Sunday, September 7, 2008

Six Degrees of Separation

On the same day that I had my breast MRI, I also saw a genetic counselor, Mr. Resta.

As he walks across the waiting room to greet me, it's immediately apparent that Mr. Resta can be simultaneously 100% absurd and 100% serious.

He's my kind of guy.

He's asking me to explore issues like, hmmm, how white and protestant IS my family...and is it POSSIBLE that my parents might be cousins?? ( To steal from Stephen Colbert -- the only way to make my birthplace, Medford OR any whiter would be to host the Republican National Convention there. However, the same sundown laws and political clubs like "The Daughters of the Confederacy" that kept Medford white, could possibly have also encouraged cousins to marry... )

I'm also supposed to show him body parts I'm sure no one has ever looked at before (the inside of my bottom lip, the inside of my top lip, the underside of my tongue, etc.) -- and while he's making sure I understand the significance of his questions, he's very good at acknowledging the bizarre side of this whole encounter.

Sitting with him inspires me to randomly associate and tell stories.

Now, those of you who know about my unusually uninhibited ability to share too much information should know that I *did* try to censor myself! I would smile and laugh and Mr. Resta would say "What?"

"Oh, it's nothing. I just keep thinking of funny stories."

"Oh tell me!" he ways, unwittingly.

So, uh, we're going through all of the serious business of genetics and at the same time, sharing things, like, uh, birth stories!

So I'm sharing stories about my childrens' births (tears, scars, number of pushes to arrival...the fun stuff) to this man I've known now for, what, about 35 minutes?

So he shares too. He tells me HIS wife gave birth to one of HIS children in the basement of their friend's house.

This is where I'm supposed to ask "Oh, what happened?!"


(Insert pregnant pause here...OK..sorry, BAD pun)

Instead I ask

"Uh, ....Are you married to Susan Jamieson??!"

(Susan Jamieson is one of my dear colleagues at Bellevue Community College. She is smart, fun, and was part of the large supportive group of people getting me through the new job and the new baby. We swapped birth stories while waiting in line for the copy machine.)

Without missing a beat or even looking up, he says evenly "Yes, I am married to Susan Jamieson."

"I love Susan!" I exclaim.

"So do I." He says.

I keep exclaiming "I work with Susan! How funny!"

I chuckle with disbelief.

"I love Susan!!"

"So do I."

"Wow. This is so funny."

I'm shaking my head.

"Susan is great! I love Susan!"

"So do I."

He's, of course, professionally serious in his response. He assures me he'll keep our encounter confidential. I promptly give him permission to share with Susan -- and I email that permission to Susan along with an announcement to her of my cancer just be be sure there's no ambiguity there.

Seriously, the session was amazingly informative.

Did you know, for example, that before this year, it was possible for health insurance companies to refuse to cover healthy people with proven genetic health risks? That is now forbidden. But it's still possible for life insurance companies and employers to shy away from covering you. As I'm rather screwed on that front by the whole breast cancer diagnosis, it makes the issue moot for me. But should I end up to test positive for one of the known gene combinations linked to breast cancer, others in my family might want to be very careful in their decision to be tested.

I will not, for example, have my kids tested. Ever. That will be up to them to decide when they are adults.

He tells me that based on my history, there's a strong likelihood that there is something genetic going on, even if I test negative for the gene combinations they know to be associated with breast cancer.

If I do test positive, there's a 50% chance my sister has the gene. I think there's a 25% chance my cousin has the gene.

If Delphine does have the gene, they will recommend she begin getting Breast MRI's and Diagnostic Mammograms at age 25. She'll be advised to have her ovaries removed by age 35.

Honestly, I don't think those nasty BRCA gene combos are what I have. But I'm going to be sure. If I'm going to do all of this work to survive breast cancer, I'm not going to get caught unawares by a nasty ovarian cancer. Here's to another 50 years!

So we'll see in about three more weeks. That's how long it takes to get the results back. They have to do $4000 worth of mapping to figure out my gene sequences.

IF, I have any known genetic connection, it will only cost my relatives $400 to get tested, should they wish to do so. It's because the family gene sequence will already be identified, so testing for it will be a lot easier.

2 comments:

Susan said...

So, I should join this love fest. I love you too and I love Mr. Resta. Great news on the genes!

Suzy said...

He *is* rather adorable. ;-)