my original room. Also I had to leave my phone at home. The horror! It was like 1999 all over again! Also it was boring and lonely and depressing. (Also it was the right thing to do - see: they lost my clothes and glasses briefly.) (I also had to leave my wedding and engagement bands at home, which felt so naked and terrible.)

A week later (A WEEK - I took anti-anxiety meds specifically to get through it) I had to battle an ice storm and my kid being home from school because of it and finding someone to watch her to go for the results with my husband (I really didn't want to face this alone), and the results were...benign. Another fibroadenoma. It had calcifications in it. I was left with pain, a scar, huge medical bills, and relief -- but also anger and frustration and sadness and confusion and a whole host of emotions. Was I thrilled it was benign? Of course. It just was a long road to get to that point.

I was supposed to go back in a certain number of months (I think three?) for a new baseline mammogram and a visit with the surgeon. Unfortunately, though I was told that someone would call me to make the appointment, that never happened. I saw my GP instead several months later to confirm that things had healed up properly and then I kept an eye on it. As 2014 came to a close, I made my appointment for my next yearly mammogram, then thought better of its original timing (December again) and moved it to February, thinking it would give me some flexibility and time to deal with whatever the results would be (but surely they'd be unremarkable!). I healed, emotionally and physically. I finally got on top of everything. The credit card debt, unfortunately, remains.

Which brings us to now. To today. Because I had that screening mammogram early last week and assumed it would show everything healed up and fine and dandy and I'd be good to go. Nope. The next day, I yet again got a call. The radiologist saw something different from last year. Come back. I went back for another mammogram (one that hurt, I cannot lie - but they usually don't hurt at all) and an ultrasound. (Oh boy, more bills.) Something's there. It's probably nothing, it's "low suspicion of malignancy," it could just be a slightly unusual fibroadenoma - and hey, I've had two. But low suspicion isn't no suspicion. There's a concern. There's a worry. I'm off to see the surgeon tomorrow for what was supposed to be a yearly follow up to the last surgery but now is going to be a discussion, a review, and a lot of unknowns.

Life doesn't stop when you get bad test results. My kid threw up all weekend and came home early from school. I've had a sore throat. I haven't had a minute to process, really. I mostly just put my head down and move through things like this. I'll be glad when I know something. It's the not knowing that is the worst. Then you know. Then you make a plan.

To be continued.