Monthly Archives: June 2019

All Clear

Here’s the TL/DR version: Check your boobies ( . ) ( . )
(and anything else that needs checking)

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When I scheduled my mammogram for June 11, the receptionist faltered. “Are you sure you want to come in on your birthday?” But it was the first available and after last year’s mini-scare I had vowed to never fall behind on screenings again.

As the daughter, granddaughter, and great niece of breast cancer survivors*, I’m in a high risk category. Doesn’t help that I’ve never been pregnant. I was advised to start annual screenings at age 35 because baseline images are key for noticing changes over time. In the beginning, I averaged about every 2-3 years. As I eased into my 40’s, closer to the age my mom was diagnosed, I was supposed to be more on top of it.

But for the last few years, dealing with my brain and some other significant issues has been the priority. My capacity for wrangling with the health care system was strained. I’d get referrals from my PCP and they would expire and ugh now I have to call and ask again? I know that’s a feeble excuse. We do our best in our stumbling ways.

When I finally managed to haul myself to an appointment last May, it had been awhile since my dense boobs had been contorted and squeezed into the x-ray clamps. (If your first mammogram is on the horizon, read up or talk to others about what to expect. Maybe the technology will improve one of these days.)

Because I am in the higher risk pool, my screenings include ultrasounds. I remember feeling a sense of dread when the technician kept sweeping the wand over an area on my right breast. Just being thorough I figured. When she completed her survey of the left side much more quickly, my worry deepened.

The bike ride home was a little shaky. I wasn’t so much afraid that something was wrong.** The heart pounding was about feeling like once again I had screwed up. How could I have let something so important slide? What if my inaction had jeopardized chances of early detection? How could I face my family? Mom and Michael had been reminding every few months. If I was sick, it was my fault. Failure, failure, failure. As always.

When I got the call to return for more testing, I was a wreck. The appointment was initially for the following week, but when I reached out with some questions, they sensed my panic and invited me to swing by the next day if I didn’t mind waiting to be seen. I showed up bright and early.

They wanted to look more closely at my right breast. The lump was probably just a cyst–nothing to worry about. There were also two grainy areas. Calcification? Carry on. Ductal carcinoma in situ? Hmm, that’s what my mom had. Early stage, highly treatable, and she has been clear for 20 years. Probably no need to freak out.

But when they mentioned the two enlarged lymph nodes, my eyes popped. I was quickly assured this was probably nothing, especially given their symmetry–one on each side, same position and size. They asked about other health issues. I wondered if all my brain pills could be a factor. Not likely. They countered: Rheumatoid arthritis? Thyroid disorders? A recent cold? Nope. Allergies? Yes! Maybe it was just some low-key inflammation. I’m a baseline itchy, sniffly person, even with my allergy medication. And it was peak tree pollen season.

Given my family history, they suggested genetic testing and an MRI to get a better baseline. The genetic testing was clear and the MRI didn’t sound any alarms.

Come back in six months. Which I did. No changes.
Come back in six months. That was yesterday’s appointment. I still have the cyst, spots, and swollen nodes. But, they haven’t changed.
Come back in 12 months. A new birthday tradition.

I took myself to the nearby Ann Sather’s for brunch to reflect and start writing this post. I indulged in warm, dense, sugar-shellacked cinnamon rolls–a special departure from my “healthy June” goals. My waitress was statuesque, a little older and grayer, with a sharp, short hairstyle. Noticing the yellow “next steps” sheet in my hand, she gently said: “Looks like you have been to the doctor.” I explained I was celebrating because I had just graduated back to an annual mammogram schedule. She paused. “I’m six months out from treatment and just got my all clear for now” results.

I stammered out awkward pablum about how I was sorry and how is she doing, oh goodness do you mind if I am asking you questions. She was happy to talk. She’s doing well. Chemo had been rough. She lost all her hair. When I mentioned I had been admiring her cut, she laughed and patted her head. “I always keep it short anyway.” On the receipt, I wrote: “Hope to see you next year.”

On the way home, I ran into two friends, fellow Goethe moms. When I cheerfully shared my news followed by a tentative question about whether they are current with screenings, one paused. She is having surgery next week. Early detection. Her words said not too worried. I am worried about what her heart says. But we moved on to chatting about our kids.

One of my best friends from growing up was diagnosed in her late 30’s. When I called last year with questions, I realized I had not been tuned into her ongoing pain about the experience. There are many people, including my mom, who I have not listened to well enough. I will do better.

Last summer, another dear friend got the “come back for more tests” call the same week I did. Biopsies. Surgery. Chemo and radiation. Medication that pummeled her mental health. She marched through the school year serving kids as a school social worker with a smile and humor. She also keeps reminding people: Check your boobies ( . ) ( . )

I am keenly aware of my good fortune to have great health insurance and the scheduling flexibility to make appointments. Even with these advantages, I still dropped the ball. Who wants to go to the doctor, especially when you’re not sick??? Plus, the guidelines around screenings are ever shifting.

Even so, if you have been avoiding that colonoscopy, mole mapping (eek, that’s next on my list), cholesterol test, breast pancaking, or other routine check-ins, today is as good a time as any to pull out your calendar and make some phone calls.

*My mom likes to remind me that all the women in her family got breast cancer, but didn’t die of it. Her mom and aunt were diagnosed in their 30’s, both had dual mastectomies and lived on for decades.
** Per above, I’ve always figured the odds were high I would follow suit, that the question has been more when than if.

June Rules

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I use WomanLog Pro to track my weight and period. The consistent irregularity of my period suggests I have entered perimenopause. Ah, ages and stages!

On May 31st, I splurged on the top shelf red wine at Armitage Produce—10 vs 5 bucks. And as the evening waned, I pawed through the bag of “for my students” goodies for some Little Debbie Nutty Buddy Bars.* I even tried to savor instead of snarf them.

Per my therapist’s orders, during the month of June, I am going to. . . I want to say try, but ugh I need to be more ambitious. For the next 30 days, I am going to:

  • exercise a lot more
  • eat a lot better? less? more strategically?
  • write it all down

I have gained almost 25 pounds since last spring, after having lost almost that much in the previous two and a half years.  This 19% relatively rapid increase is a puzzle and is starting to become a concern because the chart keeps trending up. It’s a big shift for my 5′ 1″ inches.

Many variables might be at play. Perimenopause. Having been depressed. Being back on an anti-depressant. Working mostly from home.

And. . . perhaps. . .my dietary choices and activity levels. The truth is that I have been lazy with exercise and lax with portions, sweets, and wine. Last year, stabilizing my mood was the paramount health concern. Mission mostly accomplished, which is why we are reluctant to mess around with the medication. My annual physical is next week, so maybe that will yield more insights.

It’s aggravating to keep gaining weight even as I have eased back into running (but not enough to blame increased muscle on the scale–the waistbands don’t lie). Maybe what they say about age and metabolism is true and I simply need to adjust accordingly, not only in terms of behavior, but also outlook.  If I have to accept a new baseline weight and  build a new wardrobe, I can do that, though I am embarrassed to say it will be emotionally challenging. More on that another day. 

In the meantime, I am going to (not try to) focus on the variables that are very much in my control: what I eat and how much I move. I don’t do well with restrictive rules, so instead of cutting booze, I am cutting wine. Instead of avoiding all sweets, I will stick with anything homemade and maybe the occasional square of dark chocolate. I am not going to freak out about diet, but  am tracking via My Fitness Pal (under Velo_chicago). It’s amazing how quickly calories add up.  And with that, I guess I should go for a run. Wahhhhh!

*It was a three hour class, so I always brought power bars and sweet treats. Next semester, perhaps I should lean more towards fruit.