Friday, June 14, 2013

Surgery Did Not Go As Planned

So, surgery did not go as planned yesterday.

Matt, my father-in-law and I arrived at 1:30 p.m. at Loudoun Hospital to do my registration. They ended up giving me the wrong paperwork. I was a mom being treated for anemia and had a 14-day-old baby with jaundice. I had to go back to registration to have my orders redone. That made me uneasy.

My mom and dad arrived and then I was taken in the pre-op area. I did an interview with a nurse the week prior to my surgery to go over all my medications, allergies and surgeries. None of my information was correct, so we had to go back through all my information again. That made me uneasy.

Then, there was a “Code Pink,” which we thought meant that someone was trying to steal a baby. Apparently there was a mix-up with paperwork or the mom got too close to the front door and her bracelet set off the alarm. The hospital went into lock down (meaning you could not get in or out) until they sorted out the issue. Apparently that happens several times a day. That made me uneasy.

Waiting on the anesthesiologist the lights started flickering in the hospital. I turned on my TV and Matt, my father-in-law and my parents watched the tornado warnings with me. The alert kept saying “If you’re in Lansdowne, take cover now.” The storm was right over us. My jaw started to lock and I felt the panic attack coming on.

All the surgeries were delayed 30 minutes until the storm passed. Dad and Pop were headed toward the cafeteria and the guards took everyone and pushed them into a room with no windows. It was so scary. I was more worried about my family being safe than my actual surgery.

Once I got into the operating room, I remember singing ‘Under the Sea’ with my anesthesiologist and when asked where I was, I apparently told them I was drinking lemonade on a porch in Georgia. Weird considering I don’t drink lemonade, nor have I ever been to Georgia. I just hope I was true to my character and gave them a little southern accent.

So, surgery was a mess. [NOTE: This is where I am going to go into detail, so if you don’t like this stuff, please skip to the end.]

Once they got into my uterus they cleaned it out. By doing this, they then could not find the 1cm mass/polyp. They think it came out with the cleaning. Now, the overgrown tissue was much more severe than originally thought. My surgeon Dr. Roopa Duggal took a small biopsy sample from one side of my uterus and a much deeper biopsy from the other side. Those two samples were sent to pathology to rule out uterine cancer, which is a concern being on the Tamoxifen.

They could not do a D&C (where they remove the overgrown tissue) because she couldn’t tell the difference between the tissue and the muscle and did not want to hurt me more than I am already hurting. The tissue growth expands down around my fallopian tubes. It’s not good and is causing me all the discomfort I have been having for the past few months. I have a feeling it won’t be long and I will be back in the hospital to have this build up resolved. It is so uncomfortable.

My pathology report should come back Tuesday or Wednesday, at which point Dr. Duggal will call me to review the results. I hope Dr. Roopa Duggal will talk with my oncologist to figure out where we go from here. If it is cancer, the decision is pretty clear. I have a hysterectomy. If it is not cancer and is being caused by the Tamoxifen I have been taking for the past five years, then we need to decide:

  • Do I follow Dr. David Heyer’s wishes and stay on the Tamoxifen another five years? (which means continued build up, discomfort and no babies until the age of 36) 
  • Do I take a three-month break from the Tamoxifen and get this tissue cleaned out and harvest and freeze my eggs? 
  • Do I take a six-month to a year break from the Tamoxifen and get this tissue cleaned out and try and have a baby? Do I want to chance having my own baby knowing my hormones will go crazy and my cancer already likes estrogen? 
  • Do I say, “screw it” and just have the hysterectomy, knowing I would need one any way before the age of forty, since I am at a high risk for ovarian cancer due to my estrogen positive cancer. And then we move on with adoption once we are in the new house. 

I’m not sure what the correct path is for me, but first things first, we need to get the pathology report back and then I need my doctors to talk. I have to think of my health first and foremost, which probably sounds selfish to a lot of people, but having babies is secondary to that. I just want to live as long as I possibly can and have a healthy life with my husband, friends and family.

Matt is much more logical than I am and doesn’t necessarily believe in my more spiritual view. I don’t like messing with “the plan.” Meaning, I am not sold on surrogacy, because it doesn’t feel natural to me. I cannot take fertility drugs because of the increased hormones. Then, I feel like I am tempting fate if I get pregnant and my estrogen levels rise. I could be pregnant and get cancer again. That would be so horrible. I believe we all have a plan and by messing with that plan, we don’t end up with what was intended. Meaning, maybe there are babies out there waiting to be adopted that are supposed to be with Matt and I.

Everyone has their own path and I am certainly not passing judgement on how other people create their families, I just know what I feel in my heart. I know we will have a family. I just don’t know how we’ll get there quite yet. It will come to us.

Let me get off my soap box. I will be sure to let everyone know what the pathology report says next week, until then, I am heading back to bed with my prescription-strength Ibuprofen and am on a break from swimming and exercise for 14 days. Time to get some reading and relaxing in.

Sunday, June 2, 2013

My Double-Edged Sword

Dr. Roopa Duggal:   “You have a mass inside your uterus and need surgery as soon as possible.”
Me:  “Do you think ...” My breath left my body. “Do you think it’s cancer?”
Dr. Roopa Duggal:  “It could me a number of things, but ... yes, cancer is one of them. You have been on Tamoxifen therapy for five years now and one of the side effects is overgrowth of the uterine lining, polyps and uterine cancer.”
Me:  “I can’t believe this is happening." My jaw locked as it normally does right before a panic attack. "This feels like a nightmare.”
Dr. Roopa Duggal:  “We just need to get it out, because if we leave it and you become pregnant, the probability of losing the pregnancy is very high.”

"Other side effects [of Tamoxifen] are rare but are more dangerous. These include: Overgrowth of the lining of the uterus (endometrial hyperplasia) and cancer of the lining of the uterus (endometrial cancer).” -- WebMD 

The good news is, the shape of my uterus is normal. It looks like it’s in the shape of a lightbulb, although it is very narrow. There is no malformation and my ovaries are very healthy. The problem is, with the mass and the overgrown uterine lining, the inside of my uterus looks like an hourglass. I am experiencing continuous cramping and frequent bleeding.

My surgery is confirmed for Thursday, June 13 at Loudoun Hospital with Dr. Roopa Duggal. They will remove the mass and the overgrown uterine lining (D&C) and then send both for pathology. Then I wait to find out what all this means for me ... is it cancer?

This Tuesday, I have my six-month appointment with my oncologist, Dr. David Heyer. I plan to talk through what my different options might be considering this new development. I am preparing myself for several scenarios, which could include stopping the Tamoxifen four months ahead of time or even needing a hysterectomy.

My heart is heavy and I am trying desperately to stay positive, but it is not easy. I hope this mass is simply a polyp and I will be able to stop taking the Tamoxifen. I want desperately to just be healthy and to live out my days as long as I can with my husband, family and friends. I don't know why I, along with countless others, are continually tested, but I do know that it only strengthens my faith, love and hope.