Good to Go-- Mostly

Today's the six-week anniversary of my ovarian tumor and a lot of other things removal surgery. And yesterday, I had my appointment with my local gynecologist, Dr. P, to clear me for full activity.

And yes, I am cleared for whatever I want or need to take in hand. He said, "Everything inside is healed up by now." I mentioned how I had "been good" and given up on, say, opening stuck windows because I felt my abdominal muscles pull. "If you don't push past that," he said, "you'll never get any stronger." Good, that means I may and can and should go on with it. How much exertion is too much? Let's put it this way: As in ordinary exercise, I'm to ignore those who tell you to "go for the burn." Otherwise, let the garden digging begin!

And guess what? I wasn't crazy or deluded when I thought the ovary with the mass was the righthand one. Dr. P, going by the sonogram, thought so, too. Apparently, there's things you can tell from those images and things you can't.

I asked him if he was looking for some uterine problem when he clapped me in for that ultrasound. Yes, he was, and I picked up that he was more shocked than I was when the ovarian mass was revealed. I, after all, had been worrying about ovarian cancer before I even booked my examination by him in mid-February. I got my cancer anger and fear over with beforehand (thanks to the answered prayers of many). I mentioned this to Dr. P, and he said, "Yes. I see. And once you knew the mass was there, it was a matter of dealing with it."

I thanked him for his expeditious action and vigilance. As I've commented in this blog before, the symptoms that got me in to see him turned out to have nothing to do with the ovarian cancer. It would have been so easy for him to have treated them and sent me blithely on my way, with the mass silently growing in me until it was practically too late.

My friend Frieda* gave me a ride to this appointment, then had to return to work. She offered to excuse herself and come take me home, but I celebrated my liberation by walking the two miles home. It was a nice day to walk along the bluff above the Ohio River, admiring the houses and what was growing in people's front gardens.

And shortly after I arrived home, I got my car key and when out and drove it for the first time in six weeks. Only from one side of the street to the other, so I wouldn't get ticketed when the Borough swept the other side of the street last night.

But alas! not everything is good to go. The check engine light came on on the dash and wouldn't go off! This evening I asked my next door neighbor, who's been moving the PT Cruiser back and forth each week to avoid the Borough sweeper, if he'd noticed any lights that stayed on, and he said no. He thought the rotors on the front brakes were grinding, though. And when I moved the car back tonight, I noticed it, too.

I'd really hoped to go get some garden plants tomorrow. But I see online that driving with the check engine light on could prove dangerous. So I remain effectively carless until I get can get it into the shop and fixed. And that won't be till Saturday morning.

Otherwise, it's time to get back to normal and get things done.

Easing Back into It

Sang last night in our first choir concert of the Spring season. It went well. Some friends brought me a stool I could perch myself on. And when, during the first number, I discovered that holding up my black folder was too much of a strain on my sore abs, I lay my music down on another stool that'd conveniently been left in front of me.

I should have the music memorized by now, anyway.

It's a little frustrating to be able to do stuff like this and still not be allowed to drive or mow the lawn or even take out the used cat litter out to the trash can in the alley, but I guess that's how it goes.

And Sunday, when we have our big concert, I think I'll bring a lightweight folding music stand. Can't depend on that other stool being there.

Knowledge Is Power

My surgeon Dr. C was in at 7:30 this morning, the whole parade of interns, residents, and so on in train, and he confirms that I can go home today, hooray.

(True, all systems are not Go as yet, if you know what I mean, but they have ways of dealing with that . . . Yes.)

Dr. C sees no need to wait for the pathology report; everything points to my "low malignant-potential tumor" as having been Stage 1; that is, confined to the one ovary. That bit of me and rather more is now out, out, out, which means Problem Solved. The tumor was only 6 cm long, compared to the 9.7 it was scaled from the February 19th sonogram, so there's no way to get a comparison to see if it grew in the last two months. But it's nice to know it wasn't as honking big as my gynecologist originally thought.

No chemo, Dr. C confirmed. Great to hear; I wouldn't have looked forward to that, even if I did have insurance.

This is all very good, but I had more questions. Only 15% chance of recurrance, right. But if it does come back, how will I know?

There'd be lower digestive tract problems that don't respond to anything else. In fact, where LMP ovarian tumor fatalities come about is due to bowel obstructions and the attendant sepsis, not because its cells infiltrate and change an affected organ.

Where would it come back?

Someplace in the abdomen.

And the response?

Surgery, again, unless that meant taking out something I couldn't do without. In which case they'd try chemo, even though it's not that effective, since the LMPT cells are so close to normal cells it's hard to hone in on that target.

But, says Dr. C, why am I fretting over this!? We're only talking 15%!

No, I'm not fretting! In fact, it makes me fretful that he should think I'm fretting! My academic mind wants to know all the facts, sort through them, arrange them as needed, and go on from there! In one of my favorite novels, Dorothy L. Sayers' Gaudy Night, the hero Lord Peter Wimsey, is shown to be a paragon among men because he correctly interprets a female academic's question about a certain male wardrobe malfunction not as skittishness, but as a desire for precise information. My Dr. C is not necessarily a paragon of that calibre, but he knows his medicine. So if he wants to chaff me for being a worrywart, he can do it, as long as he answers the questions.

Though maybe I should admit to an smidge of Eeyoreishness . . . My prevailing feeling is that with me, a 15% chance of anything is like 0% should it be about something good. Like if I should play the lottery or if we're desperate for rain or I'm angling for a job. But if it's something undesirable . . . it may as well be even odds. I mean, I already "beat the odds" and got this weird kind of tumor, didn't I?

Never mind. Knowledge is power, and the more I'm master of it, the better. Anyway, who wants to be one of those patients who don't have all the available facts and goes around believing and talking as if her doctor is withholding information and may be doesn't know what he's talking about?

Adventures in Medicine

Well, I've been in the hospital since Thursday morning and coherent enough to get online since Thursday night, but only this morning did I find a person here at UPMC Mercy who could show me how to get connected on their wireless network.

And that was by coincidence, since I'd intended to read the newspaper my friend Frieda* bought me yesterday this morning over breakfast, but I guess it fell on the floor over night and the cleaning lady cleared it away. I lamented the loss of my paper to the nurse (a guy) and he said, "I see you have your laptop with you. Why don't you go on one of the newspaper websites and read it there?" And he showed me how.

Believe it or not, breakfast this morning is a medical adventure in itself. I still haven't passed gas (a very important indicator!) so far, so technically I shouldn't have anything by mouth. And I'd been feeling queasy. Etc. But my surgeon's fellow in their practice, Dr. K, who was in early this morning, said they could try me on some liquids this morning, regardless. 4 ounces of apple juice down the hatch so far, and working on the grape. So far, so good.

But people (all two of you!) will want to know about the surgery on Thursday.

Here's the good news: My surgeon, Dr. C, says everything looks good; the mass they took out wasn't cancer and there was no sign of cancer anywhere in the abdominal cavity.

Here's the routine news: They've taken all my ladybits and scrapings of everything else in there (from the lower lungs on down) to the lab to make absolutely-certain-sure there's no cancer anywhere.

And now, the ambiguous news: The ovarian mass, while not cancerous, is nevertheless not a "normal" cyst. If I understand correctly, it's not even precancerous. What they're calling it is a "low malignant potential tumor," and I have no idea where the hyphens should go on that. Dr. K says they'll go over all that when I'm discharged.

The mass is not invasive and therefore not a cancer, but wasn't a benign thing to be having in me, even so. There's a 15% chance it could recur, and there's nothing that can be done to make that risk nil. There's no role for chemotherapy or radiation to obviate that 15%, because, well, it's not a cancer! But if I understand the doctor's message right, it's the short of thing that can pave the way for a cancer in the future.

I think. The inconvenience in all this is that Dr. C had leisure to talk to my friend on Thursday, but not to me-- I was in the Recovery Room. So I couldn't ask any questions!

She said Dr. C told her "Nobody wants to hear this sort of news. Everybody wants things black and white."

Well, maybe, but my first reaction was, "There I go again, being original! I never can seem to do things the ordinary way!"

And if I want things to be black and white, it's not just for my health's sake, but so I can explain it simply and easily to people and not bore them going off on tangents.

Oh, well. It is what it is. And if my breakfast of juice and jello will stay down nicely, that will be one less adventure to confront!

Mild Hysteria

My surgery is two weeks from tomorrow. Today my MD cleared me as healthy enough to tolerate it. Too bad I'm not healthy enough to not need it!

And today I got the pathology report from what they sampled last Friday. No uterine cancer, thank you very much. And CA-125 levels in the normal range.

Which is good. But not always good for my attitude. Because it makes me wonder, do I really gotta go through this?

I mean, there's the "discomfort" of the post-op itself. Pain! Swelling! Mindless-making drugs!

Then there's the six weeks of enforced inactivity. Right when my house needs so much renovation! Right at the start of gardening season! Right when I should be taking advantage of the last weeks of the school year and getting in a lot of substitute teaching!

And what am I to make of what I read about hysterectomies online?

There's one site (which shall remain unlinked and unnamed) that seems dedicated to the proposition that 99.9% of all hysterectomies are needless and avoidable and only perpetrated by devious, greedy doctors out to make a quick buck at the expense of downtrodden women. What it tells you about the aftereffects will curl your hair. Nerve damage! GI tract disablement! Your ribcage falling down to your hipbones! Not to mention lifelong depression, loss of maternal feelings, and perpetual heartbreak, regret, and distress.

Then there's another site (which shall also remain linkless and nameless) where women who have had hysterectomies compare notes, and on it we have women complaining that their gynecologists wouldn't take their pain seriously and refused to take their bothersome female plumbing out.

Of course, this site makes its own contribution of stress, such as the contributors who say it was over six months to a year before they "got back to normal."

So with all this rattling around my brainpan, again, I can't help wondering, Do I really have to have this surgery? I mean, the gynecological oncologist is of the opinion that the ovarian tumor isn't even cancer! Can't we just ignore it and wait for it to go away?

. . . Oh yeah. Right. At my age, these things don't just go away. At my age, I really shouldn't have a goose egg in my abdomen like this. And malignant or "benign," the thing is growing. It's bad enough that it's already given me a pot belly I can't get rid of by any exercise of dietary discipline. But now it's interfering with my digestion. Benign or not, it can cause mechanical trouble. And they won't really know what sort of thing it is until it's removed.

So it's time to accept the PITA, and keep doing what I need to do to be as ready as possible when the time comes.

Promising

Outpatient surgery yesterday went well. And I'm blessed in that I have no trouble with anesthesia, before, during, or after.

And . . . how to say this without TMI . . . ? Let's just say that apparently it's been verified that the symptoms that got me to my gynecologist's in the first place-- the pain and the bleeding-- had nothing whatsoever to do with the mass on my ovary, and were, in themselves, annoying but harmless.

Meaning that it was a happy coincidence, or an act of Providence, rather, that caused this tumor to be discovered at this point.

The cancer surgeon is still pretty confident that it's benign. Hope he's right.

And it still has to come out. Along with everything else in there, what fun. That's in less than three weeks. All sorts of things I gotta do before then!

Exploratory Surgery

Tomorrow at the crack of dawn (6:30 AM) I'm due at the hospital in downtown Pittsburgh for exploratory surgery.

Well, ok, for a D&C. The other day at my first appointment with my gynecological oncologist, he examined me and said, "This doesn't feel like a cancer."

That doesn't mean we get out the bells and trumpets and kick up a celebration. No. But it is hopeful. Better odds than before.

However, says he, "That bleeding you're having. That ovary's not causing that. We need to do a D&C and see what's going on there."

So that's what's happening tomorrow. In and out the same day.

They'll biopsy whatever they find. Whatever it is, I still have to get the whole works out, which will happen March 25th. When that occurs, far as I can tell, best case scenario will be that the mass on my right ovary turns out to be a belated, post-menopausal fibroid and the bleeding was caused by, say, endometriosis.

Worst case would be that the tumor is, after all, a big nasty cancer and it's spread to my uterus. And who knows where else.

Best or worst case, it's all in the hands of God (with some help from the hands of my surgeon), and that's the best place for it. My job is to go get some sleep.