If you’re new to my blog or this particular series on my blog, start here: As You Read This.
It is 4 a.m. on Election Day. My bedroom is dark. The world is quiet. My mind is racing.
There are ten hours until my mammogram and ultrasound at Hope Women’s Cancer Center and I can’t fall back to sleep.
Instead of worrying about my tests, however, my brain has decided to focus on the possibility of a mass shooting at the Election Watch Party scheduled for that evening. The scenario that plays out in my mind is completely based in fear and not even the slightest bit in fact so I try to push it away and remind myself over and over again that I can’t believe everything I think.
I head downstairs to grab a cup of coffee and fight my compulsion to google “chances of a mass shooting at an Election Watch Party” by instead googling articles about OCD, something my therapist suggested I do a few weeks ago when I told her about my affinity for obsessive googling.
I read the first paragraph of a Psychology Today article titled “How Do Obsessive Compulsive People Think?” and then read it again out loud to Jeff because the more I read about OCD the more relieved I feel that I finally have an accurate diagnosis for the irrational thoughts that have plagued me for years.
At some point, I admit to myself that the reason my brain is focussing on a very unlikely scenario is to distract from the very real appointments I have scheduled that afternoon. I pour myself another cup of coffee even though it’s the last thing my anxiety needs.
I go to a spin class and then spend the rest of my morning helping out at the Buncombe County Democratic Party Headquarters, where I distract myself with data entry and chug more coffee against my own best interests.
By the time I’m ready to leave for my appointment, I am surprisingly calm. My friends Holly and Mary Beth accompany me and as we pull into the Breast Center parking lot I can’t shake the deja vu.
As I check in, the woman behind the desk asks if I want to ‘upgrade’ to a 3D mammogram because they’re supposedly better at early detection for young women and it’s only $70 more. I agree and casually ask how much both tests are going to cost. On the phone with my health insurance the day before, I’m told that since I’m under 40 (aka not eligible for free yearly mammograms) that my tests will count toward my $2,000 deductible. The woman writes the estimate on a post-it note and pushes it my way.
That’s how much it costs to have a mammogram and ultrasound in Asheville, NC if you’re under 40 years old and your health insurance declares that the tests aren’t medically necessary, even though your doctor has ordered them.
That’s how much it costs when a 31-year-old woman (or a 23-year-old woman) discovers a lump in her breast and opts to have it checked out to hopefully confirm that she doesn’t have breast cancer, or to catch it early if she does.
That’s how much it costs when you’re under 40 years old, even though 100 percent of cancer research has proven that early detection is key to treating and preventing the disease from killing you.
That’s how much it costs regardless of whether you’re a 31-year-old self-employed woman or a 23-year-old woman waiting tables to make it through college.
That’s how much it costs and it’s absolutely appalling that a woman might have to choose between putting food on her table and undergoing a potentially life-saving test. I am fortunate to be able to pay for it, to not have to choose, but the fact is, many Americans don’t have that luxury and simply cannot afford to even go the doctor, let alone pay nearly $700 for a test. It’s completely unacceptable and needs to change.
I tuck the post-it note into my wallet and sit down to fill out paperwork.
Current Breast Problems: Lump. Right. Tenderness. Pain.
Family History of Breast Cancer: None.
Date of Last Mammogram: February 2010
My name is called and I enter a very familiar room. I change into a robe and sit down next to two older women. I distinctly remember how I felt as a 23-year-old sitting in a similar waiting room 800 miles north at Albany Medical’s Breast Center: too young to be there.
I’m told that my mammogram is up first and if they don’t see anything troublesome I’ll be free to go without an ultrasound. My immediate thought: great, that will be cheaper. As the technician walks me back to the exam room, I warn her that I had a panic attack during my last mammogram. She doesn’t say much to reassure me and I brace for the worst.
I don’t know if it because almost 10 years have passed between this mammogram and my last one and that the technology is a bit more comfortable or if I’m just that much stronger, but this time I don’t panic. I don’t panic even when the tech asks me to hold my breath right when I start to practice the breathing techniques I’d learned in therapy the day before.
It’s over before I know it and I return to the waiting room. The tech tells me that someone will be with me shortly to either let me go or bring me to my ultrasound. I wait, feeling certain that I will be able to go home without the second test.
A tech comes in to tell another woman that her mammogram is all clear and that she’s free to go.
That’s probably what they’re going to tell me, I think.
Then a tech calls my name and leads me back to an exam room for my ultrasound.
They found something, I panic. What did they find?
I follow the tech back into another exam room. I’m used to ultrasounds by now so I know what to expect, but it doesn’t help my anxiety at all. I watch the tech mark things off on the screen, wanting to ask what she sees but knowing full well that she can’t tell me. I have to wait for the radiologist to tell me the results.
The tech finishes up and tells me she’ll be back soon with the radiologist. I hold my breath and stare at the ceiling. ‘Back soon’ feels like five years. It always does.
“Welp! I can’t seem to find anything wrong with you!” the radiologist exclaims as he walks into the room.
“What?” I practically yell. “Nothing?”
“Nope. I’m not sure what your doctor felt but there’s nothing there,” he says. “I see the metal clip where your fibroadenoma used to be but I don’t even see that anymore.”
I stare at him blankly not sure what to do or say.
“Come back when you’re 40 for your routine mammogram!” he says cheerily.
I leave the Breast Center feeling a million things at once.
I’m relieved. This is amazing news! I’m ok! I don’t have to worry about follow-up tests!
I’m angry. Why did they go through with the ultrasound when they didn’t see anything on the mammogram? Now I have to pay for both! I guess it’s better to be safe than sorry.
I’m confused. How did absolutely nothing show up on either test when my doctor was so sure she felt something there? How is the original fibroadenoma gone?
I’m skeptical. He probably missed something. I’ll google ‘chances of missing lumps on a mammogram and ultrasound’ when I get home.
I’m anxious. I’m always anxious.
About a week later I get a letter in the mail confirming when I already know: no breast cancer. I think about what it might be like to receive the opposite news and my breath catches in my throat. I feel lucky.
The letter indicates that I may have dense breast tissue, which is apparently common and found in more than 40 percent of women. It explains why the surgeon failed to find and remove the fibroadenoma during my surgery in 2010. It explains why they needed to put a metal clip on it the following year during my needle biopsy.
Does this mean that it’s more likely that the radiologist missed something this time? I panic and start to google dense breast tissue. The letter says it makes it more difficult to detect abnormalities and may be associated with increased risk of breast cancer!
I take a deep breath, put my phone down, and push those thoughts out of my mind. It’s just OCD, I assure myself.
I’m writing this post almost a month later and I’m happy to say I haven’t worried about it since. I decided to write this follow-up for a few reasons: 1) to wrap up an almost 10-year series and stress the importance of regular breast exams for early detection of breast cancer, 2) to call attention to how horrible the American health care system is, and 3) to continue to be candid about my struggles with mental illness.
I hope you have found this post interesting and informative and please don’t hesitate to reach out to me in a comment or private email if you want to share your story or have any questions.
As always, thanks for reading!!
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