I voted AND had my first mamogram!

[OakLeaf]

Okay, I'm venting now, and I know it. Let that by itself demonstrate the psychological trauma of a biopsy, and the complete absence of any provision in the oncology system to deal with that trauma. Of course it's enormously less than what someone with a cancer diagnosis suffers - of course it is. That doesn't mean that it's nothing (any more than a sprained ankle should be ignored just because it's not a leg amputation).

The idea that it's good to put lots and lots of people through repeated trauma, for the ultimate benefit of only a handful, goes straight to the psychology of loss aversion that I mentioned. Yes, the Brafman book is a popular, layperson's summary, but it appears to be well documented. No, I didn't review the psychological literature the way I read the medical literature, this was just a book my parents happened to send me at a coincidentally opportune time.

You're right, the biopsy pain was only significant for about two weeks. I could ride a bicycle on smooth flat roads after two days, run after a week, do aerobics after ten days. It was considerably more painful than the doctors would have one believe, but it wasn't intolerable. The back pain from being immobilized in spine extension was gone in a day or so.

The post-traumatic nightmares were gone after about three weeks.

The pucker in my breast where the main incision went is continuing to break up, and I'm hoping that by the end of a year it won't be so disfigured. The loss of volume in that breast, of course, is permanent. It's only maybe 5-10% of the pre-biopsy volume - obviously not even close to as disfiguring as a lumpectomy, but it is quite noticeable. I am hoping that the remaining breast tissue will rearrange itself so that there won't be such a conspicuous "hole" in one place.

Yes, I am too old to wear shelf-bra tops in public, but this is a s*cky way to be forced to acknowledge that, because they used to be my favorite summer wear. The external scars, judging by my other scars (and there are plenty of them), I'm guessing are permanent. Is this "just cosmetic?" Sure, in a sense it is, but don't underestimate how important a woman's breasts are to her sense of herself as a sexual being. I did totally underestimate that until it happened to me.

And then there's the sensation (or lack thereof) during sex. Anytime DH touches that breast, it reminds both of us of the pain, trauma and horror we went through together this summer. Let me tell you, that is an enormous turnoff; but having him totally ignore that breast during sex is emotionally painful, too. We're trying to work through it, and I'm sure we will be there someday. Physically, maybe the scars will regain the thinness and elasticity of the surrounding skin, so that DH won't be able to feel them, and maybe they won't. Maybe the sensory nerves will regrow and maybe they won't. Based on other injuries I've had, it's too early to tell those things.

Considering that the changes I had were a marker of an increased risk in either breast - and also considering that the absence of invasive cancer on an excisional biopsy correlates strongly with whether all the radiographic lesions were removed on the stereotactic, which they were - I really couldn't see a point in doing further damage to that breast. I do understand now, totally, why women have prophylactic mastectomies, something I never understood before. That's not my choice, but it's one of two ways that women have of going on with our lives and not permanently turning control of our bodies over to the doctors. I've chosen the other path, which is harder in some ways and easier in others.

Through all this, no one said one word to me about prevention. Things like avoiding bpA and parabens, I learned on my own (ironically only shortly before the biopsy). Things I probably should have known, like the fact that the two glasses of wine I used to drink with dinner was considered "heavy drinking" by the medical establishment, I had to learn on my own too - even though alcohol consumption was on the medical history forms I completed for both oncologists, neither one said a word to me about it. Things like what forms of soy are beneficial, what forms are definitely dangerous and what forms' effects are unknown, I had to learn on my own, even though I specifically asked both oncologists about soy.

At the median age where I'm at risk of developing breast cancer, I'll be 63. There's an 80% chance that I won't develop it at all. I'm at the age where I've been able to have "adult" conversation with a number of elderly people in my extended family, and except my mother - who's a special case, she'd be able to find something to enjoy in Hell - every one of them has told me, in these identical words: "Don't get old." I'm at the age where it's time to consider taking that advice.

My strategy for the future is to keep control of my body. I intend to remain as healthy as I can for as long as I can, and then to die as quickly as I can. We would do no less for our pets, why not for ourselves? Having put three dogs to sleep in the past five years, I'm acutely aware of this. I have no desire to die any time soon. But I have even less desire to have pieces cut off of me year after year after year, or to be sick, traumatized and miserable for years.

I will die someday. I'm becoming angrier and angrier at doctors who would like me to ignore that inconvenient fact. I don't think it's a service to myself or to anyone who loves me to obsess about it or to choose to die slowly.