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I turned 40 this year but I feel healthier and more youthful than I ever I have. With every bit of my being I am trying to live like “40 is the new 20!” (FITNT) I have more cardiovascular endurance. I am taller and leaner (and I just logged in at another 5lbs lighter at my last physical). I no longer wake up with back pain every day. I have better hair (most of which is still not grey). But you know what? My boobs don’t care if FITNT.

So I finally got around to my annual physical. It’s not like I didn’t know what was coming up but I guess I was just in a bit of denial. Also, I basically suck at my own healthcare and have long put off my own health-related action items.

But, according to the American Cancer Society “Current evidence supporting mammograms is even stronger than in the past. In particular, recent evidence has confirmed that mammograms offer substantial benefit for women in their 40s. Women can feel confident about the benefits associated with regular mammograms for finding cancer early. However, mammograms also have limitations. A mammogram can miss some cancers, and it may lead to follow up of findings that are not cancer.” And, I have known several friends or colleagues whose first screening mammogram has resulted in an early detection and subsequent cure for breast cancer.

Yup, it was time for these aging breasts to have their first mammogram (luckily I am not in a high risk category). And how it went down has shown me that I might not actually be fully capable of living like FITNT.

1) I call the healthcare system that my PCP is in to book the appointment. I am required to restate every pertinent demographic detail and insurance information that quite obviously should be on file.  Argh the frustation! Since I work in the healthcare system, the scheduler and I bond over the fact that none of our EMRs talk to one another thus creating reams and reams of more ‘paperwork’ for all of us. Perhaps if I were still twenty (and the work was still on actual paper) I would be less frustrated by the inefficiencies that plague my work days. But this middle aged patient just didn’t have the patience for this.

2) Mammogram day. I have to wear a pink gown (pictured). I suppose this should not matter and I get that the color has been adopted by the breast cancer foundations as a way to raise awareness. But we (me and the other patients all lined up in pink gowns) are there to make sure we don’t have early cancers, or see if a suspicious finding may be cancer, or  find out if a past cancer has come back so I would argue that we are not the target raising awareness demographic. So why not just choose a standard hospital issued seafoam green or ocean blue instead of boxing me into a “cancer” frame of mind when I am really hoping that my m? Also, baby girl pink is just not a good color on any grown woman. Twenty year old maybe, but screening mammogram age, no way! Why am I smiling in this picture!?! 

3) Speaking of grown women, I wonder if the mammography techs have a pre-written speech because I had to go twice (the second time to more closely study an abnormal finding that turned out not suspicious) and each time I was asked “What do you do?” And each time, when I responded that “I am a trauma surgeon.” I was asked “Do you like it?” Again, I am a grown woman. You know this because I have told you I am here for my screening mammogram which typically starts at age 40. I am not a twenty year old who just declared her college major which I may or may not like.

4) Oh and about inefficiencies in the healthcare system. I went back for repeat imaging for that abnormal finding <1 business day (and <72 hours of the earth’s rotational time) after the original mammogram. On mammogram day 1, I detailed my menstrual history, my birthing history, my breast health history yet when I returned on mammogram day 2, I was required to re-do all of this. At age twenty I might have just politely complied with this line of repeat inquiry but my forty year old self (especially after the booking annoyance) just didn’t have the fortitude to go through it. I insisted that I had not birthed any additional children or undergone any emergency breast surgeries over the weekend; the rest they would just have to look up.

5) ‘But how was it?’ you’re wondering if you too are about to realize that your boobs
don’t care if FITNT. I had the standard 2-view mammogram on day 1. Honestly, though the device looks a bit like Eve from Wall-E to me and the plastic pallet clamping the breast tissue seems decidely more violent than any rated-G movie, the test did not drop me to my knees begging for mercy. Is having your breasts squashed with god knows how many PSI like getting a massage? Umm no. But it was not nearly as violent an experience as I was prepared for. But owee, wowee the extra views needed to rule out that funny finding on for the second mammogram…yeah that took my breath away. I suppose if I still had the dense, perky boobs of a twenty year old, unravaged by the effects many months of breast feeding and the effects of aging, this may have been more comfortable. However, barring very specific high risk factors, those youthful boobs would not need a mammogram.

Sadly, my aging boobs did; and this whole experience has reminded there are still many ways in which I am decidedly not reacting like FITNT. It seems that with twenty additional years of life, my patience has sagged as much as my breasts have.