Friday, September 6, 2013

Happy Freaking Birthday

Turned 40 in July.  Of course, as a female in the US, that means the advent of the dreaded annual mammogram.  Had mine Wednesday, the first day of my kids' school, because there are some things I am just not willing to do with kids in tow and enough with the finding of babysitters, already.  Can I just say "OW!"??  Not much of a birthday gift for me...going to think of it as one for my family.

Anyway, got a call in the middle of yesterday's taekwondo class.  They were concerned about one set of images and needed me to come in for more tests.  Cue panic mode.  Unfortunately, courtesy of my Ph.D. research, which related directly to breast cancer, I know more than enough about the subject to be dangerous but not nearly enough to be fully educated.  Fortunately for my mental well-being, I was able to get back in again this morning.  And after the additional tests were done, everything was fine.  But a hell of an introduction to the world of mammograms, thank you very much.  Cripes.

But at least I do have access to them, along with other routine screenings.  And everything did turn out ok.  Thinking back to a woman I saw when I was a graduate student and spending a few days following an oncologist.  This woman, who had immigrated from somewhere in Central America, had never had access to basic healthcare, and presented with a massive tumor, clearly visible externally.  It had grown into the skin.  I don't think she ever had a chance.  So I will be thankful for my blessings today, even if some of them do hurt more than others.


  1. I have issues with mammograms. Not the best technology, exposing us to radiation, most younger people find tumors without mammograms, can't really read the denser tissue of younger women, etc. etc.

    That said, I sheepishly showed up to a mammogram this year because my doctor ordered me to, and after she saved all my lady bits during a cancer scare she gets a "yes, ma'am" from me. Then a few months later I got this massive lump which is probably an abscess which STILL is not gone.

    Sorry, just my rant.

  2. I'm still waiting for somebody to develop legitimate, sensitive blood tests for cancers. All the radiation from mammograms can't be good, but finding lumps early is a hell of a lot better than finding them late. And if the blood tests work, there would be a lot fewer scary false-positive experiences like I had today.

    And are you ever actually going to go and get that abscess thing checked out again?? I ask because I worry, not to be a nag. :(

    1. There's no possibility for medical care for such a thing here. And I still don't have health insurance.

      I'm not speaking about blood tests (though that would be great) - there's the, oh I forget what it's called - like the heat sensor test that they use in several European countries and a few parts of the US. Far more accurate than mammograms I've heard, though not enough research. thermal imaging or something?

      Finding lumps early is better than finding them late - the concern that some have is that mammograms give a false sense of security and stop women from paying attention. Everybody I know who has survived breast cancer found a lump on their own, not by a mammogram (obviously purely anecdotal and no attempt to make a scientific statement).

      I guess my response is caution, not full resistance. But also, my doctor made me get a mammogram when I was like 33 years old, as a baseline. I now realize that was total bullshit, which got me interested in other possibilities.

    2. Curious. According to my doc, the 40-year mammogram is the baseline. Wonder how big a lump would have to be to be felt? Pretty good-sized, I'd imagine.
      What kind of medical care is available on Yap?? Hopefully better than the vet care...

    3. Actually no, to size of lump. I read a really interesting article a few years ago about training nurses to feel for lumps and how that is far more effective than mammograms. All the really good doctors I've seen found things like breast lumps and fibroids long before any test. Since it's the aggressive cancer, the ones that grow quickly, that are the ones that kill people, it's way important that women pay attention to their own breasts and not count on semi-regular mammograms.

      Well ... I've heard plenty of tales about medical care here. Cipro prescribed for a skin allergy. Expired medications. People die a lot here. Once I get medical insurance I would get medically evacuated to the Philippines if necessary, BUT they will not allow any treatment for any cancer that has less than 50% chance of survival. Interesting caveat.

    4. What??? Who are "they," and who is making the determination of chance of survival from a particular cancer on an individual basis? Wow. I assume that this is intended as a means for allocating a scarce resource (healthcare dollars) in a somewhat objective manner, but cripes. Talk about giving statisticians and bean-counters the ability to play God. I do think that the US goes way too far in the other direction, though, and eventually the pendulum will have to swing back in the general direction of the model you describe just for financial sustainability. Not sure whether different cultures really have different attitudes toward the idea of death and how hard it should be fought or just a more clear-eyed acceptance of (and resignation to) financial realities.

      When will this job offer you health insurance? Out of curiosity, where are doctors who practice there generally trained?

    5. Oh, and I agree entirely with your point about aggressive, quick-growing cancers being the biggest problem and the need to self-monitor. Absolutely critical. As a grad student, one of the things I studied was particular gene mutation in breast cancer that leads to formation of aggressive tumors that don't respond well to chemo. I was trying to figure out what this gene mutation was messing up on a molecular level. As it happened, it was causing two separate, very bad things to happen. Fascinating to me as a scientist but really ugly news for the poor women with the disease. The advantage of molecular profiling is that at least you can get a handle on the severity of the situation you're facing upfront, and also run lab tests that show which targeted therapies have a chance of working and which are a waste of time.

    6. That research sounds really interesting - and it's definitely a "more you know" kind of situation, in terms of more knowledge is definitely better for any chance of survival.

      I don't know who the "they" is - it's not detailed in the info. Funny, huh? Not funny haha, but you know. If I had a low chance of survival, I would skip treatment and I would have a massive party for my last days - but I have no children and this would be my choice, not externally imposed. I totally agree with you about the pendulum. I think it's really hard to conceptualize how to do that, though I remember when Oregon instituted their plans and the pretty good conversations about what to pay for and what not to.

      I signed up for the insurance right away so it SHOULD kick in within the week but we'll see.

      Doctors ... I have to get more info because I do not know. I want to say Philippines but I really don't know, and my friend who just got treatment there was very happy with the level of care.

    7. Given the air travel constraints, how long would it take you to get to the Philippines if you actually needed to?? If I had a low chance of survival, I might just go with the party too, and I have kids. Why put them through having to watch a train wreck? My folks live in Oregon and I have to say that I think it is an inordinately civilized state. If a suffering dog or cat can be euthanized as a kindness to them, why can't a person choose it for himself as well? We will have some very complex and difficult healthcare policy decisions to make in the upcoming years. (Definitely a BIG ISSUE for you!!)

  3. Every GD mammogram I've had since turning forty has required a call-back. "Senior tissue" one of them turned out to be.
    Well damn duh.
    It IS panic inducing. I hate it.

  4. "Senior tissue?" They actually called it that?? The post-test panic yesterday reminded me a lot of my kids' prenatal ultrasounds, actually. My older son had some weird brain thing that resolved. My daughter had the cardiac thing that resolved. Those ultrasounds just stressed me beyond belief and ultimately for no reason! And the one kid who actually does have problems didn't show anything at all before birth. Go figure...


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