Sunday, January 30, 2022

2021 Was Supposed to Be Better than 2020

I am writing the depressing account of last summer's medical drama because in a way it is healing to get it out of my system.  So here goes...

So, as it turns out, my ultrasound technician found 'something' and the radiologist herself was called into the room.  After a prolonged session of rechecking the area and looking at the scan, there it was.  A shadow which the radiologist felt needed more exploration.  

"I'm afraid we'll have to schedule for a breast biopsy," the technician said.

 Oh.  Well.  Ok.  There's not much I could say, and I was glad I didn't have to speak anyway, because the panic was now in high gear and the tears were sliding silently into my face mask.  If there's one thing the masks are good for, it's hiding a plethora of emotions from public view.

The radiologist continued, "I'm wondering why your former hospital didn't see this on your 2019 scan, it's clearly visible.  I would have questioned it two years ago."

Wait? I've had this thing for two years?  And no one noticed?

 "I'm going on vacation for three weeks.  I could have another radiologist take over for me, but I want to be the one to do your biopsy.  The area I'm concerned about is very small, but I don't want it to be missed.  Waiting 21 days won't make a bit of difference in your outcome.  We'll send you out to get dressed and I'll have scheduling set you up for an appointment in August."

My biopsy appointment was set for August 2.

I left the room and headed back to the mammogram locker room to change back into my street clothes.  I was in a daze.  This is not good.

I met Carl in the waiting room and the moment our eyes met, he knew the same thing.  This is indeed not good.  On the way home from the hospital, I went all the way from tears to denial and back to tears again.  Maybe just like all the other times I had repeat mammograms, this would turn out to be nothing serious.

Though we still had a lot of work to do in the house and the gardens, my mind was not my own any longer.  Having to wait the three weeks for the biopsy was torturous.  I would have much preferred to have the procedure done right away just to have it over with, but sadly, there are a lot of people needing biopsies.  Wait your turn, please. 

In the meantime, life goes on.  We were to host a wedding here at the garden in mid-August.   Wedding ceremony, reception, dinner and dance were all going to be in our yard.  The groom is my son's good friend and coworker and his beautiful bride is such a sweet person.  We were honored they wanted to share their special day with us.  We wanted to get everything right, especially since this was the first time we had more than just a ceremony and reception here.   We had to clear an area of ailing spruce trees big enough to put up a tent to accommodate the dinner and dance area, so at least I had something to do.

Finally, August 2 arrived.  I didn't sleep very well the night before.  I arrived at the hospital and was ushered into the biopsy room.  The procedure was explained to me and I was given a little time to read over paperwork and sign, though I don't remember what I actually read. 

I'd never had a biopsy before, so the nurse explained the procedure.  The exam table was very high off the floor because the doctor and nurses have to be able to sit under it.  A rolling step ladder was in the room, and I was told to climb up to the exam table and then either sit on my behind and pivot around, or go down on my knees and crawl to the head of the table.  The object was to lie on my stomach and position my breasts through two holes in the table.  This way, they would dangle (great description, right?) through the holes so the radiologist could perform the biopsy. 

The problem was, I was very nervous and shaky and therefore not thinking very clearly.  The room was rather dark and all eyes were on me as I ascended the staircase and knelt on the tall table.  What I didn't realize was the holes in the table were covered with a paper drape, so when I went to crawl forward, my left arm went through one of the holes and I fell in up to my collarbone with a resounding thud. 

"Oh no!  Don't put your ARM through the hole!" one of the people in the room exclaimed.

I won't lie, it hurt.  By this time the tears were rolling again, I hadn't been sleeping well anyway and I was so, so nervous.  They were able to position me correctly and the procedure began.  Another nurse came in and was rubbing my back, trying to distract me from what was going on beneath me.  The area was numbed with lidocaine but I felt the punches of the biopsy nonetheless.  A titanium clip was placed in my breast where the lump was so they could locate it if need be later on.  It didn't take very long anyway, and I managed to make it back off the table without further incident.  Still shaky, though.

  I was led back to the mammogram machine again and two more images were taken of the breast to make sure the titanium clip was placed correctly.  Before I left, I was given a cold pack and post-biopsy instructions on what to do for the next few days. 

We'll call you when we know results, it could take up to two weeks.

Carl decided to take me for a ride that afternoon since I wasn't supposed to do much of anything physically.  I grabbed a spare cold pack from home and we drove aimlessly in a northerly direction.  Going for short road trips has always been a thing we loved to do since we were teenagers. 

We ended up over two hours from home and both of my cold packs had warmed up, so Carl stopped at a small gas station to see if he could buy something cold enough to put on the biopsy site.  We ended up with a pint of chocolate ice cream which worked very well and when we got home, it was the consistency of a milk shake.  It worked out well; we drank it for dessert after supper that night.

Another week went by, and finally on the tenth day, I received a phone call from the hospital.  The lump turned out to be cancerous.  Very small, less than 3/8", but it was invasive ductal carcinoma, Stage 1. 

"The good news is this is very treatable," the nurse said.  "We've caught it early (Not too early, I thought, since the radiologist said it was clearly on my 2019 mammograms) and I don't want you to panic."

Too late, lady.  Panicking already.  Actually even before the biopsy.  Right after the call back for the repeat mammogram in June, panic was already present.

"The next step will be for you to meet with your cancer team."

  I have to admit, I've never been much of a team player.  I really dislike sports.  

A week later I had one appointment with three doctors.  I simply sat in a room with Carl and all three doctors came in to talk with us, one at a time.  The first one was the oncologist.  He told me that his role would come into play after the surgeon and radiologist was done with me.  He asked if I had any questions.  I asked a few, but didn't have much to say.  He wished me luck and departed.

Next up was the breast surgeon.  She was in her early 60's and very tiny and perky.  She outlined that my best course of action would be a lumpectomy followed by radiation therapy. 

I had done some homework before this appointment and decided that I wanted a double mastectomy.  With dense breast tissue and constant repeat mammograms at every yearly visit, I felt it would only be a matter of time before the other breast was involved, too. 

The surgeon was not in favor of my decision. "Having a double mastectomy is not warranted.  It will not increase your chance of survival at all.  This is an early stage breast cancer and a lumpectomy would suffice to rid you of the tumor.  I really do not recommend this course of action.  Other countries around the world laugh at America because so many needless mastectomies are done here.  As I said, it is not necessary in your case."

With that said, she left the room and the radiologist was next up to present his case.

He was a pleasant man with bright green and yellow argyle socks (weird what I notice when under stress) who told me that with the size of my tumor he felt fifteen rounds of radiation to the lumpectomy site should suffice unless after surgery they were to notice a need for more.  

I asked what side effects the radiation would have and was told that there's a special breathing technique wherein I would hold my breath which would expand my lung and protect my heart from 'most' of the radiation.   Ok, but what about my lung?  Well, just the top of the lung would be affected, not all of the lung.

I asked if I had a mastectomy, would I need radiation?  He said, no, not unless the surgery turned up something more dire.  After the radiation was complete, I would be coming in for mammograms every six months for at least a few years to make sure nothing else pops up.  Mammograms every six months?  For years?  No.

I asked if it would be possible to see the breast surgeon again, and he said he would send her in again.  I thanked him for his time and he left.

When the surgeon came back in, I told her I had now decided that a double mastectomy or DMX, for short, was what I wanted, and I wanted an aesthetic flat closure.  I did not want any reconstruction, I wanted to be flat and one and done.

She did her best to dissuade me, more or less saying I was burning down a house to kill a spider, but I had my mind made up.  Fine, she would schedule me for a DMX if that is what I really wanted.

Of course it was not what I 'really' wanted; I wanted to not be there and have cancer at all, but hey, let's get it over with.