Friday, October 19, 2007

Breast Care

I wasn't going to write about this yet, but I found a cat-chewed appointment reminder telling me I had an appointment I accidentally-on-purpose missed today at the San Francisco General Hospital Avon Comprehensive Breast Center. I didn't remember what day it is. October, which it is, is Breast Cancer Awareness Month, so I have been feeling continually made aware. But I didn't go anyway, today.

This appointment was a follow-up for an appointment, I did go to - by the Breast Center's calculations, six months ago already.

The appointment, then, was optional. I am 41-years old, already. Mammograms are suggested, but not recommended till 45. But a nurse examining me said she felt some "thickening" in my left breast that I shouldn't worry about - a lot of women have that, but that I might want to have checked out.

So I made a first appointment and went to the very new-feeling, clean, quiet, matte pastel-"feminine" SFGH Avon Breast Center. (I don't know if my appointment time was unusual for them or something, but I didn't see any other patients. I'm used to the semi-gloss primary color-painted, packed and busy SFGH HIV ward two buildings over, and six floors up.)

I checked in, didn't have to wait long to be called to the clean empty, little locker room, to lock up my clothes, and put on my pastel gown, and go to a room with big, heavy equipment.

An expeditious radiologist told me to remove my gown, and squeezed one breast, then the other, between big metal plates that took pictures of their insides. (It was definitely uncomfortable, but OK.)

She told me I could put on my gown and she'd be back in a minute.

She came back after a long minute, and said we needed to do the mammogram again, which we did.

She came back again after that one and said that my mammogram was concerning, and that I needed to have a sonogram, (breast ultrasound). I could either make another appointment--if I promised to do it for soon, or, if I had time now, we should do it now.

I said now.

I asked her what was concerning, and she said that I just had a spot on (/in) my left breast, a cyst, and not to worry--that a lot of woman have them, but I should have it looked at.

So I was led to a smaller, darker room, with a smaller machine.

A very doctor-ly Indian woman came in and asked me to remove the top of my gown and lie back for the sonogram.

She examined my left breast for a long time.

I could see my cyst on the monitor she was looking at.

She said it was definitely not a cyst. She wasn't sure what it was. Cysts are round, and light doesn't show "through" them on the screen because they're fluid-filled. Cysts look like dark circles. This was shaped like a kidney bean, which I could see.

She went and got someone else, who watched as she examined again.

The first "doctor," the sonographer, said that I had a small tumor, but that it was nothing to worry about--that a lot of women have them. She didn't stop examining it, though.

She said it didn't have anything to do with my having suppressed immunity from HIV, when I asked.

All I could think about, watching the screen with her, while she moved the small, cold--at first transducer around my lubricated nipple, was what it must feel like for pregnant women to see their embryonic babies for the first time. With this same equipment. To see the little heartbeat.

It was a similar strange/guilty/fearful excitement of many, many moons ago, thinking I might be pregnant, knowing that it was not the right time. It was never the right time.

She said that the good news was that she couldn't see any blood vessels attached to my little kidney bean of light. She showed me that the edges were "smooth." She told me it was probably a "fibroadenoma," which was OK, but should be watched. The other doctor said nothing after introductions.

The sonographer said I could either go ahead and schedule an appointment for a biopsy so we can know for sure, or we could just do this again in six months to see if it's changed in that time period--which is what she recommended, as long as I absolutely promised to come back then.

I had said OK.

continued...

Breast health

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