Know your girls

Many of my friends and family members have routine, yearly exams.  As women we need someone to rummage around in our vagina at least once a year to check for all sorts of things we cannot see.  We put on paper gowns and turn our heads because it's all so tiresome and sometimes unpleasant.  It's something we often let be done to us, instead of actively being involved in the process.  Our own bodies are a mystery, and we rely on health care professionals to tell us what we need to do for ourselves.

As we get older our doctors or caregivers ask us to consider mammograms.  This, of course, is on top of the monthly routine manual breast exams that we're already doing ourselves, right?  Right?  Because I'll be the first person to admit that I have never done an honest, true breast exam on myself.  I've always laughed that that's my partner's responsibility - that if anything were wrong, he'd find it.  But he didn't find my little lump.  And my caregiver didn't find my little lump.  I found it, accidentally, all by myself, but not during a manual exam.

So those routine mammograms we're supposed to have - you know, the ones the insurance industry has deemed aren't really as valuable as once believed - here's a secret about them:  They don't catch everything.  In my case, my little lump was outside of the area generally mammogramed - but still in breast tissue.  So that little squeezy machine cannot guarantee it'll get an image of your entire breast.  On top of that, the mammogram sometimes doesn't pick up everything that's in your breast.  Or the radiographer may interpret the results differently.  So while they're an incredibly valuable and important tool, they are not without their drawbacks.

And then there's the cost.

When I went to my original mammography appointment, I was told the mamm would be free (to me) because it was a routine screening.  As we age, we go from having them once a decade for a "baseline," to once every five years, to once a year, because as we age our chance of getting breast cancer rises considerably.  Routine screening and early detection are still considered valuable tools in the fight against breast cancer. 

But the minute I told the technician I had found a lump, I was turned away from the "routine mammogram screening" location, and sent to the hospital for a "diagnostic mammogram screening."

And in that instant, the cost of my mammogram went from free to over $1,000.  Out of my pocket.

When I got the bill I called my insurance company and was politely told that they pay for routine mammograms - it's part of health wellness and preventive medicine, and they are proud to pay for them, blah, blah, blah.  But once I found the lump it became a diagnostic test, and diagnostics are subject to copays and deductibles and out-of-pocket expenses, and that's just the policy of the insurance company and they are glad I found my cancer early but sorry, they're not going to pay my bill...  (Do you not realize how much money I've just saved you by not waiting until next year, when my cancer would be more advanced and I would require far more treatment?  Or are you just hoping I'd be so far gone that, well, frankly, you wouldn't need to pay for treatment?)

I'll gladly pay the bill, but will continue to complain not just about the unfairness of the situation, but the larger implications.  I am blessed to have really good health care insurance, but what about women who do not?  Do we encourage them to keep their mouths shut if they find something, hoping it will then be "discovered" during a routine screening so they won't have to pay for it?  Or worse, if something is found during a routine screening, will they then be required to pay for that screening later because it changes to something diagnostic?  What kind of message are we sending to women - stop feeling your breasts and hope that your cancer will be detected during your yearly rummage-session?

So ladies - get to know your breasts.  Intimately.  If you have a partner, help them get to know your breasts, too.  Really, ultimately, we are responsible for our own health.  Our insurance companies aren't going to be helpful, and even our healthcare providers will miss things or make mistakes.   If you ever think you've found something, seek medical advice and attention.  Better to check it out than wait too long, or to wait at all.  Early detection is key to survival. 

Love your girls, because we are our own breast friends.