The MRI was painful. Mostly because I had a cracked rib back in high school that left behind painful scar tissue and I was born with a bad hip. You have to lie face down on a somewhat uncomfortable table that has holes where your “sisters” hang through and you hold your arms above your head- for a very long time. When I was done – I could hardly raise myself up. My ribs and back and hips ached so badly I had to sit in my car for a few minutes before I trusted myself to drive home.
So, if you’ve never had an MRI or seen one, I’ll explain a little. It is Magnetic Resonance Imaging. Basically there is a giant circular chamber that they slide you into and while you lay very still, they run a computer program that makes the magnet inside the chamber spin around and around very quickly (and very loudly!), which it uses along with radio frequencies to create highly detailed computer images. That is my most basic explanation and is not the entire explanation. For my fellow scientists, see http://hyperphysics.phy-astr.gsu.edu/hbase/nuclear/mri.html
First you get an IV that sends some contrast agent into your bloodstream. This then will give greater contrast in the image where there is specific types of tissues, allowing the radiologist who views the computer images to more clearly see the delineations of soft tissues, joints, and especially lesions (they call cancer a “lesion”). Then the entire table slides into a large circular chamber. When they start the computer program- it has a set number of pictures, the depth it will take pictures at, etc. It takes a long time- I had maybe (?) 5 or 6 different programs that ran. Some were only 2 or 3 minutes, a couple were 7 or 8 minutes and one was 12 minutes! It was tortuously loud, even with the required earplugs- some extremely loud clunking, clicks and rotating sounds. It is also impossible to control your breathing if you suffer from minor panic attacks like I do: I can’t breathe! My hip hurts, I can’t lay still here any longer! If I breathe too hard it will mess up the pictures and they’ll have to do it over. Why does my shoulder itch right this second?! Oh my God, aren’t we done yet?!
I was told that it was going to take several thousand pictures of my breasts. Even I had to laugh at that – what heterosexual man wouldn’t want that job?
I also learned that an MRI can catch things that a mammogram can’t, and a mammogram can catch things that an MRI can’t, so both are needed sometimes for a full scan and the best diagnosis. For me, because the cancer is lobular (see below), the cancer is deeper in my breast tissue, closer to my chest wall. It is difficult to squish a “sister” flat enough so close to the chest wall to get the clearest image to determine size and shape. The ultrasound did not show everything that they wanted to see either, therefore the MRI. As I said in an earlier post- is it two lumps or one? What is the specific shape and size?
Invasive (or infiltrating) ductal carcinoma (IDC) is the most common type of breast cancer. It starts in a milk duct of the breast, breaks through the wall of the duct, and grows into the fatty tissue of the breast. At this point, it may be able to spread (metastasize) to other parts of the body through the lymphatic system and bloodstream. About 8 of 10 invasive breast cancers are infiltrating ductal carcinomas.
Invasive (or infiltrating) lobular carcinoma (ILC) starts in the milk-producing glands (lobules). Like IDC, it can spread to other parts of the body. About 1 in 10 invasive breast cancers is an ILC. Invasive lobular carcinoma may be harder to detect by a mammogram than invasive ductal carcinoma. I have this one.
I went in the next day for my genetics test and they first do pre-counseling to explain what having a mutation in these two genes could mean, what it doesn’t mean, the things I talked about in a previous post. Then they sit down and explain what your insurance does and doesn’t cover.
Turns out my insurance doesn’t allow the “spit in a cup” genetics test, which they could administer right there and then. My insurance required me to first undergo the pre-test counseling, THEN the doctor could submit a request for approval, which generally takes a week. THEN they would call me and I would have to go back in and have a blood draw, because my insurance only covered it if the blood sample was sent to U-M for analysis. Interesting… (I work at MSU, you know…)
So, that was a bit of a let down. I found out that even once the sample is submitted it can take up to a month to get results. Luckily they explained that my expected treatment plan would not wait on those results!
And then – more waiting. The medical oncologist had asked me if I had any new pains, any consistent pain. I had told her no, except for the gas pain in my side, but I wondered. Did I feel more pain than normal? I knew why she was asking- metastasized breast cancer (cancer that spreads outside of your breast) was most likely to go to your bones, brain, liver or lungs. Pieces of the cancer basically break off and then float around in your body and start growing elsewhere. She wanted a clue if maybe the cancer had spread. I believe it is unlikely it would spread far without also showing up in my lymph nodes, but we’d only tested one lymph node. And the cancer can also spread through the bloodstream.
I had pain in lots of joints. Pain I hadn’t had before.I kept excusing that it was probably due to stress overload, lack of sleep, things like that. But the more I tried to excuse it, the more it showed up. My shoulder blade behind my left breast (the one with the cancer) was painful. Almost like I’d pulled something, but I would feel the pain simultaneously on my front side as well. Right in my breast and just below it, where the scar tissue from my rib break was. It was connected, I knew it! The cancer had spread into my chest wall and into my back, I was convinced. This was my 3rd stomach dropping moment since discovering the lump.
My appointment to discuss the results and finalize treatment was 8 days away – would I make it that long without a full blown anxiety attack? I had to keep “talking myself down from the ledge” – it’s okay, since you stopped running you’ve started walking more, you use different muscles (my back always hurts more when I walk than when I run surprisingly), you aren’t sleeping as well, so your body isn’t restoring itself as well as it should, if it had spread it would very likely show up in your lymph node, etc. Over and over, I had to tell myself this each day. I prayed. A lot! My main prayer was similar to a country music song I like:
“Let me watch my children grow to see what they become
Oh Lord, don’t let that cold wind blow till I’m too old to die young” (Moe Bandy version)