from somewhere in my imagination

Lumps, Bumps and Feeling Yourself Up

Today is the first of the month.

Do you know what that means?

It means, that if your periods have stopped, it's a good time to do your monthly breast self examination.  If they haven't then the first day after your period is the reccomended time to do it...ideally you want to make it the same day each month because changes will be more noticeable that way...but being a new month it seems like the perfect time to finally share this post with you!

To be honest I am kind of clueless in the area of breast self exam.  I always get my GP to check them out when I have my bi-annual pap smear and feel them regularly myself however I'm not completely sure I'm doing it the right way.  I am pretty proud of my rack so I'd like to look after them thankyou very much!

I had a few questions I felt too embarrased to ask anyone until it occured to me that my sister Sam is actually an expert in the area so I asked her if she would be kind enough to answer a few questions for me here :)

I originally planned this post for new year's day but reality didn't leave it an option and I am proud to finally share her awesome information with you!

Sam is mum to two gorgeous girls and her husband Luke is lucky enough to be my brother in law ;)  Sam is a radiographer with postgraduate qualification in breast ultrasound.  When she's not mumming, wifeing, running or radiographing she's probably sewing something lovely for her business Verri Charmed.

A funny thing about Radiography, is that you often get asked mid procedure “Is this what you do all day?”  I used to feel a little annoyed whenever I was asked as it felt a bit demeaning, like my job was not at all interesting or difficult, after 10 years in this profession I no longer feel that way.  In fact, now that I am primarily a Breast sonographer/ mammographer, I really do understand why I am asked this question with such incredulousness.  But, now I answer with pride, “Yes, yes, I do indeed look at boobs all day long.....”.

How often should we self examine?

Doing a self breast examination once a month is a good start, though while some suggest picking a certain date, like the first of the month, it's actually best to avoid mid menstral cycle.  In other words, do it after your period.  The reason is that your breasts tend to be at their most lumpy and tender just prior to and during your period, which is all completely normal, but it makes it much harder to self examine.

When should we start?

NOW. Trust me when I say that onset of breast cancer in one's 20's was not limited to the beautiful Belinda Emmett.

How do you go about it?

The shower is a good place, considering you are usually already nude (right?). Put your right arm up above your head make your left hand flat and firmly, using circular motions examine the right breast one area at a time (it maybe best to think of it as a clock face, 12 o'clock being the area directly above your nipple) making sure you cover the breast in it's entirity. 

Don't leave out your arm pit, check for lumps up there too. Then switch to the other side.

Boobs are pretty lumpy things anyway, how do you tell the difference between the lumps that are supposed to be there and the ones that aren’t?

I often hear from patients “Oh I don't self examine, I leave it up to the GP, my boobs are so lumpy I can't tell what is what”.  Yep, boobs are lumpy suckers, that is how they are made.  There are two kinds of tissue in the breast glandular tissue, the active stuff that does all the work, it's the tough fibrous stuff, and then we have a nice smooth fatty layer coating over the top.

In some parts of the breast we have more of the glandular stuff than other parts with less fat on top and that's why they feel lumpy.  That's why it's so important to check regularly, it gives you (the owner of the boobs) time to work out which lumps are always there, then if something new crops up, you will recognise it.  GP's are awesome but it's really hard for them to know if something is new for you if they haven't examined you for a year.

What do lumps typically feel like?

This is a hard one, lumps can feel all sorts of different ways.  As you'd expect, in my job I am directed to feel many different lumps, and more often than not I can tell what something is going to be before I start imaging.  BUT, there are times when I'm surprised, and that's what makes it hard.

A benign (non-cancerous lump) is more like to feel smooth and round and be a little mobile with in your breast.  A nasty lump will general feel harder, grittier and will not be mobile.  However, ANY new lump should ALWAYS be checked. It's not silly, it's smart and thorough.

Do lumps have any pain associated with them or are there any external changes to look for?

The most common benign lumps are cysts and they often do have some tenderness associated with them, cancer, however doesn't usually present with any tenderness. At times when cancer is present there can be a slight tethered or dimpled appearance to the skin associated with the region.  Or, if there is nipple involvement the nipple may become inverted (though that can just be a normal occurance too!).

How much does family history play a part?

If you have a family history you should be extra vigilant with your checking. You can even start your mammograms at 35 if you have a young family history.  Unfortuanately I see so many people who have or have had breast cancer that have no family history what so ever, someone always has to be the first.

Should we be checking anywhere else at the same time?

Don't forget those arm pits!!! You are looking for smooth round lumps there..

Anything else that you would like to tell us or any resources you might like to share?

Men are not exempt from breast cancer, they should check too, especially if they have a family history.

Boobs are tricky things and breast cancer can present in so many different ways that checking is just not an exact science, but if you are vigilant, you will have the best chance of catching it early.

WOW!  Thankyou so much Sam for sharing with me.

I hope that you have all gotten as much from this as I have!  As a follow up I have asked Sam to unveil some of the mystery surrounding the mammogram.

Tatum xx

Birth Stories - Summary

The lovely Dr Bron is currently researching birth stories.  After telling my breastfeeding story a couple of weeks ago I have been waiting for a good excuse to share my birth stories.  I have broken them up into

Bron is looking for lots of people to share their birth stories as part of her research.  You can find the information here if you want to share yours.

With four birth stories there is a lot to remember, there are things that they had in common and things that were different.  Here are a few interesting facts about my deliveries.

• None of our children were born in the town we were living in at the time.  I was living in Mt Isa when the first 3 were born but chose to travel to Adelaide to have my babies so that I had my family near by for support.  Having a baby in the town I live in now is not an option.  Pregnant women are expected to leave town four weeks prior to their due date.  I was living here when I had J.
• I had the same Ob for the first three but had to find a new one for J because my doctor was no longer delivering private patients.
• All four were born in the same labour ward in the same hospital, they have four rooms.  I actually requested the same one for J's birth.  I do have my funny superstitious tendencies and in my mind it didn't bode well to change rooms.
• All of my babies were breastfed.  You can read about my breastfeeding journey here.
• If we were to have another baby I would not be induced again.  My body and induction don't neccesarily agree.  It was having such a huge baby second time around that 'scared' me into induction with the next two.
• I wish that I'd had a photographer present at my last delivery.  If I were to have another I'd want a photographer there.  A water birth would be my ideal scenario.
• It was very scary thinking retrospectively that Charlotte's delivery actually would have been much safer if she had been a C-Section delivery than forceps.
• There is definitely no right or wrong way to want to give birth.  Every woman has a different, unique experience.  No two women or two births are the same.

You can read all the birth stories linked up to Bron's blog here.  If you are willing to share yours with her I know that it will be helpful for her research.

Obviously I'm quite happy to talk freely about my birth stories, most mum's I meet are.  Is it something you enjoy talking about or is it something that makes you uncomfortable?

Tatum xx

Birth Stories - Jasmine

The lovely Dr Bron is currently researching birth stories.  After telling my breastfeeding story a couple of weeks ago I have been waiting for a good excuse to share my birth stories.  I have broken them up into

Bron is looking for lots of people to share their birth stories as part of her research.  You can find the information here if you want to share yours.

After my relatively quick labour with Sebastian I warned Steven that if, by some chance, my waters broke spontaneously to call an ambulance because there may not be time if he were to drive me to the hospital.  They didn't.

As a 3 birth veteran, the last having been completed with no pain relief other than gas I was pretty sure that everything would be nice and easy with Jasmine.  I couldn't have been more wrong.  Her birth was definitely the most traumatic for my body and definitely the most irritating.

My doctor, prompted by me, decided to induce at 39w3d.  I checked into hospital for gels the night before for gels around 10pm.  My contractions got pretty intense fairly quickly but then died off again.  I had a restless nights sleep before the doctor arrived in the morning to break my water.

After having my waters broken 3 times previously with the 'knitting needle' my new Ob (my old one wasn't doing private deliveries anymore) used a funny little 'finger condom' with a tiny hook on the end, an invention by a Perth doctor I do believe.  At this point 2 unexpected things happened.

The baby had passed enough meconium to tinge my waters green and I unlike every other time my waters had been broken I didn't start contracting properly.  Because the waters were tinged green I would have to be hooked up to the monitor for the duration of my labour.  Bad news when you were planning on having an active labour and expecting to spend some time in the shower.

I spent some time sitting on the fitball rocking in the hope this would get the contractions moving before they got me hooked up to the monitor. 

After a period of time they administered a centocin drip for the first time.  I'd never had it before because breaking my waters had always done the job.  Then I was pretty much limited to the bed so I didn't get myself in a dreadful tangle between the drip and the monitor, which kept popping off my belly...which for all intents and purposes was gigantic!

Around lunchtime I started to get pretty exhausted, I still wasn't progressing very far or contracting properly.  The centocin was either making my contractions crazy close or not doing much depending on the level.  I asked for an epidural which finally arrived about an hour later.  At this stage I still hadn't dilated much so there was no issue giving me one at this point.

At this point my body went haywire.  The epidural only worked on one side.  My body went into shock and started shaking uncontrollably.  I was crying and screaming and within in minutes I had the overwhelming urge to push.  About 90 seconds later Jasmine was born, with me still shaking.

Second and Third stage labour clocked in at less than 5 minutes combined.  No wonder my body went a little bit crazy.  Initially my doctor thought I wouldn't need stitches, no such luck.

Here's the real kicker.  Because J had passed some meconium they had to suction her ASAP.  My Ob did this once her head was out.  I had to ride out a pushing contraction with only her head out.  Probably the most intense minute of my life.

J was only a touch bigger than Charlotte, weighing in at 7lb13oz and 50cm.  She is our last baby but it doesn't stop me having ideas about how I would want to do things if there was another labour.

Tatum xx