Wednesday, October 6, 2010

The Waiting Game

I'm not good at waiting. Whether it be waiting for the pizza delivery person to arrive or waiting for water to boil, I'm just not patient. But, I'm especially not good at waiting for medical tests.

On September 17 I had my annual screening mammogram. On September 20 I got a call from the breast center letting me know they saw a "density" on my right breast. They explained it's probably nothing and could be anything, but they wanted me to come in for a diagnostic mammogram and an ultrasound. I scheduled the next available appointment, which was September 30.

I woke up on September 21 and realized there was no way someone as anti-waiting as I am was going to make it until September 30 without driving myself bonkers. I understood it was almost certainly nothing, but sometimes you want more than "almost." Especially if you've watched your sister go through breast cancer treatments. So, at 8:00 am I called the breast center to see if there was any chance I could get an earlier appointment. They told me to come in at 9:00 that day. Peachy!

I was glad to hear them say that I would have some sort of an answer right then. Yay! No waiting! I had the diagnostic mammogram first. In case you're wondering, the experience is pretty much like a screening mammogram except they compress it more and they focus on a specific area. When they looked at the pictures, the density wasn't as clearly defined, but the doctor advised that I go ahead and get the ultrasound just to be sure.

On the way to the ultrasound, the gal who escorted me asked if I had been called back before. I hadn't. After all my previous mammograms I had gotten a letter in the mail saying that everything was A-OK, come back in a year. I was a little annoyed that they went off script this year by calling me. She said, "you're probably freaking out, then." I said I wasn't (much) and that I kept reminding myself that it was probably nothing. She told me to keep reminding myself that, because it usually is nothing.

On the ultrasound they spotted a small nodule. I saw it on the screen, but I didn't ask the technician any questions about it. She escorted me in silence back to the breast center. I tend to crack jokes when I'm nervous (or any time I get a chance, really) so when we walked past an exam room that had a treadmill in it, I said, "At least none of my tests today involved a treadmill." She laughed.

Back at the breast center, the radiologist confirmed the presence of a "suspicious abnormality." A biopsy was recommended and my doctor's office would be calling me about that. She asked if I had questions. I was sure I should have about a dozen, but I asked none. She said if I came up with any, I could ask the nurse when she called or I could call them. She handed me a pamphlet about breast biopsies and I headed out the door. The gal who escorted me to the ultrasound spotted me in the hall and asked, "well, did it go alright?" I didn't know how to answer. I smiled, "yes, it went fine, thanks."

Yes, it went fine. At this point, I still realized it was probably nothing. 80% of all breast biopsies are benign. Yay! But, please God, make me one of the 80%, thanks!

I had to wait a whole day to get the official order from my doctor to schedule the biopsy. Of course, I wanted to schedule it for the next moment possible, and they were happy to oblige...except the next moment possible was October 4. Twelve long days away. Seriously? OK. This non-waiter was going to have to learn some patience. Like now!

I spent the next few days reminding myself that it was probably nothing and that even on the off chance it was something, it was pretty small, thus nothing to worry about. Early in the waiting period, I was about 96-97% sure it was nothing. But, by about day 6, that grew to about 99.99999999%. But the waiting was still getting on my nerves.

A week before the biopsy, a nurse from the breast center called to walk me through the procedure. It went something like this. "You will be getting an ultrasound guided core needle biopsy. They'll find the lump again on the ultrasound and the doctor will mark where she wants to enter your breast. They will numb you with lidocaine. The doctor will make a small cut where she will enter with the instrument. The instrument has a core needle, or hollowed out needle on the end and she will use it to collect samples. It will make a clicking sound when she collects a sample. She'll deposit the sample in a container and then go back in to collect a total of 3-6 samples. When she is done, she will insert a titanium marker so that we can watch that spot on future mammograms. We'll apply pressure for 10 minutes to stop the bleeding. We'll cover with steri-strips. Then, we'll take you in for a mammogram so we can get a new baseline for your right breast. Bring a supportive bra that you can sleep in because you'll need to wear it for 24 hours. Any questions?"

I don't remember what questions I actually asked, but the one that was reverberating in my brain was, "Really? You're going to give me another mammogram after all of that?"

Anyway, the day of the procedure finally arrived. I was told to arrive 45 minutes early, so I did. I'm not sure why that was necessary unless they wanted me to get really familiar with their waiting room. Luckily a friend had come along so the wait went quickly.

They called me back on time and had me change into the lovely short smock thing they provide. Then, I had to wait for the ultrasound tech. More waiting. But, it wasn't a long wait. She took me back to the room and explained that they suspected it might be a papilloma, which is benign, but would probably need to be removed. But, there was a chance it was nothing at all. That sounded good to me. It sounded like worst-case scenario is that it's benign and needs to be removed.

She went on to describe what would happen during the procedure and it was pretty much as described a week earlier by the nurse. Pretty much. When she got to the part about the needle, she said, "Oh, and we have this new instrument we're going to use today. You'll be the first one we've used it on. Instead of having to go in multiple times to collect samples, this instrument collects multiple samples on one insertion. We've never used it on a human before, but we've used it on a fake breast with peas."

Really? Really.

I'm all for the latest gadgets and gizmos when we're talking computers or ways to make my tv-watching experience better. But, do I really want to be the first person whose breast they've used an "instrument" on? Well, OK. Even better, a representative from the company who makes this fine instrument was there and wanted to observe so I had an extra person in the room.

The procedure was pretty much painless. (Even the post-biopsy mammogram was pretty pain-free.) When they injected the lidocaine, they could tell by the way the lump behaved that it is probably just fibrocystic changes or something...not a papilloma. But, they'll test the tissue to be sure. Waiting on those results as we speak. As they inserted the titanium marker they assured me it wouldn't set off the metal detectors at the airport. I asked if I could at least brag to my friends that I have a titanium breast. They said I could. Be jealous. (It's a tiny little ribbon shaped marker.)

So, now all that is left to do is wait for the official word. I am not at all anxious about it, but looking forward to the official news and an end to the waiting.

(Reminder: October is national breast cancer awareness month, so I feel inclined to remind my gal friends that if you are due for your annual mammogram, schedule one soon!)