Lump in the Road (eBook)

2

The First Step Is the Hardest

March 2019

The big “four-oh” comes with requirements—health requirements. My penchant for following the rules stuck with me well past my junior year of high school, so I did the thing we are all supposed to do—I made an appointment for a mammogram.

My doctor had urged me to do so when I was lying on the table, one arm up so she could give me a breast exam. “This is the year you start getting mammograms!” she said excitedly, yet sarcastically. We have a good rapport. We often chat about kids and getting enough time for ourselves. She is a doctor I trust because she is conservative in her testing and respectful when she listens. She hears me.

She warned me that there was a high probability I would be called back due to an abnormality on my mammogram since this happens a lot when you are young and have dense breast tissue. Also, because this would be the first of many images made over the next thirty years or so, they would want a clear and high-resolution picture to compare with all future images.

The imaging office was in the hospital, a relatively new building overlooking a historic mining town. On the day of my mammogram, I walked into the first floor, where a piano played by itself in the atrium, seemingly to make patients more comfortable. People wandering the hallways were there for primary care, cancer treatment, pain clinics, rehabilitation, and testing. Others were visiting a loved one who just gave birth.

The imaging reception area was staffed by friendly people greeting patients with “Good morning,” and “Last name?” I walked up to the reception and interrupted a conversation one woman was having about a new sweater she got as a gift for her birthday. After giving her my name, she told me to sit down and wait for a nurse to call me in for my mammogram. The waiting room was full of people of all genders and ages. MRIs, X-rays, and mammograms all waited for these people behind swinging doors.

“Kate?”

My heart skipped a beat, but I followed the exceedingly nice nurse wearing dark-blue scrubs to a quaint waiting room, which had a row of five changing rooms with curtains to the left and some soft, cushy chairs next to a coffee maker and TV on the right. It smelled like carpet cleaner. She asked if I had any belongings I wanted to put in a locker and showed me how to operate the combination lock. Then, she reached down into a warming drawer and picked out a top robe before leading me to a changing room.

“Change into this with the ties in front and we will call you back when we are ready. Should only be a few minutes. Any questions?” She was so polite, and it struck me that she probably had to say that string of sentences many times in one day. I wondered if I was the youngest of her patients for the day, having just turned forty.

After I locked up my purse and shirt, I checked out what kind of coffee they had to offer and sat down on the closest chair. There was a screen rotating on the TV advertising programs the hospital offered—bereavement services, outpatient resources, lactation assistance. It really seemed like they could have lightened up the mood of the room by putting on something like Seinfeld or Friends instead.

I looked around the waiting room. There was a woman maybe in her fifties browsing her phone. Behind me, a daughter escorted her frail mother to a dressing room, and I listened to her patiently assist her in getting her gown on. Her mother clearly did not want to be there. I projected myself far into the future, at fifty or seventy years old, back once again to get a mammogram to make sure that I was healthy. Would I sit and scroll through my phone? Would my daughter help me get changed in a dressing room?

The nurse came and got me and led me down two hallways to the mammogram imaging room. It was a small room with so much equipment in it that it seemed like it was a storage room. I sat on an oversized barstool chair with a back. It could be raised or lowered to position me at the right height for the test.

For me, the mammogram was easy. I have quite large breasts, and after breastfeeding both my kids, they were shall we say, saggy. Having them smooshed onto two plates, in two different directions, actually wasn’t painful at all. The most uncomfortable part was having to hold my breath while they took the image. The team of nurses and technicians were lovely and explained everything step-by-step while making sure I was as comfortable as possible. The technician reminded me that many first-time mammogram-ers come back so they can get a crystal-clear image for comparison in later years, and that such a call to me shouldn’t be of great concern.

I went back to the changing room after grabbing my things from the locker, put my gown in the bin, and left the hospital. I did not give the procedure another thought for the rest of the day.

As much as I was prepared for the subsequent call asking me to return for more images, I absolutely was not prepared for it. The woman on the other end of the phone had a calm voice. She did not—would not—give me details, but said I needed to come back for a different ultrasound because there was something unclear on my right breast. She scheduled me for an appointment two days later.

I drove to the same hospital, walked by the same piano playing by itself, entered the same waiting room, put my belongings in the same locker, and put on the same warm top robe—opening in the front. Another nice nurse technician escorted me to the room and performed the ultrasound, taking pictures as she went. As most technicians do, she avoided talking and held a completely blank stare at the screen, performing her duties while not letting me know if she’d found something terrifying or nothing at all.

She asked me to wait, and a radiologist came in.

The radiologist briskly walked in, opened up the images on her screen, and redid the ultrasound of an area on my right breast, just above the nipple. She pressed hard and moved it around, pressing harder. You could tell she was trying to get a better or different image. She put the wand down and scooted her chair back.

She just couldn’t hide her concern. Her brows were straight, and her eyes were wide open, unblinking. She looked directly at me and said there were three spots in my right breast that looked suspicious and that they could either be just calcifications or something called DCIS. She explained that DCIS is Ductal Carcinoma In Situ, which refers to cancerous cells in the lining of the milk ducts which have not spread into the surrounding breast tissue. It is customary to remove DCIS cells to prevent them from becoming an invasive cancer that spreads outside of the milk ducts.

She scheduled a biopsy right then and there for just four days later.

Panic.

Fear.

What if…?

Four days felt like an eternity. It was like I was waiting to wait for more bad news.

Past a certain age, worry about your boobs seems like a universal experience in our society. I knew that many women who had been through ultrasounds and waiting for biopsy results would understand what I was feeling, so I texted a few close friends, two of whom were older and had been through this kind of worry and waiting before. Some friends offered to drive me to the biopsy or to just wait in the waiting room. It felt like I was being wrapped up in a warm hug when I heard these offers, but I declined, saying that it was no big deal. I could get through this. It was just an appointment. I think in the end, I didn’t want company because I was so scared. I didn’t want to spend the energy putting on a brave face for other people, even my husband.

On March 22, I went by myself to the biopsy. Little did I know that this was only the first time that these medical tests would interrupt the regular schedule I had with my kids. I would not be at school to pick up my daughter, and my husband had to pick up our son at preschool. It was my full intent not to let a change in our schedule scare them or cause them anxiety, so I just told them I needed to see a doctor. They did not ask any questions. I kept details to myself, probably more to ease my nerves since they did not know anything was going on.

There was one nurse and one technician present at the appointment. The nurse seemed to be there solely to distract me, and the radiologist performed the biopsy. Most of it was automated, which was pretty cool. They started the procedure by finding the suspected DCIS spot they were biopsying, which meant they had to squish my breast to hold it in place, take an image, then place the needle biopsy machine on my breast. They injected me with numbing medicine. Then they placed the needle core over the position on my breast where the spot was on the image. The radiologist pressed a button, and the needle took six quick samples for biopsies. Every time the needle left my skin, it left more numbing medicine in there (thank goodness!). They double-checked that the biopsy captured enough tissue, and the radiologist was not satisfied and wanted six more needle samples so they would have enough tissue to study. She double-checked that I wasn’t feeling anything and did the procedure again.

During this process, the nurse charged with distracting me was regaling me with stories of her teenagers and how fast they grow up. I was engaged, but it was hard not to think of how scared I was becoming of missing out on things with my own kids. The “what ifs” creep in mighty fast when you are literally stuck in a boob-hold and know that once you walk...