Navigating the Healthcare System

I’ve often wondered how persons who don’t work in health care—or don’t know persons who work in health care—manage to find their way past the gatekeepers, the schedulers, the delays, the unacceptable answers. Especially when stakes and emotions are high.

I found one, possibly two, breast masses on Friday evening, August 2, 2024, after peeling off a sweat-soaked sports bra. In an attempt at efficiency, I called my clinic’s answering service the next day and asked to speak with the GYN provider on call so I could have mammogram and ultrasound orders placed. Silly, silly me. I was turfed to a triage nurse who told me she would not forward this request to a provider over the weekend. Instead, she would forward my message to the clinic. If I did not get a call back within three business days, I was to go to urgent care.

Having worked with this group of providers at the hospital in the past, I texted my GYN, who happened to be out of the country but nonetheless responded immediately. Yes, I do realize what a privilege this was. She told me to call the clinic on Monday morning and let her know if I had any trouble getting scheduled to be seen.

Why would I have to be SEEN to confirm that I had a 2 cm hard, painless mass in my left breast and possibly another behind it? Didn’t they believe me? Couldn’t we just get the imaging scheduled? On Monday morning, the clinic nurse was kind and explained that things didn’t work like that. I would have to be seen. She then looked at the schedule and said the first opening they had for any provider would be September 6. Imagine my thought bubble filling with hot lava and profanity. I asked her to find me something same day, somewhere, anywhere; eventually she did find a same-day cancellation to schedule me into.

That afternoon I met with a compassionate GYN provider at another clinic who agreed with my assessment and ordered a mammogram and breast ultrasound. Calling to get that scheduled ASAP was another ordeal, but the breast center scheduler found a cancellation in two days’ time. Otherwise, I was told, it could have been several days or even some weeks. This is our healthcare model for urgent concerns? Relying on cancellations?

At the imaging appointment, the radiologist communicated concern at her findings and said I would have to schedule an appointment to come back a different day for biopsies. Yet another meltdown occurred in my brain. I probably had cancer. Didn’t anyone CARE? I asked the tech if she could find a same-day opening, anywhere, at any time, at any other breast center in the Twin Cities metro area. She returned to the room minutes later and asked if I could come back in two and a half hours for biopsies. I replied, “To the persons who gave up part of their lunch break for this to happen, I am very grateful. I’ll be back.”

Biopsies were collected from two masses. The shallower of the two measured 1.9 cm. The deeper one behind it was a little smaller. Biopsy results came back the next morning, Thursday, August 8, with the diagnosis of invasive ductal carcinoma. The following morning the hormone receptor testing returned: my tumors were not fueled by either estrogen or progesterone, but a 3+ amount (out of 3) of human epidermal growth factor 2, a protein called HER2.