Sunday Stealing: The Madness Meme, Part The Dos
What A Pain In The Brain

Speaking Of My Boobs...

...Oh. You weren't? Well, let's, shall we? And if you'd rather not, just skip this one, because I'm feeling a verbose post coming on.

I went to the Virginia Oncology Center or something like that today. Here's the backstory: I had a lump checked in October of 2009. It turned out to be nothing. I had another lump in February or March of this year, and they were concerned enough that it got its own ultrasound. That led to a mammogram. My first mammogram, at the age of 34. In the end, the People Who Read It (PWRI, not that I'll probably refer to them again, but just in case) decided it was breasticular tissue and not a tumor or something insidious, so, case dismissed.

More backstory: My maternal grandmother had breast cancer in her 30s and 50s and also died of cancer throughout the body. (She was a longtime, heavy smoker, so I'm not sure from what part of the body that stemmed, and Grandpa's no longer around to ask these things, so, I dunno.) My mama died at age 33 from diabetes, so we don't know whether she'd have gotten it or not. She had no sisters. My dad was an only child of Christian Scientists, so I have absolutely no knowledge of the (female or otherwise) medical history on his side of the family.

Based on all this, my BFF, Dr. Lisa, recommended I get the genetic screen done for BRCA1 and BRCA2, ie., the breast cancer genes. So I asked my primary care doc, who agreed and put in the referral, telling me that based on my limited family history, Tricare (military insurance) probably would not approve. Lo and behold, she was wrong, and they agreed with Dr. Lisa that the screen was necessary.

So. You're all caught up. Today was my appointment with the Oncologist/Hematologist, who, incidentally, also gets direct referrals for post-gastric bypass patients needing intravenous iron supplementation, and it's his opinion that my labs will show such a need, too. (I'm very anemic, get deferred - rejected - all the time when I try to donate blood, and am so dizzy I almost black out on a regular basis. I'm supposedly on iron supplements, but I'm out right now, so. Anyway. Part of the visit covered all that, as an aside.)

Dr. G was extremely thorough, had an amazingly, astoundingly awesome bedside manner, and was completely unpatronizing when I asked a billion questions. I appreciated all of this and told him so, which elicited a quick, "Thank you for that." Again, anyway...

He took a detailed medical and family history on me, and then he did an exam that included a breast exam (did you know you're supposed to check all the way up to your collarbone and past your armpit to the middle of your under-upperarm area? I did not! I thought I knew where to check but was falling way short of the mark), a neurological work-up (I passed that, whew), and typical stuff like heart, lungs and belly listening-to-ness.

During that, he found what I had mentioned occasionally experiencing but never mentioning to anyone else, because I assumed - having heard it was possible - it was latent milk production: white secretions from both, erm, um, nipples. He took samples, which, thankfully, proved to be free of trace amounts of blood, but it was still something he scribbled down furiously on his ever-lengthening set of notes about me.

Then we sat down and chatted a whole bunch more. Based on his calculations and my history, it's his opinion that I need to see the genetic counselor, who will then refer me for the gene test. He could've just ordered it straight away, but we need to make sure Tricare will cover it first, so I don't get hit with a $3500 bill or something. Thanks, doc. 'Preciate it!  After the test, if I have the gene, we either get every-six-month pictures of my boobs and remaining ovary (hysterectomy in 2008 took the right one) via mammography and MRI, or we go for the more drastic route of preventative surgical removal.

I told him, "I'm all about getting new boobs!" and pointed to my pathetic little puppies. He laughed and said we'll cross that bridge when we get to it. I told him I assumed it wasn't up to me, but rather the insurance coverage, but he assured me that, no, Tricare was really good about, "doing whatever I tell them to do." So if I have the gene, I'm totally getting new mams. Mark my words. Not sure if I'll let them take the ovary, too, though I'm not sure if it's an all-or-none proposition.

So when he asked me if I had any more questions, I said, "Yes, but nothing to do with my medical history or health..." and he said to go for it. So I asked him about his ethnicity, where he grew up, whether he'd ever broken his nose, etc. He answered all of my questions honestly. Ha! I apologized for my nosiness, and he said, "Fair questions, all!" I told him, "Well, you did get to feel me up, and all!" He blushed, laughed again and replied, "Not exactly medical terminology, but that's true..."

I like this doctor. Can you tell?

So, they'll call me in the morning with my appointment information for labs and the genetic counselor, since all that was closed by the time we were finished. And that's the news 'til now. Stay tuned!