It’s not very often that you’re asked, “Are you wearing deodorant?” and then handed a wipe to remove it. (Deodorant shows up on the x-rays as calcification.) The mammogram wasn’t for especially urgent matters, just luck of the draw.

I had heard that it was painful if you had small breasts, so I was ready for pain. It was an ordeal, but I’ve experienced much worse. The tech helped shoved me forward into the machine. The procedure involved much shoving and maneuvering my torso forward while a glass plate flattened my boobs in a way I didn’t know was possible—a type of magic trick/medieval torture technique, I believe?

It only really hurt for my right side, but the discomfort was tolerable otherwise.

What is most valuable is the raw data, which is available for download in a non-proprietary format. Through using 3rd-party software with the raw data, I’ve been able to learn more than 23andMe reveals. (The raw data also comes in very handy if you’re not 100% European because 23andMe has a self-acknowledged Eurocentric model.)

For example, how Neanderthal I am from Interpretome: 11 out of 84 identified Neanderthal SNPs. I like the little meter it uses.

Interpretome is a great resource for digging through your raw data since it involves using your browser, instead of downloading and installing something such as R and then running available scripts. Not everyone is comfortable with the latter so the Interpretome interface makes it highly recommended.

Some things I learned from 23andMe:

• I’m 100% European.
• My mitochondrial DNA (mtDNA) haplogroup is H11, from “Central Europe.”
• Compared to average, I have nearly twice the risk for Alzheimer’s disease and about 1.5x the risk for Coronary Heart Disease, lung cancer, Restless Legs Syndrome, and ulcerative colitis.
• I have an “increased risk” of gout and Chronic Obstructive Pulmonary Disease (COPD).
• I’m not a carrier for any of the various things they tested for: Cystic Fibrosis, Tay-Sach’s, Connexin 26-related sensorineural hearing loss, etc.
• I am norovirus-resistant.
• My blood type is likely B (it’s B positive).
• My eyes are likely brown (they’re green).
• I’m not resistant to HIV/AIDS.

Some things I learned from the raw data + third parties:

• I have 19 “European alleles” and 1 “East Asian allele,” whatever that means. (Interpretome)
• At maximum: my ancestry is 93% Northwestern European, 7% Southeastern European, 0% Ashkenazi Jewish. (Euro-DNA-Calc)
• I have 11 out of 84 identified Neanderthal SNPs (as seen above from Interpretome)
• From Doug McDonald’s BGA Project (search the 23andMe forums for his email address):
  

  Most likely fit is 43.0% (+-  6.4%) Europe (various subcontinents) and 57.0% (+-  6.4%) Europe (all Northeast Europe), which is 100% total Europe. The following are possible population sets and their fractions, most likely at the top.

  Italian= 0.386 Lithuani= 0.614
  Spain= 0.381 Lithuani= 0.619
  French= 0.538 Lithuani= 0.462
  French= 0.416 Belorus= 0.584

  For some reason the above and the spot on the map, which both look like Germany, seem to contradict the scatter plot, which looks quite like plain England. So I would say that it could be anywhere from England to Germany.

• I have 21 out of 32 Coronary Artery Disease risk alleles. (Interpretome)
• I have 19 out of 36 Type 2 Diabetes risk alleles. (Interpretome)
• My combined risk of narcolepsy and Restless Leg Syndrome is 3.63x the average. (Interpretome)
• I have a ton of alleles associated with an elevated risk for mental health issues (such as depression, bi-polar disorder, and schizophrenia), and being less likely than average to respond to certain antidepressant medications. (Promethease)

A couple other things you can do with your 23andMe raw data involve submitting it to CureTogether or GEDmatch, and cross-referencing your SNP data using the FireFox extension SNPTips. If all four of your grandparents are from the same background, you can use DIYDodecad. (Mine aren’t, so I didn’t use it.)

By the way: my advice is not to pay full price for a kit, but to wait for it to go on sale because this seems to happen pretty frequently. The wait isn’t long for them to process your sample (of your spit inside a tube), it was only three weeks for me. “6-8 weeks” is the maximum time frame given.

My genetic counselor took down my family cancer history and plugged other details into models designed to calculate my risk of cancer. One model, the GAIL model, can only be used with women 35 years and older. It feels odd to be too young to use all the models possible, but what ones I could use were informative and illuminating.

A few days later, my genetic counselor sent me and my doctor a long letter in the second person:

“You are currently a 24-year-old female, gravida 0, para 0, with your first menses at age 12 and no birth history. You are currently premenopausal and have no history of hormone replacement therapy. You have a history of roughly 5 years of oral contraceptive use (oral contraceptives may decrease a woman’s risk of ovarian cancer by as much as 50%). Your ovaries are intact. [...]“

The main issue is my mother’s young age (35) and her cancer’s advanced stage (4) when she was diagnosed. The general recommendation is to begin mammograms at either age 25 or 10 years prior to the earliest diagnosis in your family. For me, both of those numbers are 25. Next year should be interesting.

“You do meet NCCN guidelines for genetic testing of the BRCA1/BRCA2 genes due to having a first degree relative diagnosed with breast cancer under the age of 45.”

Of course, it doesn’t matter what NCCN says; it’s all about how much Myriad Genetics wants to charge my insurance company (which will bill whatever amount leftover to me). I wasn’t able to do preauthorization so I have no idea how much money I’d be on the hook for until too late. It could be zero or it could be thousands. I have no way of knowing. Right now, it doesn’t matter much to me whether I have a mutation or not. While I probably can’t afford the test, it wouldn’t change a thing for me either way in the immediate future: I’m already classified as “high-risk” and set to undergo annual mammograms and breast MRIs. The only thing a mutation would reveal would be a higher chance of ovarian cancer, which would ultimately lead to needing the ovaries removed before the 45.

“Using the PENN II risk assessment model, the estimated likelihood of finding a [BRCA] mutation is about 8%. This risk would increase to 16% if an affected [with breast cancer] relative were tested.”

90% of breast cancer occurrences are sporadic, happening entirely in people without a family history. You may be more screwed than me! The remaining 10% is thought to have a hereditary component (AKA hereditary breast and ovarian cancers—HBOC). But only half of those are presently identified, and those cannot be tested for like the BRCA mutations can.

Overall, assuming I don’t have any of the BRCA mutations, my lifetime risk is pegged at 23% using the IBIS model. “Lifetime” = 90 years. Typed out, 23% you might think that doesn’t sound “so bad.” However, it is over 2x the normal risk and puts me into the high-risk category. It’s a good thing that I’m actually excited to get mammograms and breast MRIs (which look way cooler than mammograms, by the way)—I don’t think it’s often that someone gets to have their breasts imaged without it being pornographic in the slightest.

Anyway, I’m not really worried or whatever. Which might seem weird to some people, but trust me—I’ve had more traumatic shit happen than this, and I’ve got more important things to worry about. And don’t worry about the BRCA1/2 tests, I don’t need to know the definitive outcome for several years. (Although if you want to give me money, go ahead! I’ll probably just buy socks, though. Sorry.)

Komen ingrained themselves deeply into the breast cancer world. They are synonymous with the pink ribbon and breast cancer itself. They surely realized that when a loved one is affected, you will do anything if you think it will help stop their pain. And when it just wasn’t meant to be, you will do anything to make sure it doesn’t happen to anyone else. All they needed to do was create a community, make it uplifting and valuable to participants, sell them pink trinkets… and profit.

Throw in capitalism and business savvy, some massive profits, and it was only a matter of time before they hooked up with the GOP and lobbied for atrocious bills that favored the HMO over the consumer. In return, the Komen founder was made an ambassador by George W. Bush in 2001.

One day in early October, I walked through the Mall of America and was barraged by pink. It was impossible to escape. Nearly every store was selling something specifically for breast cancer awareness. Later that same day, I stopped at a Walgreens location and discovered that there was even a pink Snuggie.

Every time I encountered something pink, I was reminded that my mother was dead. My mother had died of breast cancer at the age of 38 in 1996–I was eight and my sister was five. Over 13 years later, my family is still experiencing the aftershocks of losing the person who glued us all together.

There is nothing that stops a company from slapping a pink ribbon onto a package and toting it as “breast cancer awareness,” when there is no donation to anything but the company. The pink ribbon is not regulated, and is easy to abuse.

Often, a portion of the proceeds are supposedly going towards research, and other times the product (in one case, General Mills’ Cheerios) mentioned that the company was going to donate money regardless of product purchases. In Yoplait’s “Save Lids to Save Lives” drive, you mail in lids from yogurt cups. A single lid fetches 10 cents for breast cancer research. If you sent three lids a day for four months, your total donation would be only $36.

I find it hard to swallow the sincerity of commercial interests. If marketing things for breast cancer awareness weren’t a guaranteed way to make money from consumers with a conscious, companies would not be doing so.

Swimming in fountain across from Union Station; Washington, D.C.; by Marion Post Wolcott 1938

• Anxiety, depression and alcohol and drug dependency cases might be more than twice as high as researchers currently believe.
• An immigrant from China with mental illness has finally gotten out of detention in America
• The “M” word in health care: mental illness and health care reform

An award-winning duck of some sort at the MN State Fair.

• Adults who were mildly depressed as teenagers are more likely to have major depression, anxiety disorders, and eating disorders. However, researchers could not say if mild depression contributed to the development of major depression, or if the mild depression as a teen was an early phase of major depressive disorder.
• They have the thinnest skin, the shortest fuses and take the hardest knocks.
• “Despite all this help, there are days when I can’t get out of bed because I’m in a deep depression or didn’t sleep at all the night before. Sometimes I’m unable to do anything other than get my kids fed.”
• “I recognize that I’m hallucinating. I know this isn’t real, but maybe there’s some lessons I can gain.”

"Cavern carved by the sea in an ice wall," by Frank Hurley, circa 1911-1914

• Depression’s evolutionary roots: an adaptation, not a malfunction.
• The 2008 American College Health Association Survey found that 30% of college students said they had suffered from depression in the last 12 months
• In Florida, the State argues that gay people have higher rates of “domestic violence, psychiatric disorders and breakups” (none of which is true), and thus should not have the right to adopt a child.
• Ted Kennedy was instrumental to the passage of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, which he called “a major breakthrough for those with mental health needs.”
• Connection found between heart disease in women with no previous warning signs (such as high blood pressure) and hopelessness:
  “What we found is, those women who reported feeling hopeless about the future or their personal goals had more thickening in the neck arteries — more atherosclerosis — which is a predictor of stroke and subsequent heart attack,” Everson-Rose said in a telephone interview.

• A video from The Onion: White House Reveals Obama Is Bipolar, Has Entered Depressive Phase.
• “Drugmaker GlaxoSmithKline used a sophisticated ghostwriting program to promote its antidepressant Paxil, allowing doctors to take credit for medical journal articles mainly written by company consultants.“
• An L.A. County program helps female inmates handle their mental illness and regain custody of their children.
• The Virginia Tech shooter’s medical records were released on Wednesday.
• “A study published last year suggested that bipolar disorder may be over diagnosed in people seeking mental health care. Now new findings shed light on which disorders many of these patients actually have.”
• Woman who claimed to be expecting 12 babies at once (“next to impossible,” said health experts) turns out to just have a freaky phantom pregnancy. It happens when you spend too much time in opera houses.
• “Faded numbers stamped into small cement blocks marked the graves of more than 3,200 mentally ill patients buried here at Western State Hospital between the 1870s and 1953.”

A vintage electroconvulsive therapy (ECT) unit at the HCMC History Museum in Minneapolis, MN.

An excerpt from a book I’ve been reading lately, The Noonday Demon: An Atlas of Depression:

People around depressives expect them to get themselves together: our society has little room in it for moping. Spouses, parents, children, and friends are all subject to being brought down themselves, and they do not want to be close to measureless pain. No one can do anything but beg for help (if he can do even that) at the lowest depths of a major depression, but once the help is provided, it must also be accepted. We would all like Prozac to do it for us, but in my experience, Prozac doesn’t do it unless we help it along. Listen to the people who love you. Believe that they are worth living for even when you don’t believe it. Seek out the memories depression takes away and project them into the future. Be brave; be strong; take your pills. Exercise because it’s good for you even if every step weighs a thousand pounds. Eat when food itself disgusts you. Reason with yourself when you have lost your reason. These fortune-cookie admonitions sound pat, but the surest way out of depression is to dislike it and not to let yourself grow accustomed to it. Block out the terrible thoughts that invade your mind.