Tuesday, February 20, 2007

She's a Bad Mammogram(ma)

Okay, that's a goofy headline, but it's been going through my head for over a week, every since my doctor said those magic words: "I'm going to refer you over for a mammogram." It sounds almost exciting, like a telegram made of breasts. But it's nothing like that, I can assure you.

Let me back up. For a couple of months, my boobs have been bothering me. They've been sore and irritated and just generally kind of bitchy. Sometimes I've had shooting pains. Other times I felt rashy and itchy. It seemed like the sort of thing I should go see a doctor about, but in case you hadn't noticed, I've had some other things going on, like funerals and work. To my credit, I did call my doctor's office between Christmas and New Year's and no one called me back. (You would think a message like, "Um, my boobs sort of hurt a lot and I have a mysterious bump," would generate a return call, but you'd be wrong.)

I finally made an appointment to see my doctor for the Friday before Valentine's Day. I told her all of my symptoms and explained that the Internets scared the bejeesus out of me when I googled "breast pain and itching." (Try it!) She examined me and suggested a mammogram "just to get a baseline." I assumed this meant my boobs were weird, but she wanted to make sure they'd always been weird and/or would continue to be weird and she'd have documentation to prove it. The paperwork said "BILATERAL MAMMOGRAM TO RULE OUT MALIGNANCY." Not words you want to read in conjunction with your boobs.

I left the office and called the number on the referral slip to schedule my mammogram. I had the most delightful conversation with a young man named Ernie.

"What are you coming in for?"

"Um, a mammogram."

"For just one side?"

"No, it's a bi-lateral mammogram. It should be in the system."

"Yeah, yeah, here it is. Uh, you're 31, right?"


"Oh, your insurance company isn't going to want to pay for this. Or you'll have to get pre-approval because you're too young."

"Well, considering my doctor wants to rule out CANCER, I would think my insurance company would be down with that."

Ernie suggested I talk to my doctor and have her staff talk to my insurance company. Frustrated, I headed back up to her office. The receptionist and nurse were as irritated as I was. It turns out all of my information, including the fact that I was already pre-approved by virtue of belonging to United Healthcare's PPO, were in the system, but Ernie was too clueless to figure this out. I finally managed to schedule my appointment for Valentine's Day. I was instructed to arrive early and not to wear deodorant.

I'm not ashamed to admit I was terrified, not so much at the fact that I could have a life-threatening illness, but because I have an incredibly low tolerance for pain and I had heard from my sisters that mammograms hurt like hell. It's too bad I wasn't allowed to wear deodorant, because I'm sure I smelled like a sweaty, nervous wreck.

My appointment was at the UCLA Iris Cantor Center for Breast Imaging. I give props to them for surrounding me with estrogen rather than Ernie, who I might have throttled had he been present. A kind lady at the front desk checked me in and directed me to a waiting room, where another woman appeared to escort me into the center to change into a gown and wait my turn. My technician Karen popped out a few moments later and brought me into the room where she would perform the mammogram. She was very warm and friendly, taking the time to tell me what the procedure would be like. She showed me the machine, which looked like this:

Then she had me remove my gown, gently took my boob, squashed it with her hand, and had the machine flatten it into a tan little pancake. Fondle, squash, flatten.

"Just relax," she told me. "I know it hurts, but if you tense up, it will just be worse." Well, I'll tell you, it's not really easy to relax when it feels like your boob is being smashed by a steamroller. I did my best. Then I did it FIVE MORE TIMES. Yes, I had six separate boob smashings in a row. Fondle, squash, flatten, repeat. First flat and horizontal, then on the diagonal, then straight up and down. Every possible view of my poor smashed boobs that was possible with that machine.

(The truth is, it hurt, but it wasn't as awful as I expected. Better than a hot stick in the eye, I'd say, but not as nice as a good old-fashioned feelsie in a parked car. I'm hoping childbirth is similarly not as bad as the hype, should I ever be subjected to that.)

Karen asked me to sit in the waiting room while she showed my images to the doctor, but to keep my gown on in case they needed more images. Lucky me, the doctor wanted an ultrasound. If I was nervous at all before, this made me quiver in fear.

I asked Karen if the doctor had seen something, is that why I needed another test? She promised me that it was only because of my symptoms, not because of anything in the images. She put me in another exam room, showed me the ultrasound machine (same one they use to do a sonogram on a pregnant woman), and then left me alone to wait. A youngish doctor walked in, asked me to lift my gown, and proceeded to squirt some warm clear goo all over my left boob. She took the ultrasound wand and rubbed it all over my breast. All this without even buying me dinner!

It was hard for me to tell if what I saw on the screen was good or bad. It sort of looked like a poorish quality green-and-black aerial image of Afghanistan. Then we saw a small black blob, which she kept going back over.

"Is that bad?" I asked, alarmed.

"No, I think it's just a cyst," she replied.

"You THINK? Or you KNOW?"

At this point, another doctor waltzed into the room. She didn't even knock, which was a bit unnerving, but at least she was a woman. They proceeded to talk about me as though I wasn't there.

"She has pain and itching in her breasts," said the first doctor.

"Hm, have you done the right breast?" asked the second doctor.

"No, the left one is more remarkable," the first doctor replied.

"I have remarkable breasts," I thought.

The first doctor captured some images of my cyst from various angles, like headshots. The second doctor explained to me that a cyst usually shows up as a black spot and that cysts aren't uncommon. An examination of my right breast showed nothing abnormal (or remarkable, as the case may be.) The first doctor handed me a small washcloth to wipe the gel off my chest. "Wow, this is really starting to feel like a bad date," I thought.

The doctors went off with images of my cyst for another consult. I was sent back to the waiting room again, and then back in with Karen for one more set of mammographic images. My girls felt like big stars. Big, flat stars. The images were sent over for one last review.

FINALLY, the first doctor came out. "Everything looks fine," she said. "At least on the inside. You can talk to your doctor about the itching." So the good news: I'm cancer-free! And I survived my first mammogram! The bad news: my boobs still itch.

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