Monday, January 16, 2006

my timeline: from lump to diagnosis with one noteworthy detour.

December 2: the lump
While getting undressed at night, I find a lump in my right breast. It's feels about the size of a walnut.

December 3: the referral
A very nice Dr. (who looks about the same age as Doogie Howser was in that series) is concerned enough to refer me for a mammogram.


December 8: the mammogram (and ultrasound)
After calling around, I am able to schedule a mammogram in less than a week. The mammogram itself (which involves having your breast mushed between glass plates) is no big deal. Uncomfortable but not painful. I had been told to expect my results within a week but the technician comes back from developing my films looking very serious. She decided to show my films to the radiologist on call, who has referred me for an immediate ultrasound. Everyone I deal with from that point on looks very grim to me.

After the ultrasound, I am herded into a consultation room for an impromptu meeting with the radiologist. I don't remember much from this conversation except "It doesn't look good," and "hope and pray for the best but prepare for the worst." I also remember the word "urgent" being used several times. I later learned that this radiologist also called my GP to reinforce the "urgency" of my situation.


I do what any sensible person would do and spend the rest of the day drinking with friends.

December 20: the detour
I'm on my way out the door when my doctor calls. She sounds furious. Instead of being forwarded to the cancer centre, my mammogram films are in the film library at the hospital. My "urgent" films have been put into storage. I drop everything, go pick up my films and deliver them to the cancer clinic.

I receive a call the next day to set my biopsy appointment for early in the new year.

December 30: the second lump

I find a lump under my arm, about the size of a large raisin, or a small grape. This is new. It was definitely not there when my GP examined me on December 14.

January 3: the biopsy
I have an ultrasound guided biopsy of both lumps. Once I am injected full of Novocaine, I feel nothing. I will be a little sore for the next couple of days but all in all, I am more traumatized by the sound the larger needle makes as it takes the sample from my breast (a loud sort of "kachung!") than by physical discomfort. Also, I'm not really sure why, but I can't raise my arm above my waist for the next 24 hours.

January 5: the diagnosis
My GP calls me at work with the news I have been expecting but still hoped not to hear. I have cancer. Technically speaking I have "infiltrating ductal carcinoma in my breast and metastatic adenocarcinoma in my axilla that is consistent with the carcinoma in the breast" (Translation: Garden variety breast cancer located in a milk duct. This same cancer has spread to my lymph nodes).

January 13: the surgeon.
My experience with the surgeon deserves an entire post of its own. The good news is that my physical exam reveals no lumps above the collarbone (this is a huge relief). The not so good news is that my tumour appears to have grown to about 5cm (the size of a plum, to continue using fruit as comparators).

My surgery will take place February 2nd.

Three observations:

1-I must act as my own advocate. I'm not sure that the snafu with my mammogram films would have been discovered so quickly if I hadn't been pestering my GP and the cancer clinic with daily phone calls. As a cancer survivor put it to me, "People may be concerned and mean well but it's your life that's at stake."

2-Our public health care system does work reasonably quickly and well. And the competent, caring health care practitioners have, in my experience so far, been the rule, not the exception.
Watch this space to see if I still feel this way in a few months' time.

3-One should always bring a small army of supporters (or at least one very good friend) to every appointment.

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