Tuesday, September 14, 2010

Girls on Film


The ad shows a woman, spade in hand, dressed for a morning in her flower garden. On closer inspection, “she” is a lifelike sculpture. On her lapel, a pink ribbon for breast cancer awareness makes it clear how she met her untimely death.

I find the ad while flipping through a magazine in the waiting room in the radiology suite, where I have had a mammogram, have been told it is abnormal, and have been left to wait for a radiologist to consult with me.

When you are waiting for the radiologist to tell you just how abnormal your mammogram looks, the last thing you want to do is see a reminder of breast cancer’s toll. But what should you be doing while you are waiting in radiology during your annual screening?

Mammograms have a regular part of my health care since I was 25. Because my mother was diagnosed with premenopausal breast cancer, I started getting screenings earlier than the average woman, who usually begins screening at age 40.

I practiced diagnostic surgical pathology at the world’s largest medical center and saw many breast biopsies under my microscope every day. Although I still dread my mammogram, I have become more savvy about how I mentally prepare for the screening.

Taking all kinds of potential problems into consideration, I have come up with a list of action points to minimize the stress of scheduling and getting a mammogram. My suggestions are based on a decade of mammograms at three academic centers in large metropolitan areas.

• Understand your insurance company’s policies regarding reimbursement for a mammogram. Last year the radiologist suggested I have an ultrasound on the same day as the mammogram. I complied. When the explanation of benefits arrived in the mail, I was surprised to find out that the insurance company did not pay for the mammogram because a second service was billed on the same day.

• Schedule your mammogram for the first two weeks of your menstrual cycle when your breasts are less tender. The compression during the exam will be less uncomfortable that way.


• When you call to make the appointment, get the mailing address in case you need to send any previous mammograms in advance of your appointment. Find out the exact physical location of the building and ask where to park.


• Consider telling a trusted friend when you are going to have your appointment, but think twice about asking a friend to go with you. When I am mustering courage, sometimes talking stresses me out, and I would feel obligated to talk to my friend. See if a friend can help you with child transportation duties if necessary.

• Plan a fun activity to follow the mammogram, but make sure it is one with a flexible start time since you won’t be able to control how much time your visit to the radiology department will take. Whether or not you receive immediate feedback on your films, it is nice to celebrate that the exam is out of the way.

• The night before the mammogram, pack your insurance card into your purse and review your breast health history, including all procedures and screening exams. You will be filling out a history sheet in the office before your mammogram. Also, check your calendar and write down your LMP—you will be asked for it. Having this information on hand will keep you from feeling ill-prepared while completing the necessary paperwork.

• Don’t wear deodorant; do wear separates. Pack your deodorant into your purse the night before your appointment--this way you won’t reach for it out of habit the morning of your mammogram, and it will be in your possession when you get dressed after the appointment. Deodorant can cause aberrant spots on the X-ray. If you accidentally apply deodorant the morning of your exam, don’t sweat it: The radiology suite will have moist towelettes for you to use. During the mammogram you will be asked to undress from the waist up. If you wear separates, you may be less cold during the procedure. Wear a top that won’t wrinkle after it has been folded into a plastic bag and left there for an hour. This way you’ll look fabulous for your post-appointment activity.


• Eat breakfast before your mammogram. Even if you are scheduled for an eight o’clock appointment and think you’ll be at the bagel shop by nine o’clock, eat at home. You never know what delays could occur or what additional tests could be performed over the course of the morning. Stress plus an empty stomach is a sure recipe for unease.

• Be very careful when you walk through the parking lot. Stay aware of your surroundings and don’t allow yourself to slip into a mood of anxious unawareness. If you have an early morning appointment, the parking lot for patients may be used by employees who are speeding into the lot to find a spot. Look for crosswalks and don’t assume cars will stop for you.

• Take a portable music player. I say this for two reasons. You will make yourself unavailable for chit chat with well-meaning people whose story may only make you more anxious. Secondly, you will be able to drown out the audio of the TV in the waiting room that may be blaring a talk show dialogue about cancer, a faltering economy, or anything else that could zap your positive attitude.

• Take your own reading material that you have selected based on its low likelihood of stressing you out. Books that you already read but would like to revisit are excellent choices.

• When you leave the mammography suite, be certain that you completely understand when you are supposed to return to the clinic for your next appointment. Mark that date on your calendar as soon as you return home and call to schedule that appointment two months in advance.

I hope you share this information. The idea is to get more “girls on film.”

My day in the radiology suite ended with an ultrasound that showed benign changes; I left and took myself to lunch.

"And she wonders how she ever got here as she goes under again."
"Girls on Film" Duran Duran





Sunday, September 5, 2010

Questions 67 and 68


“Was your hair that red Friday night?”

That was the first question he asked me, when at 11:55 a.m. Central Time on Labor Day, I came to the front gate to enter the code to let him into my fortress strong.

So we were for all intents and purposes on a blind date because clearly he was blind to my hair color three nights prior when we met at the Duck. But interestingly, I came to find out several weeks after Labor Day, we had been matched as dance partners at the Duck by Therese and her decorator friend, Craig, on the basis of hair color although his reddish highlights were more subdued than my brassy red hair. My Parisian hairdresser, Sebastien, referred to us, his clientele, the female physicians from M.D. Anderson Cancer Center, as his “painted ladies.”

I dismissed his question as one of sincerity and not approbation and invited him in. I pulled him through the corridors pretty quickly, as I recall, trying to avoid the man down the hall that I had canceled the date with for Labor Day. (That was fairly easy because his sister fielded the call when I canceled.)

Inside my unit the next thing I suggested still causes laughter: I invited him to have a quick cup of hot coffee in my kitchen when it was 105 degrees outside. I did not know that he was not accustomed to slamming a cup of Joe like a physician does before heading to the OR. So he politely sipped at hot coffee in spite of not wanting it.

He drove us to River Oaks Theaters in his black Tahoe to see Celestial Clockwork, my choice.

I lost all movie picking privileges very early in the relationship. Since that time we have both returned to IMDb to see there just were no good movie picks for that Labor Day weekend. Just like there are probably no good movie picks for this Labor Day weekend. It is historically not a good movie release week. Try not to start a relationship with a movie date on Labor Day weekend.

In the parking lot of River Oaks Theaters, I noticed that his car had two bumper stickers, Fly Girls and a Darwin fish. I didn’t understand either one.

Questions. He asked a million questions, which he later told me was because he was nervous.

At one point I felt like invoking my grandfather Farmer's line: "You ask the damnedest questions!"

In the Darwin fish car in the movie parking lot, he asked me what nationality my last name was. I told him it was my ex-husband’s last name. That silenced him for a while.

The movie was no sleeper. It grossed 410,000 dollars in the US. Ten of those were ours.

On the way back to my apartment, we passed Randall’s on Westheimer. He asked me if I wanted to go out to eat for dinner. I said I had picked up a few things for dinner.

That was the understatement of the year. Susan had spent her last day in Houston helping me shop two or three stores for this date. But I wasn’t going to mention any of the date prep to him.

You see after I left him in the parking lot of the Duck the Friday prior, I decided and vowed to my best friends that there was no way I would try to find him if he did not call me Sunday as promised. Evidently, the call almost never happened because by the time he looked on his hand for the phone number later that night, he found that most of it had transferred onto the steering wheel of the Tahoe, most likely while the song "Good" by Better Than Ezra played over the car airwaves. (My friend Barrow dated a guy in that band back in Baton Rouge.)

The night after I gave him my number, I spent with my girlfriends at Cezanne, the jazz club above the Black Labrador Pub, listening to an African American woman deliver jazz standards with a “sultry, meet you after midnight voice” (Susan’s words, as told to me in a personal correspondence last week).

The day before the date, Suzanne flew back to Louisville early, and Susan and I hung out, shopping at Whole Foods (the small one that was closer to I-59 in Shepherd Plaza), Whole Earth Provision, Cactus Records and Randall’s. I won’t tell you everything Susan suggested I buy, but I will tell you it was fun.

After the movie, back in my kitchen I had the chicken breasts, Tahini sauce, eggplant, and a salad I prepared of avocado, Kalamata olives and grapefruit.

During this second visit to my kitchen, he noticed the photo of the little girl on the beach at Galveston mock surfing on a piece of driftwood and asked who that was.

“That’s my daughter.”

The questions stopped for a while longer. Then I asked him to do something for me: Grill our dinner on the patio. He had told me he was a volunteer fireman in Austin. I figured he could stand the heat.

We ate at my dining room table with clover cutouts, a hand-me-down from my Hoffmann grandparents’ Germantown kitchen. He pushed the salad around on his plate, not mentioning that he hated olives.

Then we moved to the sofa for more Q and A. Somewhere between questions 67 and 68, we fell asleep. Then we woke at two and he went home.


Can this feeling that we have together/
Oooh, suddenly exist between/
Did this meeting of our minds together/
Oooh, happen just today, some way

“Questions 67 and 68,” Robert Lamm