Thursday, June 20, 2013

Day 1,093: Bonding with My Gynecologist

In addition to the million things I need to do at work and at home before I go on vacation, there are some health-related things that need attention. I haven't gone to the dentist since the fall, for example, but my teeth and the teeth of my family are just going to have to be on the losing end of the crazy-train that is our hectic family schedule. I did prioritize getting my annual pelvic exam and pap, however. Even as medical standards are changing and encouraging healthy women, especially the rare minority of us who are HPV negative, to avoid unnecessary paps, I will always be raising my hand and volunteering for one anyway.

What other excuse do I have to visit my gynecologist?

I mean, my husband had a vasectomy. I can't call in and say that I'm afraid I'm pregnant. Well, I could, but then I'd have bigger problems and my husband would probably get kind of mad at me. I don't need regular breast exams, because I get 93 of those a year from my cancer doctors. So, I need some reason to visit the man, because...

I really, really like my gynecologist.

He's a strange one. He's big and swarthy and gruff and can be absentminded, or seemingly so. The first time I met him, I was planning to get pregnant and was just doing the "am I healthy enough to get pregnant" exam. While I was lying on the exam table, I told him about my history with epilepsy and asked if I should be concerned about anything related to pregnancy. He thought I meant that I was concerned that the baby could have epilepsy, and he asked me some version of "well wouldn't you have the baby anyway?" and I was like, whoa Doc of course I would, after all I'm glad my parents had me. I explained that I was worried that I could start to have seizures again, because those types of hormone changes can have a big effect on women with epilepsy. He stared at me blankly, and left the room without saying anything.

The man left me there, with my feet in the stirrups, naked from the waist down, and he didn't even SAY anything.

I had rarely been so furious with a doctor. When he came back in the room I was ready to unleash all kinds of fury on him. Then he told me that he was sorry it took so long but he was on the phone with his three favorite neurologists asking them questions so that he could adequately answer my question and that I shouldn't have anything to worry about and it would all be fine.

I've kind of loved him ever since.

I know it sounds weird. Shouldn't I have remained angry? Well, no. It was one of the first times that I heard a doctor admit that he didn't know the answer. It was definitely the first time I had seen one work so damn hard to find the answer he didn't know right then and there. And as I was to soon learn, I wasn't wrong in sensing a larger empathy that this awkward situation unveiled. During both of my pregnancies, I never spoke to a nurse, not once. He would call me back anytime, from any place. He always listened to my questions and concerns and never acted as if I was being overly dramatic, even when I was being overly dramatic. He delivered my daughter, while doing pushups on the wall and punching my husband regularly in the arm. He cruelly stopped my epidural drip because I was pushing for so long and he didn't want me to have to have a c-section. He practically bullied me into that final push by threatening to get the forceps. Some women would have hated him for all of this, but all of this worked perfectly for me. I was like, goddamn it doc FINE. And then Lenny was born. He saw how exhausted I was after that difficult delivery and he told me that if I didn't mind, he would remove the placenta for me. He literally reached his enormous hand inside my body and pulled the placenta out in one piece and showed it to me and I was all, thanks doc, I was a little tired. He visited us in the hospital on his day off, just as he did after Augie was born, delivered by a different doctor because he was 3 weeks early and my doctor was delivering babies in another hospital that day.

He's the one who told me at my six week post-natal appointment after having Lenny that everything looked great and if I wanted to I could start having sex again. He actually said the following words to me: "It's gonna hurt though. You had a stitch. I'm just warning you. One of my patients once told me (laughing) that that first time, you basically just need to hold onto the headboard and take one for the team. And use lots of lube." Hands down best and most practical advice I've ever been given by a doctor. After Augie was born and I felt amazing and had so much energy I could've just gone and done the whole thing again right away, he went through a similar speech at six weeks. This time he said "now is your husband pressuring you? Look, I'm sure he'll do whatever the hell you want. He didn't just have a baby. Tell him to calm down." I didn't have the heart to tell him we had already started having sex 3 weeks after the baby was born and that everything was fine and that sexual pressure was not a part of my marriage. I'm glad he said that kind of thing to me, because I know a lot of women who deal with that in their marriages, and thank God some doctor somewhere has their backs.

And then, he gave me an order for an ultrasound for a hardness in my lactating breast that most other doctors would have said was nothing. He found out before I did that I had cancer, and he called me with his voice breaking to see if I had "heard anything." Once my diagnosis was official, he checked up on me. He called me on the weekend a few times. He told me I'd be around in 10 years. He cried.

He was the one who told me I had saved my own life.

Now, when he sees me--for these annual exams--the visit is 75% social, 25% medical. When you're 100% buck-naked and sitting there reading about Jennifer Aniston's non-wedding in People magazine and this big man walks in the room and removes your gown and then says "Holy shit! Look at you! You look so thin! You look great!" it could be awkward, but somehow it's not. All the cancer doctors always say "you look great," but this dude gets specific. In that office I'm thin! and fit! and stylish! and oh my God I love your hair!

And then it's Did your husband get that damn vasectomy? (there's lots of swearing in his office. I love it). and How are your kids? Do you have pictures? All of this is happening while he is using his enormous hands and equally enormous speculum to do these various internal exams and you are conversing as if you're sitting on a patio somewhere drinking Coronas.

And then you have to go and bring medicine into it. Well Doc, there is a spot I want you to feel. I had my mammogram last month and they found this calcification, so this could be it (WAIT! why didn't I see that mammogram report? Um, I don't know I told them to put you on the list. WELL THEY DIDN'T! DAMN IT!) but anyway I feel this hardness right by my scar, and in the last few days it has really started hurting. It hurts when I touch it and it hurts when I sleep on that side. My husband felt it too.

Commence 97 breast exams done by him alone. He feels what I feel. He feels it seemingly hundreds of ways in seemingly millions of positions. He actually looks at me at one point and says "You must get tired of people feeling your breasts all the time."

Amen, honey.

He said that it felt like a cyst, or scar tissue, not like a separate distinct mass. He also told me to go to my surgeon, especially if I didn't notice it before a few weeks ago. He said he wasn't worried about me, but he was worried that I would worry needlessly. And as he suggested I contact the cancer docs he said this:

Look, they don't get it. They aren't a 35 year old or 37 year old worrying about breast cancer. They see thousands of people. They care about you but in a medical way. This is your body and your disease. If you need to get something checked out, you're smart, go do it. Enjoy your vacation. I will get your mammogram report and I will call you this afternoon and read to you exactly what it says (which he did) and I will tell you right now that I could not feel calcifications, so that's not what this is. IT feels like normal post-surgery and radiation changes to me. But I want you to go in after you get back from vacation. If they are too busy (when I called I was told my surgeon was booked for the REST OF THE YEAR. I raised hell and got a July appointment) tell them I said you need to go. Look. I care about you differently. I don't know, maybe it's because of your deliveries. It's because I have a different relationship. Because of the babies. Because I don't deal with breast cancer 24/7. Because you had this damn disease and it's scary and you're normal to be scared. You want someone to tell you you will be alive in 50 years and no one can tell you that. But no one can tell me that either. (But doc, it's a lot less likely that some of us will get there, though). Well goddamn it that's true. You had this disease. You have to live with it. I don't and they don't. They know what it's like to see people with this but not to BE those people. It was aggressive. It's bullshit. I think you're fine. But you worry. I hate to see you worry. And you're going to the north woods? My son is in camp near Rhinelander. Your daughter looks exactly like you, like a clone. She's beautiful.

Commence enormous bear hug and kiss on the top of the head like your grandpa used to do when you were little. I'm going to call you this afternoon. Promise me you'll have a good trip. Promise me you'll call them.

OK, promise.

I'm worried and I'm not, I'm scared and I'm not, it hurts and that bothers me but it also makes me feel a little better because cancer doesn't usually hurt, I'm dying to go on vacation and I have too much going on at work and at home and with the kids and sometimes I feel like a cog in various machines.

But I'm not--I'm a real live person, a woman who is still on the young side, a woman who is sometimes convinced she beat the beast and sometimes convinced she wasn't meant to live a long life anyway. If you are a doctor, or a regular person who has found out someone you know or love has cancer, and you don't know what to say, do me a favor and think of this strange, eccentric man. And say, I hear you. I'm so sorry. How scary. What bullshit. I care about you.

And above all else, do what he has always done. Keep your promise. I had to leave a meeting to take his call. He didn't even announce himself, he just launched into the mammogram reading. He reminded me to make the appointment. And then he said

Take care. Sweetie? Take care.

Promise?

4 comments:

  1. "Take care." My thoughts exactly.

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  2. That's a very hilarious story yet very informative as well! I too had a male gynecologist before I recently relocated to Texas. He was also very compassionate and willing to ensure I get great care. I wasn't sure if I would find another as great as he but thankfully I found a prominent gynecologist in Sugar Land, TX.

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  3. It’s amazing how you developed such a deep relationship with your gynecologist. It appears he’s a very pleasant person and very capable of what he’s doing. No wonder you are fully confident in airing all your womanly issues and concerns to this man. I hope that soon everything will be alright with your health!

    Elli Degennaro @ Centennial OB-Gyn, P.A.

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