Radiation Roulette

February 26, 2009

Another day, another morning spent in a waiting room flipping through an old issue of People. I assure myself this visit will be a breeze—no clueless surgeon telling me I may already be Stage 4, no needles jabbing into a “suspiciously swollen” lymph node, no jaunty pink ribbons of sisterhood. I’m here for a simple pre-surgical chest x-ray. But nothing is as simple as it seems these days. And, as I hear the technician’s monotone instructions–take a deep breath, hold it, let it go–I can’t help but wonder if this is where it all began.

I was 13 years old when our family doctor ran his finger down my spine and announced to my mother that I had scoliosis. I knew the word all too well. Like my peers, I gobbled up every book by Judy Blume, including Deenie the ode to the adolescent angst of scoliosis. The tears began to roll the minute I hit the parking lot.

How many x rays are too many? No one knows, but the orthopedists who mapped my wayward spine seemed to think nothing of ordering them in abundance. Strangely enough, even then, I feared the radiation might damage my ovaries and breasts. How on earth, at age 13, I suspected that radiation was bad news for my budding reproductive system, I’ll never know. (Blume? Was it you?) On the day my anxiety boiled over I mustered the courage to ask the x-ray technician for something to hold in front of my ovaries. I can still picture the quizzical tilt of her head, the you’ve-got-to-be-kidding-me expression on her face. Without looking at me, she handed over a small plate of some kind. I took my best 13-year-old guess and held it beneath my navel. Deep breath. Hold it. Let it go.

Of course, one can’t re-examine every choice. (Maybe I should have held the plate in front of my breasts?) But that doesn’t keep my brain from wandering off to pan the stream of my past for carcinogens. What’s maddening about breast cancer is that I’ll never know what tipped me over the edge. The place I go looking for answers isn’t rational, but I like to visit it anyway. I peruse the statistics, run my fingertips over the risk factors. I find bizarre comfort in the unavoidable ones, such as early menses, but my gut lurches when I seize upon something questionable, something avoidable, like one too many x rays.

As someone who writes about women’s health for a living, I knew my history of radiation exposure put me at a higher risk of breast cancer but I didn’t know by how much. Was I naïve to think I could mitigate that risk by eating a vegetarian diet, staying fit, buying organic? I told myself a few x-rays wouldn’t raise my risk substantially. After all, it was just a little scoliosis; it wasn’t like I was in Hiroshima when the bomb dropped.

Then, on a flight to DC two weeks ago, I opened Dr. Susan Love’s Breast Book. While browsing the chapter on breast cancer risk factors, my eyes snagged on two sentences: “…there are other studies confirming the existence of radiation-induced breast cancer. One showed an increase in the disease among women with scoliosis who had a lot of x rays to monitor their backs during puberty…these studies show that the danger is from exposure to moderate doses of radiation.” Shit.

I’ve spent the past twenty-five years trying to make peace with what happened to my back. Trying to understand how an otherwise healthy young girl with a mild curve ended up in an operating room where surgeons carved a 13-inch incision, deflated a lung, took out a rib, removed a couple vertebrae, and rebuilt her lumbar spine out of metal rods and screws. One week in the ICU. Two weeks in the hospital. Three months flat in bed in a full body brace. Six months in a half-brace. Twenty-five years of thinking—was it worth it? Maybe I finally have my answer.

And that’s how I found myself at 9:15 this morning face to face with yet another x-ray machine. Breasts innocently awaiting another blast of radiation.

This time I didn’t bother to ask about protection; obviously, it’s beside the point.

By this time next week, they will be gone.

Deep breath. Hold it. Let it go.