Thursday, December 22, 2011

New update! Things are moving along!

So Tuesday, December 20, I went in first for an appointment with the general surgeon, then mammogram, then an unexpected ultrasound based on the preliminary review of the mammogram by the Radiologist.  Let me break it down...

General Surgeon:
Total jerk.  Not interested in my subjective data.  He needs to go to Nursing School.  In NS you are taught to dumb things down for people.  This doctor asked me the same question, without clarifying, like 5 times. "How long have you noticed this excoriation?"  "How long have you noticed this excoriation?"  "How long have you noticed this excoriation?"  Excuse me Doctor No Bedside Manners, what is excoriation?  When I am the patient, my nursing brain just isn't working.  It wasn't until I was driving away that I figured out the meaning of excoriation.
So anyway, he did a clinical breast exam, palpated for lymph nodes, then had his conversation with me.  I assume he never felt anything abnormal.  If he did, he didn't have the decency to say.  He brought up Paget's Disease of the Nipple and Ductal Carcinoma in situ (I am really good at this self-diagnosis thing, obviously) and said that we should proceed with the scheduled mammogram (Duh) and then see him back in one week to discuss a biopsy.  One thing that made him seem a little more down-to-earth was that he managed to force an admission from his mouth that he could perform biopsies all day, but when it comes down to the part that actually deals with cancer, he has no clue.  Thanks Doc for humanizing yourself!

Mammogram:
Arrived promptly at 1350 for my 1400 appointment.  Checked in, all was good (seemingly).  1500 rolls around and I am getting a bit antsy.  I walk up to the receptionist and ask her if they had forgotten about me.  They had!  After apologizing for the printer's mishap, she told me to sit back down and wait.  At 1530 I go back, meet my tech, and put on a cute, pink sheet.  I knew that thing wouldn't last long.  Its purpose is only psychological.  I would like to note that mammogram horror stories are WAY overrated.  This woman  (and machine) smashed me every which way to Sunday.  Yes there is some pinching.  That only lasts long enough for her to run to her button, say "hold your breath", and its done.  If you have an upcoming mammogram (baseline), have no fear.
Nice lady tech leaves the pink, feminine, dimly lit room to go show the Radiologist.  In that time I do some sneaking around, looking at all of the buttons on the machine, wash my hands, think about how bad that wasn't, and before I know it she's back.  "We are going to get you in line for a breast ultrasound".  Nice.  This isn't scary at all!  Just 20 minutes ago she had told me that is the Doctor notes anything suspicious on preliminary review, I would need an ultrasound.
So now it is time to stand in line and wait once again.


Breast Ultrasound:
The technician was nice right from the start.  She used her two patient identifiers and that impressed me.  Gotta make sure we are probing the right boob on the right person who was born on Christmas Eve!!  So I lay down and notice a screen on the ceiling.  I know that this screen is for happier moments such as finding out if your baby is going to be a boy or girl, but immediately ask if I will be able to see the screen for my depressing procedure.  She states that yes, I can, but not to ask her any questions because she will not be able to answer them.  I kinda already knew that too.
So the exam begins.  I am looking at the layers of my own adipose tissue on the screen wondering how she knows what to look for.  I don't have to wonder for long.  She begins placing her digital measurements on the image and I knew that was not good.  The black oval shape at the 9 o'clock position measured 5mm.  So did the same shape at the 3 o'clock position.  5&6 were merely marked, and the exam was over.  She left saying that if the Radiologist needed anything further, she would be back accompanied by him.
I take this time to deliver some important text messages, look at the buttons on yet another machine, and stare at the ceiling until there is a knock on the door.
The Radiologist is young looking, but I can immediately tell he is more compassionate that the other one.  He listened to my concerns, did some probing himself, and then started explaining treatments, shapes, sizes, etc.  He too brought up Paget's and DCIS (go me!) and said that by Tuesday, December 27, he will have had time to fully review all of the tests and give me a more definitive diagnosis.  The 5&6 o'clock positions were clusters of cysts which could be aspirated with a needle easily.  The other two, he wasn't sure about.  Those were the ones that are concerning to him.  Also at that time a Breast MRI would be ordered and the biopsy to screen for cancer cells.
As I was walking down the hall to leave, I heard him doing his recorded dissertation.  "Hyperplasias" he called them.


Summary:
I left the hospital feeling a sense of PEACE!  All that I had expected could possibly be correct.  We will hopefully know on Tuesday.  I am sad, don't get me wrong.  I had fully expected to be bawling my eyes out, but I didn't and felt no need to.
On Tuesday I will go to the hospital prepared to have skin excised under local anesthesia for the skin biopsy.  And then, I think, the scariness will begin!

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