I called the endocrinologist in charge of my case this morning. Let’s call him Dr. Endo. Things took a turn for the worse over the weekend, and I wanted to find out how soon he can see me, give me my final test results and refer me to the breast clinic for surgery. Incidentally, I see a pattern here. I can count on this granulomatous mastitis to start acting up on Friday night and proceed to full-blown tantrums by Saturday and Sunday. I get it, GM. You’re here. You’ve hijacked my life. I’m counting the days until I can cut you out of my life. Dr. Endo’s receptionist promised she would have him call me today. It’s 17:30, and still no phone call.
Fortunately, I had a plan B and a plan C. John called the breast clinic for me because I was crying too hard. They told him they cannot see me again without a referral from either internal medicine or my GP, because my case is out of their hands at the moment. I got angry enough to stop crying and called my GP, who agreed to see me at 15:00. I emailed him prior to consultation:
- “Dear GP: I have an appointment with you at 15:10 today. I am doing much worse. The pain in my breast is worse, there is more swelling and redness. I now have a hard and painful lymph node in my left axilla. The diagnosis is confirmed as granulomatous mastitis. My CT scan from 12-02-13 also showed some small suspect masses in the liver, uterus and ovary. Dr. Endo suggests long-term medical treatment, but I cannot handle that. I want surgery as soon as possible, and wish to deal with this quickly. I want to know if I can have a localized steroid injection at the inflammation site, or perhaps intravenous steroids. The surgeon in the breast clinic is willing to do a mastectomy once the inflammation is somewhat reduced. I am in unbearable pain, and I am very scared and worried. This is affecting my life in every way, and I just want this to be over so I can get my life back. I hope you can give me a new referral to the breast clinic. Jeg orker ikke en langvarigt medicinsk behandling.” (Translation: I cannot cope with and cannot be bothered with a long-term medical-pharmaceutical treatment.)
My GP confirmed that my boob looks worse, and he could clearly see the swollen lymph node in my armpit. It looks like I have a bean in there. He agreed to give me an intramuscular injection of prednisolone. Yay! A steroid shot! (Remind me not to go to the gym anytime soon.) I had this idea that he could inject steroids directly into my boob, but he said the deltoid muscle, just below my left shoulder, was as close to my boob as he was willing to inject. He reassured me that this one-time shot would not cause such bad side effects as taking the pills. He also showed me my latest blood test results: all normal, except for a slightly elevated marker for inflammation and very low hemoglobin levels. What a surprise! Every blood test I take shows worsening anemia. I cannot take my iron pills. I haven’t taken them since this started because my stomach is a mess. At the rate I’m going, I may just ask for an iron injection when I see my GP again on Thursday. He wants to see if the steroid shot has any effect, and then he will refer me back to the breast clinic for surgery. He knows me. He knows my history. He’s been treating me for the past four and a half years. He knows that long-term medical treatment with prednisolone and methotrexate is all sorts of wrong for me. He knows I’ll do better getting a mastectomy. He also said that he doubts the other findings on the CT are related to my boob. They are probably nothing serious, and we shouldn’t worry about them at the moment. So, I’m going to stop worrying about them. I can’t feel anything from them, and come on! How much can go wrong with me at one time? Seriously!
I asked my GP if having been recently injected with prednisolone and being anemic could have a negative effect when I undergo my surgical intervention. Actually, I mixed up my Danish vocabulary and asked him: “Kan det påvirke mig når jeg får mit kirurgisk angreb?” He smiled and told me that he liked my word choice, as it is very fitting and a bit poetic in this situation. And, no, there should be no negative effect. Wait a minute! “Angreb” means attack. “Indgreb” means intervention. Doh! (Slap forehead and groan.) They sound almost the same. It turns out I asked whether these conditions could have a negative effect when I undergo a surgical attack! I still amaze myself with my ability to make unintentionally amusing mistakes in Danish. So, yes. This is a surgical attack I am going in for, not just a surgical intervention.