#1 SEPTEMBER 2015 "God supposedly gives us only what we can handle. God must think I'm a badass."

A couple of years ago, I wrote about my total knee replacement (See "Dr. Ortho or How I Learned to Stop Worrying and Love the Knee.")  Since then, the knee has been great, my life has been great, everything has been going great.

Until September 2015.

In 2014, I had to change my physicians because I became eligible for Medicare. I picked up a primary care provider that I liked and had my annual exams done including mammogram. Everything was good.

In July 2015, I called to make an appointment for my annual physical and was told my PCP was no longer there, so I made an appointment with the new doctor.  I had a cursory examination, discussed referrals to two specialists, and was told I might not be able to get an annual mammogram since the "powers that be" have decided every other year is good enough for my age group. I demanded an annual mammogram since my mother had breast cancer, so my PCP put in the referral.

I made appointments for the two specialists in September.  I had to see a podiatrist because of recurring pain in my left foot, and I needed to find a new orthopedic doctor since I knew my left knee - the UN-replaced one, would someday need some help. The podiatrist took X rays, the ortho took X rays, and both suggested some things.  I took the recommendation from the podiatrist for a shot of cortisone, and told the ortho that I wasn't really in pain at the moment, just needed a baseline and someone to call if necessary. Everything was good.

The cortisone shot made my left foot hurt more.  I limped around on it for a while, and then my left knee began to hurt.  Dang!  Finally just after the ides of September, the left knee sat up and began screaming loudly that all was not right.  At this point, I was really hobbling. I even had to resurrect the cane and everything. I called the ortho and got an appointment on the 22nd for a new shot series - one a week for three weeks. This new stuff is called (I am not making this up) Euflexxa. I know, sounds like a bad joke, doesn't it?

The mammogram appointment is set for the 21st.  I hobble in, holding onto my cane and the mammogram machine in order to get my mammogram done.  They are always such fun.  My late Aunt used to refer to them as "Titty squeezing." That doesn't begin to describe it. I’ve often said that if men had to get their prostate exams by having their testicles squeezed between two hard, cold plates, we’d have a whole new way to test for breast cancer.

The day after the mammo, I got the first knee shot. I felt no real difference right away, but after a couple of days, it did seem to be slightly better. Foot was still hurting, but I’ve decided to ignore it.  Maybe it will go away. The knee trumps the foot right now.

And then, on the 23rd, I get the really great call, the call we women love to get, the Mother of All Calls, "We need you to come back in and do another mammogram."

Actually, I’m really not too worried at this point. I’ve been called back before and nothing was found. I come in for the mammo redux on the 24th.  By this time, the knee had settled to a dull roar, and I am able to handle the second mammogram without holding on to a cane. Of course, it’s my left breast that is affected.  What is it the Bible says, “If thy left side offends thee, cut it out?” or something like that. The left foot, the left knee, the left breast. As the French say, this is really “gauche.”
The "squeezing" is much more lethal now as the large press is exchanged for the smaller "increase the pressure" paddle. More pressure on smaller plate equals big ouch.  I’m escorted to the waiting room for the results.

Whoops, second mammogram isn’t enough; I must now go into the ultrasound room. Suddenly, things are not so matter of fact.  Hundreds of years ago, when I was pregnant, ultrasounds were not routinely done. I’ve never had an ultrasound before, but I’ve seen them on TV. The ultrasound doesn't hurt like the mammo as the technician slides the “puck” around on my breast, but the very idea of it has sinister possibilities.  She presses into my breast and side numerous times, but I don’t look at the screen. I don’t want to see what’s on there.

After the US, I'm told to get dressed, and they will tell me the results.  I walk into the radiologist's office, and he has a lovely, big picture of my breast on the screen with a nice white spot in it. There it is. I have a lump in my breast.  The one thing women fear has happened to me.

"Wait," I tell him, "I self-exam.  I've never felt anything."  He tells me there is no way I could have felt this one because it is so deep.   Well, so much for the joys of self-exam.  They’ve been telling us for years how important it was to self-exam, but obviously, not always.

“Wait,” I tell him, “I have a mammogram every year. There was nothing on it last year, was there?” He assures me he checked last year’s film, no lump detected.

“Wait,” I start to tell him, but there’s nothing I can tell him. Defeated, I sit and listen.

He tells me the lump is about 1.5 cm. Small.  Got it early. Before I can even breathe a sigh of relief, he says, "You'll need to come in for a biopsy of your breast and also your lymph nodes, since one of those appears to be swollen."

Well, isn't that special? It’s two for one day. Not just the lump in the breast, but the lymph nodes as well. I don’t know much about breast cancer or any kind of cancer, but I know lymph node involvement immediately raises the stakes. The nurse manager steers my body into her office and asks if I have any questions.  Questions? I don't know what to ask.  What just happened here? I'm in shock. She is very nice and supportive, we set up the biopsy appointment for October 2nd, and I leave.

As I walk out of the office, my mind is reeling. I don’t feel sadness or anger or fear. I don’t feel much of anything. I simply cannot process what has just happened. 

My health care group has email notifications of test results, appointment reminders etc. When I get a notification of the latest mammogram and ultrasound results, it uses the term "BIRAD-5, highly suspicious." I google this, not having heard this at the exam. WHOA - I have a 5% chance that the biopsy WON'T be cancer.  The odds are definitely NOT in my favor.

I begin to read everything I can about breast cancer - no, let me clarify that - breast cancerS.  There are so many different kinds of breast cancer, and for each difference, there is a different treatment.  I had no idea.  My knowledge of breast cancer goes from 0-60 in a flash.  I now know enough to be extremely dangerous.