Anyone who looks at me knows I have two eyes, a nose, a mouth, two ears, hair, arms, legs, everything. Few know that in the recesses of my right breast tissue grows a painful, benign tumor known as a fibroadenoma. They also don’t know that I’m barely covered under a less-than-worthy insurance company.
I can’t even pronounce the damn word “fibroadenoma.” I’ll never know if it’s fi-bro-ad-en-oma or fi-bro-den-oma. No one seems to agree on a pronunciation. No one seems to agree whether or not I should have surgery to remove it.
A whole year went by before I told anyone about it, and then I didn’t even know what it was. It flared up each month before I got my period, and as the last of the blood drained out of me, it seemed the lump, too, drained out. I figured it was a cyst.
At seventeen, the age I was when I discovered the growth as I rubbed my tender, PMS-sore breasts, I was not ready to deal with its actuality. I wanted to be sure that something was wrong because whenever the idea of a lump in the breast came up on WebMD or in health class at school, doctors and teachers always reminded us that “the breasts are naturally lumpy.” It would be far too embarrassing to cry wolf, so I waited.
Four years prior, when my sister, too, was seventeen, she grew a breast tumor that had to be surgically removed. I remember my mom telling me that when the surgeons removed it, the tumor was two inches in diameter. My own growth wasn’t nearly that size, more like a little pea that rocked side-to-side as I pressed my finger into it. I imagined it in there, attached to nothing, firm like it had just come from the freezer, perhaps dimpled and green.
So for the next year, I followed its progression—growing before the red gates opened, shrinking once the red gates closed. But now in college with a serious boyfriend who touched it at its most tender point, where the pain beat into me like a fresh bruise, there was no more hiding. He forced me to see a doctor and that’s when it all began.
The doctors. The tests. The inability to reach a decisive conclusion. Three different doctors have said three different things, a firm diagnosis of the growth as a fibroadenoma the only thing agreed upon and that was diagnosed after an ultrasound in ‘04. This is the ultrasound my mother forced the doctor to refer me for when doctor #1 saw “no need for concern.” Doctor #1 said it would go away, that this happens in teenage girls but it’s nothing worth looking into. Doctor #1 was a condescending bitch.
After leaving the MRI center with my mom a few weeks later, we checked out my sheet which looked something like this:
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Patient Name: Elena Beth Pushaw DOB: 06/15/85 Insurance Carrier: Guardian HealthNet Diagnosis: Fibroadenoma
_____ Benign. No risk for malignancy __X__ Benign. Medium risk for malignancy. Follow-up in 6 months _____ Benign. High risk for malignancy. Schedule biopsy _____ Malignant. Referral necessary
Bergen Open MRI & Diagnostics 1 W Ridgewood Ave Paramus NJ 07652 (201) 652-1213 |
“Medium risk” meant I wasn’t in the clear but six months later I would be back at college and in order to go to my follow-up, I’d have to lie to my new friends about where I was going. When the time rolled around, I avoided scheduling the appointment. The growth was again fluctuating with my menstrual cycle and I didn’t want to make a big deal out of nothing, not to my new friends, not in front of the doctors. So, when my mom didn’t bring it up and the office didn’t call to remind me I was due in, I kept my lips sealed.
Today the lump’s size doesn’t fluctuate. It doesn’t just hurt when I press on it, but sends surges into my breast that produces an embarrassingly noticeable shudder. Some days the pressure of a sports bra is too much and other days I can’t wear an underwire bra because the end of it prods the exact spot where my fibroadenoma thrives.
But I don’t call it my fibroadenoma. Depending on who I’m talking to, it will have different names. If you are a distant friend or doctor, it’s a growth. If you are my boyfriend, it’s my spot. If you are a close friend or family member, it’s the little guy in my boob. That name started after a visit to doctor #2: male, old, uptight. I had tried scheduling my annual visit at doctor #1’s office only to find out they stopped accepting my insurance a few months before. So, off I went to my second doctor in two years who turned out to be a strange, grown man, eager to prod my nineteen-year-old vagina with gloves and a cold metal spreader. Before I knew it, the words “I have a little guy in my boob” splattered all over the awkward space that loitered between us. His response: Little guys shouldn’t be living in there, huh? Embarrassing.
But nothing has been more embarrassing than realizing that I don’t have the insurance necessary to deal with this problem. I had always associated low-income minorities as being the people who have poor health insurance and now I was becoming one of them. I moved from north to south Jersey just a year ago and found a wonderful OBGYN practice that accepts my shitty insurance. It happens to be the only practice within almost fifty miles that accepts Guardian HealthNet and it happens to be two blocks from my apartment. At my first visit, doctor #3 was a total angel. Unlike the others, she talked to me like an adult and eased my nerves before I could blurt out something as embarrassing as “the little guy in my boob.” She talked to me about different patients she has seen that have dealt successfully with fibroadenomas: one has decided to live with it, another had surgery to remove it and nothing has grown back. I felt comfortable enough to tell her that I hadn’t gone to my six-month follow-up ultrasound, so she wrote me a prescription for one and recommended Atlantic Medical Imaging (AMI) just down the street.
The next day, I decided I’d make the call. A friendly woman answered the phone and I made my appointment, answering “no” that I’d never been there before and “yes” I know where they are located. At the end of the call, she asked what type of insurance I have and I said Guardian HealthNet. “I’m sorry,” she said. “We don’t accept that.”
For the first time, I began to understand what the movie Sicko was really about. What’s the point of having insurance if insurance isn’t going to cover my ultrasound? She told me to try calling Doshi Diagnostic, but not before scolding me for not telling her my insurance carrier at the beginning of our conversation. I was drained after making that call that turned out sour after I’d pushed it off for three years, so I waited a few days before calling Doshi.
At the beginning of this call, I told them my insurance carrier and that AMI recommended I try here. “I’m sorry,” she said. “We don’t accept your insurance.” I asked if I could come and pay out of pocket, but she told me “that’s probably not a very good idea.” I hung up and cried. As my chest heaved, my little guy shot pain into me, like he was yelling at me for not taking care of him sooner, or like he, too, was outraged at the fact that I can’t have a medium risk tumor checked for malignancy.
Slowly but surely, New Jersey is weeding out Guardian HealthNet and my dad’s boss refuses to switch his employees over to a better coverage plan because that would mean less profit for his greedy penny-pinching ass. This has been going on for years. We pay vision out-of-pocket. We pay dental out-of-pocket. It’s amazing that Starbucks and McDonalds have greater coverage than Micro Powders, Inc.
I push off making the call to the original MRI place that I went to four years ago. I’m terrified that they no longer accept my insurance and then I’ll really be up shit creek. Odds are that they do still accept Guardian HealthNet and that my ultrasound for a tumor that has tripled in size will only cost twenty-five dollars, but at this point I’m so over-the-top sick of hearing the rejections that I’d rather not know.
But what if the U.S. had a universal healthcare system? It’s what has driven my republican upbringing to the dreaded, ‘evil’ other side, the land of democracy where wives allow their husbands to cheat on them and where we’d rather be attacked on our own soil than kill terrorists overseas. All I know is that with the insurance I have now under the healthcare system we have in place, I have a potentially large problem on my hands. I might have to decide whether to shell out thousands of dollars to remove a tumor or to keep the painful, potentially life-threatening thing in me so as not to taint my clean slate with the insurance company if something more serious were to occur later in life.
If the 2008 Presidential Election was to be held tomorrow, I would vote for the democratic nominee, whether it is Hillary Clinton or Barack Obama, just so that I can have a better insurance plan. Or maybe I would accept a marriage proposal just for the insurance benefit; a crummy job for the same reason. I thank the little guy in my boob for pushing me to learn more about our nation’s healthcare system. And I thank him for making for making me feel like a complete ass. If I ever rid him from my breast, I will miss rolling him around, feeling him grow.
RIP, little guy.
Fuck you, insurance industry.
