Monday, November 4, 2013

Breast pain

If you are a man, you may not want to read this.  Just warning you.  I mean, you may have already figured it out from the title, but I want to make sure you are fully informed.  Some topics addressed in this post will be uncomfortable.  In fact, even if you are a woman, you may not want to continue reading.

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When I was an early teen, like all early teen females, I began to develop breasts, and this was excruciatingly embarrassing to me.  I had no desire to grow up, and would have happily stayed straight, skinny, platonic, asexual, genderless, and neutral forever.  I did not want to be a woman.  I most certainly did not want to be noticed for being a woman.

The solution was to hide in loose, floppy clothing as much as possible.  Since it was the late seventies, this was quite possible, peasant blouses being plentiful on the fashion scene.  I didn't know whether it was more mortifying to be seen with a curve on my chest or a bra strap showing through my shirt, so I compensated with layer upon layer of gathered calico.  Sometimes I didn't have enough layers to vary them throughout the week, so I wore the same things over and over, more willing to bear the humiliation of repeated outfits than the humiliation of exposing my development.  I hated breasts, despised, loathed and feared them.  And yet, there they were.

One spring day I was walking home from junior high, walking diagonally across Sorenson Park.  It was sunny, and my book bag hung heavy in my right hand.  As I walked, the book bag banging into my leg at each step, a pressure began to build in my right breast.  It was quite uncomfortable.  I wrapped the handle of the book bag more tightly around my hand and soldiered on, trying not to breathe too deeply, because something was catching in my breast with my deeper breaths.

At one point, the pressure increased suddenly and intense pain exploded in my right breast, reverberating and expanding.  Involuntarily, I leaned forward and cried out, pressing my left hand to my chest above my breast as though I were saying the pledge of allegiance, but the other-way-round.  Nobody was near me, but at a distance people populated the park.  Although I felt as if I might fall to the ground, I was determined not to call attention to my breast.   I did not look down to check whether blood was running out of my nipple as my senses suggested.  Pulling my right arm in as tight as possible to my side, using my left hand to rub my ribs where they joined my right shoulder, I continued moving forward, forcing myself to breathe, forcing myself to take steps.

By the time I arrived at home, the pain had subsided.  I never said anything to anyone about this experience.  I was too flushed with shame, and I didn't know how to explain it, anyway.

Since then, I've always felt lumpy, tender spots under my arms.  Under my arms.  Ha.

When my children were babies, I used to bathe them together.  Once as I was soaping one of them up, I said, "Let me wash your armpits," and the child said, "Mommy has big armpits!"  Another child (just as wet and soapy) replied in disdain, "Those aren't armpits.  Those are milks."  I never bothered to correct that terminology.  I liked to think of them as milks.  I felt it reflected their most noble purpose: nourishing infants. 

I always felt happy and surprised that my lumpy, tender milks were able to feed four babies.

"Do you do breast self-exams?" the doctor would always ask, and I would hem and haw, and not be responsible and talk about what I felt.  "They are tender," I would say.  "I have a fair amount of breast pain."

Then the doctor, an older gentleman with strong, warm fingers, competent, reassuringly clinical, would quickly check me himself, and it seemed like he was being thorough.  I always felt quite safe and relieved after the doctor's exam.  He never found anything.  Then they'd send me for a mammogram, and that never showed up anything, either.

But I knew that what I was feeling was up under my arm, in the part that never came under the rays of the mammography equipment.

Then my sister got breast cancer, and over the course of a number of conversations, I somehow learned that the doctor had found her cancer, her lump, and it was a tiny slippery thing that moved back and forth and was easy to miss.  Her mammogram had missed it.

On October 21, one day before I had a scheduled doctor's appointment, I was bathing and washing my armpits.  Once again, I thought I felt something.  This time, I somehow had more guts than usual.  I put a finger down firmly to trap it from one side and came at it from the other side.  I caught it.  It was there, a lump, a bump.  A specific thing.  After I almost fainted and then recovered myself, I decided it was good that I already had an appointment scheduled for the next day.

The doctor sent me for a diagnostic ultrasound, and from there they sent me for a core biopsy, which I had Thursday afternoon.

Core biopsy.  You go in, and they find the lump again with the ultrasound (actually, they were looking at two lumps), and they mark your skin with a pen to show where stuff is.  Then they get you all ready for the procedure.

You're already lying on your back with rolled towels propping you in such a way that your breast is at the top, the apex of your being.  They frame the breast with pieces of blue cloth, like a draping, but somehow different.  It lies there, a poor, crumpled pile of shriveled flesh five inches above your head.  A nurse swabs it with betadine, painting it orange which in this case is perfectly appropriate, as it is Halloween.  The betadine is cold and smells disinfecting, somewhat reassuring.  Nothing hurts.

"Now you will meet the doctor!" they tell you cheerfully, and in he comes to the sight of your orange breast lolling above your head in pitiful anticipation.  He has dark hair, slightly rumpled, and dark eyes, slightly owl-like.  You don't remember his name but that's ok because he surely doesn't remember yours.

They go to work on you, and you are glad that you cannot see their instruments.  Needles are the theme.  As I gather, there are needles to inject lidocaine to numb you, and then a hollow needle that goes in, with the ultrasound guiding it, to rest snug against the lump inside your breast.  When that needle is placed perfectly, they say, "Now you will hear a snap, but you should not feel anything uncomfortable." I don't know what they do then, but my impression is that they pull some sort of trigger that shoots some sort of sample-gathering needle down through the hollow needle and smack into the lump where it obtains the necessary cell sample.

During all the sticking and imaging and prodding, I closed my eyes and prayed and thought about God.  I recited Psalm 23, lingering on, "He restores my soul," and, "Yea though I walk through the valley of the shadow of death, I will fear no evil."

I quoted Joshua 1:9 to myself, "Be strong and of a good courage.  Be ye not afraid, neither be thou dismayed.  For the Lord thy God is with thee, withersoever thou goest."  I like it in King James.

I remembered 1 Peter 5:7, "Casting all your cares upon Him, for He cares for you."  I reminded myself of Psalm 145, and even though I couldn't remember the exact verse, I knew that it says God is good and full of lovingkindness and He has compassion on all He has made.  I thought about the caring, compassionate, faithful nature of God.  I couldn't think of any more specifically comforting verses, so I just started searching my memory banks for any random verses.

I thought of Genesis 1:1, "In the beginning, God created the heavens and the earth."  I thought of God as the Almighty Creator who cares for me, and, my eyes still shut, I smiled.  Then I realized that all these people could see my face, and I wondered how weird they must think me, smiling away silently with my eyes closed.  I decided I didn't care.

They got ready for the first snap.  "In just a moment, you will hear the first snap," they told me, pulling me out of my spiritual reverie.

Snap went the equipment.  I felt it.  My body convulsed involuntarily, and an explosion of pain spread all the way to the sternum side of my breast, then began to grow and expand.  I had not been prepared for such intense pain.  By the grace of God, I responded calmly.  "That hurt,"  I told them. "It hurts, actually, quite a lot."  I lay still and tried to breathe, but the memory of being 13 and walking across Sorenson Park in exploding breast pain came flooding back to me, too real and close.

They scrambled to stick me full of more lidocaine.  I did not complain.  The second snap, in the same lump, was much less painful, and the three snaps in the other lump were painless.

They injected metal markers into the lumps, cleaned me up and sent me for a baseline mammogram.

Since the lumps had never before appeared on a mammogram, it was interesting trying to get a mammogram to pick them up now with their shiny new markers.  The professionals had promised a gentle mammo, but I really had to contort in order for the technician to get the images she needed from my armpit.

Finally it was over, and they bandaged me up and sent me off with an ice-pack in my bra.

They have asked numerous times if I have questions.  What question is there to have before the results come in?  Percentages?  I figure the percentages are meaningless.  I am me, and either I am clean, or I am cancerous.  It makes no difference what happens to other people... I mean, what?  Would you expect them to say, "The chances are about 10% that you will have cancer.  We did 14 people today, and we already found 2, so you are probably good to go."  I just don't think that's the way it works.

I'm a little concerned about the pain.  I don't think that was "normal."  Also, my sister just had breast cancer, so there may be a genetic predisposition.  And I have lupus, and 30-33% of people with lupus develop cancer, so I could scare myself silly thinking about this.

On the other hand, this lump is very different from my sister's.  They never even biopsied hers; they did immediate surgery to take hers out because it was something they knew they needed to take out.   I am pretty sure that I've had mine for years and years, that it is not new, and that it has merely gone undetected for decades... undetected and not growing.  Also, a number of women have shared with me that they had similar biopsies done and that theirs turned out to be nothing.

It is in God's hands.  We will find out tomorrow.

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