The Mammogram I Have Not Had
Well it's not very festive, I know, but today I'm going to tell you about my mammogram. The one I haven't had, but should have had over a year ago.
In case you don't know, a mammogram is a screening test to detect the early signs of breast cancer. They tell you it won't hurt but may be a bit uncomfortable and then squish your Upper Lady Bits into something resembling a sandwich toaster, left to right, up to down, one side at a time. It's really not very pleasant or indeed very dignified - - but it's a very good idea.
Now then, because my mother was given a drug called Stilboestrol when she was pregnant with me, I am supposed to have annual mammograms as it has increased my risk of breast cancer.
(Don't start me on Stilboestrol - - evil drug, supposed to prevent miscarriages, but actually causing womb deformities in the children, which is why - being a child of a woman who had it - I lost my first baby).
Anyway, in Blighty there's a screening programme where women over 50 have a mammogram every three years. All very well but I'm supposed to have one annually, because of the Evil Drug.
My last mammogram was in November 2009. So early this year, when I had received no summons for another one, I mentioned this to the doctor and asked him to refer me for one.
Then, a few months later, when I realised I still had received no appointment, I assumed that the doctor had forgotten and asked again.
By November this year, I realised it was now two years since my last mammogram. So I rang the surgery and asked the receptionist, very nicely, what was happening about it.
"Oh yes," she said, "the doctor referred you in September. You should have heard by now. I can give you their telephone number so you can chase it up if you wish."
What I wanted to say was, "Look, sunshine, why is that MY job? YOU chase it up." But hey, I could hear the sound of a buck being passed so I took the phone number and rang them.
"Ah yes, your doctor referred you in September, and before that in January," said the woman who answered the phone.
"So why haven't I had an appointment then?" I enquired.
"Well this is a Well Woman breast screening service. We can only screen people every three years. You had a mammogram in November 2009."
"Yes, but because of a drug my mother was given I'm supposed to have a mammogram every year," I replied, with rather excessive politeness. "That's why the doctor referred me."
"Yes, but this is for women who are well. We only screen people every three years."
I suspect a teensy little bit of "NOW LOOK, STUPID!" was creeping into my voice as I replied, "As far as I know I AM well. I am trying to STAY well. In order to do this, I am supposed to have a mammogram every YEAR AND NOT EVERY THREE YEARS."
"Oh, no, we can't do that here. We haven't the funding."
"So," I said with elaborate politeness, "HOW AM I SUPPOSED TO GET MY MAMMOGRAM THEN?"
"Well you'll need to go to Leeds General Infirmary, of course," she said and I could tell she was thinking "Doesn't everyone know that?"
Look, the NHS is wonderful. It's just that there are idiots who work in it, as everywhere. When they received the two referrals from my doctor, wouldn't it have been good if they thought "How odd, when it's not been three years since her last mammogram. Why does he keep referring her? Let us speak to him, using this modern device known as a telephone, and find out."
Mind you, when I had my last mammogram, ALL THAT TIME AGO, the woman who did it wasn't exactly great in the communication skills department.
"So, have you found any lumps, then?" she asked me.
"Oh, no, I haven't found anything, I'm just coming for screening."
"Ahh well," she said, as though to a small child, "just because you haven't found any lumps, that doesn't mean they're not there, you know."
D'you know what, I like to think I'm more knowledgeable about medical matters than most people not trained in healthcare, and I know about people who phrase things carelessly because their communication skills are not very good: and I knew what she meant, which was that the screening test is to detect cancers early before they become large - - AND IT STILL FRIGHTENED THE LIFE OUT OF ME!
I did think about giving her some strongly-worded feeback about the way she'd said this - - but since she was about to clamp my boobs into a sandwich toaster-thingy, I decided to keep quiet.
Back to the doctor. I need to tell him to refer me to a different hospital, and what explanation to give. Really, sometimes you need to put a lot of hard work into being a patient.
In case you don't know, a mammogram is a screening test to detect the early signs of breast cancer. They tell you it won't hurt but may be a bit uncomfortable and then squish your Upper Lady Bits into something resembling a sandwich toaster, left to right, up to down, one side at a time. It's really not very pleasant or indeed very dignified - - but it's a very good idea.
Now then, because my mother was given a drug called Stilboestrol when she was pregnant with me, I am supposed to have annual mammograms as it has increased my risk of breast cancer.
(Don't start me on Stilboestrol - - evil drug, supposed to prevent miscarriages, but actually causing womb deformities in the children, which is why - being a child of a woman who had it - I lost my first baby).
Anyway, in Blighty there's a screening programme where women over 50 have a mammogram every three years. All very well but I'm supposed to have one annually, because of the Evil Drug.
My last mammogram was in November 2009. So early this year, when I had received no summons for another one, I mentioned this to the doctor and asked him to refer me for one.
Then, a few months later, when I realised I still had received no appointment, I assumed that the doctor had forgotten and asked again.
By November this year, I realised it was now two years since my last mammogram. So I rang the surgery and asked the receptionist, very nicely, what was happening about it.
"Oh yes," she said, "the doctor referred you in September. You should have heard by now. I can give you their telephone number so you can chase it up if you wish."
What I wanted to say was, "Look, sunshine, why is that MY job? YOU chase it up." But hey, I could hear the sound of a buck being passed so I took the phone number and rang them.
"Ah yes, your doctor referred you in September, and before that in January," said the woman who answered the phone.
"So why haven't I had an appointment then?" I enquired.
"Well this is a Well Woman breast screening service. We can only screen people every three years. You had a mammogram in November 2009."
"Yes, but because of a drug my mother was given I'm supposed to have a mammogram every year," I replied, with rather excessive politeness. "That's why the doctor referred me."
"Yes, but this is for women who are well. We only screen people every three years."
I suspect a teensy little bit of "NOW LOOK, STUPID!" was creeping into my voice as I replied, "As far as I know I AM well. I am trying to STAY well. In order to do this, I am supposed to have a mammogram every YEAR AND NOT EVERY THREE YEARS."
"Oh, no, we can't do that here. We haven't the funding."
"So," I said with elaborate politeness, "HOW AM I SUPPOSED TO GET MY MAMMOGRAM THEN?"
"Well you'll need to go to Leeds General Infirmary, of course," she said and I could tell she was thinking "Doesn't everyone know that?"
Look, the NHS is wonderful. It's just that there are idiots who work in it, as everywhere. When they received the two referrals from my doctor, wouldn't it have been good if they thought "How odd, when it's not been three years since her last mammogram. Why does he keep referring her? Let us speak to him, using this modern device known as a telephone, and find out."
Mind you, when I had my last mammogram, ALL THAT TIME AGO, the woman who did it wasn't exactly great in the communication skills department.
"So, have you found any lumps, then?" she asked me.
"Oh, no, I haven't found anything, I'm just coming for screening."
"Ahh well," she said, as though to a small child, "just because you haven't found any lumps, that doesn't mean they're not there, you know."
D'you know what, I like to think I'm more knowledgeable about medical matters than most people not trained in healthcare, and I know about people who phrase things carelessly because their communication skills are not very good: and I knew what she meant, which was that the screening test is to detect cancers early before they become large - - AND IT STILL FRIGHTENED THE LIFE OUT OF ME!
I did think about giving her some strongly-worded feeback about the way she'd said this - - but since she was about to clamp my boobs into a sandwich toaster-thingy, I decided to keep quiet.
Back to the doctor. I need to tell him to refer me to a different hospital, and what explanation to give. Really, sometimes you need to put a lot of hard work into being a patient.
posted by Daphne at 8:19 pm
9 Comments:
Having spent years trying to beat some sense into NHS systems, this is exactly the sort of thing I was up against.
The thing that is lacking among NHS staff time and again is any sort of empathy. Never pausing for a moment to think, "What if that was me?"
Your post should be essential reading for your MP, PCT and anyone else who thinks that the NHS is the 'jewel in the crown'.
This is exactly why so many Americans don't like what used to be called "socialized medicine" and is now called "Obamacare"...at least over here people tend to raise a ruckus about inadequate care and stupidity in management until something is changed or they decide for themselves to change doctors. From our perspective, youse guys just seem to think, "Oh, so that's how it is, then" and never make a fuss and just go along with the programme (except for a few brave people like you, Daphne).
With a little more pluck and spunk you would make a great American. Maybe knowing Silverback has had an effect on you.
Nothing to do with the NHS or socialized medicine. Here in Oz we have a good public mammography screening programme (and the same for Pap smears) but the private imaging services can be dreadful. Not 'joined up' and it really is like visiting a mediocre supermarket. It's just a product to them and is very much up to you to make sure they send your X-rays or whatever to the right doctor/clinic. Not to mention the cosy arrangements by which some corporate clinics will only refer you to their partner imaging labs and if you don't want to go to that one then hard luck.
I have had a similar problem, Daphne. I missed one of my (3 yearly) mammograms after moving here because someone had got my address wrong. Did I get an apology from anyone? Did I heck! And having 2 friends recently diagnosed with breast cancer does not make me feel any better about it.
Shooting Parrots - To me, in my work with medical students, it seems that these days they ARE choosing students with much more empathy - and then senior consultants try to remove it from them!! Arrrgh! I agree, it's essential.
Bob - but actually, this had nothing to do with the NHS itself - more to do with the stupidity of individuals, and there are stupid people everywhere!
Michael - you're right, this was all about the lack of "joined up" and people not going the extra yard, never mind the extra mile!
Jennyta - yes, well I hope there's nothing wrong with me either but ohhh boy if there was THEN I'd be making a fuss!
Oh, so that's how it is then...never make a fuss and just go along with the programme.... This is a cartoon of Englishness. The reality is very different. We've got pluck and spunk in truckloads! We invented pluck and spunk! Our NHS is a national treasure and though there might be hiccups in the system, the service that ordinary people receive, irrespective of family income, remains outstanding.
With several more pounds round the middle, a gas guzzling vehicle on the driveway and a biography of that mad woman, Sarah Palin, on the coffee table you would make a great American Daphne.
I'm kind of hoping that the service I'm about to receive will be better than that Daphne. I found a lump in my breast on Sunday, saw my (lovely) GP on Tuesday and have an appointment to be seen in the breast clinic on 3rd January(ie 2 weeks from the referral date)I'd quite like to have it all sorted (and OK of course)by Wednesday 4th January!! I've worked in the NHS for over 40 years and I'm an optimist, so I'll let you know after New Year. Hope you're OK when you finally get there.
Happy Christmas
YP - yes, I agree, the NHS IS a national treasure, and most people who work for it are superb. It's just those few who need retraining or removing!
Christine - I am so sorry to hear this and I do hope it works out well for you. Please do let me know how your appointment goes - I'll be thinking of you.
DES Daughters over age 40 do need annual breast screenings. The highly respected New England Journal of Medicine ran a research article (10-6-2011) about Adverse Impacts of DES, including an increased risk for breast cancer in DES Daughters over age 40. Perhaps waving that among those sorry health care providers you must deal with could help you make your case. http://www.nejm.org/doi/full/10.1056/NEJMoa1013961
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