Lumpy, Sneezy, Dopey and Doc (Or Why Policies can Suck It) – Part 1

Part 1:  Lumpy

Earlier this year, I found a lump in my breast.

Since I’m not a regular self-examiner, I found it because it itched.  It was huge.

The timing of this discovery coincided with a) a report about breast cancer during pregnancy in older women and b) finishing a book where the heroine’s best friend dies from breast cancer leaving two young daughters.

What went through my head was
holymotherf*ckingshitImgoingtodieandneverseemygirlsgrowthisisn’tfairwhatthef*cknonononononono!

Or something along those lines.

What’s worse is I forgot to mention it to my OB.  For a month.

When I finally did, she suggested I get it checked. (um, yes.)

So I had an ultrasound done by a  radiology technician.  The doctor never came in, never introduced himself, never called me with results.  The results did not indicate cancer (evidently cancer shows up on film like bright white alien life) but because it was so big the radiologist wanted me to have a biopsy.  He never mentioned that to me.  Instead, my OB followed up with him, heard that a biopsy was the way to go and relayed that info to me.

So I called several oncology offices for a biopsy.

No office would schedule a biopsy without an exam appointment first, which meant not only the delay of getting the original appointment (two weeks) but also the delay of the follow up appointment (unknown time) and double the appointment with a specialist appointment (what am I made of money?).

Being five months pregnant at the time, I lost my mind.  I literally scream-cried at several people.  I’m not proud of this but it is what it is.  I had reached the point where logic and rationality left and hormones took over.

My OB and her reassuringly competent nurse took over.  They got me a few names and told me what I needed to say to get the right appointment.  The exam/biopsy by the first doctor who would see me was nothing short of violating.  I don’t know if what he did was normal or not but it was mortifying and I felt abused and disgusted for weeks.  Those biopsy results were “inconclusive” so I was told I needed to go through the process again.  I would have rather “died” but since that was actually on the table, I decided I’d better suck it up and get a second opinion.

I chose a doctor via my hospital network rather than revisit the site of the ‘attack.’

That experience was SIGNIFICANTLY better – sterile, clinical and very very public.  Rather than one dude in an office exam room, I had two doctors, a radiologist, and three nurses in the room with gloves, gowns and masks.  Two nurses were hands-on comforting at all times.  The doctors were slow and careful in their practice and talked to me about my family and in particular my unborn daughter the whole time, sharing anecdotes about their own families and offering kind, reassuring commentary.

They definitively concluded that the lump was normal breast tissue – likely a duct that went haywire under hormonal showers and would
either go away on its own or be a benign part of my breast until I wanted it removed in a simple surgical procedure.

Here’s the kicker:  my sister-in-law, a nurse in Australia, suggested that exact diagnosis when I first discovered the lump.

Maybe this was a case of CYA.  Maybe our litigious society mandates that doctors ignore Ockham’s Razor and pull as many levers as possible in our complicated and expensive sick-care system.

I have an estimated 47 separate bills from this experience – from the doctors, the hospitals, the labs, the radiologists, the techs, the
offices, the insurance company, etc.  Everyone billed me separately with terms and codes I couldn’t possibly understand.  I tried calling a few times to determine what exactly I was paying for and why more wasn’t covered by my insurance but I quite frankly gave up.

It was exhausting and confusing.  I’m pretty sure that is intentional.

Whatever the case, the system is broken and is making me broke.

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