Monday, October 24, 2016

A Lump Named Lucille

I sat in the chilly examination room, my legs dangling from the padded table with nothing to shield me from the germ-annihilating cold but a thin cloth gown, opening in the front. My heart was racing, which prompted a warning of concern about blood pressure from the nurse, but I stopped short of arguing. How do I point out that my heart is racing because I'm terrified of doctors' offices, that I dread being poked and prodded, and that I'm here because I found a large lump in my breast?

In reality, I found the lump over a year earlier. The small, marble-sized bump in my left breast was easily discernible, but my doctor wasn't concerned. She noted that I was young and that there was no history of breast cancer in my family, writing off the lump as a simple anomaly. She advised me to monitor it nonetheless and sent me home. She wasn't worried, I felt foolish for overreacting, and I went on about my life.

Over the months, I continued with blase breast exams, grazing my hands haphazardly over my chest once in awhile, checking to make sure the little marble hadn't grown, and finding virtually no change. I began to experience a distinct ache in my chest and beneath my left shoulder blade, but chalked it up to stress and a poor sleeping position. It wasn't until March of this year that I noticed changes in my breast I had never seen before. Distinct dimples had developed over the side, creating a field of pock-marks in my skin. A bulge had begun to distend slightly a few inches from my marble. In a panic, I began aggressively examining my breast, digging my fingers deep into my skin until my chest ached. As I dug deeper, I found that my little marble was not so little anymore. 

I have a large chest, sporting a DD bra, and one of the pitfalls of having such a large chest (besides the adverse effects of gravity) is that detecting changes in your breasts can be extremely complicated. While the little marble felt small on the surface of my breast, what I didn't know was that the lump was extending deeper into the center of my chest, where I could barely detect it. Coupled with half-assed breast exams, anything could grow, any change could happen without my knowledge. I began to panic but tried to reason with myself and rationalize the anxiety away: this lump has been here for over a year, surely if it was cancer some other signs would have been obvious, right? There's no family history of breast cancer. I'm young, it's rare for women my age to develop breast cancer! But the negative thoughts flowed in and overpowered my feeble attempts to set myself at ease: the lump has grown. I have dimples and a bulge, which I learned could be a sign of breast cancer. There's still a family history of cancer in general, and young women can develop breast cancer just as easily as older women.

Initially, I tried to avoid overreacting, fearful I would look like a hypochondriac rushing into the doctor's office again. I noted I was due for a physical, and figured I would schedule one, then mention the change when I saw my doctor. The problem with scheduling a physical is because it's considered a routine examination, the appointment is not given priority, and I wasn't scheduled to see the doctor for another month. I tried to keep myself busy and distracted, but it seemed stories of cancer and diagnoses were everywhere I went, and I couldn't bear the wait any longer. I called the doctor's office to request an earlier appointment and I was in the examination room two days later. 

The doctor, a per diem physician I had never met before, examined me, and like me, had difficulty locating the lump at first. After detection, she considered conducting a biopsy then and there, but noted that the lump was too deep to draw a good sample from. Noting again that I am young and there's no family history, she eventually advised I get an ultrasound and a biopsy done and provided the number. If I have one complaint about Kaiser, it is the extreme difficulty in scheduling these critical tests. I was instructed to call a number, and was informed by the individual who had answered that she would leave a voicemail for the specialist and they would contact me in 2-3 business days. Of course, I was calling on a Friday, so I had to wait the weekend in addition to the business days. My weekend was spent in angst, my stomach in knots. By Wednesday the following week, they still hadn't called. Frustrated, I called again, and was met with the same response: she would leave them another voicemail and hope I get a response. Finally the following day I received a call, and my ultrasound and biopsy were scheduled for the following week.

Another week to wait. Sadly, I've never been one of those chicks who lose their appetite when they're nervous or stressed, and I began to eat my way to an unattainable comfort, gaining a fair amount of weight. I lost sleep, and my hair began to fall out as well. I made the mistake of not telling anyone about my circumstances, which only added to my burden. Though I wanted to reach out to my mom, like me, she tends to jump to the worst conclusions and instantly panic. Given that my mom had just lost her mother a few months earlier, I didn't want her faced with the prospect that her daughter may be ill as well. So I kept it to myself. Eventually I told my best friend, but it did little to relax me. Humor is usually the best medicine, and the only way I could cope was trying to lighten the mood in the dark cloud around me. Having a propensity for naming the lumps and bumps on my body (I have a bunion named Bertha), I found it only fitting that I should name the lump in my breast as well, and the pestilent mass became known as Lucille. I personified her, talked shit to her and about her, and vowed to mercilessly shank her ass if she turned out to be cancer. I could laugh about this at times, and other times, I just cried and hated Lucille with a passion.

When the time for the appointment came, I drove myself to the hospital and checked myself in to Radiology. The technician was friendly, and attempted gentle conversation with me while taking pictures of Lucille (she too had trouble locating Lucille, this bitch is like Carmen San Diego running around the globe that is my boob). She rose and stated she needed to consult with the doctor, which surged my anxiety. Did she find something? Was something wrong? Is it worse than we thought? I lay on the table freezing in yet another paper thin gown with a horrible pattern scattered across it (who designs this shit?) with my heart racing again. Finally she returned, and with a smile on her face, she informed me that I was clear. There was no need for a biopsy as the scan had come back clear. She stood in wait as I attempted to process this information, then cracked a smile and breathed a sigh of relief. I think she expected me to jump up and scream and shout, but after a month and a half of anxiety and stress, I couldn't switch my mood up that fast. I thanked her, she hugged me and guided me back to the lobby. As I walked to the car, I teared up and allowed the emotions to wash over me as I broke down crying. I called my mom that night and shared the news, finally disclosing what I had been struggling with for the past 6 weeks. She chided me for not telling her sooner and I cried on the phone with her for awhile. For the first night in weeks I slept soundly, and the weight had been lifted from my shoulders.

This moment of bliss was to be short lived, as a few days later I got another call from the doctor's office. I sat in my car listening to the voicemail as the doctor informed me that they wanted to run more tests and wanted me to get a full mammogram. Lucille was ruining my life. I yelled and cursed in my car as I was thrust into another episode of panic and distress. I called my mom crying, and this time I had her shoulder to lean on. I went through the disastrous process of scheduling another appointment, again waiting the weekend and the 2-3 business days for a call back, then was scheduled for a mammogram a week and a half later. Another week and a half of waiting on this bitch Lucille. I had my mom accompany me to the hospital this time, and put on the all too familiar, poorly designed gown in preparation for my pancake boob tests. The technician was not as friendly as the ultrasound one. She stuck little metal stickers on my nipples (likely used as a point of reference for the x-ray), and she stretched and pulled my boob like it was a lump of bread dough with absolutely no sense of feeling. She flattened me between two slabs of plastic and demanded I hold my breath and hold still. One photo-shoot for each side and I was sent to another waiting room. The consensus came back and I was told again that Lucille was nothing but an obnoxious presence in my chest, not a deadly one. My ultimate relief was almost overshadowed by trying to pull those super-glued stickers off my nipples (a pain rivaled only by childbirth), but I went home with a sense of peace I hadn't known in two months.

It turned out that Lucille was a mass of hardened breast tissue that had gained considerable density over the year. This contributed to the pain in my shoulder and chest as well, as my breast has become heavier and my body is struggling to adapt to the added weight. But this process has been an important one, and in spite of having a clean bill of health, there are many things to be noted here during this Breast Cancer Awareness month. First off, age doesn't mean shit. I have had many friends, one as young as 16, who were diagnosed with breast cancer, and while it is not as common as it is in older women, it is not impossible for a woman my age to get cancer. Second, while family history is a good predictor for breast cancer risk, it is not the only indicator; clearly you can get cancer even if your family has never had it. Third, breast exams are crucial, and you might as well start them now to get into the habit. Check here for information on how to correctly check yourself, and ladies, if you have big breasts, remember to dig deep! And last, in spite of being afraid of overreacting, don't let your doctor make you feel foolish or crazy, you know your body better than anyone else. Taking time to go to the doctor only to find out nothing is wrong is far better than avoiding the doctor only to find out it's too late when you finally get the nerve to go.

I was fortunate that my journey stopped here. Given the emotional toll the diagnostic process took, I can't imagine the anxiety, the stress, the overwhelming feelings that come with a true cancer diagnosis, and I give all my admiration and respect to women everywhere who have fought and are fighting this terrible disease. The sad reality that I found is the reason Kaiser takes so long to schedule these appointments is because there are so many women getting the exact same tests, some routine, some out of concern, and we should haven't to go through this any longer. Though we edge closer to a cure in the future, self-exams, early detection, and good health care make all the difference today. And if you are fighting, give that lump a name and beat the hell out of that bitch with everything you've got.

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