Mammography

I went for a little ride yesterday. No, I wasn’t at Disneyland or driving some stretch of highway. I was lying on a table in the ultrasound room of the Women’s Imaging Center, waiting for the results of a breast exam. It was a long half hour.

I had a mammogram a few weeks ago, just a routine screening. I got a call on my cell from my gynecologist’s office while I was in Arizona for Riley’s birthday. I needed to come back for a follow up. The radiologist had requested “more views.”

“This happens all the time,” the woman on the phone said. “They just like to be sure they haven’t missed anything.” Well, I was in baby mode, birthday mode, and it was comforting to accept that opinion. I didn’t lose any sleep over it, but I did make an appointment to have the second screening when I got back to Ketchikan.

I went downstairs for the second mammogram yesterday morning. Fortunately for my peace of mind, the radiologist read the images right away. She was still not quite satisfied, and recommended the next step, a breast ultrasound. I agreed; better to be safe than sorry. Since I work in the hospital, I asked the person scheduling to work me in whenever she had an opening. It might be a few days, but she assured me she would do that.

Two hours later I got a call. Could I come down at 2:30? Yes, I was happy to get this done, get it out of the way. A little voice in my head wondered if this was really just a sudden opening, or if there was something the radiologist had seen that pushed me up in the urgent queue? I hadn’t picked up on any concern. But isn’t that the job of professionals? Don’t alarm the patient. Remain calm. And after all, they do this every day. I’m the novice. I can still count on one hand the number of mammograms I’ve had.

The staff in the imaging clinic is extremely nice. I am polite and calm as I check in. The gowns are warmed. The lighting is soft. No one is excited here, we all know this is just routine. If they don’t seem alarmed, why should I? I could have taken a nap during the ultrasound, except that it’s a bit difficult to relax with gel on your breasts and questions going through your mind every time the tech lingers over a specific spot. What does she see? Why is she slowing down? I know it’s not appropriate to ask the technician to tell me what she thinks. Although I’m sure anyone in that role has enough knowledge to recognize an abnormal tissue mass, it is not the tech’s responsibility to discuss findings with the patient. So I resist the urge to pepper her with questions. I’m a model patient, shifting and adjusting as she completes the test.

Again, the radiologist will read the views right away. And again I wonder: is that normal, or do they seem something that requires urgency? The tech steps out of the room to confer with the doctor, and I’m left to stare at the ceiling and question.

I think the things that I assume most women think: this will be fine. Nothing to see here. I comfort myself. I don’t have a family history of breast cancer. I feel fine. I’m only 50! (Cliché alert: as they say, it looks younger every day!)

Then, for just a moment, I allow myself to imagine. This is how it starts sometimes. Just a routine exam, a little question, another test. And then, something definite. A diagnosis is made. Suddenly the lists are not about errands or chores, they are about appointments, tests, surgery, follow up, treatment. I watched my dad go down this path with colon cancer. I’ve seen others go through this. Why do I think I’m immune from this possibility? Why do any of us think the age old “it won’t happen to me?” I already know the end of the story. I know someday I’ll die of something. But I’m only 50! And that eventual reality is comfortably distant, isn’t it?

I think about the times in life that have focused me: the birth of my children, the loss of a loved one. Or on rare occasions, the poignant moments that stand out, that are frozen in my memory: the good stuff. Why, I ask myself, why can’t I keep the truly important things at the top of the list? Why do they always slip down below the urgent? Why is so much of life about keeping milk in the house?

Maybe we aren’t built to stand the intensity of the deepest emotion, the pinnacle experiences, on a 24/7 basis. They’re intense, these times of insight. They’re beautiful, magical. But intense. Who could live at that level all the time? And maybe, the very fact of routine in life is what keeps the magic in the other moments.

It seemed like a long time the tech was out of the room. Maybe it wasn’t. I was just rounding the corner of all of this in my mind when the door opened. “Ok, just keep up with your scheduled screenings. Looks good.” She smiled and opened the door for me. I went back to the dressing room to change, reassured and feeling vindicated that I had known I was fine all along. Nothing to see here.

Yes, it was all routine. Except for those few minutes on the exam table. They were a sharp reminder of what’s important in life. Funny how the extremes, good or bad, wonderful or frightening, can have the same effect. I left the clinic and walked back to my office, smiling, thankful that this wasn’t the day to switch out my lists. I have to remember to pick up milk on the way home, and the dry cleaning, not schedule a surgery.

This week I was so good…had my annual well-woman exam, a mammogram, and made an appointment to have my lipids checked. I work in the administrative department of the local hospital and there’s an OB/Gyn clinic literally down the hall from me. (Thank God I only need the Gyn services of the clinic…I’d have to kill myself if I needed the OB side! But I digress.) In anticipation of leaving this job when the house sells, I thought I should take care of some of these pesky things while it’s still an easy and relatively painless process. The mammography clinic is downstairs, as is the lab, so the excuse of having to leave work to get to these appointments doesn’t apply. Nice that it’s so convenient.

When I saw the doctor for my appointment, she went through all the routine questions, and since this was my first visit with her, asked the date of my last exam. I had to admit it was five years ago, shortly before we left Colorado. I know, I know…but I feel fine, and it’s incredible how quickly the years can slip by. And I’ve meant to get it done; I’m sure that counts for something. So now, I’m back on the straight and narrow. She made me feel a little better about my negligence. Told me it has been eight years since her last exam, so right away, I was reassured. I’m not the only woman in America who let this little life chore slip. And I was happy to report to her that I actually take supplements…flax seed oil, and the occasional Vitamin D, and now and then a calcium. Of course, I didn’t volunteer the frequency of my habit. Still, I must be doing something right. I have all the parts I came with, except wisdom teeth, but that’s a different professional visit anyway.

After the exam, my doctor announced, in confident tones, that I would live forever, providing I schedule a mammogram immediately, and continue to follow my excellent program of diet and exercise. I do so go to the gym! No, I came clean with her. She gently encouraged me to get into a more regular exercise routine. Three times a year is simply not enough at my age. Any day now I may wake up and have major issues. So far my knees are doing fine, thank you, and I have energy to burn. But the big M is just around the corner, and I have to be vigilant about my health. No more taking it for granted. Next time I see her the questions won’t be about my choice of birth control, we’ll be talking about the latest style in hormone patches and whether I’m experiencing my own personal summer.

I promptly scheduled the mammogram, was able to get that pleasure out of the way the same day, thanks to my ability to be worked in at a moment’s notice. The trip downstairs was just enough time to soothe myself, saying repetitively, “It won’t be too bad. How bad can it be? And besides, the waiting room is so well decorated!” Made me feel right at home, me being a woman, and as everyone knows, women appreciate the small decorative touches that take your mind off clamps pressing you quite mercilessly. The gown they gave me to wear during the exam had been thoughtfully warmed. The techs were extremely polite and pleased to note that, in fact, I had been a bit more responsible with my mammogram exams, having the last one only three years ago. I almost got a star on my chart. But not quite. However, the scolding was more in the form of encouragement to never again let more than a year and a day pass between these tests. I’m at that age, you know. And really, they meant well.

After so much confrontation in the same day with my approaching infirmity, I couldn’t decide if I should celebrate the fact that I’m this old and doing as well as I am; or if I should go out with a bang and do something really meaningful to mark the end of life as I’ve known it. I’m going south (the Alaskan phrase for going down to the Lower 48) next week and have made a pact with myself to eat whatever I want for the whole week. I certainly won’t be exercising, and I’ll probably be living dangerously in other ways…staying up late, shopping extravagantly. Hope I can take all the excitement!

So if I can remember to skip breakfast on Monday (that fasting requirement) to have a blood draw to check my cholesterol levels, I’ll be set for a while. Of course, I still have to get the results of the tests I just had…but I’m going with the assessment that I’ll live forever…or anyway, long enough to wear out some essential part of myself…maybe a tummy tuck or brow lift will be life saving procedures I’ll need before long…have to stay on top of this stuff, you know.

Now if only my cream habit doesn’t show up in my blood work!