Thursday is here way to quickly. I am dressed and ready to go, the anxiety just a small curl in my gut. I sign in at the Breast Diagnostic and Care Center, go through the form signing and wait. I am called back. Leave my purse and water bottle with my husband out in the waiting room and I am taken back to the room where the procedure will happen. The Technician walks me through a bunch of forms and confirmations of name spelling and items labeled correctly that need to be signed or confirmed, and goes over the procedure once again with me. I will change into a gown after disrobing from the waist up. I will be laid down on the procedure bed, with my right breast exposed. They will cover me up with towels except the area of my breast they need to work on. They will wash my breast with betadine solution to ensure a sterile field. Then Lidocaine will be administered to completely numb the area. At this point, the technician, using ultrasound, will provide a field of vision for the doctor to then proceed with the biopsy. I will feel pressure, but no pain. If there is any pain I am to let them know so they can administer more Lidocaine. A small tube will be inserted into my breast right up to The Lump. Through this tube a tool will be inserted to take 4 to 6 different samples of The Lump, which will be sent off to pathology for analysis. Once that is done the doctor will place a small clip in the middle of the The Lump as a marker should we have to go back and address additional issues. Once that is done, and the tube removed the technician will then place firm pressure on my breast to stop the bleeding. This will take anywhere from ten to twenty minutes. After the bleeding has stopped and steri-strips applied, I will then go have a mammogram done to insure the marker can be seen in imaging. Once I am cleared from that I am to keep ice on my boob for a minimum of 6 hours, no lifting anything heavier than a TV Remote, my cell phone, an iPad or my kindle until Friday afternoon.
OK, I’m ready. All the forms have been signed, i’s dotted and t’s crossed. Disrobe and put on the gown, opening to the front. Done. Lay down on the bed, right arm out of the gown, boob bared to the world. Wedge placed under my right side to elevate boob to doctor, and my right arm is raised above my head. I am tilted to the left. Tech starts draping me with blue surgical towels. Doctor comes in, and introduces herself. She tells me not to worry, there are great new medicines out now that will shrink this tumor down before surgery. Wait, what? Tumor? Shrink? No, no, no, this is benign, it’s a fatty tumor at worst. That little curl of anxiety in my gut starts to get just a little bit bigger.
Doctor keeps talking, she’s asking me of any history in the family, no, not that I am aware of… an Aunt passed earlier this year from Melanoma, but she was a teen in the 60’s and sun bathed with baby oil. Others in the family, married in, their kids, but nothing that I know of in my direct blood line. I did have thyroid cancer almost 20 years ago. Oh, OK. Surgery? Yes, and then ablation with the isotope. Oh, good. Yes, made me sick, lucky me being that half of one percent that gets sick from it. Ohhhhh, and her demeanor changes slightly. Not so reassuring, more, that is a little troubling. Shit, shit, shit… and the curl of anxiety in my gut starts to tighten.
She walks me through briefly what’s going to happen again. I am nodding my understanding, concentrating on keeping my breathing even. The technician and the doctor keep up a cheery banter as the doctor starts washing my breast with the betadine. Swipe, swipe, scrub, wipe, repeat. Technician calls for an aide to come in to help ferry pieces around me, like the used gauze pads from the betadine wash and the mini scrub brush used in the first washing.
Again, my right side is slightly elevated by a wedge to make my breast the highest point. My right arm is extended up over my head, and because of the wedge I am tilted to the left. As they start I close my eyes and proceed with my own meditation to keep my parasympathetic nervous system calm. Shit, in all the bustle I forgot to tell them. It’s OK, there is no IV, this is a simple procedure, like going to the dentist. Drown them out. I’m at the beach, I can hear the waves, take a deep even breath, in, one, two, three, pause, out, one two, three.
“There will be a little poke, and a slight sting here for a second as we start administering the Lidocaine.” Breathe, one, two, three, slowly, pause, out, one, two, three. The ocean is calm, there is a slight breeze, you can smell the salt in the air. There is pressure on my breast, I feel crowded even though my eyes are closed. Breathe, inhale, slowly, one, two three, pause, exhale, slowly, one, two, three. Lots of external activity around me, pressure and more pressure. Beach, sand, warm, breeze, salt, sun on my skin, gentle wave on my toes, breathe, one, two, three, pause, out, one, two, three.
Doctor says ok, the tool I am using will make two clicks, and then a much louder click as I take the samples. And she demonstrates the tool sound by my right ear.
No, no, not now. Breathe in, slowly, you can do this, beach, sand, breeze, sun, hear the surf, feel the wet sand, feel the breeze, smell the salt, in, one, two, three, shit, shit, shit, shit, no, breathe! Face is cold, shit, breathe, sand, slow in one, water, two, breeze, three, sun, the cold, clammy sweat on the back of my neck, slowly exhale, one, oh god, the queasiness, two, I have to say something, they are in my boob and I can’t move, I can’t throw up! I can’t move, I need to move, tell them, tell them.
“Um, excuse me, but my BP is dropping, I need my feet raised up please.” Technician is on the ball, while holding the ultrasound wand steady she raises the feet of the exam bed I am on to elevate them. She also tells the aid to get ice packs on my forehead and the back of my neck. The doctor asks me if this happens all the time. It’s difficult for me to answer as I am still concentrating on trying to control this reaction so I don’t throw up. Doctor keeps working as I answer “yes, kind of”. At first she says it’s just my nerves, and then asks if I have a problem with needles. Again, I know what I want to say, but can’t get the words out, so just say “yes”. She can tell I am struggling to try to control this reaction, and answering her has taken my concentration off my breathing and I am now starting to hyperventilate. This has all happened in under 30 seconds. Doctor is now talking to me, helping me slow my breathing down, calmly, reassuring, it’s OK, good that you recognized what was happening. That’s it, slow breath in, evenly, good, now slowly exhale, you’re doing good. She continues working and is done, before I can even say I feel the effects of my BP drop start to wane. I hear the tech comment that may face is still ashen, I sense the doctor move away for a brief moment, there is a lot of pressure on my right boob, but no feeling. Then the doctor is back, she is the one holding pressure on my breast and the tech is now wiping the cold sweat from my face. I am done. Breathe, that a girl, slow even breath in, and out.
I can feel the clamminess starting to recede. Tech replaced ice on the back of my neck with a fresh ice-pack. I hadn’t realized if felt so warm until the fresh pack was placed there. Doctor remains holding the pressure on my boob. Aid asks if she wants her to take over, doctor tells her no, she’s got this, clear the trash. I feel the aftereffects start to come on, the shakiness, the flush of warmth moving out to my extremities.
The technician then says she sees the color starting to come back to my face. Minutes have passed at this point. I am starting to feel normal. I apologize, I tell them my BP is on the low side of normal, how I didn’t think to warn them, and how sound is my biggest trigger, but yes I do have problems with needles, but can usually control that. Now the only time I really have this issue is when I get a new person who doesn’t believe me when I tell them how to start an IV on me, or a phlebotomist that doesn’t believe me when I tell them where blood comes out.
I am reassured that it’s OK, and they were very glad that I was able to tell them what I needed, and that I recognize what was happening. Doctor asks me if I am OK now. Yes, I just need some time to get over the shakiness. She asks me if I would like water or juice. “Yes, water would be lovely right now, please.” She looks at me and says, no, I think you need juice. Can you handle juice? I think so. Tell us if you think it will make it worse for you. No, I think I can do the juice, I just need to sip it. OK, let’s get you some juice then. The aid is sent to get me juice, the tech is still holding pressure on my boob. The doctor asks the tech if everything is under control and does she need her to remain. Tech says, no, we have it from here. I am told to take as much time as I need to recover.
Before the doctor left she told me that the biopsy results should come back by Monday, they would call me to schedule an appointment to review the results and an Oncologist would be there at that appointment to explain everything. That didn’t sink in at first.
First to go through my mind at that point was I’m more used to be ignored, especially when I provide the warning of what can happen. Most of the time, I am ignored, or told that they can do this without causing an issue. When I do have the problem of the BP dropping suddenly like that, I’m used to being treated like an anomaly at best, or it’s my fault at worst. To have a team so readily come to my aid, while they continued to do the job that was at hand, and treat me so kindly was so refreshing. If I could have stood up at that point, I would have hugged each and every one of them for making me feel like it was OK to have this issue with my blood pressure.
As I laid there with an ice pack on my forehead, an icepack on the back of my neck and the tech still applying pressure to my boob and the tremors working their way through my body, after the doctor left the room, her parting words started to sink in, and that is when that slightly bigger, tight curl of anxiety started to take over my whole torso.
The aid came back to the room with a box of juice, and the tech kept checking to see if the bleeding had stopped. Finally the tech said the bleeding had slowed enough the steri-strips could be applied. As I slowly sipped juice and moved the ice packs around, to aid in recovery from the BP drop, I was asked if I wanted my husband with me. Before I could even answer, the tech said, yes, that would be a good idea. I started to tell her what he looked like, but she said, I remember where you were sitting, I’ll be right back.
I closed my eyes and willed the anxiety back into a little ball, it was not working. I couldn’t grab enough of its wispy edges to gather it into a compact area again. I took another sip of juice, I said I silent prayer to my guardian angels, and then my husband was there. I just needed him to touch me, to give me an anchor. I knew with an anchor, I could stretch myself further to gather in the ever spreading anxiety. It was like thick tendrils of grayish fog trying to roll its way through my body, to surround me and fill the entire room. That word, Oncologist, was food for that fog of anxiety, like a triple hit of sugar to a toddler, making it spin out of control.
He held my hand as I lay there, now with an ice back under my neck and one on my breast, sipping juice from a tiny juice box. I looked at him and said, “it’s cancer”. He willed that it wasn’t, denied that it could be, we didn’t know yet. It could still be nothing. As he held my hand, I saw in his eyes, he was going to continue to deny this, could not think this until we had no choice. I had my anchor, he would be there with me through all of this. I slowly reeled that monster of anxiety back into a ball and tucked it away. It was still there, not gone, ready to pounce at the slightest release of control. I could stand up now. Still a little shaky, they asked if I wanted some crackers. No, no food. Just the juice for now. Off for the mammogram to insure the marker could be seen. Two quick images, yes there it is, back to the original room to get dressed and to go home and wait.
Ice pack into the sacrificial bra, and then tenderly place my right boob into the already filled cup and gingerly move the strap up to hold it all in place. Not too bad. Loose sweater over the top of it and away we go, me with my extra-large right boob, walking out hand in hand with the best man I know, being my anchor. I had stocked up on frozen peas as they make some of the best ice packs. I had a blue surgery towel to use as the insulator, and with instructions to change the ice every 30 minutes, sat myself on the couch prepared to binge watch something.
As feeling slowly came back to my breast, the discomfort set in. The sacrificial bra was tight and painful, so I gave up using the bra to hold the ice to my now bruised and bloody boob, to just holding it myself. Trying not to think about what would happen next week. Ignoring the word spoken back at the Breast Diagnostic Center (that sounds like a store where you go pick out the ones you want, or buy the tools to renovate your breasts…). That gray fog of anxiety, sitting curled in my gut, just waiting for its chance to take over.
I was allowed to take Tylenol for discomfort, and I did do regularly from the time we left the Breast Center to insure I stayed on top of any pain. We didn’t talk about The Lump, the biopsy, or the word that fed the anxiety. This was nothing. It was Jon Snow – “you know nothing”. (I read the books, have not watched the series.) We went to bed, it was awkward with my now slightly swollen and sore right boob.