It’s Mets Monday again, and I want to talk about something that impacts young metsters in particular: pregnancy tests. For me, it’s one of the most dehumanizing parts of mester life. Here’s how it played out for me last week.
I developed a cold last week, which doesn’t sound like a huge deal, but when you’re having chemo, spiking a fever means a hospital admission. Ain’t nobody want that, so my oncologist said “No chemo this week, we’ll start the cycle next week instead. How about a PET scan while we wait?” I was like, “Perfect, let’s do it.” We were going to do one after this cycle, but, given the opportunity and a good insurance plan that covers regular scans, bumping it up a month makes sense. My oncologist put in the referral for the scan, and they scheduled it for Thursday morning.
On Wednesday, I got a call from the radiology clinic where the scan would take place, and the scheduler on the phone confirmed the appointment, and asked if I needed her to go over the instructions for prepping for the scan. I told her I’d had several already so I knew what to do–nothing to eat after midnight, last meal low in carbs. She said that’s right, and then said, “And because you’re under 50, we need you to do a pregnancy test up at the hospital before you come for your appointment.”
Now, this isn’t the first time I’ve had to have a pregnancy test before a PET scan. PET scans involve radioactive isotopes and that shit is bad for a fetus. But, since I’ve been in menopause for over a year now from the treatments for my terminal cancer, the last scan they’d said I didn’t need a pregnancy test. Because they used logic. So, I told the scheduler this, and she said, “Well, it’s protocol, but I’ll ask the radiologist if it’s necessary and call you back.” Which she did, with the news that I would have to take the pregnancy test.
I get it, modern medicine: you worry about me suing you if it turns out I was pregnant and the baby has a birth defect. On behalf of the legal profession, I apologize that we’ve driven you to behave in ways that are not even remotely about taking care of your patients, and are solely about covering your butts. Because that’s exactly what you’re doing when you ask a woman who has lost her fertility to cancer treatments to submit to a pregnancy test. That’s not about protecting her, because it’s actually causing her emotional harm.
I didn’t want any additional kids by the time I found out I had cancer–two was my limit, and The Hubs got snipped like five minutes after The Girl was born. But that doesn’t mean it’s not still traumatizing to be menopausal at age 38 from the cancer treatments that are only going to extend, but not save, my life. To then be required to not only be reminded of what cancer has taken from me, but to submit to testing to prove that cancer has indeed taken it from me, in order to get the testing I need to stay alive? That’s incredibly insensitive. Actually, the word I want to use is cruel. It’s cruel to do this to women.
On top of that, there’s the obvious paternalism involved in forcing women to take unnecessary medical tests “for their own protection.” What’s happening in my situation is that this radiology protocol says that I, a woman who hasn’t had a period in 14 months, whose husband has had a vasectomy, and who is actively undergoing chemotherapy, am unable to be trusted when I say “No, there is no chance I’m pregnant.” They know better than us dumb women about our bodies. Just trust us, ladies, we’re only trying to protect you.
Well, fuck you. No, I won’t pee in your cup. I refuse.
I emailed my oncologist and the clinic manager for his office explaining what was going on, and how upset I was about it. I told them that I knew this wasn’t their fault, as the radiology practice isn’t part of the cancer center, but that I hoped they’d pass on my concerns to the radiology practice. He and the clinic manager both wrote back and promised to try to help me out.
A few hours later, after 5PM, I got a phone call from the radiology clinic, this time from a different scheduler. She asked if I’d gotten instructions for tomorrow’s appointment, and I said yes, and she said, “And you know you need a pregnancy test first, right?” This is when I had had enough. Hearing I had to have a pregnancy test for the third time that day was more than I could take. So, I said that I didn’t think I should have to take one given that I’m in menopause and receiving chemotherapy, and my husband has had a vasectomy. She trotted out the “It’s protocol” line and that’s when I snapped. I started crying, and I told her that I think it’s incredibly insensitive to tell a terminally ill woman whose fertility has been taken from her by cancer treatments that she has to take a pregnancy test in order to get the medical tests that guide those treatments.
There was a long pause on the other end of the phone and she apologized, and said they certainly didn’t mean to come off as insensitive. She explained that her supervisor wasn’t there, and she was worried if I didn’t get the test done, that they’d refuse to do my scan when I got there the next day. I explained that the last time I’d been there for a scan, they hadn’t required a pregnancy test, given that I’m in menopause from treatment. And she said, “OK, then, don’t worry about taking the test, I’ll put a note on the file.”
The next day when I got there for the PET scan, nobody at the front desk mentioned the pregnancy test. And in fact, when the nurse brought me back to get me prepped for the scan, she apologized for the whole debacle and said they have some new schedulers who don’t fully understand the rules, and they’ll be doing some training for them. I told her I appreciated that.
Thing is, it shouldn’t take a patient bursting into tears on the phone to make this kind of change happen. And I’m not the only young woman with cancer this has happened to, nor is my story the most horrifying one I’ve ever heard. One friend told me that after having spent the previous 10 days on the hospital and having several pregnancy tests during the time she was there, she had port surgery. After they started anasthesia for the port surgery, they decided to test her for pregnancy AGAIN. She had to pee in a pan while prone on a bed, half-conscious and in pain from a spine surgery she’d had six days earlier. What in the actual fuck.
I urge doctors to trust their cancer patients, especially those that are terminally ill, to know whether they’re pregnant or not. Making them take a pregnancy to prove it is cruel. Please, stop doing this harm to us.
Uuuuuugh. This is such bullshit. Why can’t they just pop a note in your file to say “leave her the fuck alone about the HPTs” and move on?
I have been asked many times to pee in a cup, even after my ovaries were removed. “There was still a chance” since it had been in the last few months. WTF!?!?
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I can relate to this. I am not stage 4 but I am on tamoxifen. Every time I go for a freaken test I am been asked to do a pregnancy test. Just recently, when I did the colposcopy (cervical biopsies) the GYN asked me if I was pregnant. I told her no. She asked again, “are you suuuure?” Out of frustration I replied, “unless I am carrying the anti-Christ I don’t believe I am pregnant, no.” (I hope I didn’t offend anyone with my response but that’s exactly what I said.)
I understand situations are different but I totally agree with you that Doctors should be able to trust someone with your situation. xx
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Wow. In my 13 years of treatment for metastatic breast cancer, I’ve never had to take a pregnancy test to prepare for a PET scan. Breast cancer took my fertility too, at a time when no doctors were asking young women if they wanted to “preserve their fertility.” But peeing in a cup for anything but a urinalysis? That’s SO insensitive.
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