*This blog post is not meant to provide medical advice. Please consult your doctor before making decisions about your medical care.
Yesterday, December 1st, I performed an annual tradition. No, it wasn’t opening the first door of an Advent Calendar to reveal a treat inside. It wasn’t eating leftover Thanksgiving turkey. And it wasn’t buying all of my Christmas presents at Cyber Monday sales, though I did manage to snag a few good deals.
What was the tradition, you ask? It was my annual breast MRI.
Because I am “high risk” as a result of having breast cancer, and because I still have one heterogeneously dense breast (post on breast density coming soon), which means that a mammogram might not spot a tumor that is very small, my care team recommends an annual MRI.
It’s not my favorite day of the year. This time, my appointment happened to be scheduled for 6:50 am. Now, while I’m up at 6:00 am most weekdays, the only reason I get up is to exercise or do yoga. It’s my “me” time, before I have to give my day to others: kids, work, dog.
But none of the other times they offered worked with my hectic schedule. So by 6:30 am I had done yoga, showered, walked the dog, and was on the train on the way to the hospital.
The train smelled like smoke from the people who had been riding it all night to stay out of the cold. I held my nose for the entire ride.
When I exited the train and walked through the icy morning, I could see both my breath and a pink and purple sunrise. Okay, I thought. I’m pretty grateful for this sunrise. It was unlike anything I’d ever seen before.
The first cost: my time. The entire experience cost me about four hours of my day. That’s half a workday. It’s two movies. Four massages.
The benefit of being one of the first patients: I was called in right away. The phlebotomist asked me if I wanted a warm blanket. I wasn’t particularly cold, but the offer just felt so warm and caring; I took it. There’s something about a warm blanket that just makes a morning better.
The phlebotomist is sweet; the room quiet and dark. The IV pinches, but only a little. I spin around in front of a metal detector that does not beep. I guess I am human after all, not a robot. The MRI tech removes my front gown and has me lean forward in the machine, my head on a headreast (kind of like the headrest on a massage table, but not nearly as comfortable). I’m propped up on my forearms, which, along with my face, are bearing the weight of my upper body. I don’t remember it being so uncomfortable before.
I hold a rubber ball in my left hand. “Squeeze it if you need help,” the tech says.
“Can I squeeze it now?” I think.
The second cost: anxiety. Constant testing of my breast ensures that cancer will be caught early. But every time I go for a test there is the worry: will they find something this time? Will I have to go through the biopsy, the surgery, the chemo, all over again?
MRI machines make an unmistakable noise: once you’ve heard it, you would always recognize it in the future. It’s a low drumbeat that sounds like a House dance party about to start in the next room.
But at this party, all we’re doing is using magnets to take pictures of my boobs.
The tech and her assistant leave and I slide into the machine. I’m wearing earbuds (so I can hear the tech) and noise cancelling headphones (to dull the thrum of the machine). I didn’t ask for music this time, and I regret it. I wish I had something to distract me.
As the imaging begins, I remember the sounds from last time. There’s the one that sounds like Belle is practicing her drums next to me. There’s another that sounds like an alien ship landing. And my least favorite: the one that sounds like a machine gun.
All the while, the House dance party continues next door, that low, ominous beat reminding me that I am stuck in this machine while the techs sit in a protected room behind glass.
My MRIs happen with and without contrast: a dye that enters my IV and moves through my body, literally turning my veins cold as I feel it move up to my neck and into my chest. Cold like metal.
Because it is metal. Gadolinium, number 64 on the periodic table, is the chemical component in contrast dye. While the doctors and nurses remind me frequently to drink lots of water after the test, I know that no matter how much water I drink, traces of gadolinium can remain in my bones, brain, skin, liver, kidneys, and spleen.
The third cost: my future health. How much will yearly, repeated gadolinium injections harm my organs, and is it worth it to keep a breast? “More research is needed” to determine the effects of repeated gadolinium injections on the body. Yet, we pump it through women annually to save their breasts.
As the metal moves through my body, I can feel my arms falling asleep. “Don’t move” is the only rule of the MRI. I’ve already failed one of the tests: the tech told me through the earphones that a scan had to be repeated because I moved.
Not intentionally, mind you. My hands started to twitch spontaneously as they lost feeling. I will them not to twitch. I want to get out of the machine and on with my day.
The monetary cost of a breast MRI? If you are paying out-of-pocket, the average cost is around $1,000. With insurance, it is usually less, around a few hundred dollars, though that will depend on your particular insurance company and your deductible.
The fourth cost: money. I am in my early 40s, and hope to live another 40 years. That means my future MRIs could cost me between $12,000 and $40,000 over my lifetime.
Your doctors don’t tell you any of this when you’re deciding whether or not to keep both breasts. In fact, there’s no discussion of the cost. There’s only the reassurance that you will be left with one healthy breast. One fierce tit.
There are options: MRIs can be done without contrast. Chemicals other than gadolinium can be used. Please share with the Fierce Tit community below the decisions you have made about your annual breast screening.