Mind Games

This feels like the longest week ever....well, a long 8 days actually. While I feel a little better today, I've been weighed down all week with the fear that a small lump in my left armpit might signify cancer has infiltrated my lymph node(s).

A few weeks ago, around the same time my right boob was really swollen and sore (which it still is but to a slightly lesser degree), I noticed a small, firm lump in my left armpit. The only reason I even noticed it was because a lot of my lymph nodes have been swollen and tender the past three weeks or so - armpit, groin and neck. At first I just figured I was fighting something - there are so many cold/flu viruses around at the moment - believing that, if my glands are swollen, at least that means they're doing their job and fighting any signs of infection, so that's a good thing. Then I noticed the one small but firmer lump (reminiscent of the one I found in my right breast that turned out to be cancer) and then I decided to mention it to my doctor while visiting her last week for a prescription renewal. BIG mistake.....maybe. Her reaction was quite dramatic and has since sent me spiralling into a vortex of questions, fears, doubts, uncertainties, anxieties and general mental mayhem.

"Yes, I see what you mean. You really need to get that checked out."
"Well I have a repeat ultrasound scheduled for Feb. 8th - following up on what they identified as an atypical cyst in my left breast, I thought I'd mention it (the armpit nodule) when I go."
"Ok, good. Yes, you should absolutely mention it. Make sure you do. They need to check that out. And if they can't look at it during that ultrasound, then make sure you come right back and I'll give you a requisition for a separate one right away." (I felt myself do a big gulp.)

"You see an ordinary lymph node, like the one next to it, feels smoother like this...." she said, drawing a sort of kidney-bean shape on the paper drape they put over the bed. "But that firm one you're feeling is more like this...", she drew what looked like a jellyfish. "It has very irregular edges. You need to get that checked out."

Yup, her gentle bedside manner is still decidedly lacking. While there are advantages to your doctor being up-front and cutting to the chase, I came away feeling her honesty was perhaps just a little brutal for my liking....and from there my mind went into total overdrive. For the next six days!

What if it's the cancer again? If it's in my lymph nodes, that's a whole other ball-game - and definitely not good. (Not that having breast cancer in the first place is ever a good thing, but at least it was small and very low-grade.) It'll mean Chemo for sure. I'll lose my hair & feel like sh*t. What after that? What if they suggest a mastectomy? Or double-mastectomy? If that lump's only a few weks old, is it growing fast or did I just not notice anything before? Does this mean I do have some cancer in my left breast as well? Is that what the 'atypical cyst' really is? Could the cancer in my right breast really have travelled to my left lymph node when the right lymph node biopsy came back all-clear? Is that possible? Und so weiter, und so weiter.....

Of course, in my escalating desperation, I turned to Dr. Google, only to read that a firm lymph node generally signifies cancer. Great. Just bloody fantastic! In fact almost all search items associated with firm lymph node came up with breast cancer right alongside. Well isn't that pally? - those two just hanging out together - like best buds - and frazzling my mental state!

Suffice to say, it's been weighing on me horribly all week - I've felt close to tears most days - and this ultrasound (the third on my left breast in 8 months) can't come quick enough. I've been more worried since seeing my Doc last week than I was even pending biopsy results and being given the original diagnosis last May!

For a moment last week I even toyed with the idea of a private ultrasound just so I could get in sooner. (Lorne did that just recently and got in the very next day, paying $350 for a private appointment, compared to the 6 weeks he would've had to wait to get one through regular MSP health care. Thankfully a lump on his bicep that has been quite painful lately appears to be a clump of fatty tissue and benign. Phew!!! Now that the word 'cancer' has so closely touched our lives, it's entirely understandable that he felt he'd rather pay for a private appointment than wait - and worry, not knowing - for a further 6 weeks!)

Anyway, since the report from my last ultrasound stated that it was too difficult to effectively compare reports from two different technicians and from two different machines, I came to the conclusion that paying for a third - that would be in a completely different clinic (not BCCA), on a different machine, with yet another completely different technician - would really be of very little use. (Besides, I could do with using that money to buy a replacement Ipod for the one I dropped down the loo a few weeks ago!)

So with that and the fact that I already have an ultrasound scheduled for Feb. 8th back at BCCA,  I decided I might as well wait. But it's felt like a veeerrrryyy long wait and my mind has been on little else. Needless to say I started to wonder if I'd been just a little pre-emptive in my sense of having had a close escape the first time around. Perhaps there's more to come: a whole other (more ominous) chapter to add in what I'd previously thanked my lucky stars as being a close brush with cancer that had been easily and quickly taken care of. In darker moments recently I've felt like I'm half-expecting the other shoe to drop.

Thankfully by the time yesterday came around I think I'd exhausted all what-if scenarios and finally found room for some less daunting prospects, like: if they didn't notice anything in the previous two ultrasounds, then maybe it's nothing; if it's new from the last one, three months ago, then it would still only be very small; it's not necessarily cancer (is it???), if my right lymph node came back all-clear and that's the side the breast cancer was on, could I really have cancer in the other side without yet having been diagnosed as having cancer there?; if I'm on tamoxifen, wouldn't that be fighting any potential cancer cells?; should I find myself a new, less dramatic and more diplomatic family doctor?

Anyway, as we finally tick to within the last 15hrs to tomorrow's ultrasound, then maybe I should just breathe and hope they at least give me some little of morcel of hope during the appointment and don't just do the exam but tell me nothing (which is usually the case, so I'd better brace myself). And the good thing is, my follow-up appointment with Dr McF, who did my lumpectomy last July, has been moved forward from Feb. 19th to the 12th (apparently he's scheduled to do a surgery on the 19th) - so hopefully, by the time I see him next Tuesday afternoon, he'll have some answers for me. I hope so anyway, since I had to wait three weeks for someone to finally get around to writing up the report from the last one. Failing that I'm booked to see my oncologist on the 20th, for the appointment he cancelled on me from last week because he'd rather see me after the ultrasound - even though that's to check my left boob and not the swelling and pain I've been feeling on the right. Urgh!

And so continues the legacy and mind-f*ck of getting that initial cancer diagnosis. It certainly makes your  head spin and fires your imagination in dark and not-so-wonderful ways.

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Post-Ultra-Sound update - Feb. 8, 2013

7:45am is unreasonably early to be flashing your boobs at a stranger (I usually wait till at least 9am....hahaha!) - especially when he's a grumpy old git who can't even be bothered to grunt a meagre good morning. Instead he spits out instructions with all the compassion of a Gestapo officer, "Take off your top. Put the gown on, open at the back. Clothes in the basket."

Once changed, I followed him to the imaging room where he was busy at the computer, zipping through my previous reports and images. After a range of snorts and exasperated huffing and puffing he finally turned to me and snarked, "Take your arm out the sleeve. Left side. Are you feeling a lump?"

"Yes, a couple actually, around here...". I pointed to the side of my boob and towards the armpit.

He prodded my boob, "They're very lumpy", he says. (Charmed, I'm sure). Yeah, I've been told that before, doc. Well, I believe the 'technical' term used last time was lumpy-bumpy actually, you ignorant ass.

There was not one degree of warmth to his bedside manner and I soon remembered his overt grumpiness was just the same when doing the ultrasound on my right side almost a year ago. And he's the same misery of a man that got all mad when he couldn't place the wire correctly just prior to my surgery in July, and had to call in two others to help pummel and wrestle my boob around until they got the marker in the right spot.

No surprise then that he gave me no information to go on today. Not one hint. I tried to look up at the screen as he did his thing but it was hard to really see without getting cramp in my neck.

I tried to explain about having swollen lymph nodes and the new, firm node I've noticed in my left armpit. He cut me short, "Show me where." I placed my fingertip on it and he promptly stabbed the spot with a marker pen.

Within 20mins he'd apparently checked out my boob and armpit to his satisfaction - the last two ultra-sounds - both with women - had taken close to an hour. (Of course now my mind is wondering, was he less thorough in his examination, or is it that he quickly saw enough evidence to confirm the worst? Or, if I dare try the silver lining approach, maybe he saw nothing of concern?)

"Ok. You can use that towel to clean yourself up."

With that, his job was done.

I tried to ask if there's any way the report will be available to Dr McF in time for my Tuesday afternoon appointment. "No, Monday is a holiday." he snapped. "If he wants to find out, he can listen to the dictation."

With that I was shown the door.

"Thanks you f*cking Pig! Have a day!"