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What if One Insurance Was Not Better or Worse Than Another,

November 12, 2008
and Mammograms Were Scrotumograms?

The other day I had a mammogram. My last one was spring 2006. Do I even need a mammogram every year? Or is it just another way to make money off women. We already have the entire commoditisation of breast cancer awareness, which, I suspect in many cases do nothing or very little for cancer research, prevention of, and women with breast cancer.

Why hasn’t there been a less coarse procedure invented and implemented by now? It is awful, just horrible. It has been my experience that normally four to five shots/angles are necessary for an accurate mammogram, –left breast top, left breast bottom, right breast top, right breast bottom, and then an all out squeeze the breast together to get an overall aerial shot.

My first mammogram was in the mid 1980’s. Here it is 2008 and very little has changed in the technique. I did have one before, long ago, in which they tried to use balloons. An inflated balloon attached to the machine was used to cushion my breast from the steel plates. Except the balloon kept popping and the films were not very clear so we had to keep trying until we finally ended up doing the old squeeze the breast as tight as possible between two metal plates method.

I was immediately prejudice approaching this mammogram place, and was aware of my hostile opinion, and tried to shake it, and I did remind myself to try again after each negative judgment, although unsuccessfully. To begin with, the W in the sign that supposed to read Women’s Clinic was missing, so instead, it read Omen’s Clinic. Not a very good start. The outside windows were filthy and had that ugly metallic colour tint used to prevent people on the outside seeing in. Also, it was very close to the street. The waiting area was crammed with chairs and it was narrow. In square feet, the reception desk and all the space behind it was twice as large as the area reserved for waiting patients. There were many patients waiting. Often a woman would leave the waiting area to smoke outside the front door. The entire clinic had a lingering smell of once wet carpet. There were cob webs behind the television (mounted from the ceiling the way it is in many hospitals rooms) housing a very thin but long-legged spider. The channel set on the television was on some cacophonous program, a people’s court or some sort of who is the baby’s daddy type of show.

The two receptionists were crude in their movements, almost snatching one’s insurance card and referral papers, then quickly copying them and slinging back to the patients while bellowing expedient information to the back rooms.

When it was my turn, my name was abruptly called out and unapologetically mispronounced. I was corralled into one of two small dressing rooms/stalls/closets and was told to undress waist up, to put the gown on with the opening in the front, and when I was done to bring myself and my things to the room across the way. My undressing was delayed when I tried to manage the accordion door that would not close all the way, or lock so as it would hold the door shut. It was in the next room where my hostility heightened because on the wall there was a framed certificate like letter, citing a half-hearted mission statement along with a notice of who was the office manager. It was a male’s name. It was a he that was managing this rundown office. So we were at the mercy of a he to assure our mammogram was conducted in a pleasant environment. What I suspected would be a similar experience to the one in 2006 when I had a very quiet and gentle mammogram (although it still hurt) at a different place where they practiced hush tones and pastel colours. At the time, I thought they were being cheesy and somewhat stereotypical regarding women, but I realised how I wished I were there instead of where I was at the moment. I had no choice but to go to that clinic because we have a different insurance than the one we had before, thus we must go where directed, and to imagine, people complained about the old insurance, when I am seeing now that that insurance afforded better places than our current insurance (yet less assess to doctors, as in always wanting to pawn someone off onto a nurse practitioner, even when one is supposedly approved to see a specialist), while I also understand that there are people who would appreciate having at the very least the insurance that I am currently complaining about.

The technician that called me in for the actual mammogram was quick and short. There was no putting one at ease or time for hesitation; it was all about getting the job done so the next x-ray could be taken. Less patients equals less money, so the solution is, more patients, more money. No deodorant, no lotions, no powder means dry skin sticking too cold metal plates. All the mammary flesh must be squashed in, if there is excess skin or tissue between the breast and the underarm that goes in too. I was standing there on my tip toes, my breast squashed upward to downward, right to left, left to right, downward to upward, and commanded to hold my breath, to hold my pose, to not move because if I did we would have to start it all over again. At one point, I was simultaneously wanting to leave, to escape my torture and run away, while trying to persuade myself to stay, to wait it out, and wanting to scream out in agony, and thinking of bashing the technician over the head with the first object I could find. I was nauseated and felt faint, wanting to faint right there while holding my breath and counting the steps it took for her to make it over to her little button, the button that makes the noise that signals that she will soon command me to exhale, all during the first shot/angle, knowing that we had four more to go.

While she was reviewing the image on the computer (to determine if we needed to do it over), I thought about how if this yearly thing was necessary for men, for a man’s scrotum, how it would not be so many years between progress. After masses of men have been corralled in and had their scrotum squashed, contorted, twisted, and scrutinised, how someone would have gotten around to making a less invasive and painful procedure. Judging by the television commercials geared toward a man’s ability (or should I say inability) to have sex, I am confident enough to conclude that yes, yes a less invasive procedure would have been invented by now. But who would do this inventing? Men have been in the x-ray field the longest and are the dominant players in the academic areas of medicine, and now women are coming up in the technical side, as the ones conducting the mammograms, but I am sure that will be held against her under the label of limited expertise (she only knows mammograms) and lacking academic credentials. However, if an astute mammogram technician came along with a better way, will she be given the means to innovate, or will any possible thoughts be drowned out by the daily grind of pushing as many cows through as she can.

4 Comments
  1. momo permalink
    November 12, 2008 8:55 pm

    Your description is way too vivid–I hate them, but I have them faithfully every year because there is a history of breast cancer in my mother’s family. I have lumpy breasts (benign cysts) so the self-check just freaks me out. The times when they’ve wanted to check out the lumps they’ve ordered an ultrasound. I don’t know if/why an ultrasound would be so much more expensive than a mammogram. Something to Google.

  2. momo permalink
    November 12, 2008 9:00 pm

    OK, found the answer: mammograms can detect certain signs of BC that ultrasound and other tests cannot. http://www.cancer.gov/cancertopics/factsheet/Detection/breast-cancer

  3. The Fabulous Kitty Glendower permalink
    November 13, 2008 5:01 pm

    Notice how the emphasis is on “Improving Methods for Breast Cancer Detection and Diagnosis.” It is all about reading the films better. Which is not a bad thing by any means, because, how horrible it would be to learn one has breast cancer that was missed on a mammogram. However, it is as if the actual technique, the barbarianism of that technique is a non sequitur.

  4. Natasha permalink
    November 13, 2008 5:03 pm

    Well I’ve never had one but then, my insurance deductable is ridiculous, $ready for a laugh here,

    $6,000

    lol lol lol

    so, anyway, I would have Thought by now they would have modernized it a bit, its infuriating to read this because you are absolutely right, IF this was men having their scrotums sqeezed they would have advanced the technology long ago.

    Unlike you though, I probably Would have bashed the technician, maybe why I don’t go to doctors for that sort of thing, though I’m usually pretty vocal first,

    due to bad experience from some rapist jerk [I call him a rapist because he did gyno exams like a violent racists] when I was a teen, and it really was So unnecessary to be as rough as he was Then he called me a baby, said how do I expect to have a baby [ever] if I couldn’t handle an exam–I was young and mousy then, never again though, next exam I flat said, you shove that thing and I’ll bash your face in,

    Funny thing is, they Look at you like you’re a bit ‘off’ but you know something, they are a bit more gentle. And they say aggression doesn’t pay off,

    Sad though, that one has to Get like that, but you see I’ve dealt with low income clinics where they treat you like cattle [worse actually] so you just learn to get really assertive,

    you have to cuzz they damn sure won’t be caring unless you Insist on it. Testing can hurt but IF the climate is hostile that testing can hurt far worse and when being rushed like that,

    its dehumanizing, and what Angers me about your experience Kitty is that it was a woman,

    and like you said, too many patients and the assembly line medicine—but thats how it is with socialized medicine too,

    its not much better, not for women that is. Not sure about men but I think, the bottom line of the problem is that Medicine has become either about Statism or Money [profit],

    and CARE has gone out the window, unless of course there is a lot of Profit tied to it then the care quota goes up. And That aspect is yes, infuriating,

    especially when its children too. And the thing is too, all these mammograms yet, still all this breast cancer And other female organ cancers,

    in this country. Its interesting to see that some countries with low breast cancer rates,

    and That part, that I think is something that the public needs to demand more as to Why? Why we have the rates of cancer in this country that other countries simply don’t have,

    [other than countries with high rates of nuclear testing that is].

    One theory I’ve always wondered about, is how much damage was caused genetically to women who were given milk drying injections back in the day when breastfeeding was ‘un’chic’?

    Always wondered about that…

    and oddly enough, in countries where women breastfeed for longer periods, they statistically have lower rates of breastcancer, compared to countries that don’t. Now where there is correlation there I don’t know,

    but it has left me to question — how much modern things have helped live our lives easier but we pay for them later, that sort of thing.

    Anyway, the state of medical care in this country, is horrid, and why I don’t think socialized medicine [though we Need something] with the mentality of profit drive here, will make that much difference,

    not to be cynical but just based on how I see clinics work. Or like you said, those places that do take the inservice insurance plans, its the same way with dental too. Have money/great insurance, get great care,

    have cheap HMO, or State, enjoy the extractions and then, like me, dentures at 40 years old. [medicaid, rather than fixing teeth, yanked them all out in my twenties so what was left, had to be pulled later] and That experience, never will forget [was low income single parent then],

    they still had Blood on the floor from the twenty people in chairs getting teeth yanked out–it was, pop in chair, yank out, walk out with a tynelnol,

    but you were greatful NOT to be in pain so you put up with it. And they do kids the same way…who cares if you have no teeth by the time you are twenty,

    and IF you say anything, its the ‘you’re poor so you know you never heard of a toothbrush type of shit blame’ cuzz you know poor people are just so damn nasty and dirty,

    argggh [so you see where I get some of that ole aggression from].

    :)I learned to say MOO MOO at a very early age

    Natasha

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