Saturday, February 18, 2012

The Great Ovary Debate

Blog friends, I fell off the blog path.  I was over it, you could say and was tired of sharing everything when all I felt was a sad, empty, hopeless nothing.

But, I figured I needed wanted to update those who read this blog with what I'm facing now.

Last year I had to meet with a gynecological oncologist to discuss the removal of my ovaries.  Since I carry the freaking mutation, I am at a 27% increased risk of getting ovarian cancer (the normal non-mutant population has about 1.5% risk).  That is pretty significant.  So most of the docs I've talked to have suggested that removing the ovaries is the natural next step for me.  Removing the ovaries will bring my risk down to that of the normal population.  It doesn't eliminate my risk, unfortunately, because cells will be left behind with even the best surgeon.  It also decreases my risk for the recurrence of my breast cancer.

I've known since the initial diagnosis and identification of my mutant status that I would face the decision of whether or not to remove my ovaries, but I was too busy kicking breast cancer's ass to think about my ovaries.  When we sat down to discuss it seriously last year, I shut down.  It was too much for me to take on top of finishing chemo and losing Tboz.  I had no fight left.  So I put it off until early this year.

In January, I went back to see the GYN oncologist.  I was prepared and had done much research and thinking.

I told him I would like to wait until I am 40 because removing them prior to age 40:
  • increases your overall mortality risk by 170%
    • Yep, that is one hundred seventy.  Of dying.  Hard to get past this one, huh?
  • increases your cardiovascular risk by 35%
    • Most men in my family have/had heart disease - would imagine that because I am lucky like that, I will too
  • increases the rate in which you decline cognitively (no comments from the peanut gallery, this is serious)
  • increases the rate and severity of osteoporosis and bone decline
  • Oh, and totally eliminates all possibility of creating a small person of my own and a lot could happen between now and age 40
  • Removing your ovaries (regardless of when) also causes
    • instant menopause
      • Chemo pretty much put me into menopause and the breast cancer medicine I take has wreaked havoc on my hormones as well so I am already having so many hot flashes and TERRIBLE mood swings. I really hope this does not get worse
        • Apologies to all in my path, I have been a hormonal mess. Sad, angry, happy, crying, all in the same day.  So sometimes, its just easier to stay at home.
    • definite decrease and sometimes total elimination of libido
      • DON'T READ MOM AND DAD - I don't need any kind of obstacles in this department.  I don't leave the house and Mr. Right is not going to come knock on my door, so I need motivation to get out there.  Libido (wanting to get some) is a good motivator. Sigh. 
He was OK with this decision.  He said it wasn't his recommendation but was agreeable to my plan.  He said that this means screening every 6 months.
  • The screening methods that they have for ovarian cancer are poor and unreliable.  But docs use them, because that is all they have.
    • Screening is a pelvic exam (with finger up your pooper), vaginal ultrasound (LARGE dildo type thing up your hoo-ha), blood test
  • Typically, once ovarian cancer is found it is advanced, hard to treat and carries a low survival rate.
I asked him what most of his patients did, he said most removed the ovaries right away because they could not deal with the anxiety.  He also said most don't know what I know.

He commenced with sticking his finger up my hoo ha and pooper and left.  I cried.

I went to get my blood test and it hurt and the phlebotomist missed the vein.  I cried.

I went to get the ultrasound.  The dildo was in my hoo ha for 30 freaking minutes.  I felt violated and ashamed and terrible and scared and sad and alone.  I cried through the whole thing.  There was concern from the tech and they sent me home telling me the doc would call me for a follow up.  I went home and I cried.

Doc called and left cryptic message.  I cried.

Doc finally reaches me after I leave him numerous frantic messages.  They found stuff on my ovaries.  Each ovary had a complex cyst on it.  Most cysts they find on ovaries are simple and come and go.  Complex cysts cannot be ruled out as cancer.  The plan was to do another ultrasound in 6 weeks.  If they go away, then it is nothing to worry about.  If they grow, or stay the same, then we would need to explore options.

I hung up and decided I couldn't go through this every 6 months.

A few days later I scheduled my surgery.  I will be getting spayed 1 March 12.  

I will do all that I can to keep my uterus (my breast cancer medicine causes uterine cancer, so they will push for me to get that out too).  I don't know why I want to keep my uterus other than I just want some piece of femininity left.  And who knows maybe I could grow a small person.  Someone else's small person.

Asking my friends and family, once again, to send good juju, positive vibes, rain dances, prayers, praise to allah, whatever, that what they take out will not contain any cancer.

Love to you all.

P.S.  I got a new dog.  Her name is Muppet and we are bonding.  She is no Tboz, but someday I will see her for the great girl that she is and as a wonderful being completely separate from Tboz.