The Middle Ages Two Friends--different ages, different husbands, different opinions
Barbara: First, I have to set this story up by telling you all that Deb and I have a kind of health dichotomy: if my health-care professional (doctor, naturopath, esthetician, whoever) tells me one thing, hers will tell her the complete and utter OPPOSITE. And vice versa. Never fails. It’s become a running gag between us. It’s gotten so bad that we can’t even get through the “But my doctor said…” without bursting into a fit of giggles.
Second, a proviso: I am not nor do I claim to be any kind of health professional. My wish is to share an experience, my assumption is that you will all do what’s best for you, and my hope is to open the floor to discussion.
Earlier this year, Deb and I were talking mammograms—I told her that I hadn’t had one yet. She balked—her doctors and everyone she knew recommended having regular mammograms when they turned 40 (I was 46 at the time). I said that neither of my two doctors had mentioned me needing one yet and that all the literature that I’d read (or skimmed, in truth) had always said mammograms for women without breast cancer histories should start after 50. Deb didn’t say much more about it that night—she seemed to accept my take on it. But the next day, I received a heartfelt and beautiful email plea from her. Would I please reconsider my stance? She knew so many friends whose breast lumps were discovered in their 40s. Cancer concerns were rampant. She supported any decision I made, of course, but please, oh please, would I think it over again.
Well, I did think it over. Have you ever noticed how when you have a weighty conundrum the universe suddenly inundates you with relevant information? If you haven’t noticed, start paying attention—I swear it’s a real phenomenon. After I got Deb’s email and while I was pondering her powerful words, not one but THREE articles came into my world (by way of our national paper and two respected magazines––here and here) and all of them weighed in on the side of starting mammograms after 50. The crux (bear with me here) is that the medical community is finding there are so many false positives on breast lumps and that, with the attendant procedures, more harm is being done than good. The problem with this logic is that there are also cases where early mammograms find lumps in women in their 40s that could have resulted in death had they not been found earlier.
So the dilemma was still: was I that more common woman who might have lumps that come and go and are of no medical concern but if found would begin a flurry of unnecessary medical activity, or was I that one in a million woman who might have a malignant tumour that needs to be found pronto?
I had my annual physical and discussed it with my doctor. With my family history, she still advised after 50. As usual, she also felt around for lumps and was satisfied with my general good health.
Flash forward three months. My affectionate husband stops in mid-nuzzle and says, “There’s a lump in your breast.” And then the world stopped.
What?! Yes, I could feel it. About the size of a nut. Mobile. Soft. We reassured ourselves that it was most certainly nothing. But, of course, the doctor appointments began. And, of course, the debate about the mammogram was officially over. A mammogram, by the way if you haven’t had one, isn’t really that bad. Firm, emphatic pressure, that’s about it.
And while I waited for results, the nut-sized lump got bigger. And bigger. Before I knew it, it was the size of a plum.
Then the dreaded phone call from the doctor’s office: the mammogram wasn’t conclusive; I would need a breast ultrasound. Okay, in all my personal drama herein, I never thought to ask anyone why breast ultrasounds don’t trump the mammogram. In an ultrasound, there is absolutely no discomfort; it was the second procedure in my case, so presumably it gives a better scan of the breast; and there’s no friggin’ megawattage of radiation! Any answers out there???
Anyway, I waited, waited, waited for the results of the ultrasound, all the while fingering this swelling, confusing, foreign ball inside my body. And, again, get the dreaded phone call that I need to talk to the doctor. This time she tells me the results show that the lump is not a cyst like we’d assumed, but a “benign-looking tumour”. I confess, I burst into tears. Didn’t hear (or care about, for that matter) the “benign-looking” part. All I heard was TUMOUR. Tumour, tumour, tumour. The kind of lump that needs to be surgically removed. The kind of lump that, in my world, has “malignant” written all over it.
For two weeks, while we waited for the appointment with the surgeon, my husband and I tried to be brave and optimistic. For me, this was very very hard. Deb’s beloved dog was dying and my mom was heading to Paris for two weeks. I decided to spare them the worry until I knew more. I had my husband, my sisters, and a good friend to lean on. It was a quiet time of nervous introspection.
Then the date came for my husband and I to meet the surgeon. I was immediately reassured by his calm, sweet, and informed presence. It would be okay. Then he very carefully outlined all the next steps and possible outcomes so that we would be prepared for every eventuality. “If we have to remove the lump and the area around it, there would be a significant change to the shape of your breast because they’re relatively small. Then we biopsy and go from there,” he said. He told me to lay down on the examining table so he could extract some tissue from the lump. The room fell away. That was it––I was going to die.
As I fought to remember to breathe, the kind doctor inserted a needle—which I didn’t feel at all––into the lump. A thin film of sweat enveloped my body. I guess I was watching his face intently because I noticed him give the smallest possible doctorly reaction. “Well, that’s good,” he said. What was good? How could anything be good right now? Doctors don’t biopsy by sight, do they?
“This changes everything,” he said as he held up the needle. It wasn’t the hard tissue of a tumour, but the (sweetest, most wonderful) fluid of a cyst. And just like that the lump—and my stress and worries—was gone.
Mammogram or no? If I’d had one 3 months earlier, we would all have known that there was nothing in my breast at that time––and we would’ve been able to reassure ourselves that no tumour grows that fast. It would have been obvious that my lump was only a cyst. That said, I know my breasts, my husband knows my breasts, my doctor palpated my breasts, and all of us knew there was nothing there 3 months earlier. Same logic. The time while I waited for the results and debated the language (while relatively short) was horribly stressful. Enough to trigger one lump or two (I believe in stress triggering disease in our bodies). Could there have been a better way?
I will say this: I believe in positivity, of being proactive about your health, of learning as much as you can about your personal situation. I also believe that most of us get to sideswipe real health issues (90% of all breast lumps are benign tumours or cysts) while many of us, sadly, do not. So, is the biggest lump of all that our health is just one big crap-shoot?
Deb: First of all, to add to the dramatic tension, I only just found out about this when Barb sent me the blog-post this afternoon. True to her kind nature, she did not want me to deal with this as we were in the middle of our dog Frisker’s illness, which eventually killed him. I wish I had known so that I could have supported her in this tough time, but I totally understand why she did not tell me. I have read this post three times. Twice to grasp the reality that she was talking about herself and once more to come up with some sort of response.
Barb and I just had a very long chat on the phone about our different views on tests and mammograms and we both came out of it, I think, realizing that there are so many variables and so much conflicting information out there. There is good solid information and many of it contradicts the other side. To Barb’s point, is our health just a crap shoot? Maybe. I often think of people like Linda McCartney who did everything she could and lived so well and pesticide-free and yet still she died young. But all I know is, I am still reeling from this new information about my dear dear friend. So my response is this: thank you, dear God, for my darling Barb and this wonderful outcome. May it be the same for thousands of other women no matter how they find out.
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