Today was my first mammogram since my diagnostic mammogram 18 months ago. I went by myself, telling Robert that this was just normal screening; I could manage without him. I need to start weaning myself from the dependency of requiring Robert at every damn doctor appointment. Time for me to make checkups normal. Make a new normal, or figure out what is normal. Nothing feels normal anymore, not even a simple doctor appointment or screening tests to insure I am still whatever this “normal” is.
Anyway, I went by myself, and was doing well, until I had to walk up to those doors to the Breast Diagnostic Center. That is when my dragon unfurled from the little ball it curls itself into a niche in my gut, sleeping away peacefully until moments like this. She unfurled her wings and stretched out her tail taking my breath to shallow little gulps, flicking my heart with her tail causing it to beat irregular. I know how to deal with her, pause, take a deep breath despite her wings trying to squeeze my lungs. I take note of what I am hearing, birds chirping, construction work sounds, cars, planes. What do I see, the plants in the planters and landscaping, a butterfly flitting along a small bush plush with flowers, wispy clouds in the sky. I take note of how the air feels, and what I smell. My little dragon is not squeezing my lungs as tightly now, and her tail has stopped thumping against my heart.
I walk through the doors and sign in, take a seat and wait for the front desk to call me to register for my appointment. I continue with my cleansing breaths every few minutes to keep my little ball of anxiety dragon calmed down. She is still active, swirling slowly through my torso, but she is not making me feel like I need to put my head between my knees so I do not pass out, or breathe into a paper bag to keep from hyperventilating. I tell myself her occasional squeeze is really just her hugging me in comfort. I pull out my knitting to keep my hands busy and my mind slightly occupied.
As I sit and wait on the check in desk to call my name, I notice the men and women sitting in the lobby. You can tell those who are in for their annual mammogram/imaging, and have never had anything come up on their scans. They have a bored look to them, completely at ease with themselves, knowing they will walk back out those doors with another year tucked under their belt and a clean report. They have done their diligence in early detection of an insidious hijacking by their own body, and can spend the next year with confidence that their body will not be betraying them. I envy those women and the ease they project at being in this place. I used to be one of those women with my feelings of all is right in the world when I went through my annual screening. No history of Breast Cancer in my family that I was aware of, I breast fed my children, had them earlier in life, all positive actions that reduce your risk of breast cancer, this was just another screening as part of my Women’s Health Management. I miss those days. I never had a thought for those who looked tense or uneasy. I never thought of all the worries that come into this place with these women. It never once crossed my mind how hard it could be for some to walk through those doors.
Then there are the ones with the nervous glances, the ones you can see holding their breath, holding their middles as if they too have a dragon like mine, and are trying to hold it still. Those with a cloud of worry in their eyes. Some have a partner or friend with them, a few, like me are alone to brave this place, the little room, the machine that will squeeze intimate parts of your body into an unrecognizable shape while corners of this machine dig into other parts of your body so you are at the right angle to capture the best images. You can see the jittery movements of hands, not knowing what to do with them. Some stare at my short purple hair and I see a knowing look in their eyes. Yes, she is one of us. One of the group of women who no longer walk through the doors knowing that everything will be OK and another year can go by in confidence. I am now one of the women who walk through the doors to face demons and dragons, to face our own mortality and the fear of the unknown.
I get through the registration for my appointment. Since this is my first mammogram since chemo, three surgeries and radiation, they need a new baseline and this will be a diagnostic mammogram. The nurse at the registration desk gave me the sheet of paper with my history and any relevant information for me to review and give to the tech. I correct a few items and add some information that is missing, and shortly after the tech comes to the door that leads to the back part of the center, where all the imaging, biopsies, and surgery prep procedures are completed.
She leads me to a small room and provides me with the instructions on what to remove and how to wear the gown she has provided. She pulls the curtain to separate me from the rest of the room as she continues to talk to me as I change. She told me she has been looking at my last set of images that led to the biopsy and diagnosis. She makes a comment that the mass was quite large and asks me how long I had felt it before getting it imaged. I explained to her that I felt it for the first time just a couple weeks before the biopsy. She asks me how I am feeling after the lumpectomy, and after a slight pause where I can tell she is reading my file, she adds in the reshaping of the right breast and reduction of my left breast. I explain about the seroma, how it burst though the incision, the months of shoving gauze into my breast, and finally how it would not heal completely, which led to a third surgery to close up the remaining area. I also told her that the mammogram and ultrasound imaging only caught about half the mass, the MRI that was completed the day of my diagnosis, came back with a mass almost twice as large as what was measured in the original imagining.
She then asks me how everything feels now. I explain I still have some numbness on the left breast around the incision areas for the reduction. The right breast is numb in more areas then where I can feel due to the extensive surgeries and sentinel lymph node removal. I also make the comment that I still do not understand how I can be so numb on the right side and yet experience tenderness and hypersensitivity. The Tech explained that due to how much trauma the breast sustained she could not tell me that any of my tenderness, sensitivity and numbness would fade over time. I had changed into the gown by this point and had pulled back the curtain. I looked at her and said, “Well aren’t you full of good news.”
I noticed she still had my last set of digital films up on her screen, so asked her if I could look. She was completely open to letting me see the images. I could clearly see the lump in my right breast. It was white compared to black, gray and grayish white of the rest of my breast tissue. The mass was not clear edged, had little strings of white fading into the surrounding tissue from the large white center of the clearest part of the mass. It took up quite a bit of the lower portion of my beast from the imaging I could see. As I looked at those images, my thoughts were “Ha, I was stronger than you this time. You are gone, and I am still here.”
We proceeded with positioning me for the first round of x-rays, and even though the tech moved the plates slowly to clamp down, flatten and capture as much of my breast tissue as possible, my right breast tenderness was evident from the very first position. I had six different angles taken of each breast in all. After the first four sets, the tech went to consult with the radiologist to be sure she was happy with all the images completed. I asked her if I could look at the current images while I waited. Sure, no problem. This is so different from all my previous mammograms, when I had asked if I could see the images, the techs always denied my requests. I could see the scar tissue in each breast. There was a great deal more scar tissue in the right breast than the left. The scar tissue was very white, and had hard edges compared to the original images from 18 months ago. Some of the edges looked furled and bumpy, but even with those distortions the edges showed clear definition.
The tech returned and said the radiologist wanted two more image angles of each breast and if those came out clear, I would be able to leave. These two angles were the least comfortable and at one point, a corner of the table that holds the bottom plate in place was digging into my armpit. In the less than one minute it took to complete this image, my whole right arm started to tingle.
We completed the x-rays, the tech quickly checked with the radiologist to make sure she was good with the preliminary review. She returned in moments and said I could get dressed and the final report would be sent to both my oncologist and primary care doctor, as well as a note mailed to me with the findings. I took this as a good sign. No rushing me off to ultrasound for more imaging. I am good.
My right breast continued to ache for the remainder of the day and through the night. Now I know I need to take some sort of anti-inflammatory prior to my next mammogram.
The last week of April I, need to get some blood work done, in preparation for my next follow up with Dr. Sikaria (oncologist), the first week of May.
Life is 6 months cancer free