Tuesday, November 30, 2010

I'm baaaack and how to make a decision {Ch. 1}

I am content.
{for today}
It is raining outside...
it would be lovely if it was white fluffy snowflakes piling up,
but I, too, like the rain.
A lot has happened since I last posted.
I went to good ol' New Orleans and healed my lungs.
Realized a few days into July that I hadn't coughed-
time to celebrate, indeed!
I spent one additional month with our girls, regaining my strength and
walking our southern belle grand pup then returned home to a follow-up internal sonogram/ultrasound -- is there a difference?
I didn't need to do this; really, I chose to have it done
to close the chapter entirely on the book of my health happenings of May, June and July.
A new school year calendar was laid out freshly before me.
I wanted to be entirely confident I wasn't going to have a repeat episode of May so I confidently went to my appointment the Friday before school began.
Thunk.
That book was not closed.
Oh, no it was not.
It was thrown wide open when it was discovered I had a new, larger cyst.
Not good.
I have never had one previous to my May episode; thus, my dr thought it a fluke.
Usually a female has ovarian cysts for many, many years; not me.
The technician couldn't believe I wasn't curled up on the floor in a ball of pain.
Ummm, no. I wasn't in any pain at all.
None.
Is that a blessing or a curse?
Hmmmmm.
Hard to decide.
When my dr received my results her office called to set up an appointment to discuss with me my "options". I wondered and pondered what those options would be. I asked many a teacher, friend, neighbor. No one had had an experience like mine, which I did not find comforting. Everyone had either had super heavy periods {not me} or very sporadic periods {not me, as regular as can be}.
I just kept thinking, roll with this, Mari.
Just roll.
A week later I was in the dr's office and she said they were definitely going to take out the cyst.
Okay.
Then I was given the option of having everything taken out.
what?!!
Rewind. Please repeat.
Why.would.I.have.both.my.ovaries.falliopian tubes.utures.and.cervix.removed
when I have totally normal, regular periods?
Oh, the book was open, wide open, with many an unwritten chapter ahead.
But I don't want this book.
I don't want to be a character in this novel.
I don't want to be the leading lady in this role.
No, no, no.
I decline.
I politely decline.
I vehemently decline.

How does one make such a decision?
She, my outstanding dr, that I years ago had waited three years to get into her practice,
stated, "Hormones or cancer."
Excuse me?
She said one needs to make a decision based on their family history; if cancer runs in the family tree, most women opt for everything to be taken out as there isn't a test for ovarian cancer.
I grabbed my right side and resolutely proclaimed,
"I am keeping my right ovary."
Then I inquired, "Why would I have my right ovary taken out
if I will have still have my left one?"
She said, "I am taking out your left ovary no matter what."
I gasped, "You said you were taking out the cyst,
you didn't mention my whole entire left ovary was coming out."
I then grabbed my left side and said, "It could have given me our children."
I absolutely thought sitting on that table I was only going to have my left ovary removed
and we would be done.
She said to take a week and think about it; to talk with my family.
I said they will 100% want me to do what I feel is best for me.
I asked her what I could read, where could I look up the research,
whom should/could I talk with regarding this monumental decision?

She again explained that there is no correct answer.
Each body responds differently and there are no predictors.
One doesn't know how their body will respond.
*this was very, very hard for me to digest*
Give me something to research, people to talk with; some concrete information;
please point me in a direction to understand all this so I can make a decision.
Hormones or cancer.
I declared, "No doubt, God is a man."

My doctor did prove correct in the next six days as I asked anybody
[practically everybody]
what they would do:
left ovary only or the whole she-bang?
If cancer runs in their family, especially women whom have lost a loved one to breast cancer
{and I, incredibly sadly, had my eyes opened in this, so many; far too many, each one is too many!} or a father to cancer they did not hesitate, not even for a second.
They ALWAYS responded to get all of my female organs removed.
No question. No hesitation. Do it.

We have other things in our family tree; but, very, very fortunately, not cancer.
I really was hanging onto my my right ovary...
to have natural menopause.
I cannot emphasize this enough; I was having regular periods on a regular schedule.
I had not had nor experienced any perimenopausal symptoms.
WHY would I have all my organs taken out?
why, why, why?

And...I would experience "traumatic surgical menopause".
My understanding, of course I am not a doctor, but again, my understanding,
is the moment you are on that surgical table and they snip your ovaries,
you experience an abrupt hormone withdrawal
[estrogen, progesterone and testosterone].
Scary.
Not an easy decision to make.
No gradual transition into menopause.
Definitely a life changing decision and obviously no turning back.
Permanent.
And no real answers.

Where oh where is my crystal ball?!

Then, about on day three or four of my decision making week,
our youngest daughter called and said,
"Mom, you are going to go into menopause someday.
It could be gradual or sudden. You don't know that either.
You could have only your left ovary removed and then you could have a cyst grow in your right ovary, as this may be in your system and then you will have to go through another surgery. The greatest risk of surgery, Mom, is anesthesia and opening the body cavity (infection). Why not get it all taken care of now?"
And..."There is no test for ovarian cancer so why not get this taken care of and never have to worry about it?"
I said, "Because cancer does not run in our family. WHY would I do this to myself?"
Then she, with her master's in neuroscience quietly replied, "Mom, you have your sister and your mother and her mother, your maternal grandmother. That is not a large sample size!
Just get this taken care of. Completely."
sigh.
true.

When I returned to my gynecologist seven days later, I replied resolutely,
without hesitation, "I am going to have it all taken out."
Finally a decision.
Dr asked, "Final answer?"
I felt good about it.

Now let's get the show {or surgery} on the road.
Let's do this!

I must mention also, and some may find this embarrassing but I am fine with it because I had no one to discuss all this with so I am putting it all out there for you or anyone you know who may go through this, I also have bladder incontinence. When I was formed in my mother or when ever these things take place, maybe puberty, I have had a tipped uterus.
From the first time I went to a gynecologist before we were married I was told I had a tipped uterus. It has tipped all these years onto my bladder, resulting in my bladder incontinence.

I had asked my dr, Dr E, at the first appointment if I had a total abdominal hysterectomy, could I please also have Dr H, a urogynecologist, fix my bladder? Mrs Dr E had referred me to Mr Dr H three years ago and I had undergone a series of bladder function tests.
Dr H said I definitely needed my bladder reattached.

This honestly is also what tipped me into choosing to have everything removed; get it completely taken care of, all of it.

Now to schedule the surgery(ies).
Tricky, as each of the two involved surgeons have different surgery days of the week!
Heads up--if your dr's office calls and says they need to reschedule you please try to be patient and understanding!
I knew one of the doctor's was going to have to cancel their patients for that slate of time I would be in surgery. No one wants to upset their patients by changing schedules and both my doctors are sought after as people travel to be treated by them.
Um...both also kind of have big ego's.
They are great at what they do but which one was going to change her or his schedule?

Also....my sister had given me an incredibly generous gift for my birthday back in April; to go to Old Quebec. I had suggested we go in the fall. Everything was a go for us to have our passports stamped on September 19.

This, my second appointment with Dr E, was September 8.

I didn't mention our travel plans as they said I needed to get this surgery done.
I was rolling with it, remember?
No stressing.
Go with the flow.

I thought it may take a week for them to coordinate everything.

Three business days later, Monday, September 13, my two dear friends Linda and Deb, were here visiting with me and as I was explaining all this to them, my cell phone rang.

It was L, the scheduler from Dr E's office, and a former student and she said, "You went after your appointment and had a chest x-ray, mammogram and your blood work. You are cleared for surgery. How about this Thursday?"

What?
Rewind!
This Thursday, as in 60 hours?

I was slightly a flutter.
My mom and sister who were going to take a turn each to fly out and take care of me live on the west coast which involves plane tickets and the purchase thereof. Last minute is expensive.
L said, "I have secured an O.R. and Dr E is on board. WE will not know until we confirm first thing in the morning with Dr H's office."

Was I going to Old Quebec on Sunday, September 19
or to the operating room on Thursday, September 16?

Either way I was packing a bag!


to be continued...


p.s. it is still raining....awaiting a dusting of snow.