Archive | April, 2015

Breast Task Force … (Not Again!!!)

25 Apr

Her left breast has a deep dimple underneath a 2” scar. It has lost some of the fullness that use to mirror that of its twin that is nearby. Changed though it is, she is forever grateful to have it. She was over 50 when she was diagnosed.

The first few sentences of this blog entry are not a crude attempt at “Boob Porn.” They are a description of the landscape of the left breast of a friend of mine as she told it to me. Her breast now includes what she refers to as battle scars; significant reminders of her battle with breast cancer.

We may think that far too many women have a similar description but they are, for the most part, testimonies of lives that have been saved because of early breast cancer detection.

Six years after my own battle with breast cancer, I believe I may have won. If not won (none of us is ever sure about that “winning thing”) at least I have survived this far & am more grateful than I will ever be able to put into words for the last six years of my life. Every day I am ecstatic to be a member of that elitist group, the Survivors Club, for there is no stronger group of people alive.

I, too, was past 50 when I was diagnosed with breast cancer with my annual mammogram. My mammogram the previous year had been normal. But a lot can happen in a year & if anyone would like to argue that point, I am up for the argument & the challenge. Not only can a lot happen, an entire life (lives) can change.

Right now I have three very pressing things that I need to be doing. I’m putting them off because yet another of those Mammography Task Force Recommendations has made it to the forefront of the nightly news, is again generating talk show debates & I feel a very personal need to address that. I’m taking this time because I want you to hear it from ME, the truth, … from a survivor … someone whose life was saved after the age of 50 by an ANNUAL mammogram.

I have the poop, the skinny, the raw truth that the men & women (could there possibly have BEEN women?) on the most recent task force apparently have never come face-to-face with. Apparently none of them have had a personal acquaintance with breast cancer or watched a loved one take that uncertain journey through treatment. Had they, I believe their recommendations would have been different … or different depending on who paid the task force (entirely my personal opinion, of course, & pointing fingers is not the reason for this blog entry).

The latest Task Force – the US Preventive Services Task Force recommends, in case you have missed this in the news, that the decision for mammography screening on women prior to 50 years old should be an individual one. Women ages 50 to 74 should have mammograms every other year (biennially).  Data on the benefits & harms of mammography on women over 75 years old is still inconclusive & they recommend AGAINST teaching breast self-exams. WOW! They did point out, however, that family history & other risk factors should be considered when deciding when to begin mammography screening. I guess that’s something.

There are many truths but I will start with truths about women in my age group … those women over 50. We are productive people with unfinished careers, second careers to be embarked upon; families that still need us, retirement to look forward to. We are powerhouses of ideas, experience, productivity & worth that embodies so much that is positive. That does not suddenly stop because one reaches the age of 50. We deserve all the technology available to help us achieve the longevity we need to reach our goals & continue to be the productive people we are.

As with a similar Task Force in 2009 that mostly came to the same conclusions & shared their recommendations with the public, this most recent task force concluded that women age 50 to 74 need only get a mammogram every other year. Yet I am sitting at this desk a prime example that annual mammograms DO save lives. Because more women have taken responsibility for their health care & are getting annual mammograms … key word ANNUAL …. breast cancer is no longer a death sentence.

The thing I find so disturbing about releasing these task force findings is that there are women who are already frightened of breast cancer & the associated mammograms. These are the women who will cling to the suggestions of such task forces out of fear & by the time they finally go for a mammogram, it is often too late. My heart grieves for the wonderful women we have lost & WILL lose because of these task force suggestions.

The most recent statistics have proven that annual mammograms save lives so I am at a loss to understand the necessity of beating this dead horse to a bloody pulp time & time again.

In 2007 I had a normal mammogram. In 2008, almost to the day of my mammogram the year before, I presented with breast cancer. Had that lesion gone undetected for another year while awaiting my next mammogram that would have taken place in 2009 according to the task force recommendations, my chances of survival would have decreased exponentially.

In light of the statistics, I am at a loss to understand the recommendations by the recent task force on this subject. Before they beat that horse to death again, they surely must have confiscated & made personal use of his blinders.

While more breast cancer cases have been detected, the death rate associated with breast cancer has impressively decreased … due to early detection … & early detection is directly related to mammography.

Findings from both task forces site the emotional trauma women of every age experience from “false positive” mammography results. Please ……. women give birth to babies, are heads of households, head corporations & run countries. You cannot convince me that women can’t handle a false positive mammogram report that leads to a follow-up mammogram or ultrasound that gives the woman, in most cases, a definite negative result. It’s still a win-win no matter how you slice it (or squeeze it). If you have a false positive, you are retested & have very good results. If your false positive is actually “positive,” then your survival expectancy has increased due to early detection. It’s a no-brainer. Believe me; I’d rather deal with the anguish of a false positive report for a small amount of time than a surprise diagnosis of breast cancer gone wild.

And then there’s the claim that mammography is painful. Depending on your tolerance of pain, mammography is on the lower “smiley face scale” where the little round head has hardly a grimace. A little discomfort for a very few moments once a year is worth the peace of mind you get with a normal mammogram. And once again, oh, please ……… women give birth to babies, many live with abusive spouses, they are heads of countries … we can tolerate, once a year,  a few minutes of discomfort that generates hardly a grimace on face #1 on the pain scale.

Even though the recommendation is that non-high risk women begin getting mammograms at age 50, I still believe that ALL women should get their first screening mammogram at age 40 … earlier if there is a strong family history. That’s STILL the recommendation of the American Cancer Society, doctors & breast specialists everywhere. More & more women are being diagnosed at an earlier age. I strongly believe that women should make informed determinations about when to get their first mammogram based on family history, genetic testing & being proactive about personal health care but age 40 should be when a woman begins her mammography history.

Bottom line … PLEASE continue to get annual mammograms. Do self-exams. Do NOT allow a task force to dictate your life expectancy. Breast cancer is one of those cancers that we can beat … we only have to be willing to be firm in our determination to be THE most active participant in our own health care.

Now … just ONE MORE THING. A friend of mine went to her GYN doctor for her annual check-up & Pap Smear shortly after having turned 65. While mostly naked & having “assumed the position” in the stirrups her doctor informed her that Medicare, of which she had recently become a participant, will not pay for Pap Smears annually in women over 65 but WILL pay for the test every other year. My friend was livid & told her doctor to do it anyway & SHE would pay for it.

The doctor told her “statistics” show that women over 65 are less likely to get cervical cancer. Less likely is key here … if women over 65 can still get cervical cancer, they should still be tested for it without having to pay for it out of their own pocket.

Another reason for not doing a Pap Smear, the doctor pointed out, is that women over 65 are less sexually active. OH, PLEASE (again)…….. has anyone taken a good look at 65 year old women lately??????

If even one life is saved because someone reads this blog entry then I feel blessed …and I do thank you for reading this.

 

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Sharing the Ride

18 Apr

I have a friend who has always had a good marriage but when her husband retired several years after she did, life took on new meaning for her. When they began sharing the home space … same walls … same ceilings … same rooms continually following his retirement, she discovered she’s happiest when he has golf days with his buds & is out of the house. I believe she even tries to ARRANGE golf dates for him on days when he doesn’t have them & is trying to interest him in Mahjong. She’s desperate.

I’m forever grateful not to have that problem. Willy & I manage really well in the house together for long stretches of time. If there’s any problem it’s probably that we stop & talk to each other & don’t get a lot done. That’s much better than trying to farm each other out to golf buddies & Mahjong competitions.

So recently we were put to the test when Willy had knee replacement surgery & was home, non-stop for two months. The first two & a half weeks he couldn’t drive so we were mostly welded at the hip for a spell. He was motivated to get back to life as he’d known it & didn’t seem to mind the temporary loss of his independence while I was his chauffer, so it all worked out well.

After the first week, which involved knee swelling, using 55 pounds of ice in 5 days in the Polar Cube machine that kept swelling & knee pain down, physical therapy sessions, his walking with a walker & me tossing up my hands at one point in frustration, we actually had a lot of moments that were fun & just plain enjoyable.  We even ate pizza in bed a couple of times.

I wanted to give him the very best nursing care I was capable of (he’d been such an excellent caregiver when we went through my breast cancer) but I’ve never been a bedside nurse & that was the source of my frustration. Bedside nursing …changing dressings, doing wound care… are as far out of my comfort zone as fly fishing for marlin off the coast of Aruba in a helicopter.

My last experience with bedside nursing was way back in nursing school; not as long ago as Howdy Doody but back when there were 8 tracks & hair spray was doing some serious damage clogging up the Ozone layer.  I told myself I probably could have taken better care of him if he’d had a gunshot wound of the head, a rotten gallbladder or a strangulated hernia because THAT’S what I’d been use to in the OR. But he didn’t complain & told me I’d done a great job … & we both came out the other side unscathed … Willy recovering way ahead of the projected recovery time.

Once he got most of his mobility back & was driving again we still didn’t get a lot done because of that stopping & talking to each other thing but I really liked having him at home.

During those two months we DID get a taste of what retirement & advanced years may be like for us.

I’ve had a knee replacement myself & I remember how difficult it was to wash my toes on the surgery-side leg so I worked up a plan for Willy. When it came time for daily dressing changes he would sit on the side of our big whirlpool tub & put his surgical leg into the tub itself … no water. I would hop into the tub, remove the dressing, wash the incision with Hibiclens (the antibacterial scrub we’d been given for just that purpose) & also wash his leg & toes. Then I’d put a new dressing on the incision. It got the job done efficiently, was kinda fun & on several occasions we laughed ourselves through it. I may not have won any Lifetime Achievement Awards for bedside nursing but I certainly made myself a prime candidate for one in the TUBSIDE Nursing category.

A little more than two weeks after Willy’s surgery I hopped into the tub to do the dressing change & did something “funny” to my back. It seemed OK but I woke up in the middle of the night & couldn’t turn over. At 7 a.m. I hobbled to the bathroom & told Willy I couldn’t stand up. The pain was intense. So he offered me the use of his walker, which was invaluable. He really wasn’t so walker dependent at that point, although he hadn’t been officially graduated to the cane.

My medical doctor worked me in that morning but Willy hadn’t been cleared to drive & I certainly couldn’t drive myself. We called his physical therapist who reluctantly gave us his “OK to drive in an emergency” blessing & Willy drove me to the doctor.

We rolled into the office … me hunched over the walker & Willy leaning on his cane. I imagine we were quite a sight. I was diagnosed with a severe muscle strain in the lower back & given pain medicine & muscle relaxants. I stayed in bed most of that week.

Willy says he lost his nurse that day. Although I kept helping him, by then he was mostly independent & was graduated to cane walking at the end of the week & was given permission… “officially”… to drive again.

What we learned from the back thing & the whole knee recovery process was, when we have to, we can adapt. We also learned that we are pretty committed to helping each other through most anything.

As we enter our “Twilight Years” a little while from now I think we’ll be OK. We know we can coexist in the house together without golf or Mahjong.  We can get around our bumps in the road simply by being there for each other.

What we DON’T know is how long we can share a walker without one of us becoming greedy & trying to hog the wheels (now THERE’S a visual that I’m hoping to put “on hold” for a while). Maybe we’ll invest in a Hoveround now & start making installment payments. Maybe we can get one with a sidecar.

I imagine sharing a ride will be a lot easier than trying to share “the wheels.”

 

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