Shirin - Interview 41

Age at interview: 62

Brief Outline:

Shirin has always attended for screening and had normal results. She feels anxious before having a mammogram and whilst waiting for the results.

Background:

Shirin is a retired PA. She is divorced with 1 adult child. Ethnic background/nationality: Iranian.

More about me...

Shirin attends for routine breast screening every three years and has always had normal results. She also attends for cervical screening and feels it is important to do what she can to look after herself. She wondered if the three year interval between mammograms was too long and said she wants to continue having breast screening after the age of seventy, provided she is still fit and well. 

She likes the mobile unit in which breast screening is done and finds it comfortable. Shirin finds mammograms slightly painful but would rather 'grin and bear' a bit of pain than not be screened. She is happy with the screening procedure and the staff at the unit. Her last appointment letter was delayed and she phoned to find out why because she didn't want to miss her 3-yearly appointment. 

Shirin worries about going for a mammogram beforehand, is also slightly anxious while waiting for the results and when she opens the actual results letter. She feels she has all the information she needs about breast screening and cancer but wondered about the effects of alcohol on people's overall health, including in causing cancer.

As long as she was still healthy, Shirin would continue going for mammograms after the age of 70.

In terms of breast screening, women are invited up to the age of 70, up to the age of 70, they receive a letter. After then it is up to them whether they want to go for screening. They would have to phone and make an appointment. Would you want to carry on after the age of 70 to go for screening? 

It would depend how fed up I was [laughs]. Depends how fed up I am with life, you know, the screening and x-rays and all that, you know, but obviously I wouldn't mind after 70 provided I am fit and happy. Because if I am not going to be healthy at that age, then quite frankly I wouldn't mind succumbing to the illness. Who cares? You know. But obviously if I am healthy then I wouldn't want this to make me, wouldn't want any sort of cancer to make me unhealthy. But if something should go wrong before the age of 70, say for example I am handicapped or in a wheelchair, then I don't care, one more illness like cancer will kill me off quicker, you know.

So it depends on what is happening at the time?

Exactly. Exactly. Yes.
 

Shirin has always attended her mammogram appointments and wonders if the three year interval between screens is too long.

Have you always been to this breast screening unit, this local one, every time?

That is [hospital name] you are talking about?

Yes.

Do you know I don't remember early days at all. I can go back maybe about three years, maybe I can go back to, maybe twelve.

That would be really good.

Yes or something like that, maybe I remember, I know I can't remember. I can't. I may have the record in the file, but I will have to refer to it.

So you have been going, from the very first time around the age of 50, every three years?

Yes. Yes.  If it starts from the age of 50 then definitely every three years. I haven't missed out a single one. And I would not want to, definitely not. 

Would you mind if I asked you what your age is now?

62.

So you have been every three years?

Yes, yes. 

Never missed one?

No. I don't, either mammogram nor cervical. No.

All of them you have attended?

Yes. Because I have always been in the country fortunately at the time. So, I haven't missed it. No. I wouldn't want to. Definitely not. Sometimes I wish it was done less then three years, because I still find three years is a long gap, since the disease can come maybe three years, after I have been for a mammogram, so if it was done like every sixteen months or eighteen months. I mean I don't have much scientific knowledge but that may not be too long a period of time for it to spread. But like three years, say for example I went two weeks ago, or something, and I could develop who knows, something may be lurking that I develop in two or three months and then for me to wait three years it could be too late. So it has to be less then three years, in long term saving of life and money as well, less treatment.
 

Whenever going for a mammogram, Shirin makes sure she wears a top that's comfortable and easy to...

Have you ever felt when you have gone, because I am going for screening it is more convenient to wear certain clothes?

Oh definitely. Definitely. Garments which is easier to remove. Easier to wear again to save time, staff time especially when they are so busy. I wouldn't like to fidget around with one dozen buttons on a sweater you know, or something with a zipper on. Something like a skirt that you don't have to remove. No I am very specific, I always bear that in mind, always wear something that is easily taken off, removed, yes, definitely.

So if someone was going for the first time is that something, did you think of that the very first time, or later with the experience?

Maybe, because, oh I don't remember going that far back, because the thing is I don't remember the machine, or else it was done by hand, so no. But I am quite wary of all these things, you know, that whenever, irrespective of mammogram, if I have ever to have to go to any hospital or any dental appointment even, if I think my clothes are not going to let me breath because of a lying down posture, I always wear loose underwear and garments which is comfortable. I think it is very important for breathing sessions and it is time saving. Yes. Yes.
 

Shirin finds the breast screening unit cosy and homely, but has wondered about mammograms and...

When you have been for screening, what have you thought of the whole process? You know, when you have gone in, you waited to be called in, have you been happy with the whole process?

Oh yes. Yes. Very, very, ' very homely environment. I love that trailer. I could sit in there for hours [laughs]. It is such a nice break from domestic life, you know, really I mean it. I love sitting in that trailer. It is just very homely and very cosy environment and well everything has been quite well. It is well organised let's put it this way. No problems, no.

And when you have been for breast screening has it always been in that trailer there?

Yes, yes, as far as I remember but obviously I cannot remember the start of the screening, where it was. I just cannot remember that.

Were you still living in this area?

Yes. Yes. I have been here since '75. I don't, unless it was in the local clinic by hand, I don't remember. 

And the actual procedure of the x-ray, how have you found that? Some people have said it is uncomfortable, other people painful, and other people said they didn't notice too much. What was your experience?

Painful yes, it is like, it is like a sandwich, you know, I mean, of course this is a delicate part for a woman. And when it is sort of squashed between the two, like slabs or whatever you call it, it is painful and hurtful and very often, as I mentioned before, I feel that I hope it is not damaging something internally, that tremendous pressure. But then, if that is the only way for screening and it is the only successful way of screening that it can not sort of damage internally the tissues or whatever you call it, or sense or whatever, then it is acceptable. You have to just bear and grin. 

And in your case it was painful. How long did the pain last? Only a while or afterwards too?

No, not afterwards, no, only at the time when the machine, when the screening machine is compressed for the film to be taken. That is the time, yes, yes. 

And afterwards?

Afterwards back to normal, yes, yes.
 

Shirin has always gone for her three-yearly mammograms but worries about cancer and how it can...

In your case, every time you have had a letter you have always attended for cervical screening and breast screening?

Yes.

You have always attended?

Yes, yes, I have. Every three years I have. But that doesn't mean that it eradicates my thoughts, you know, always at the back of my mind, this does lurk, you know.

Has it been something, that these thoughts have come more with age?

With age and then the dependency, you know, obviously an illness like that means a lot of treatment, maybe family life being disturbed, you don't want to impose problems, your problems, onto your family. They have their own life to lead. I don't know, I have seen and I have heard as I previously mentioned of what families have to go through, how much they have to suffer to see, and even the family members go beyond recognition with that person's illness because they spend so much of the time visiting his wife or visiting the patient who has cancer, lying in the hospital. That person, or the visitor I should say, goes beyond recognition, you know. Like losing weight, stressed out. And sometimes the family member feels relieved if, when the person departs you know, they feel relieved because this is so much suffering and obviously it has a purpose but personally I wouldn't want to go through that, believe it or not. I mean it is such a curse on a woman. I wouldn't want to go through that. No.
 

After having a routine mammogram, Shirin worries about the result and feels anxious when opening...

In terms of getting the results from the clinic, have you had to wait long, or have you always got them, is it every two to three weeks that you get them after the mammogram?

I don't think there has been any trouble. No it comes may be three weeks, two and a half, three weeks, no, no trouble.

Have you ever been called back at all?

No. Not called back, because I dread opening the envelop, my gosh.

Every time?

Oh. You know, the moment I know it is the result envelope. I can tell, you know, the NHS envelope, it is, yes, it is a very difficult moment.

Do you think about it in between times?

Oh definitely, definitely. Definitely I do.

So if the letter took longer '?

I would still think, but then I would phone, if it goes likes beyond three and a half, four weeks then definitely I would phone in, in case the letter has gone astray. And it does happen. Letters do go astray. Sometimes some neighbours might come and pop in the letterbox. But some, they just tear it up. So no, I take that responsibility. Can't give every responsibility to the NHS. It is not fair, you know, a woman has to do that, you know.

So before opening the letter you are anxious?

Definitely. Until the letter comes I am anxious, yes.

And then do you keep all your letters at all or '?

Yes. I do. But recently I have cleared out the file, you know, sort of, I thought if it is l980s or early nineties. But I can't remember about the mammogram or cervical. I think I have got a record of that if I am not mistaken. Because the result has been good, I don't keep everything, only the recent ones I keep.