Elizabeth Gets a Mammogram

This is the first in an occasional series in which I tackle important health-oriented must-do’s through the lens of an abuse survivor.

Sometimes I start sentences with “ever since my mother died,” and while it is tempting to use that here, I have always been pretty pro-active with my health. I see my primary care physician on an annual basis and for the most part follow her suggestions. But as I said on my personal blog a few months back, I’m a questioner, so it’s important for me to feel confident that my doctor's recommendation really makes sense. So after the second year she recommended a mammogram when I have no family history, I still needed convincing. But what persuaded me was this: did I want little E to see me make my health a priority or did I want her to see me neglect my health?

Yeah, you’re right. Little E. wouldn’t know. 

But I would. And that’s just like lying…to me and to her.

So I scheduled a mammogram. I opted for 3D which cost extra (thanks Blue Cross Blue Shield NC!) because why not go all the way, if I am going to do this at all? Two weeks later it was time to leave my office and head toward North Durham. But first, I got my nails done because there’s nothing like some good self-care before going into an unknown experience. 

Nails a lovely shade of pale lavender, I walked into Durham Diagnostics. Check-in was easy, quiet and low-key. There was no horrible television in the waiting room but there was a restroom. I waited only about 10 minutes before my name was called. This was a huge plus and put me in a good place because long wait times increase my anxiety, especially before an unexpected procedure.

I was greeted by a female technician and was told to undress to waist only and put the cranberry gown/shirt on with the opening at the front but with the ties tied. I always, always opt for female providers and as far as I could tell, there were no men working at Durham Diagnostics at all. For me, seeing a female provider is really important. I have always had this preference so I’m not sure this is a side affect of being an abuse survivor as much as it is that women, in my mind, have more of a chance to get me, are more willing to listen and are more patient overall.

After gowning up, I was lead to a small waiting area where there were four other women all in similar garb watching HGTV. The irony of a waiting room full of women watching an HGTV show about buying a new house no less, was not lost on me. I had just enough time to Tweet about it before I was called into a small, low lighted room. Mary greeted me and told me that she would be the one doing the mammography. Later on, I learned (when I asked) that Mary did mammographies all day long. It was all she did. That felt reassuring to me, even after the fact.

I reconfirmed my date of birth and the name of my doctor. I signed a few forms basically giving them permission to do the mammography and another form indicating that I was not pregnant. Mary then asked me some basic questions, was this my first mammography (it was), when I last had my period (2-3 weeks ago?), was I wearing deodorant (nope) and one other heath history-type question. Mary explained that I should not be concerned if I received a call asking me to come back for additional screens (I think the word was “screens”). Since there is no baseline to use as a contrast, it’s common for a doctor to want to see an area of the breast more closely or at a different angle. I liked the fact that Mary reiterated this fact a few times over the course of the next fifteen minutes together. She was clear in saying that she liked to tell patients this so they would not be worried if they were asked to come back. By the time I left, I was not worried and was just expecting a call. Repetition of a reassuring fact can be so helpful for an abuse survivor. It establishes trust and helps them trust themselves that they remembered the “right” thing(s).

Before I had to loosen my gown top, Mary told me that she was asked if the procedure was painful and she always told women that some people are more pain sensitive than others. I like the fact that Mary mentioned this because it takes the pressure off the patient to ask a tough question about pain. And an abuse survivor would be less inclined to ask a question like this, although it is on her mind, because she may not feel that she trusts the provider enough to ask such a vulnerable question.

Next Mary had me position myself in a few different ways, giving me helpful instructions on where to place my hands (handle bars) and how to tilt my head so she could get the best angle of my body. Mary was taking pictures (my technical term) that included even the armpit area (hence the no deodorant instructions since the residue can show up as calcification). Basically, one breast at a time was placed on a shelf where a plastic tray-like piece descended on top of it and sandwiched it into a stable place. I then had to hold my breath for a short time (5 seconds) and then a longer time (10-15 seconds) while Mary took the pictures. The procedure was actually not painful for me; I felt a lot of pressure but my breasts weren’t hurting while they were sandwiched in there. (Which does seem like a strange contradiction as I read that sentence back.)

At this point, I should say that I am not a modest person. As an undergrad I had cryotherapy done at my local Planned Parenthood and consented to having people who needed to learn the procedure to observe the process. It didn’t bother me. (The cryotherapy was after my rape but before the abuse from my long time partner.) I didn’t want anyone to watch me labor as I gave birth to my daughter, however, but that wasn’t about modesty as much as my fear that too many people in the room would influence how I was acting and my willingness to go with the flow, so to speak. The idea of nakedness is not a trigger for me as an abuse survivor, as it is for some survivors. So I wasn’t bothered about being basically topless and having Mary move my breasts for an optimum screen. I wish she had said that she was going to touch my breasts when she did but she didn’t. This could be triggering for some abuse survivors though.

Top off to being dressed again was no more than twenty-five minutes. Mary repeated that I may be called back for additional screens but I walked out the front door without needing to do anything else. On a scale of 1-5 of how trauma informed this visit was, I would give it a 3.5. Mary did many right things but there were many easy opportunities for her to view my visit through a trauma-informed lens. And now I am just waiting.

What are you waiting for? Was your last experience with a healthcare provider as trauma-informed as it could be? Leave me a comment below.