Incentives

There are things that I enjoy doing very much. Some of these things include reading, spending time with my family, watching TV, taking photographs, writing, making collages, hiking and socializing.

Then there are things that I don't really like and would rather not do. Some of these things, like swimming when it is below 95 degrees, zip-lining, watching the World Cup  and skiing, are things that can be easily avoided.   

Then there are things that I don't  like, but really should do them for my own good. One of these things is having a mammogram. Another one is having a Colonoscopy. 

We don't have much control over who gets cancer and who doesn't. I hope I  don't get cancer. However, the next best scenario to not getting cancer at all is to catch the cancer while it still very treatable. That is why I have these tests. 

The other reason I have the tests is because if I didn't, the doctor would talk to me about them too often. 

I have a great doctor. I don't want to use his real name, so I am going to refer to him as Dr. Isaac Moscowitz. He shares an office with his twin brother, who I will call Dr. Nathan Moscowitz. The twin brother is  a pulmonalogist. The part about the identical twin doctors is true. You really can't make this stuff up.

I could see the writing on the wall. I'd be going to Dr. Moskowitz with a sore throat and he'd be asking me about the colonoscopy. The man can be very persistent.  I don't want to talk with Dr. Moskowitz about my colon when I am there for a sore throat. So I just went ahead and made the appointment. I've already had the colonoscopy.

When it comes to mammograms, I'm more used to that. I've been going for the last 10 years. I used to get really worked up before going. I'm better about it now.

There are many reasons I am more relaxed about mammograms than I used to be. One of my coping mechanisms has to do with my deliberately working out a  system of incentives attached to going to the mammogram place.

There are incentives I have implemented for  before and during the mammogram, then additional incentives for after the mammogram. In addition to incentives that I've established on my own behalf, I've also discovered that there are certain rewards attached to the actual mammogram facility that I enjoy, but did not initiate.

Here is a typical mammogram experience.

I wake up in the morning, and I do my usual things except that I don't put on any deodorant, because the mammogram place doesn't want you to do that. I pack my deodorant for later.

Then I take the subway and then the bus to the mammogram place. That's where the first incentive kicks in. I am not allowed to do anything useful, like respond to email, make lists, work on Noah's IEP or research enrichments for the kids. I get to just read. I read whatever I want. 

I might read books or magazines, as long as they are not about ADHD, Autism , the NYC public school system, launching a career or attempting to renovate a small apartment. In other words, I get to luxuriate in totally useless, pleasurable reading. If I want to spend a long time on Facebook, I do it. 

I also love going into a special email folder called Blogs to Read which is exactly what it sounds like. The last time I had a mammogram, I read  what Gwyneth Paltrow wrote about Conscious Uncoupling. I read that I my iPad on the way there, then while I was in the mammogram room waiting for the radiologist, I read about Gwyneth Paltrow's uncoupling some more in a People Magazine they had in there.

Which brings me to the mammogram place itself. I always plan my mammograms for when my children are in school. One of the best things about the mammogram place is the lack of children. I've discovered that I can really get some solid peace and quiet in there. 

The lighting in the waiting room is dim and calming. They have some really good magazines there as long as I avoid any medical literature. The people are really nice.

By the time I'm actually having the mammogram, I'm reminding myself of the incentives I've planned for after the testing. That is because I am either contorting myself to get my breasts inside the machine, or waiting for the technician to talk with the radiologist and for the radiologist to ask her to do more views. The first couple of times this happened, I almost had a heart attack but now I'm used to it. The radiologist is just very thorough. More on that later.

Usually what happens is once the radiologist has enough views, I sit and wait for a bit, then Dr. Greenburg comes in to say that everything looks great. He always looks very cheerfuI while he is sharing the news that I don't have cancer. I  think it's very nice that he cares one way or the other.

His enthusiasm is contagious and It is with a sense of celebration that  I get dressed, put on deodorant. and then go to Shake Shack for lunch. Shake Shack for lunch is my reward for having gone to the mammogram place, contorted myself, traveled about with no deodorant on, had multiple views and then waited for Dr. Greenburg without freaking out.

I order whatever I want at Shake Shack without regard to any dietary guidelines or health implications .

There are situations involving the mammogram place that call for additional incentives.

About a year ago, I went to the mammogram place and the technician did many views at the request of the radiologist. Then instead of the usual routine they asked me to go into a separate smaller room. Dr. Greenburg came in and explained that there was an area that he was concerned about. He wanted to get an ultrasound of the area. 

I asked him a couple of questions. Did it look like cancer? He said that he wasn't yet sure what to make of it. Was the area in question big or small? He said that the area in question was very tiny. Okay, good, I said. It isn't some out of control, enormous, wildly metastatic cancer. 

He felt that my assessment of the situation was accurate. He also facilitated an immediate ultrasound. 

The people working there are always nice. But once they think there might be something wrong with you, then they are extra nice. They kept on checking on me while I was waiting for the ultrasound room to free up. They also said complimentary things about me to one another in hushed voices. One of them used the words chatty and cheerful.

While I was waiting, I thought a little bit about the possibility of cancer. I felt surprisingly calm about it. My hunch was telling me that I didn't have cancer. I figured that even if I did, it was a very tiny cancer. I'm always a glass half full person. I was thinking that a tiny cancer was better than a larger, more challenging cancerous area.

I was aware of becoming bored waiting around. I then noted how much my medically triggered PTSD has improved, after some self congratulation, I took out my iPod and began reading some enjoyable blogs. 

I did not google tiny breast cancer lesions. 

What I did do was read about some hipster urban homesteaders. I read about someone's mom crush. I posted some photos that I took on the way to the mammogram place to Facebook. I did not post to Facebook about waiting for the ultrasound room to free up because I wasn't looking for that kind of attention.

The ultrasound technician was really nice. I decided  to watch everything she was doing on the  big screen. She took pictures of the tiny areas after blowing them up to enormous proportions on the monitor.  I checked in with her to make sure that this did not represent the actual size. We shared a laugh over that. There is nothing I like better than an ultrasound technician with a sense of humor.

I also shared my medical opinion with her. Those look like cysts I said. I was basing this on the fact that they were very round and regular looking. There were no jagged edges. 

The technician concurred with my medical opinion. After some more explaining and reassuring about cysts, I got dressed and waited for Dr. Greenburg. The ultrasound experience reminded me of the time that I watched Dr. Oz get a colonoscopy on TV. Dr. Oz decided to forgo the anesthesia so he could watch and narrate the entire thing. He never stopped talking during the procedure.

The next thing I know, I'm looking at scans of my cysts with Dr. Greenburg. These are very common at your age, he said. I'm not worried about this at all, but I still want to follow you very closely. Because of my OCD I'm always extra careful he said smiling.

I couldn't tell if he was revealing that he has OCD or was joking and exaggerating like people do. Whether he has OCD or not doesn't matter. Let's just say that he's detail oriented. Even on a good day, he takes multiple views. If you are going to have OCD or be detail oriented, radiology is a good field for you. I also hear that the hours are good.

He gave me some paperwork to take home and wrote the words not cancer and underlined them.

I made my appointment for four months later and went to Shake Shack, where I ordered a delectable combination of food and drinks in giddy disregard for sugar and fat content.

After Shake Shack, I decided that this mammogram experience while not horrible was deserving of a little extra in terms of rewards. And that little extra was a trip to Sephora. I gave myself some pleasant browsing time. Then I settled on a tinted lip balm from Fresh. The color is called Rosè and it's become a favorite of mine. I also used my VIP points to get some samples. 

So now, I have a multi-tiered incentive plan for when I go to the mammogram place. Any procedure other than a basic mammogram calls for a trip to Sephora for one makeup item plus samples. That is in addition to the basic incentive package of reading whatever I want, and lunch at Shake Shack.

So because I needed ultrasounds the next two times I went to monitor the cysts, I now have a lovely new blue eye shadow and some anti aging skin care samples.

If anything truly ambiguous happens at the mammogram place, then there's going to have to be more compensation. Like I've said before, I'll cross that bridge when I come to it.