“Ten films?” The X-ray technician looks at my referral while I stand anxiously next to the mammogram machine. “Who ordered this?” She sits down at the little desk against the wall, back to me, flipping my chart pages up and down.
“My breast surgeon,” I answer. Ever since my cancer diagnosis four years earlier, I’ve had to get a mammogram every six months.
“Oh, ok,” she says, glancing at me briefly. “In that case, we gotta do ten. If it was your Primary, I’d be makin’ a phone call. ‘You want 10, Doc? No. Let’s do 6, why not 6? All that extra radiation–no good’… but if it’s your surgeon, well, then we gotta do 10.” Back still to me, she says, “Take your gown off.”
I’m used to taking one arm out at a time, leaving only one breast exposed at a time, but I remove the heavy blue cotton gown that was keeping me warm and place it on a wall hook.
“You know who’s the first person to advocate for a patient?” she asks, pausing too briefly for me to venture a guess. “The patient! You gotta stand up for yourself.”
I nod.
“My patients are my babies, you know? That’s why I tell ‘em, you gotta ask questions, and if you don’t like the answers, you gotta right to ask more questions.”
Ok, then, can I put my gown back on? I think this may be a good place to start because I’m cold, and feel unnecessarily exposed, but I don’t say anything, because I can’t start advocating for myself on a dime.
She starts to stand up, but freezes with a wince, sets my chart down, and grabs her thigh. “Cramp,” she hoarse whispers.
She stands straighter, puts one hand on the wall and extends her other arm out for balance, and begins kicking her leg high over her head, front and back like an Olympic runner warming up for the hurdle relay. For a shortish, slightly overweight woman, her range and accuracy in this tight space are impressive.
Her kicking did the trick because she’s able to walk to the command booth and fiddle with the controls. Then she walks over and pulls me toward the machine by my shoulders.
“Ok, you don’t move your body,” she says firmly. “I move your body.” She uses both hands to tug my right breast onto the sleek plastic tray. “You just relax.”
The other part of the machine can’t descend to make the breast sandwich, so her fingertips pull my chin toward her, her other palm pushes my blocking shoulder down and away, and finally the tray can clamp on, she repeats, “You just relax,” as the vice tightens bit by bit and my armpit throbs and I’m not sure my head can assume this angle without my neck breaking and I want to scream, “Uncle,” but…I stay silent. When she’s satisfied I’m properly viced, she yells, “I’m running,” and I can hear her take the three or four quick steps to get behind the protective shield to take the picture.
“Ok, don’t breathe,” she says. The machine whirs and clicks and I’m waiting for her to say, “Breathe,” but she only mutters something as the machine releases its grip. I’m still waiting for her permission to breathe, but it doesn’t come so after a few seconds, I breathe anyway. If she hadn’t told me to advocate for myself, I might have tried holding my breath longer.
Great, only 9 more, I think.
The mammo, followed by a sonogram, my biannual cocktail, shows two spots on my “good” breast that the radiologist wants biopsied. When I see my surgeon for the results, I’m relieved both are benign. Then she asks about my six-month stint in Mexico which I recently returned from and I tell her it was great until the very end when I had a UTI that would not respond to antibiotics.
“Oh, that could be the cancer medication you’re on,” she says, a punch to my gut.
I felt betrayed somehow, although by whom or what, I wasn’t sure. I had just begun having sex again after a hiatus when the UTI began. I suspected a sex/UTI connection, but never contemplated my medication as the culprit. To treat the indomitable UTI, I had been given six different antibiotics, a few orally, two by 10 daily injections, and the final one intravenously. It took nearly two months to begin feeling even close to my previous normal and I still wasn’t 100%. All because apparently, you can’t mix sex with a hormone blocker that may, only may, prevent further cancer.
“You can go on a lower dose,” she says. “Discuss that with your oncologist.”
When my oncologist had prescribed the medication, he said I might suffer joint pain. I never considered my urinary tract a joint, nor do I imagine does the medical community. He never told me UTI complications were possible. More importantly, I never asked. Even more importantly, I never did my research.
When I see him again, I tell him about the issue and he prescribes a different, lower dose medication. I take it for a week. Then the tingling and not quite urgent urge to pee, but the something is definitely off feeling returns. It didn’t help that each time I popped the morning pill, I had a little lightheaded PTSD reaction from the months of burning and pressure and feeling like I always needed to be near a toilet.
I remember the radiologist’s advice and advocated for myself by throwing the pills into coffee grounds and canceling my next visit.
“Do you want to reschedule?” the receptionist asks.
“Not yet,” I answer.
“You’ll call back?” he asks.
“Yes,” I say, although I’m pretty sure I’m lying. Right now, I think calling back means agreeing to forego sex in order to maybe prevent further cancer. Maybe. The usual treatment for drying vaginas are estrogen suppositories. As a cancer survivor, I’m not a candidate for those treatments. But I also think of doctors in the 1950’s prescribing diet pills so pregnant women wouldn’t gain “too much” weight and telling other patients to smoke to settle their nerves. I don’t need scientific research to tell me that bottle of pills will make my already drying vagina a desert wasteland rife for UTIs, preventing any semblance of a healthy sex life.
I stare at the pills and know I will continue to get regular mammograms and go to the oncologist for blood tests, but I will also continue having sex. I am in my 60s, yes. A cancer survivor, yes. But I am also still a healthy woman craving the craves.
The pills will stay in the trash.
