I'm Just Sayin' . . . (#5): Mammo-Rant
First, just so you don't think I'm a whiner, or a hothead, or whatever, let me give you a little background, a little backdrop against which the asshatishness I am about to describe occurred today:
# of physicians seen since January, 2006: 12 (not including radiologists and pathologists whom I've not actually met)
# of CT scans: 4
# of X-rays: 3
# of vials of blood drawn: 14
# of "nuclear medicine" procedures: 1
# of MRIs: 1
# of different concoctions (contrast agents, radioactive isotopes, whatnot) ingested or injected for the purpose of diagnostic procedures: 5
# of invasive procedures ending in "scopy": 1 (two more TBA)
# of times an M.D. has appeared annoyed with me for having non-textbook symptoms: 2
# of times I've heard, "Your symptoms are not specific enough!": 2
# of times I've heard, "Because your symptoms cover so many different organ systems, I cannot make a unified diagnosis." (And, note that the term UNIFIED DIAGNOSIS echoes choes hoes oes s): 3
# of tests too disgusting to discuss: 3
# of sonograms: 2 (1 more scheduled)
I'm sick. I don't know what's wrong . . . blah blah blah. Enough of that, it bores me and it would bore you, too. I tell you all that, just to say, I'm over- medicalized, and need someone to just give me a break if the opportunity presents, you know? BUT:
Today, I went to my home-away-from-home, A..... Radiology. ("A" may or may not stand for Asshat.) Now, I keep going back there when I'm sent for a diagnostic procedure because it's five minutes from my house, and they're quick enough, and nice enough, and as far as I know, they're competent enough. Today I was scheduled for a chest and abdomen CT Scan with contrast. Mmmkay? AND, since it had been a while (too long, I confess), since my last mammogram, I scheduled that appointment for after the CT scan. Two weeks ago I had the pelvic, and Pap, etc., and a thorough breast exam. All OK. That's when I got the Rx for the "routine screening" (this will become important) mammogram. I scheduled it for immediately after the CT scan. One less trip to A Radiology, with childcare, time off from whatever, etc. Makes sense, right?
So I have the CT scan (during which the technician forgot to do half of my torso, and had to come and get me out of the mammogram waiting room to go back into the little spaceship that is the CT machine, but I digress), and I go get in my teal flappy shirt to get squished. With me so far?
Backing up a few days. Remember, a couple of weeks ago I scheduled the mammogram. This past Sunday, lying on my bed, my hand rested on my left breast and I had a "Hmm, what's this?" moment. It was a lump, in the top center of my left breast. I was not, am not (really) alarmed. I have had a diagnosis of fibrocystic breasts before. For those of you uninitiated, this just means that mysterious little, benign lumps come and go, depending upon things like time of the month, stress, caffeine intake, and such. I did not panic, feeling certain it was a silly little cyst, and anyway, I already have a mammogram scheduled in four days.
Fast forward to today. I'm there in the
torture mammogram chamber, and the tech says to me, "Any recent changes in your breasts?"
And I say, "As a matter of fact, make sure you really get this area here, because there is a little lump there now." WRONG ANSWER, SUSIE.
Tech says, "You have a lump?"
"Yea, right here . . ."
"Then we can't do your mammogram."
WHUH HUH? "You won't do a mammogram if I have a lump in my breast?" Looking around . . . Candid Camera? WTF?
"Your doctor checked the box marked, 'routine screening.' Since you have a lump, this is not a routine screening. We must have a form with the box marked, 'diagnostic' checked."
"No, she was right. When I saw her there was no lump. When I called to make the appointment, no lump. Just this past Sunday, lump. We're good. No one made a mistake . . ."
"But we cannot do your mammogram without an order for a diagnostic mammogram..."
"You mean if she had checked 'diagnostic' you would do a different kind of mammogram?" I really am trying to understand.
"No, it's the same test. But the insurance company pays it differently."
"So if I hadn't told you about the lump, I'd be getting my mammogram right now?"
"Well, yes, but..."
"So, the test that I need, and in fact, may need even more now that there is a lump, I can't have, because I need it more than I realized I did when I made the appointment?"
"Just forget I said anything."
"But you did. I can't do that."
"Well, I wish I hadn't. I was trying to be helpful . . . "
"Oh, Mrs. Fairchild, don't say that! You were right to tell us. It would be terrible if you didn't mention the lump, and we missed a serious situation because of that . . ."
"But you wouldn't miss it. You just told me the mammogram is the same no matter which box is checked . . . "
"Yes but we're more careful when there is a lump . . ."
(ARE YOU HEARING THIS, PEOPLE?)
"Well, that's rather disturbing. I would hope you're careful with everyone's mammogram . . . that's the whole point of telling people to have a yearly mammogram, because you can see things we can't . . . if you're careful about what you do..."
"Well, it's not really that we're more careful . . . it's that if it's a diagnostic mammogram, we automatically do a sonogram afterwards . . . "
"Fine. I have fibrocystic breasts. You didn't know this, but you were going to have to do a sonogram afterwards anyway, because every single time I have a mammogram, I have to have a sonogram. That's just how it is with fibrocystic breast disease. Doesn't change anything for me. Let's do it!"
"I'm sorry. I cannot do your mammogram until I get the correct request from your doctor."
"You've heard me say that she gave you the correct request; that circumstances have changed since she made the request, right?"
"Yes, but . . ."
"I just want to make sure I understand you, because frankly, this sounds insane to me. You're telling me that because there is now a situation which means I might actually have some pathology, and possibly even need some treatment, I must wait longer for the necessary diagnostic tests . . . "
"I'm not finished. I must wait LONGER to be diagnosed, I must potentially DELAY important treatment, because I might actually have a problem. But if I had no problem, the procedure would be done and I'd be home by now. Is this what you're telling me?"
"Yes. I'm sorry . . . " And she proceeds to tell me 15 minutes of anecdotal stories about people who didn't 'fess up to having lumps, thinking "if they don't see them, they're not there," and then those lumps were missed, with dire consequences. Which, while fascinating, is not my situation, because I TOLD HER ABOUT THE FREAKIN' LUMP. And then she says, "OK?"
"No, it's not OK at all. But do I have any recourse? What can I do?"
"Well, nothing. But you could be very upset about it."
"Oh. Did you miss that? I AM VERY UPSET ABOUT IT! It's CRAZY."
"I promise, I'll give you the very next diagnostic appointment I can . . . "
Long story short, I will have a mammogram next Wednesday. Is it just me, or is this fucking insane? I'm just sayin' . . .
file under: &Partial Nudity &Can't Make This Stuff Up &WTF Disease &I'm Just Sayin' . . . .