As You Read This (My Election Day Mammogram)…

If you’re new to my blog or this particular series on my blog, start here: As You Read This.

As You Read This (My Election Day Mammogram)-www.roseyrebecca.com

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 You Read This (My Election Day Mammogram)-www.roseyrebecca.com

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.

$665

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.

$665

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.

$665

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.

$665

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.

$665

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.

As You Read This (My Election Day Mammogram)-www.roseyrebecca.com

Current Breast Problems: Lump. Right. Tenderness. Pain.

Family History of Breast Cancer: None.

Breast Surgery: Surgical Biopsy, October 2010. Needle Biopsy, October 2011.

Date of Last Mammogram: February 2010

As You Read This (My Election Day Mammogram)-www.roseyrebecca.com

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. 

As You Read This (My Election Day Mammogram)-www.roseyrebecca.com

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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Email: rebecca@roseyrebecca.com

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As You Read This (Eight Years Later)…

Deep Breath

Eight years ago I wrote the As You Read This series which chronicled my experience of first discovering a lump in my right breast to my first attempt to have it removed in October 2010.  When that first attempt failed, I followed up with a second biopsy a year later and found out that the lump was a benign fibroadenoma. I was 23 at the time and it was the most stressful thing I’d ever experienced.

As You Read This (Eight Years Later)- www.roseyrebecca.com

Writing has always been my go-to when obstacles in my life feel too hard to keep in my head.  Eight years ago I took to my blog to write about what felt like an impossible experience, not only to help myself but to possibly help others who might be struggling with the same scary thing and felt too afraid to talk about it. I was 23 years old. I never anticipated that I’d be scheduling mammograms and ultrasounds in between homework and college classes.

Now, eight years later, at 31 years old, I’m revisiting the As You Read This series because just two days ago, during a routine breast exam, my doctor felt another lump in my breast and though my first instinct was to cry (and believe me, I cried), my other first instinct was to write, again not just for me, but maybe for you, too.

I’ve learned a lot in the eight years since my first biopsy. I’ve had multiple follow-up ultrasounds to track the growth of the fibroadenoma and even had a metal clip attached to it so radiologists can easily spot it on imaging. For the most part, it’s stayed the same size, and over the years the ultrasounds have revealed other benign growths in my breast. I’ve learned that most breast lumps are benign and can be caused by something as innocent as hormonal changes during your monthly cycle.

As You Read This (Eight Years Later)- www.roseyrebecca.com
I received many of these letters after my follow-up ultrasounds.

Still, knowing what I do now doesn’t make the discovery of a new lump any easier.  Five years after my biopsy, my doctor in DC told me that I could stop scheduling follow-up ultrasounds. Since the lump hadn’t changed in years and the other findings were likely benign fibroadenomas and cysts, she didn’t see a reason to continue my twice yearly appointments. I continued to have regular breast exams at my physical each year and my doctors have never felt anything unusual or anything that they didn’t already know was there–until now.

At my physical on Monday, after talking for a bit about my history with breast lumps and nonchalantly mentioning that I hadn’t had a follow-up ultrasound in about four years, my doctor asked if I wanted her to do a breast exam. I agreed and as my doctor felt around, I focused my attention on the pictures affixed to the ceiling and thought about how simultaneously nice and weird it was that they were there. I took deep breaths and fully anticipated the first words that came out of my doctor’s mouth:

“I don’t feel anything weird,” she said. What came next is what surprised me. “You do have one small thing here,” she said, moving my finger to a spot on my breast where I’d never felt anything before. I could tell that she thought that I already knew about it. She probably thought that it was one of my old lumps.

“I’ve never felt that before,” I said quietly, trying not to sound too panicked.

“Oh,” she answered. “Well, let’s schedule something then since you haven’t had a follow up in a while.”

If you struggle with anxiety, you likely know about the hard lump that develops in the back of your throat and the overwhelming sense of dread that causes your chest to tighten and makes it hard to breathe when faced with a stressful situation.  An intense feeling of deja vu came over me. It didn’t matter that it was a different doctor’s office, a different city, a different time: I’d been here before.  And though it’s eight years later and I’m eight years older, the same thought raced through my mind: I’m too young to be dealing with this.

If you struggle with anxiety, you know that sometimes when you’re in the thick of it, there’s no talking yourself down.  Sometimes rational thoughts like, “you’ve been through this before” and “your doctor doesn’t seem worried” and “it’s most likely benign” are drowned out by fears like, “what if this one isn’t benign?” and “you might have cancer.”

As You Read This (Eight Years Later)- www.roseyrebecca.com

Thankfully I had a therapy appointment right after my doctor’s appointment and we talked a lot about stress management. We talked about putting stressors into two piles: ones that I have control over and ones that I don’t and how to deal with each pile separately. That helped for a little while. Later, when I caught myself googling a little too much or instinctively reaching to feel the lump, I reminded myself that worrying will never change the outcome, that I’m doing everything in my control to help the situation.

Next Tuesday afternoon, I have an appointment for a 2D bilateral diagnostic mammogram and a right breast ultrasound. I use the full medical name here to express how surreal it feels but also how familiar. In 2010 I could have written a book of all the medical codes and procedures associated with my multiple appointments and biopsies.  In case you’re wondering, mammograms aren’t usually fully covered under insurance until a woman turns 40. This means that when you’re 31 years old or 23 years old even if your doctor specifically orders a test, insurance assumes that you don’t need it and makes you pay mostly out of pocket. I mention this only to express how truly unacceptable our current healthcare situation is and since my mammogram is scheduled on Election Day, I encourage you to go out and vote for candidates that will work to change this horrible system.

On Tuesday I will enter a waiting room that I suspect will look the same as all the other waiting rooms I’ve been in before. Although I haven’t had an ultrasound in four years or a mammogram in eight, I can close my eyes and imagine exactly what it will feel like, not just the physical sensation of the tests but the immense anxiety I’ll experience while waiting for a radiologist tell me the results.

It’s true that right now I have no control over the situation, that all I can do is wait. How I handle the worry and stress is under my control though and I’m trying my hardest to utilize the tools I’ve gathered in therapy to cope. I’m practicing taking deep breaths and spotting the lies my anxious mind is telling me. I’m distracting myself with exercise and time spent with friends. I’m drinking lots of tea and reminding myself that this situation would be stressful for any woman, but my mental illness is making it feel extra hard.  I’m reminding myself that it’s OK to be scared and to take it one step at a time.

And I’m writing because that’s what I do and if you’re reading this and are experiencing anything remotely similar to what I’m going through–whether it’s  the discovery of a lump in your breast or just overwhelming anxiety over something that’s going on in your life–I hope this post has helped you feel less alone.

As always, thanks for reading.

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Email: rebecca@roseyrebecca.com

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