An out of body experience

This afternoon I visited the Breast Care Center for the first mammogram I've had since the one last June that started this whole cancer journey. I tried not to think about the upcoming appointment, expecting (and hoping) that it would be routine and uneventful.

I told myself that if I could get a routine mammogram under my belt, I would feel better about charting a new course for my future life as a cancer survivor.

Well, the routine exam I was hoping for didn't exactly pan out the way I was expecting. I reported to the front desk and went through the usual check-in with my insurance cards. I even showed up ten minutes early, hoping to get it behind me faster.

When my name was called, I changed into the cute little gown and followed the technician into the exam room. She asked me if I was there to have pictures taken of my right breast. I said, "I don't know. I thought it was for both."

She indicated that I wasn't due until June for a mammogram on the left side because my insurance wouldn't pay for it until then. This surprised me a bit because I assumed that once you've been diagnosed with breast cancer, "they" would want to keep a close eye on the other side as well. Apparently not.

The technician then proceeded with the mammogram, taking four shots of my right breast. She even asked who my surgeon was, saying that he did "a good job."

I told her that I, too, thought he had done a good job, but since I hadn't seen any other breasts that had lumpectomies, I wasn't sure how good it was. Apparently, it was very good. And she should know. She works at Providence Hospital in Everett and sees a lot of breasts. :~)

After the mammogram, the technician asked me to sit in the room while she showed the pictures to the doctor. Right away, I felt that something was wrong. I picked up a magazine and started flipping through it, but I couldn't focus at all. I started to pray.

I then hopped up to walk around the technician's computer and take a look at the images. At first, I felt guilty--as if I were looking at the answers on an exam. And then I thought, "What the heck? It's my breast--I have a right to see the pictures!"

Problem was, I couldn't tell much from the photos. I could see a large, dark area, but I assumed that was where the tumor had been removed.

I went back and forth in my mind, wondering if the request to sit and wait for the doctor to view the photos was routine for a mammogram ordered prior to radiation. I felt detached and wanted to pretend I was in a dream. It was just too reminiscent of the very scary day I had in the same facility a short six months ago.

I decided I was having an "out of body" experience and that I would return to my body after I was told to dress and go home. That's all I wanted to do. Dress and go home.

Finally, after what seemed like 30 minutes (probably only five minutes in reality, but when you're out of your body, you don't track time like everyone else), the technician returned and said something like, "The doctor would like to do an ultrasound. Follow me." Actually, whatever she said wasn't that brief and she was stuttering around a bit, but that's all I can remember.

Thing is, I am now clued in as to how these people act when something's up and they are trying not to alarm you. They try very hard to act casual, but they are not casual at all. So I knew that something was going on and I was scared out of my wits. I prayed down the hall and into the ultrasound room.

I met the ultrasound technician who said that she didn't have any information on me yet, so she sat at her computer and typed in my name and birthdate. I stood by the door and said, "I have to ask you . . . is this routine to do an ultrasound?"

In the same "trying to act casual" manner (think "Stepford wife"), she told me that the ultrasounds are done when a solid mass or something else that is hard to define is found and needs further investigation. Excuse me? I couldn't hear you; I was floating around the ceiling outside my body when you said that.

She asked me to lie down and propped a couple of rolled-up towels under my right side so that she could get a good angle for the transducer. I continued to pray, feeling near tears at this point. I just couldn't imagine going through another "discovery" of cancer. I wanted this to be a dream.

I turned my head so that I could get a good view of the ultrasound and watched the technician zone in on a large, oval dark area where she set her measurements. I thought that this was the area where the tumor and additional breast tissue had been excised. I asked her if she could tell me the width of the tumor cavity.

She responded that there wasn't a cavity, just an area filled with fluid. (Duh!) So I re-phrased my question and asked how wide the area filled with fluid was. She said that it was 4 centimeters. She continued taking photos and measurements with the ultrasound and then said, "I'm going to show these pictures to the doctor and then she will probably come in to take some as well. She will be able to answer any of your questions."

Okay, it had been made clear that they were looking at something suspicious. I couldn't believe this was happening and wished that my husband were there with me. He has been with me to every appointment and I wanted him there with me today more than ever.

I also hoped that I would NOT have the male doctor who informed me of the discovery of a "solid mass" last July. I have not forgotten his businesslike, insensitive manner and never will.

Fortunately, a female doctor entered the room and introduced herself. She picked up the transducer and took a look at the area on the ultrasound machine. After a minute, she asked if I got a big bruise when my lumpectomy was done. I wasn't sure how to respond because I assumed everyone got a big bruise on their body when they had surgery.

She went on to explain that the area in question was the fluid-filled area. It appeared that I had a hematoma (bleeding) in there and that it was an area they wanted to watch. She said that the fluid should be absorbed by my body in time, but that if my doctor desired, they could stick a needle in and drain it. She said that she was being extra-cautious about it.

For the first time in 30 minutes, I experienced some relief, but wanted to make sure that I understood her correctly. So I asked what the concern was really about. I had thought they found another lump or "suspicious mass." According to the doctor, it was the fluid-filled area that concerned her and she just wanted to verify what it was and keep an eye on it for the future.

I asked her if it would dissipate when I had radiation and she said that it could. So the ball is now in the radiation oncologist's court. He will review the mammogram and ultrasound and decide if it's okay to go ahead with radiation or whether they should try to get the fluid out first.

I called my husband as soon as I got to my car and nearly started crying. The whole experience was unnerving. I felt relief, tentative joy, and even a little anger.

What the heck? Why can't these people just tell you up front what is going on instead of behaving as if they're in a game of poker and can't reveal their cards? After all, it's my body and I have a right to know what is going on. Especially since they all knew that I had been diagnosed just six short months ago, couldn't they be a little more sensitive to that fact?

In retrospect, I suppose I understand that they can't alarm people without knowing what they're looking at . . . but being on the receiving end is not fun. Not fun at all.

So tonight, I am tired, relieved, thankful, and a little anxious about starting radiation. I wonder if I'll ever have a routine mammogram again or if every one from hereon out will be full of anxiety and dread. I know I will have to learn to live with the fear of recurrence and that it will get easier with time--at least that's what other cancer survivors tell me.

But that's a subject for another blog entry.