April 25, 2007.
It's not like I forgot this "anniversary," but I did have to look at my medical records to find out the exact date. That was the day I had a biopsy for a lump in my left breast. I said I'd blog about it after a year and so here I am.
The biopsy itself isn't really the story. The real story is what leads up to the biopsy and what happens after the biopsy. The real story is about being the patient instead of the MT.
The problem with being a transcriptionist is you've heard it all and if you have a really interesting account, like a teaching hospital or a cancer center, you've seen the really awful stuff. And if you have an imagination like mine, that's not really helpful.
I always imagine the very, very worst. Well, once I stop being in denial, that is.
Back to the lump. Of course, I noticed it in October of 2006, which is Breast Cancer Awareness Month. The first thing I told myself was I was being hyperaware... because it was Breast Cancer Awareness Month. Then I kicked myself a couple of times for being 49 years old and not getting a mammogram like I was supposed to.
People, I'm here to tell you - getting a mammogram is nothing compared to the anxiety, guilt and whatever you'll inflict on yourself if you THINK something is wrong and you haven't been compliant with the routine diagnostic tests. Oh sure - I laughed. I said "I'm not 9 years behind because when I was 40, they said start yearly mammograms at 45 - so I'm only 4 years behind." Har har.
Just for the record, since I'm just getting started and don't want to forget this, the mammogram and ultrasound I had at the local diagnostic center - where I would've gone for my mammogram had I been a compliant patient - came back as "normally abnormal" and invited me to come back in a year for another routine mammo.
Back to October of 2006. While telling myself this was nothing, I also called my friend Janice, who walked a fine line between telling me it was probably nothing and insisting that I not ignore it. She can confirm that I had all kinds of wild denials. "It's my office chair." This prompted me to make arrangements to get my Aeron fixed. She's still laughing about that one. My denial is also imaginative. Then I decided it was hormones - it just had to be hormones. I latched onto "painful lumps are hardly ever malignant" like it was the only floating object on a sinking ship. Finally, when the pain just didn't go away and the lump didn't get any smaller, I ran out of excuses. I made an appointment to see my doctor. He sent me to a local surgeon. I was disappointed that they both could feel it. Up to that point, I'd been hoping it was just me.
Let me interject here that your peace of mind depends absolutely on having confidence in your doctor, so whoever you go to, make sure it's someone you trust and don't hesitate to find someone else immediately if your confidence is eroded for any reason. Maybe I expect too much, although I don't think so, and maybe I'm getting really really short of patience as I get older (more likely). By the time I dumped this doctor, my anxiety level was so high I thought my head would explode. I won't go into the details, except to say that at my last visit with him, after he told me the MRI scan results weren't very conclusive as to the nature of the lump, at least it didn't have the hallmarks of the very malignant and fast-moving cancer he THOUGHT I had (!!); then he told me he couldn't get a bead on the exact location of the lump so I either needed an MRI-guided biopsy or he would have to do a mastectomy - he would sure hate to do a mastectomy and find out it was benign.
Gee doc - so would I!
Adding to my anxiety was the plethora of information on the internet, not to mention the pamphlet the state of California requires physicians to give to patients they suspect might have breast cancer. I couldn't read the whole thing and I had to stop myself from Google searches or I probably would've stopped breathing. In addition, I had Janice and now my sister singing a chorus: "Find a new doctor!"
I sent my records to the UCLA/Revlon Breast Center to get an opinion about an MRI-guided biopsy. You can't get one done just anywhere, you see. I'd just spent months with this surgeon who dithered around and scared the living daylights out of me, so the efficiency and speed at Revlon was like a breath of fresh air. The radiologist called me on a Friday to talk to me about the studies I'd sent and when I told her I'd like to just transfer care to UCLA, in 5 minutes I got a call from a scheduler and had an appointment for a repeat mammogram and ultrasound on Monday, which they worked in around the surgical oncologist's schedule so I could see her the same day. I knew I'd found someone who knew what they were doing when she said she could clearly see the lump and didn't know why the surgeon hadn't just done a biopsy. She asked me if I wanted a needle-guided biopsy or excisional biopsy and I voted for excision - the damn thing hurt and I wanted it out.
April 25, 2007.
Have I mentioned how quickly they can get you in and out of the outpatient surgery center these days? I was home by 11 a.m. and bored to tears by 1 p.m. I had planned a day of watching TV and couldn't stand it.
Three days later, Dr. Brooks called to tell me the biopsy was positive for malignancy. I didn't feel like a patient until then. Not only would I need more evaluation, but the margins weren't clear, so I also needed another biopsy.
Oh, I know what comes next. I'd typed it a million times. Only typing it is a lot different from living it. I'm sure I'm not the first transcriptionist to notice this, but this is the first time I've really and truly been "the patient." Everything up to this point was minor stuff.
First, there was the whole body CT scan with contrast. Then there was the whole body bone scan. My overactive imagination went into high gear and started worrying that they'd find something even worse while they were scanning me six ways to Sunday. I was relieved to find out I have mild degenerative changes in my right knee, a small hiatal hernia and bone scan confirmation that my plantar fasciitis isn't a figment of my imagination. And here's the great thing about UCLA: they hand you the records from your prior visit when you arrive there for the next. So while I was undergoing all these tests, I got to read all about my surgery - and the pathology report. Yes, I've typed a million of those, too. I wonder if the MT who typed it just plugged in and pounded out the report or if my name was familiar or if she thought about what the patient might be thinking, like I did many of those million times. I'll never know - but at least I didn't find any errors! (Do you even have to ask if I looked?) I read it and it was about me but it looked like so many other reports I've seen I still can't read it and think "that's about me." And it doesn't convey the months of denial and fear and anxiety or how I felt when the doctor called and told me I had cancer.
I think we'd all get headaches if we thought too much about the people whose reports we transcribe. The clinical language makes it easier to ignore the humanity. Production requirements make it almost necessary. Suddenly, I was on the other side of that and it wasn't so clinical any more.
To be continued...
