The Abramson Cancer Center of the University of Pennsylvania
Last Modified: April 8, 2009
In school, you're taught a lesson and then given a test. In life, you're given a test that teaches you a lesson.
I am laying flat on my back in a dimly lit room, naked and draped from the waist down. My knees are spread apart. There are two fat pillows wedged under my butt to tilt my pelvis upwards. A technician passes me a probe between my legs, and using clinically correct terminology, tells me in no uncertain terms where to stick it. Then she deftly maneuvers the probe around inside of me in a pattern that immediately brings to mind the stick shift of an old red Volkswagen Rabbit that I used to drive way back when. This is humiliating. This is dehumanizing. This hurts. This is a test.
I hate this.
Did I actually say that out loud? Or just think it to myself? I don’t know for sure. And looking over at the tech doesn’t give me any clue. Out of the corner of my eye, I watch her focusing intently on her computer screen, feel her downshift from third to second gear (ouch!) and then hear the mouse double-click.
The scene is so familiar; I have been on this table twice before. And one thing is certain - this is one of those tests that I dread from start to finish. No doubt about it. I hate this surreal-sticky-skin-crawling-nasty-trans-vaginal ultrasound test that I have to take twice a year. Why don’t they upgrade it to include a hot shower along with a glass of chilled white wine on the way out the door? Couldn’t hurt. Might help.
Tests. Way back when, B.C. (before cancer), tests were so simple, weren’t they? A predictable process that went something like this: a teacher taught the class for a time and then announced the upcoming date of the test. Next, the teacher shared important details with the students. What topics the test would cover. What form the test would be: essay, short answer, true/false. You studied, (admit it: some of us more than others), managed your test anxiety, took the test and waited to get your grade. End of story. Of course, in college, there was the added drama of larger classes, harder tests and those foolish little blue books to scribble your essays into. But somehow we all learned to play the take-the-test game and the earth continued to spin on its axis.
Tests. B.C., that was all the word meant to me – paper, pencil, getting good grades. But now, living day-to-day, year after year in CancerLand, with the real anxiety of managing a BRCA-2 deleterious mutation, when it comes to tests, (new tests, more tests, with or without contrast), I am struggling with a new reality. Instead of agreeing to more surgery I’ve got my Doctor’s notes, insurance I.D. card and co-payments in hand. I’m now a somewhat reluctant frequent flyer for tests. Truth be told, I am whining more and tolerating much less when it comes to tests these days. So while my G.P.A. isn’t suffering as a result, my patience, along with my sense of humor are both being seriously challenged.
A week later, I am laying face down on my stomach on a platform with cutouts to cradle my various body parts. This is my first Breast MRI, I say. Please be gentle with me. My initial impression is this: breasts are round in shape, but for a Breast MRI, your boobs are supposed to drop neatly into two side-by-side rectangles. Go figure.
My face is nested in what looks and feels like a catcher’s mitt. There’s a hole in the middle to help me breathe through my nose or mouth. (Just like when you get a massage, says the technician). Bright orange earplugs pop in place, followed by a headset on top. (You need these or else it will be too loud in there, says the technician). Then she takes my arms and stretches them uncomfortably over my head so that my fingers touch. Finally, she places a rubber ball in my right hand. (This is your stress ball, says the technician. Try not to move, okay?).
Stress ball? (Should I squeeze it when I feel anxious? Or is it a panic button for when I freak out? Will you stop the MRI if I signal you? Will you let me out? Then will I have to go back inside to finish the test?) I don’t get the chance to ask any of these questions that are flying around madly inside my head, because the platform starts moving slowly backwards, delivering me feet first inside the MRI tube. In a panic, I quickly close my eyes and decide in that moment to handle the stress ball delicately, like an egg that might break under the slightest pressure.
That will be my last somewhat rational thought for the next twenty-five minutes.
The clicking noises begin and through the racket I hear a male voice calling my name. Everything is so muffled by the earplugs and the headset and the pounding of my heart, it sounds like a man hollering under water. (Who is that? Why is someone trying to talk to me now? Why didn’t they say what they had to say before I went into the MRI?) I finally reply and acknowledge the second technician and he stops yelling at me.
The test takes off to a land far, far away. A land of loud, unrelenting clatter. Large waves of sound build up and wash over me, rumble around, inside and through me, again and again. Clicking sounds change to clanging sounds change to Star Wars Lightsabers slashing. Every so often, the male tech’s voice intrudes (Six minutes this time). Then the cycle of noise begins again. Clicking. Clanging. Beneath the noise, there’s a voice in my head screaming, I don’t want to be here. I want this to be over and done with already. I try to breathe slowly in and out, in and out. I try to separate from my body and disappear to some happy place far away from where I am. I try to fight the panic of feeling buried alive. I try not to squeeze the stress ball. I try. I try. I try. I try. I try. I try. I try. I try. I try. I try. I try. I try. I try. I try. I try. I try. I try. I try. I try. I try. I try. I try. I try I try.
Suddenly there’s silence. Dramatically evident. A blessed absence of noise. The table slowly moves me headfirst, back into the light. I gratefully open my eyes. The MRI technician is at my side, eager to get me up and out of the machine and into the dressing room. But I feel dizzy and altered, disoriented and weak in the knees. Please give me a minute, will you? I ask, slowly moving my legs until they dangle over the edge of the table. I have to ask you a question, I say. When you did your training to become an MRI tech, did they make you take this test?
No way, she says. In my class, we were all too claustrophobic to handle a Breast MRI.
They say laughing is good for your health. It can cure what ails you. Feed your soul and lift your spirits. After two Fridays in a row visiting my local imaging center, taking my scheduled spring tests, this was as funny as it got. In fact, after the MRI, once my head cleared, I giggled all the way home. Bottom line - here’s what I know for sure: a good cleansing laugh and a righteous rant about tests I have to but don’t want to take, will probably keep me going until it’s time for me to jump back up on the table to be tested again. And that may be the very best that I can do.
Dec 26, 2013 - The U.S. Preventive Services Task Force recommends that women who are identified as being at risk for BRCA mutations be offered counseling and genetic testing, according to a final recommendation statement published online Dec. 24 in the Annals of Internal Medicine.
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