Sunday, September 24, 2006

rethink

My ISP has been having trouble with the server on which my account is hosted, so I was unable to post anything for several days. That's why Friday's post didn't show up until this morning. There's nothing like having news and not being able to put it up to foster frustration.

Friday, the lump news more or less bounced off me: That lump has been there forever. The radiologist said it looks "very benign."

But... Saturday I had a long talk with my older sister, who has experienced the dreaded lump herself (benign, thank God). When she heard it was solid, her take was: It needs to come out.

When she said it, I realized she was right. Why screw around with a needle biopsy?

Perhaps my doctors will think differently, but even though it's a more invasive procedure, it will give me a 100% certain answer as to what's going on in there, something a negative biopsy can never do. If it's negative, that just means there wasn't any cancer in the sample, which may or may not be representative of the whole.

There doesn't seem to be much information out there on distinguishing benign lumps from malignant lumps. I found information so general it approached vague, but I didn't find any stats for comfort. With thyroid cancer, you have happy little numbers like "more than 95% of all thyroid nodules are benign." On the breast cancer information pages I found, no such stats. Is it because they don't exist or because people don't want to talk about them?

Generally they all talk about diagnostic options -- mammogram, ultrasound, MRI, and the various types of biopsies. More general information: solid lumps are bad; big lumps are worse than small lumps; lumps that are afixed to bone or muscle are suspect; lumps with irregular borders are bad, too.

I was looking right at the ultrasound monitor when the radiologist zoomed in on the lump to measure it, but I didn't see how big it is -- 1 cm would not surprise me. It seemed to have smooth borders, but I can't remember how it looked on the zoomed-in image. And it was completely black: totally solid. That was odd to see. I've seen a lot of nodes on my thyroid u/s, and never seen anything like that solid black lump.

There wasn't any vascularization under the Doppler, but the radiologist told me that it is not dispositive in viewing breast tissue the way it is in viewing structures in the neck, because the structure of the tissue is so different.

I have some of the other indicators of something-going-on, too: change in the shape and size of my breast, and changes in the nipple area, too. Nothing too startling, in fact quite subtle and I'm probably the only one who would be able to tell, but there they are.

The happy-think from Friday -- It looks really benign -- is being spun through the "Well, of course she'd say that, I told her it had been there forever" routine, along with Maybe this hasn't been there forever, after all. Now, the thought is not so happy.

I don't feel like I'm freaking out, but my TMJ is still killing me. I ran out of Prilosec late last week and thought I'd see how I did without it. The Aleve I was taking for the TMJ, combined with the stress and lack of acid-reducer, chewed a hole in my stomach on Friday and everything has been off since.

Tomorrow I get my permanent filling for the root canal, and Tuesday I see the TMJ doctor. Sometime soon I need to talk to my GYN and decide what to do about the lump, and figure out when to do it.

I had a feeling, some years ago, very similar to the experience I had before my uterine prolapse (I'll never use all these up when stocking up on menstrual supplies -- I was right, I didn't.) One day when I was annoyed about something breast-related (most likely the difficulty in finding a decent comfortable bra), the thought was just there: It will be so much easier when I don't have to deal with these anymore. Not "this," as in shopping for a bra, but "these", as in the breasts themselves.

At the time I shook it off, and even now I don't put any stock in it at all. But at the same time it wouldn't surprise me if I did lose them.

When I talked to my sister, we had some very good laughs (because if you don't laugh, you'll cry) -- she thought my "warranty expired on my 39th birthday" line was a great one, and we both laughed at my vanity when I told her I was really enjoying my long hair now, and if I have to have chemo and my hair falls out, I will be really ticked off. You see? Already, I'm steeling myself for that particular journey. I don't know whether that's pathetic or what.

Hope for the best, prepare for the worst -- avoid surprises.

We haven't said a word to the kids about this. I'm hoping there won't be anything to tell in the long run. And if there is, if I do have another cancer and need more treatment, then these last days of carefree bliss are a gift I wish I could give to myself.

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