3-D Mammogram – Frantic Shanti

Again, the Mammogram

It feels like it wasn’t all that long ago that I had my five-year 3-D mammogram…and here I am with my six-year scan.

I’m writing this prior to the scan and will follow up with the results at the end of this post, but I find it useful to write while I am still experiencing the little uncertainties that come with scans. Like a Schroedinger’s-esque situation, I am both a cancer survivor and a cancer patient right now, since no matter how small a chance that another tumor will be found in my breast, survivor and patient are my only two possible modes of existence.

For this short period of time, I’m both survivor and patient.

For my own sake, I try to release all expectations at this time. I don’t want to relax and tell myself that I’m sure that the scan will be clear, because the drop down from that back into “cancer patient” state would be too fast and steep, so I breath deeply and anticipate nothing. But that’s hard to maintain.

At the same time, just a few weeks after seeing my oncologist who skillfully performed a clinical breast exam and found nothing, it’s very unlikely that a mammogram would bring up anything life-changing for me at this time. In fact, if anything were found, it would be a tumor in its nascent stages that would be much easier to treat than the one I had in 2017. Or so I tell myself.

To be frank, it’s not locating another tumor in the breast that constitutes the scariest scary outcome. No, it’s the not finding a tumor in some other part of the body — perhaps a lone sleeper cell that evaded chemotherapy’s effects and circulated through my body before grabbing onto a vital organ and silently beginning to grow.

That’s the real bad news…but it would not be the news I’d get today.

This brings me back to that situation that all cancer survivors face: accepting that there are no guarantees.

For the next hours before my mammogram I will focus on work, think of nothing to do with cancer and take deep conscious breaths. As I sit in the waiting room I will gently distract myself, submit to the squishing of the scan and hang in the stillness of the present moment until I get my response…and hopefully go on for another year. Maybe.

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So, I’m back now with the outcome that I was both hoping for and (to be honest) expected: All clear for one more year!

And even though I always play it cool before and during the scan, the difference in my state is really noticible after I get the thumbs-up sign. Those minutes of sitting and waiting for my results [note: as a cancer survivor, I get my answer on the spot, which I really appreciate] are a little uncomfortable — I float, trying to focus on my breathing. But to this day, even when I’m “not expecting bad news”, I cannot shake that tickle of unease.

And that’s just another part of being comfortable with being uncomfortable. Still working on it…

Four Minutes of Hovering

Last week I had a 3-D mammogram. This scan marks a bit over five years since the diagnostic test that indicated I had a solid tumor on the outside of my left breast.

Heading into this appointment, I wasn’t particularly worried. Yes, I admit to having little heartbeat skips over “lumps” in my breast that aren’t really lumps: if you recall, I had felt something before my last oncologist visit; my doctor reassured me it was nothing.

I will never again hear the word “lump” and NOT think of cancer.

And because last August I’d had a chest MRI, a more sensitive scan than even a 3-D mammogram, it was HIGHLY unlikely that there was anything to be found in this mammogram.

But still, after the pictures were taken and the mammography technician left the room to consult with the radiologist, I got that all-too-familiar uneasy feeling.

WHY? I knew that the radiologist wouldn’t find anything. The technician practically said that out loud, since she was aware of my recent MRI.

But still.

I sat alone in the mammography room, breathing, looking at the clock on the wall and simply hovering. My attention was like a butterfly looking for a place to alight. I wasn’t holding my breath…but mentally, I had put the rest of my life on hold when the tech stepped out the door.

It took all of four minutes and the mammographer returned and gave me two thumbs up.

For four minutes, I had no plans for anything outside of the room I was in.

I breathed a sigh even though I had expected the good news. And while I wasn’t “freaking out” waiting for the response, it became apparent to me that I might always feel uneasy during that period of uncertainty.

I didn’t want that. I wanted to be completely unaffected, as if I had never had a bad experience and my heart was calm.

But hovering it was, because there are no guarantees. And as the gears of my life started turning once again, I remembered that there was no going back. All the negatives that have happened have happened and I can’t change that.

Eventually, years from now, my emotions may soften, but in the meantime, I’m just going to have to be okay with hovering for a few minutes.

Well, At Least the Mammogram Was Clear…

Last week was surprisingly rough.

That shouldn’t be surprising, given that it was my “scan-week” of the year, but even I was taken aback by how I’d felt.

For at least two weeks prior, I’d had that low grade, persistent anxiety simmering, the kind that you can *mostly* ignore during the day, but wow, does it rear its ugly head at night. I’d fall asleep, only to wake several hours later and then the mental battle of focusing on my breath vs. intrusive thoughts would begin. You’d think that by now I’d be better at shifting my focus, but meditation is always a work in progress.

Another year of cancer remission! Normally, this would mean I’d relax. But not this year…

Tuesday was my 3-D mammogram. That’s the one that verifies that I’m still in remission from breast cancer. Oooo, just a tad bit anxiety-provoking, but since I had seen my oncologist not even two weeks before and he’d already checked me out, I wasn’t overly frightened. I admit, it didn’t help that I couldn’t bring my husband for support (hello, COVID), but I felt positive going in.

And everything looked good. For that day it calmed my scanxiety.

But by Tuesday evening, I was frightened again.

This had ceased to be about breast cancer. Now it was all about my heart. I mentioned in a previous post that I’d been having little “heart episodes”. My blood pressure monitor kept signaling “irregular heartbeat detected” and my heart rate monitor would show funny spikes when I was working out. The app I was using for measuring heart rate variability (HRV) would show heartrates up to crazy numbers like 262bpm, and from time to time I’d get heart palpitations.

To complicate matters, the Herceptin I had been given for my triple-positive breast cancer is known for its cardiotoxicity and there are heart-related side effects associated with the endocrine therapy that I’d been taking for the past three years.

But on top of that, my heart would pound when I got anxious. No matter what I did, I couldn’t ignore it–I could hear it. And that pounding made me even more anxious.

That sounds like a never-ending loop right there.

Somehow I made it to Thursday and my cardiology appointment. The mere thought of having a scan that focused on my heart was anxiety-provoking but the medical assistant engaged me in conversation and kept my mind occupied. Even my blood pressure came out as in the 120s/80s (can’t remember the exact number), which was quite normal. She ran the EKG and went to get the doc.

So is there something wrong with my heart, or isn’t there? I bounce between those two possibilities.

So right now this story is running long, but the bottom line is that my EKG was perfectly normal. The cardiologist, an older man with a gentle voice and pleasant and calm demeanor, asked a lot of questions…and ultimately told me that he didn’t think my heart had issues.

But he suggested that we run a couple more tests: echocardiogram and 14-day monitoring. That way we could rule out anything serious.

And I, the one who hates scans and the anxiety they bring, felt so much relief that he was willing to humor me, so that I would definitely know if those “episodes” I’d experienced were real or not.

I have everything scheduled now. And wouldn’t you know it: I didn’t experience any weirdness all weekend. No perceived skips, no palpitations. I am rarely aware of my heart beating and no longer hear it in my ears.

So I had several days’ reprieve.

Sunday night I felt it again. Let’s see where this goes.

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I had mentioned to my cardiologist all those technological gadgets that I had, my blood pressure monitor with irregular heartbeat detection, my heart rate strap that can measure R-R intervals, my watch that has optical heart rate monitoring capabilities. And he said, the new tech has its benefits but it can be inaccurate.

Hope to find out soon just how inaccurate.

After Four Years of Treatment, Calling It a Day; or, “If It’s Not One Thing, It’s Another”

I saw my oncologist last Thursday, February 18th.

It was just few days short of four years from my diagnostic mammogram, the one after which I was told I had triple-positive breast cancer.

If you or someone you love has been through this experience, you know the drill: surgery, chemotherapy, radiation, maybe monoclonal antibodies, endocrine therapy. Yours may come in a different flavor, but the dish is the same, give or take.

Last Thursday, following three years of endocrine therapy (two of tamoxifen and one of letrozole [aromatase inhibitor]), I called it quits, with my oncologist’s permission. The side effects of the letrozole became too much for my joints, my brain, my intimate relationship, and possibly even my heart. My doc said he knew it when he saw me and agreed that enough was enough.

Yes, this should be me right now, since I’ve eagerly awaited this day for a long time. But it’s complicated…

Keep in mind the song that all of us cancer folk sing: “everyone’s experience is different.” Based on my personal situation, and after a medical consult, this was the right decision for me.

I wanted to know what to watch out for, so my doc said:

1. Unexplained weight loss
2. Persistent cough
3. Neurological issues (i.e., seeing things that aren’t there, blurred vision, etc.)

Obviously, there are other signs of cancer recurrence, but those are what my oncologist wanted me to be particularly wary of. And then he noted that he couldn’t remember the last time one of his HER2+ patients had a relapse, so effective is the Herceptin that we’re given. But it has heart risks.

Since I’ve been off letrozole only a few days, I’m still experiencing most of the side effects–it will take several weeks to shake them.

I almost don’t know what to do with myself, and I’d be beside myself with joy if it weren’t for a possible heart arrhythmia (!) that I am experiencing. I’ve already scheduled an appointment with a cardiologist.

Yeah, I’m miffed that there’s always something with cancer. A week prior to my onc appointment I’d been in my car at a traffic light when I felt heart palpitations, sort of–and then I started seeing dark spots, like you do before you faint. The episode passed, but I had been having those brief palpitations for months, minus the spots. Maybe once a day? Maybe less.

And over a year ago, I went in for a regular health check-up, during which time the nurse practitioner checked my vitals and noted that there was some irregularity in my heartrate.

Just like with my cancerous lump, I waited, thinking would go away. But chemo and especially Herceptin are cardiotoxic, and aromatase inhibitors have been associated with heart arrhythmias. So just as soon as I got off the cancer carousel, I’m getting on the cardiac one–until I’m able to rule out problems.

I have both a 3-D mammogram and an EKG next week, and I’m way more worried about the EKG. Who would have expected that from a breast cancer survivor?