Thursday, November 21, 2013

Even if it Sometimes Starts Small, I am Grateful for a Voice – Day 21


QUICK UPDATE for those following regularly: My scan yesterday was a complete train wreck but all is clear!

If you were reading this gratitude series like a chapter book, the above update should have been marked with a spoiler alert but, since this is a real story and people worry, it had to be done.

Yesterday when went in for what will probably be my final mammogram, the pleasant woman behind the registration desk asked, “And how are you this morning?”

“Nervous as a cat,” I thought trying to yank my Kaiser card out of my wallet. But, being in complete control of my emotions, I said, “I’m nervous as a cat!”

I waited just a few minutes before being called back to the business end of the department.

“Okay, we are going to get better results this time.” I said with false bravado as we walked.

Not callously but with an air of that’s-not-my-job she said, “I just do bone density testing” and showed me to my dressing room.

Gown on, sitting out in the behind-the-scenes-hallway, I began chatting with the other waiting woman. When a tech brought blankets to us I joked, “Oooh! Today must be spa day.”

Evidently the way I said ‘spa’ or the nervous titter that followed was a flashing wow-she’s-terrified giveaway to another older woman with a lilting South American accent. Because the woman asked me if I was nervous and I confirmed that I was just trying to pretend I was in the spa. She sweetly reminded me there was nothing to worry about and ‘the squish’ it wasn’t that painful.

I smiled and thought, “If you only knew.” But the words that came out of my mouth were, “I know it will be fine.”

When the tech brought me in to the machine room, she gave my paperwork a glance and said, “So… it looks as if you’ve had a procedure on your left breast?”

“Um, I suppose you could say that,” pulling back the fold of my gown. “I don’t have a left breast anymore.”

“Oh,” she said. “I need to speak with the doctor. I’ll be right back.”

As she left I thought it both mildly amusing and slightly disturbing that I freaked out the tech but when she re-entered the room seven minutes later, everything changed.

“Well, the good news is, you don’t need a mammogram,” she said as if presenting me with a gift.

“On my right breast I do,” I said.

“The doctor says you don’t,” she replied.

“My oncologist says I do,” I countered. Anxiety immediately refocused itself into agitation. “And if you need ME to talk to the doctor I’m happy to.”

“I’ll be right back,” she said.

A few minutes later another tech walked back into the room. She happened to be the same tech from six months ago and I was so relieved they sent me a good one.

“Hi, I remember you!” I said before I launched into the craziness of the last few minutes and how pleased I was that she was going to do my test. She looked at me blankly, walked across the room and grabbed a piece of paper. As she faced me, the door opened and my tech walked in.

“Oh,” I said. “I thought she was going to do my mammogram.”

“No, I’m just here to pick up this paper,” she said as she waltzed out the door.

My heart sank much more than my face flushed.

The day’s original tech explained the doctor wanted to talk with me so I followed her, still gowned, back down the hall to the dark room. The radiologist sat in a dark room surrounded by monitors. I remembered the last time I was in a similar room six months prior. It hadn’t gone so well. The tech stayed at the slightly ajar door but outside of the room. To me it seemed as if she was hiding behind the door.

“Hi, I’m Dr. F,” she said as I sat down. “You don’t need a mammogram today.”

“My oncologist says I do,” I spat out almost reflexively.

As the doctor explained her expertise and she regaled me with details of ‘proper screening protocol’ she admitted she hadn’t read my history.

“So do you have a family history of breast cancer?” she asked.

“My mother has breast cancer.”

“Well, have you had genetic testing?” she asked.

“Yes, I am BRCA negative,” I explained.

“Well we only recommend six-month screening with BRCA positive patients.”

I reiterated the screening protocol my oncologist had set up and Dr. F said with a flat frankness, “Well I disagree with that and if someone needs a six-month screen, it is our office that sets it up.”

“My oncologist put in the order and your office DID set it up,” I explained a little louder than was probably necessary in that tiny little room.

The conversation lasted less than 10 minutes but I was exhausted and unnerved.

“So,” I began as I put my hand up to Dr. F as a signal for her to stop what I felt was a diatribe. “I am the patient and my doctors disagree. What should *I* do?”

“I’ve already emailed Dr. J,” she began.

I stopped her again. “I understand that. But I’m sitting here in  YOUR office. You’re doing what YOU need to do. What do *I* need to do now? Do I just wait? Do I call Dr. J? Should I just go home? What do *I* do?" 

I tried hard to keep the tears from spilling over but my voice cracked anyway.

“You should contact your doctor,” she advised.

Feeling more defeated than agitated, I explained that my best unsolicited patient advice was for her office and oncology to communicate better. And then I walked out of her office, put my clothes on, pushed the brimming tears aside and began to wander my way downstairs.

At the stairwell, I paused.

Instead I ascended the stairs and decided to walk to oncology instead.

“Hi, Dr. J put in the order for a mammogram and the radiologist just refused to do it. So I’m not sure what to do?” I announced by way of introduction to the woman at oncology reception.

“Well THAT is NOT okay,” she said. “Let’s get you some answers.”

Suddenly everything changed. A green paper was completed; Dr. J’s medical assistant came out; I was offered coffee & juice; given a couple of hugs and walked around the catacombs of the infusion center. The warm reception was like a great big hug and I burst into tears.

Within 15 minutes I was told Dr. J was in contact with Dr. F and that she would be right out to talk with me.

And she was.

She came out, gave me a hug, apologized and then explained the exchange. She confirmed that she heard the same speech I did but believed that, in my case, the protocol we agreed upon was best but that Dr. F was in “violent disagreement”.

Then she asked me how *I* felt about things.

“I’m sure Dr. F is very good at her job. But I TRUST you and, honestly, I just like you better,” I responded so grateful to have been asked how I felt.

Dr. J laughed graciously and said, “Well let me make a call and see about getting you that mammogram.”
She returned before I could pick up another “O” Magazine.

“They are ready for you now,” she said. “I’m so sorry about all of this.”

Another hug and I headed back downstairs only slightly concerned my pain-in-the-arse return to Women’s Imaging would mean a more painful squeeze but pleased that I would be finally getting the screen that reassured me everything is A-okay before I go into another surgery.

The mammogram was just that. A mammogram. If you’ve never had one there are plenty of people who can share their experiences. I am not a great one to ask since I've only had two and, compared to the last one, mine was ridiculously fast and one-sided!

As I mentioned above, everything came back clear. Like many other women, my tissue is dense and the first mammogram never saw the IDC but we saw nothing alarming on this one so I’ll take it.

If you’ve made it this far, you might be wondering what in the heck I’m grateful for out of all this. Or you’ve assumed I’m grateful for a clean scan.

While I am indeed very pleased with the clean scan, I am actually profoundly grateful for a voice.

I have one. And I can use it.

It felt very small sitting in the radiologist’s office but I used it anyway to say, “This is not okay,” until it slowly became louder.

NOTE: If I were following @Kind_Spring's 21-Days of Gratitude, I would be finished with this exercise but I have so much more to be grateful for!