When you drive in Western Pennsylvania — and it doesn’t matter whether you’re in the city or the country — you’re going to see dead deer on the side of the road…. a lot of them. When you commute between city and country, it’s inevitable that you will see several each week. Despite living here most of my life, I don’t ever get used to it. This morning, for the first time ever, I drove past a doe that was still alive. She lay in the gravelly dust of the Rt 22 shoulder, her legs splayed out beneath her, head raised from her heavy torso; she looked around, as if attempting to meet the eyes of each motorist as we sped past. I couldn’t decide what to make of this: a sign, perhaps, of life where we typically see death? Or a warning: the undeniable horror of slow pain in a creature being shown no mercy.
My mother took me to the surgeon’s office on Tuesday afternoon, where they did not have me registered for an appointment even though I’d spoken to them on the phone only six hours earlier. The look on my face must have convinced the receptionist that I wasn’t going to leave until someone had seen me, so they managed to fit me in.
In the exam room, two nurses did the usual – temperature, blood pressure, a review of medications, my medical history (which I hate repeating in front of my mother, who cannot even bear to look at me as I describe the diagnoses, surgeries, etc). They asked me to change into a pink gown. Ah, pink. Always with the pink.
When the PA came in (my good friend Google tells me she graduated with her MA as a PA three years ago, so she must be at least… what… 23 years old?), she introduced herself and then proceeded with an exam. She asked me a few questions about my recent health (yes, I had been sick about three weeks ago with a pretty bad cold; no, I don’t do self-breast exams because I don’t have a menstrual cycle nor do I have real breast tissue). After finding the lump and palpating it for a few minutes, she reminded me that I had been clear at my checkup in January, and that self-exams are really important. Victim-blame much? (am I being over-sensitive here? No – fuck her). I reminded her that I found this lump while in the shower feeling my own breast, and I had called the doctor’s office immediately. She left the office to call the doctor who was in surgery at the time.
Upon returning, she babbled on and on, waffling between wanting to being over-cautious in my case because of my history and my BRCA mutation, yet attempting to convince me that this lump is most likely an inflamed lymph node related to my cold from three weeks ago (although I do not trust that my anatomy is normal in any way since the mastectomy, I am pretty convinced that this lump is well below any lymph node). She said the office would call me to schedule an ultrasound and then an immediate biopsy depending on what the ultrasound reveals.
Yesterday, in the online portal for my health record, her notes appeared:
An ~ 2 cm mobile, palpable mass is noted laterally at approximately 10 o’clock that is more easily palpated while the patient is upright. There is no overlying fluctuance or skin changes. No fibroglandular thickening. No axillary, infra, or supraclavicular adenopathy.
Obviously I spent several hours yesterday Googling the terms in this note, as well as comparing them to my pathology reports from my double mastectomy and bilateral oophorectomy and hysterectomy, all in 2013, reports from the original mammogram and ultrasound that first discovered the DCIS in my right breast – images taken in December 2012, and pretty much every other document in my electronic medical record.
Based on my research, here is what I think I know (this chart is quite useful, although it assumes a woman with breast tissue, not someone like me who has had a prior mastectomy):
- the ultrasound should be able to show if the lump is a cyst, and if so, that would be good news
- if they move on to do the biopsy, then they suspect it is a malignant tumor
- the biopsy will tell them if the tumor is invasive or not
- the PA was bullshitting me about the lymph node (swollen from a cold three weeks ago? in my breast?)
- the PA might be incorrect about the lump being mobile; I’ve been feeling this thing during every moment I’ve been alone since Tuesday, and I am pretty positive it is quite fixed in place.
- yes, I do think I know more about this stuff than a 23yo PA, at least for now
Ultrasound/biopsy are schedule for June 19th.
Blogging BRCA 