Well, Left o’ the Mississippi is back, and lots has happened since my last posts back in October. The most notable occurrence, however, was surgery, served up with painful squashiness and a soupcon of poetic justice.
Back when I was 34 (9 years ago), the recommended age for a baseline mammogram was raised from 35 to 40. This meant I could skip merrily along for another 6 years without having my breasts repeatedly smashed in a vise. And when I did turn 40, I was in graduate school with little insurance and less cash and, no matter what the medical community said, there was no way I was going to pay money for breast mangling that could better be spent on rent, novels, and peanut butter M&Ms. However, in the spring of my first year at BVU, armed with insurance, I submitted to that painful rite of passage that is the first step toward middle-age, menopause, and multiple cat keeping.
It was also surreal. The women’s center here is decorated in plums and teals and has changing rooms curtained off with rich, floral draperies, each room containing a willow basket of breast self-exam cards, pamphlets, handiwipes, and Hershey kisses. They asked me to undress from the waist up and gave me a lush, spa-style robe. Then, in the mammography room, the technician worked very hard to keep my off breast, the one not being x-rayed at a given moment, modestly covered while simultaneously slinging the naked one around like so much pizza dough. I suppose there are women so tender and shy, but I wanted to say, "Hey, we both know why I’m here. Slap the girls into the squeeze-o-rama, get this done, and send me on my way with some of that chocolate. Hey, you should give out little packages of peanut butter M&Ms!"
But I did not get any chocolate. Instead, at the end of the mammogram, I got to have an ultrasound because it turns out my breasts are full of fibery tissue. This was supervised by a male radiology doctor (everyone else I’d interacted with had been female and quite pleasant). His attitude could be summed up thusly: this is your first mammogram and why on earth did you wait two extra years and don’t you know breast cancer can develop even without a family history and it’s important that you are properly terrified of cancer and it’s especially important to keep track of changes in fibery breasts like yours and however often you’re doing your monthly self exams it isn’t often enough because we know you don’t do them every month and you probably don’t floss your teeth daily either and it’s absolutely criminal to let a person like you even have breasts if you’re not going to take care of them and you probably shouldn’t be allowed to take kittens home from the pound, either.
I didn’t like him.
The upshot of the ultrasound was that boy, I really do have fibery breasts, and I should come back in 6 months for another mammogram just in case. I did so, about 8 months later, in December. They repeated the squash-lecture-ultrasound and found a small lump deep in my left breast. Tiny, only 15 mm, but it had tripled in size since April.
Now, "lump" and "breast" are two words you don’t want to hear in the same sentence, much like "Bush" and "president." I told myself and others that I wasn’t too worried, because my sisters have had benign breast masses removed and there is no cancer in my family. I didn’t lose sleep or go off my feed.* On the other hand, if I hadn’t had a very dear friend as a houseguest at the time (hi Jennifer) and another dear friend in town staying elsewhere (hi Andy), I might have come completely unraveled during my waking, non-eating hours because whenever I thought about my mass, growing away inside my breast where I couldn’t feel it or see it or reason with it, I wanted to wallow in a hot bath and cry and drink cheap brandy in fruit juice.**
Also, to make an unpleasant situation worse, even though the lump was found around January 10, the surgery couldn’t be scheduled until January 31. This not only left me lots of time to cheerfully insist to people in the know that I was fine, really, and then take long, hot, teary, brandy and fruit juice baths, but put my surgery smack in the middle of the first week of classes. And just try to plan a course syllabus while slightly drunk in the bathtub.
On the day of surgery, my classes canceled, I found myself back in the ultrasound room, waiting for a radiology doctor to show up and drive a long, hollow needle into my breast in order to set a copper wire into the mass, for the surgeon to follow during surgery. Now, I’d been told about the hollow needle by several nurses and doctors over the course of the previous three weeks*** and every singe one of them assured me that my skin would be numbed first. "Oh no", explained the radiology tech while preparing me for the insertion, "the doctor feels that instead of making you endure two pricks, both the lidocaine and the hollow needle, you’re better off just having the one. And it’s only piercing the skin that hurts. The needle glides through the fat of your breast like it’s just butter. Unless you have really fibery breasts, in which case it can be more painful."
"Have you even looked at my chart?" I started to ask, but was interrupted when the radiology doctor came in. I’d been afraid it would be the male doctor who had lectured me before,**** but it was instead a large woman with long, blond hair and a German accent. She was quite nice and funny. She was all positioned to do the hollow needle thing when the chat I was having with her and the tech turned to the topic of pro-choice and clinic protests.***** The doctor, having what turned out to be strong pro-choice, anti-anti-abortion picketer sympathies, started waving her arms above her head and loudly declaiming that anyone with balls simply cannot be allowed to make reproductive choices for women. Except she used a bit more profanity. I can’t remember it all because, by that time, she was gloved up and holding the hollow needle in one of her righteously flailing hands. So I sat up a little and said, "I agree. Could you calm down a little before you do the whole plunging the needle into my breast thing?" and she laughed and apologized and calmed down and then plunged the needle in and, while it wasn’t the most excruciating pain I’d ever had, it was memorable enough that I’m hunching over a bit just while typing this.
When that procedure was done, I was left with about 5 inches of thin, dark wire protruding from the upper, inner curve of my left breast. The wire was capped with a small blue plastic cylinder, which had enough weight to make the wire arc a bit, so the whole thing curved out from my breast and bobbed gently with every movement. The thought that there was another 3 or 4 inches of wire inside my breast made me a little ill,****** so I instead considered the wire’s similarity to a radio antenna and wondered what I’d do if my left breast suddenly started playing am/fm.
Then a nurse came into the room to escort me to the next stop on my journey toward surgery. Explaining that we had to be very careful about moving me, since sometimes the wires come out and then have to be replaced (meaning you have to have a long, hollow needle stabbed into your fibery breast again), she cupped her hand under my left breast and supported it as I walked across the hall (because hey, where your left breast is taken, you pretty much have to follow) into — Holy Shit — the mammography lab. Yes, it seems that the surgeon wanted not only the guiding wire itself, but mammograms of the wire in the breast available to him during surgery AND I DON’T CARE HOW GOOD AND CAUTIOUS AND METICULOUS A SURGEON HE IS, HE’S ONLY DOING THIS BECAUSE HE’S NEVER HAD AN ORDINARY MAMMOGRAM, LET ALONE ONE DONE ON A BREAST THAT’S JUST BEEN SAVAGED BY A RAVING, HOLLOW NEEDLE WIELDING GERMAN RADIOLOGIST.
It really hurt. And here’s the poetic justice: remember the second paragraph of this post where I explained how I’d managed to duck getting a baseline mammogram for 8+ years? Well, here I was, having my third mammogram in 8 months — a total of 18 breast-smashing exposures, the last four being the dreaded "hollow needle special."
After the mammogram, they taped the wire to my breast to keep it in place, returned my breast to my custody and my robe, and sent me back for the surgery. That went as surgeries do, with the anesthesiologist making bad jokes and then me waking up in recovery with a nifty new 1 1/4 inch incision and minus a breast mass, which turned out to be benign. I was given Tylenol with codeine for pain, which was a total gyp — a bottle of something more fun, like Vicodin, should be standard issue following any surgery, just like getting a lollipop when you’re good at the doctor’s office. Then I was released and told I could go to work the next day.
And here’s the good part about the surgery (besides not having, you know, cancer): my school and my colleagues were fabulous. Two different instructors came over to make sure Ricky got his walks. The Associate Dean of Faculty took me to the hospital, waited during my surgery, took me home, went and got my (wimpy) drugs, and called me every 4 or 5 hours to check on me. She and my chairperson, as well as the Dean of Faculty, insisted I stay home the next day (and the next, if I needed), despite the fact that I was released for work the day following surgery. Heck, the university president’s office even sent me a huge get-well bouquet. Oh, and my lovely neighbors sent over dinner and dessert the night after the surgery.
And that’s how I spent my winter vacation.
*of course, it would take something really serious, like death, to put me off my feed, and even then I might scrounge around the morgue for a bit of chocolate.
**Leftover Xmas brandy in Welsh’s Tropical Cherry juice, with lots of ice. Yum.
***Surgery consult, GP pre-op visit, various chatty nurses, Internet medical sites.
****Thus introducing a third prick into the hollow needle discussion.
*****Don’t ask me how we got on that subject. Deep inside, I was gibbering over the whole hollow needle thing.
******I can’t watch someone give me a shot or take my blood. I can’t even watch someone get a shot in a movie or tv show. Oddly enough, I had no problem watching the doctor slice into men’s testicles during my Planned Parenthood vasectomy clinic assistant days.