Okay, so torn between American and European guidelines about preventative mammography, I finally decided to meet them somewhere – almost – half way, and at 43 have my first screening.
I showed up at the clinic on time – unlike the two previous times in the span of two years, when I deliberately missed the appointments – signed in and followed the nurse down the corridor to preventative medicine. She handed me a white bathrobe explaining the process: disrobe completely from the waist up, put belongings in the tiny locker and wait to be called in the adjacent waiting area.
I did as she said and feeling somewhat violated by the hospital bathrobe proceeded to the waiting room. There were four women inside but no chatter. It was cold, very cold. Actually it was so cold that even my inverted left nipple almost fully popped out. I sat down waiting for my turn and about ten minutes later another nurse showed up and called my name.
We went to the mammography room and she asked me if I had used antiperspirant. I said no because the instructions I received in the mail said not to use deodorant. She asked a few questions about family history – not in general, but related to boobies. She explained what she was about to do and instructed me to put my left boob between two plates of the mammo machine. She then proceeded to wind them up clamping my breast tightly between – and I mean tightly! It was painful, and I could not move an inch. If the building crumbled down at that very moment I would be stuck with (or in) the machine. Sort of like Jeff Daniels in the movie Dumb and Dumber, when he licked the frozen pole gluing his tongue to it in the process. The nurse took an image, which was fast, and loosened the plates letting my boob free. I massaged it complaining about the treatment: my boobies are not that perky to begin with and they don’t really appreciate being squeezed to oblivion by a machine. In so many words. The right breast then endured the same harassment and that was it.
The nurse said that it takes up to a week to receive the results but on day three which was a Friday afternoon, my phone rang and a different nurse told me that I have dense breasts (which sounded like quite a compliment) and that the right one is okay, but the left one needs more imaging because there is an architectural distortion present. My heart sank a bit – a big bit – while I was trying to assess the seriousness of those two words: architectural distortion. I told her that my left nipple is naturally inverted but she said that this was in a different area, 3cm from the nipple, on the left side – at “nine o’clock” position and about 0.5 mm large. Or something like that. I was trying to remember as much as possible, but somehow her words kept bouncing back without being processed. She scheduled me an appointed for the following week and hung up. I was left with my architectural distortion, deep anguish and, of course, the Internet. I immediately searched for the newly discovered term, hoping that the results will reveal a trivial asymmetry in the boobie mass. Turns out, AD is a disruption of the normal pattern of structures in the breast (a very simplified definition) and although it is most likely nothing to worry about (yeah, right) it is also the third most common sign of breast cancer. So, yes, cold sweat – a whole weekend of cold sweat sprinkled with all kinds of information and personal experiences shared on internet forums. By Sunday afternoon, I was an architectural distortion expert with a panic distorted mind. On Monday, I went back for another photo shoot called tomography, got more pictures taken at different angles – sliced, I think they said – went back to work, got another call from the nurse saying that they would also need to do an ultrasound. Okay. Went back for the ultrasound. I lay down on the bed in the dark room, was propped up on the side, had some ultrasound-friendly gel smeared over my poor, left breast, which I realized I loved so much (who cares about the inverted nipple?!) and watched the nurse freeze images on the screen. And what was on the screen? Some fifty shades of grey that I could not read. Then a blast of orange-red. The blood flow. The nurse just kept clicking and clicking, I guess looking for the “money shot” as I think they call it in fashion. I asked her if she saw anything…you know…at which she replied that it is not her job to discuss that with patients, that she just takes images, and the doctor will soon come in and speak to me. So, that’s it: the doctor will speak to me. I felt a cold shiver run down my back, I skipped a few breaths and like a bad swimmer in a wide, muddy, and powerful river, let myself be carried by the flow. The doctor will soon show up to push my head under water anyway. The nurse finished her patient case number xxxxx which I was, told me that the radiologist will come in in a few minutes to discuss the findings, and left. I got up and quickly put on my clothes. I stood in the room, like on the gallows, looking at the door through which the executioner was about to appear. I was on the verge of a full blown panic attack. I wanted to run away. I had to pee. Why did I even agree to have the stupid mammogram?! Where is the doctor? What is taking so long? It’s been almost three minutes! Or four? Or an eternity?! I had to pee. I stepped out of the room. The restroom was just outside the door…then I heard the “doctor’s door” open. I froze, just like an image on the ultrasound machine. I took a deep breath and with my head (seemingly) high went back to the room to face the verdict. The radiologist was quite young, pretty, with a pleasant smile. Reminded me of Zoe Saldana. I thought of Avatar, the first movie I saw in 3D. I still have the glasses at home. Those weird, uninvited thoughts.
I looked at the doctor, withholding breathing. She was surprised I was already dressed. Said that patients usually dress after the visit is over. “You are fine”, she said. What? I needed to hear it again just to make sure I wasn’t having a psychotic episode in which I was hearing what I wanted to hear. “You are fine”, she confirmed. I almost let my bladder go. She said some other things which I don’t even remember. All that was important was that she took the noose off my neck and let me walk. I wanted to lift her from the ground and twirl her around the room and in my mind I did exactly that. In reality I squeezed her hands and exclaimed a thank you. I left. I went to the restroom and started to cry. Tears of joy take us to a different dimension it seems, because if you think about it, they are not that common. I let them flow, myself sort of floating between two worlds, liberated.
Mammogram false positives and the anxiety they bring are some of the reasons that they are not recommended in Europe under the age of 50. They are said to cause unnecessary stress that in combination with unnecessary extra screening outweighs the benefits, especially in women with no family history of BC. What they don’t mention is the new appreciation of life one gets after a false positive. It’s like flying on the melody of Luis Armstrong’s “wonderful world”. As I was driving out of the hospital parking lot, even the dust on the sides of my not so clean windshield, looked beautiful to me. So if you ever get a call back, please don’t forget that it might be just that. Like a prank call. And hopefully it is. And nurses, please don’t call us for “more imaging” on a Friday afternoon unless you are scheduling it for Saturday morning, because whatever it is that you have to say, surely can wait until Monday. Let us have a peaceful weekend.
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