I have breast cancer. Well,
maybe. Maybe not. Actually, I have no idea whether the lump in my breast has grown, become cancerous or remained the same size it was at my last mammogram, seven months ago. That's because I am a Veteran of the United States Navy and my primary medical care is provided through the Women's Clinic at the Veteran's Hospital in Des Moines, Iowa.
As a female veteran, I have NOT had the experience of many male veterans, who were shuffled around, forgotten and mismanaged by the VA Health System.
As only 0.2% of the population of the United States, the VA Women's Clinic has consistently provided me excellent service, simply because there aren't enough of us to mix-up or forget. Now I realize that the quality of my care is primarily because I have been reasonably healthy these many years of service. Barring a hiccup here or there, my VA profile has consisted of annual exams only. Until seven months ago.
One of the problems with having so few female veterans is that the VA is often ill equipped to serve female-centric needs. When I turned 40 the Women's Clinic began referring me to Mercy Medical Center for mammography services because the VA Hospital did not have the equipment to provide these necessary screenings. On November 12, 2014, Mercy found a troubling lump in my left breast. Six days later, on November 18, 2014, Mercy had me back in for a more intense screening to take a closer look at the lump. Those appointments were some of the most stressful and uncomfortable wake-up calls of my life. What was just a little smudge on the mammogram at my November 2013 screening was now a noticeable, sizable dark spot on the film.
It scared the shit out of me. So when the doctor told me that she didn't think it was cancerous, but wanted to follow up in six months to see if the lump had grown, I promptly put a reminder into my Google Calendar to ensure that I didn't forget to schedule an appointment. To be perfectly honest though, I didn't imagine that I would need to remember to make the appointment, since I generally receive a call or post card to remind me of upcoming annual exams.
When April 6, 2015 rolled around and I had yet to hear from the VA to schedule my follow up exam, my calendar sent me a reminder and I proactively contacted them through their new, "Secure Messaging Service" to make an appointment. They had no idea about what I was talking. Instead, they instructed me that I didn't need another exam until my annual in November. After some back and forth regarding what I thought they should have already known, they scheduled me for a follow-up with their newly acquired mammography exam department at the VA hospital. *Ugh* I thought. This is a brand new machine with brand new techs who have very little training. I wasn't thrilled to be their guinea pig but I had never had a bad experience with my service to that point, so it only made sense for me to trust that they would be properly trained by the June 8th appointment date.
Women with young children face a special kind of challenge when we make doctor appointments. Since the VA could not get me in until after the school year ended, I had to bring my 6 and 7 year old daughters with me.
The inconvenience is not to be understated because this was just not an experience that I necessarily wanted to share with my young daughters. My mind raced. What if the lump had grown over the past seven months? Would I be able to compose myself in front of the girls? Would they even understand the meaning of a cancer scare? Would this stick in their brains for the rest of their lives as the beginning of the end of my life? Seriously, the tiny detail of the VA not being able to schedule me before the month of May ended was actually a huge additional stress. But, whatever. We roll with the punches. Me, Ireland and Piper arrived at the packed hospital at 8:00 AM on Monday morning and were directed to the new mammography waiting area.
The grueling question and answer session regarding every female in my immediate and extended family took no less than 45 minutes. The tech was in the process of training a young lady who was obviously slated to take over the process once she received enough instruction. After providing the medical history of pretty much everyone I'd ever known, the tech provided one of those high fashion backward mammogram gowns and my girls went to the waiting room while I prepared for the exam. It was not until I was standing, boob hanging out by the machine, that the tech asked if I had ever received a mammogram. This is where I really started to wonder if the VA's right hand knew what the left hand was doing. "Uh, yeah. This is a six month follow-up because of the lump that Mercy found in November." I told her. A quizzical look overcame her face as she stopped in her tracks, looked at her trainee and said, "OH! Uhm, I'm not sure we can even do anything for you today." She and the trainee then left the room and sent my girls back into the exam area with me, while we waited for what was OBVIOUSLY the first time they had even bothered to look into my history. Upon their return, they apologized for the inconvenience and stated simply that I would have to go back to Mercy because they just don't have the expertise on staff to properly assess any results. Honestly, I wasn't too terribly disappointed. Mercy boasts a highly qualified staff and amazing equipment. They do boob squishes all the time. I also figured that by the time they would get me in, the girls would be in their summer school program and I would not have to take them with me again.
That's where the story gets interesting. Mercy called me on June 11th. I missed their call. So they called me again today to schedule me for my follow-up exam, as requested by my VA provider. We scheduled the follow-up for Tuesday, June 23rd at 8:30 AM, right after I drop the girls to summer school. Not ten minutes after I hung up from the Mercy nurse, the VA called me to inform me that they were cancelling the Mercy appointment. The admin from the VA proceeded to tell me that I'm not allowed to go to Mercy without some sort of a third party referral, as required by a new Congressional order. I almost started to cry. Seriously. I'm generally pretty cool, calm and collected but when I began to tell the administrative assistant from the VA that they have been giving me the run around, my voice began cracking and I started to lose my patience. That is when she told me,
"Well, we've been telling our patients that if they don't like it, they should call Congress because ..." I'm not sure how that sentence ended because my head popped off my shoulders and I was in the process of picking it up as she finished whatever the Hell she was trying to convey. That's when I lost my temper and asked, "Are you serious? You want me to call my Congressmember to let him know that you are incompetent? I think congress is already aware that you're incompetent ~ that's why they passed legislation that allows Veterans to seek treatment outside the system." The admin was obviously taken back by my instant frustration and anger and stated again that they weren't to blame, Congress was entirely at fault that I would not be getting this follow up exam in a timely manner.
So this is where we are today. I imagine that the VA canceled the appointment at Mercy - you know, the one that they referred me to in the first place. I don't know what this new "process" of a third party referral entails. I can only guess that some pencil pushing contractor has to review my record (the one that the VA doesn't seem to look at very often), then decide whether I am entitled to a follow up, then call Mercy back to make an appointment? Maybe. I don't know. All I know is that I continue to wait for this follow-up that is now a month over due. All I know is that ever since Mercy pointed out the location and size of the lump seven months ago, I have obsessed with keeping track of the size and firmness through self exams. All I know is that
I am not the exception to the rule, this is the status-quo about which I have heard so much.
Do I have breast cancer? I don't know. What I do know is that since I am a Veteran, I have really, really shitty healthcare.
The Democrats on the other hand - MAN - we know how to throw down! Instead of making an argument for a Presidential Candidate, as would have been the case in a real caucus, five representatives from our party took the podium and made passionate speeches on these topics: Healthcare, Jobs, Education, Gun Control and Civil Rights. Rather than asking for a lame ballot written with the name of the candidate (in this case, issue) which you support, you are instead asked to get off your bootie and stand next to the speaker who appealed most to you. Your group must have a high enough percentage of the votes to pass the "viability" challenge. If you do not have enough votes, you must choose another campaign and move your bootie that way. Other campaigns may come to you and ask you to switch sides, which makes for a fun, healthy debate. It's all lively and motivating and most important, EXCITING! The only thing we were missing from this party was beer and cheese. Otherwise, it was the perfect social gathering of amazing thinkers ... well, at least the Democratic Caucus was, anyway. 
