Sunday, January 27, 2013


Mammograms are never fun. You start out sitting in a waiting room full of uncomfortable women who are either checking their iPhones or reading an outdated magazine, flipping pages carefully to prevent their untethered parts from slipping out of the ill-fitting hospital gowns. Finally it's your turn to go to a small room where a pleasant stranger helps you hike your breasts, one at a time, into a giant George Foreman grill. If you're lucky, all is well and you're good until next year. But sometimes you get a phone call asking you to come in for "re-imaging" because there was something that didn't look quite right. So you go back and repeat the process, maybe with an ultrasound thrown in for good measure. And every once in a while, those results are still atypical. There's a lump, or calcium deposits, or a big thumbprint on the film. So they recommend you have a stereotactic biopsy, which is a fancy way of saying they want to stick a large needle in your boob. I recently had a stereotactic needle biopsy to sample some micro-calcifications. Long story short, they were benign and no further treatment is needed. Long story long, (and at the risk of "TMI") here is how it went.

Everyone at the breast imaging center is really nice to the patients. In fact, they bend over backwards to put you at ease. My nurse had me sit in a chair and checked my blood pressure. She commented that it was a little elevated (which could be because in a few minutes THEY WERE GOING TO PUT A NEEDLE IN MY BOOB!) Then she sat next to me and explained every single step of the process, even though I had told her that I had already been through it about a year ago, right here in this very room. Next a mammogram tech came into the room, sat next to me, and explained every single step of the process. Finally the radiologist came into the room, stood in front of me, and explained every single step of the process. The radiologist had a dazzling smile and was full of positive energy, like a used car salesman. That's because he knows that no one is ever going to stick a needle in his boob. 

Getting situated for a needle biopsy is quite a production. The exam table is padded with a hole in the middle. You lay face down and put your breast in the hole, letting gravity do all the work. Your position depends on where the abnormal cells are. I was able to lay fairly comfortably, despite the rim of the hole catching right across my bottom rib. The mammo tech elevates the exam table and adjusts some plates underneath that will hold you in place. You're definitely not going to get away, but it's not as uncomfortable as the George Foreman grills.

Once you are position, it's time for the biopsy. The entire process is computerized, and the computer won't let them proceed until the target area is perfectly aligned with the instruments. Once the computer gave them a green light, they told me not to move, which immediately made me start to itch all over. I resisted the urge to wiggle and the radiologist gave me a local anesthetic. It stung a little but wasn't as bad as the flu shot I got a couple months ago. Everything after that was related to sound. They told me to get ready for a loud pop, which was when the needle actually penetrated the skin, followed by a series of buzzing noises, which was the actual tissue sampling. One more twang and a nice little souvenir marker was inserted, and then we were done. I never felt anything, but as they began to put their instruments away I got a good look at the hollow core needle that they had used on me. It was bigger than I expected, resembling the probe that came with our first microwave oven, circa 1980. 
It's no fun going through the fear and discomfort of an abnormal diagnosis,
but it sure does make you appreciate the little things in life.

I had to stay in postion until the samples were checked under
a microscope to confirm that they got all the suspicious cells. I lay there for ten minutes making awkward small talk with the nurse as she crouched under the table holding an ice pack to my chest. Finally the radiologist came back and said the samples were good and they would call me with the results within 48 hours. My legs were wobbly as I climbed off the table, but I still felt very little discomfort and, after one last mammogram for good luck, I drove myself home. I used the ice pack on and off for the rest of the day and took ibuprofen when I needed it.  Recovery was fast and bruising was minimal, and best of all I got a happy ending.

Thursday, January 10, 2013


It's like looking in the mirror..
I haven't blogged in a while because I've been busy trying to literally put my head back where it belongs. I've always had a freakishly large head, but over the past few years I've developed something called "forward head posture", a common condition also known by the more colorful and totally unflattering term "Neanderthal head".

In my case, my melon sits about 2 inches forward of upright, most likely due to spending half my life hunched over a desk. Keep in mind, the average human head weighs 12 pounds (not including big hair) and is balanced on our spines like a bowling ball on a stick. If you keep tilting that stick forward the ball will eventually fall off. Thanks to my sloppy posture and the business world's general disregard for office ergonomics, this was starting to happen to me. I've had chronic pain in my neck and shoulder blade for several years, but ibuprofen and Senior's awesome back rubs have helped me cope. More recently I noticed that either gravity was pulling my clothes off my left shoulder, or it was now lower than my right one and eventually I'd be swinging from the bell tower of Notre Dame cathedral. I still didn't take any action until I went to the doctor to treat what I thought was tendonitis in my left arm. It turns out that the misaligned vertebrae in my neck were squeezing nerves that run down that side. It was time to do something about my affliction. I despise chiropractors, so I asked my doctor for a script and headed to physical therapy.

Physical therapy isn't a new thing for me. I was a patient four years ago when I blew out a disc in my lower back, and I loved it (the therapy, not the blown disc). It's like having a spa treatment without having to tip anyone. Now, don't confuse this with occupational therapy, which I've also endured after smashing my wrist and having it screwed back together. (I told you I was clumsy.) OT is like putting your hand in a blender. But PT... now that's good stuff. If you have any chronic pain and you have decent insurance, get yourself some PT.

Each visit starts by lying in a darkened room for about 20 minutes while being swathed with warm, moist, cushiony gel packs. I can feel all my knots unraveling and usually want to drift off to sleep. Next a tech wheels in a cart and performs a short painless ultrasound right on the trouble spot. They warm the gel first, which always makes me think back to my pregnancies and go into curmudgeon mode: "We didn't have any pre-warmed ultrasound gel in my day! These women today have it so easy!" When that is done it's time for the best part - the massage! {{sigh}} I hear angels sing during the massage. The therapist knows exactly what muscles to knead to give you total relief. He usually chit-chats during the massage, and I try to answer him without drooling. All too soon that ends and it's time to be super stretched. In my case, I lay face up on a padded table while the therapist stands behind me and cradles my head in his hands. He gently pulls backwards like he is trying to make me taller, pausing every once in a while to push down on my shoulders. If I had enough visits I would finally have that swan-like neck that I always wanted. Finally, after you are totally relaxed and in a puddle, they expect you to exercise. That part kind of sucks. But the exercises are simple and the goal is to gently stretch and strengthen, not to feel the burn. The easiest and most effective one is a chin tuck, which is basically me pulling my chin into my neck wattle. Not my best look, I might add. But I find myself doing this one a lot, especially when I'm in the car. If you are ever at a red light and notice the woman in the car next to you appears to be doing turtle impressions, that's probably me.

The treatments seem to be working. My neck is aching as my atrophied muscles are built back up, but the constant burning pain in my shoulder blade is gone and the nerve pain in my arm is getting better. It even looks like my shoulders are back at the same parallel. I have a couple more visits left before my script expires, and during the last one they will take measurements to see how far I've evolved back from caveman status. Hopefully I'm developing some good habits to continue to gain and hold ground. Otherwise I'll just start wearing a bone in my hair.