Sunday, July 21, 2013
"THUD"....the sound of the other shoe that dropped
I was hoping there would be no other news flashes, changes or "shoe dropping", but it happened. On June 5, 2013 I had my follow up pelvic ultrasound (aka my "date with the ultrasound wand" as I call it).
That ultrasound led to many doctor appointments over the next several weeks and then surgery.
Although the majority of the Tamoxifen "accessories" I had gained during my 8 months of taking that drug had resolved, the left ovary was not returning to normal and that complex cyst was still there. The right ovary was fine and other things looked more normal, but the left ovary was very concerning. My ob/gyn recommended that I have surgery to remove the left ovary, left fallopian tube and biopsy the uterine lining to make certain that cancer was not lurking.
Needless to say, I was scared! My ob/gyn was calmly explaining the procedure, what would happen, etc and all I could hear was Charlie Brown's teacher's voice. The word cancer was on repeat in my head like a bad musac track from an elevator.
I went home and started a pity party for myself that lasted several days and included lots of crying, fear, anxiety and questions: "why me?", "what did I do to deserve this?" and "whose going to want me with no girl parts left and all the side effects that brings?".
We set the surgery date for June 28, 2013 and I prepared myself for the worst, but was praying and hoping for the best. I would have laparoscopic surgery under general anesthesia. The left ovary and left f tube would be removed, the uterine lining would be biopsied and all of that would have quick pathology done. IF any of those came back with cancer, then I'd have a complete hysterectomy (all my "girl parts" would be taken away). I agreed that I didn't want two surgeries so I signed paperwork that clearly stated to go ahead and do a total hysterectomy if there was cancer found.
Why wake up, hear the cancer word and then have to set another surgery date? No way. I decided to make it a "surprise" - which means I would not know if I had any "girl parts" left or another cancer diagnosis until I woke up in the recovery room.
Now this plan was finalized as far as I was concerned, but I was mistaken. There was one more decision I would have to make. I met with the gyn onc to review and discuss what would happen if cancer was found during my laparoscopic procedure. The gyn onc would be the one to step in and take the the procedure from three holes in my stomach to cutting me open and taking out everything and doing the staging (aka biopsying other bits and pieces in the surrounding areas to make sure cancer was not lurking somewhere else).
I was now hit with the new decision: if cancer was not found, why not go ahead and take out both ovaries and f tubes since I was already there under anesthesia and all?
This is where I began to fall apart - again. I had pulled myself back together (well, as much as I could) after agreeing to surgery and the original two options. Now, I had yet another decision to make: if there is no cancer found and hysterectomy is not needed, do I still give them both ovaries and fallopian tubes? In other words, do I say "yes" to surgical menopause without a cancer diagnosis?
The gyn onc explained, as my breast onc had previously explained, that not having ovaries could reduce my chances of a recurrence of breast cancer (I had estrogen receptor positive breast cancer). I'm not crazy, I had already said take out all the "girls parts" right then and there if cancer was found during the surgery.....but did I want to agree to give them parts that didn't have to come out?
It was being presented as a good news option......Hey, if you let us take both ovaries then you can start taking the post-menopausal breast cancer drug without having to take the shots to put your body into menopause....
I failed to see the "good news" aspect of this presentation. I had a lot of thinking to do and a huge decision to make in a matter of days.
I said NO to the extra donation to medical waste. I was determined to keep the right ovary and right f tube if there was no cancer! My gyn supported my decision (she is an amazing person and care provider by the way!). This way, I could consider taking the shots to throw myself into menopause and take the post-menopausal breast cancer drug. If the side effects from this drug were horrendous, I could stop the the shots and kind of come out of the menopausal state. If I gave them both ovaries, there would be no turning back from a menopausal state. My age also played a part in this discussion - there was a chance that even if I stopped the shots, I wouldn't bounce back.
So here's what happened on my surgery date, June 28, 2013:
I woke up with some girl parts left, but not as many as I had hoped. My left ovary and f tube were removed as planned, but the right f tube looked suspicious so it was taken out too. I was able to keep my right ovary and uterus. Good news - no cancer found!
In case you need a quick biology reminder, no I cannot ever get pregnant now. Even though I knew that getting pregnant and having a child was probably not in my future, it was still possible - biologically possible, it could happen. Now, it cannot happen. This news was tough to digest. It was more difficult and upsetting than I had imaged. It is very difficult to go from "it probably want happen for me" to "it cannot and will not happen".
I am still recovering from the laparoscopic surgery (takes 4-6 weeks to regain 75% of your strength). The recovery has been more challenging than I expected. I grossly under estimated the healing and recovery time. I was comparing it to my breast cancer surgery - not a fair comparison by any means. I'm working back up to my 2 mile walks, morning yoga and ab workouts and I will get there.
Yeah, I'll get there.....I'll get there with my new normal, with decisions about future breast cancer drugs and moving forward with my life. Not having another cancer diagnosis is a major relief, but I still have to somehow wrap my head around what has happened to my body and come to terms with that.
Two years ago this month, I was happy that I had completed breast cancer surgery and my radiation treatments before my birthday. That was my goal two years ago - to have it all "finished" before my 2011 birthday.
Never thought I'd be here again. Never thought I'd be facing another "get well" goal before another birthday, but here I am.