My Ovarian Meeting

Hello everyone,

I saw Dr. B today (the Gyno/Onco). She is very nice (and very petite). She first read through my history and then asked me some questions. Then did a pelvic exam (just in case the mass was gone....) No, it was still there. But she did say that it was palpable (movable) and did not seem to be stuck to anything (that is a good sign). Then Chris and I went into her office and we had our "options" discussion....


Okay Here are my notes (well the Dr. notes she wrote for me)

Options.

Conservative Options (this is where they find no cancer in the testing).


These will be attempted as laproscopic.

1. Remove just Left ovary (and mass) and tube. If the frozen sections (of the mass) tested is benign, they stop, close up and I'm done. (outpatient)


2. Remove both ovaries (and mass) and tubes. If the frozen section tested and benign, they stop, close up and I'm done, (outpatient)


3. Remove both ovaries (and mass), tubes, and uterus, if frozen section tests benign and they stop, close up and I'm done. (over night stay)

The recovery for #1 and #2 are about 2-4 weeks, the recovery for #3 is 4 weeks.

If the frozen section comes up malignant or borderline (if it is borderline then there are atypical cells and she will treat it as malignant because of my BC history).All bets are off....

She will have to make a vertical cut into my abdomen (like an emergency C-section) and she will have to remove all the reproductive organs and lympnodes and another organ called an the omentum. It is the fatty tissue that works like an apron on your organs. That is 2-3 nights in the hospital and a 6 week recovery.

Of course if it is cancer, it depends on what kind of cancer, if it is new or secondary on what kind of chemo I will need, no radiation.

She recommends since I am HIGHLY estrogen receptive that I remove both my ovaries at least.

She is hoping that my surgery can happen on March 10, I am waiting on the scheduler now.
This is exactly what I thought it would be. So I had been talking my self into the ovary removal for the past week. She said the hot fashes will be HORRIBLE and she will probably have to put me on something for them (more happy pills).

My meds will change cause I won't need the tamoxifen anymore, I will need the meds for post menopausal women.

Chris and I had pretty much agreed that I had to get both ovaries taken out. It took me a week to come to grips with that decision. Then I was talking on the phone with my mom on the way home one day this week. She said that she doesn't just see why I don't get the uterus taken out as well, and I quote, "Laurie Jo, it is just a bag wafting around in there waiting to get sick. The hard part are your ovaries, since they are coming out, why not the bag..." You got to love the way my mom puts things huh?

So I have been debating getting the uterus taken out...

Pluses...

1. Nothing else to get sick.
2. It is a baby basket for the most part, and with out ovaries there will never be a baby in there anymore.
3. Get it all done at one time and hopefully it will be the last time I'm cut.

Minuses...

1. They are going to have to cut off the cervix and then stitch up the vaginal canal, is it going to be shorter? Will it hurt to have sex?

So far I am leaning towards the uterus too right now, but I got back and forth. I don't have to make a final decision until my pre-op appointment that will be after they schedule the surgery.

So I am going to really push on praying and hoping this thing is normal and not malignant or atypical.

Are you Serious??? Ovary-Gate?

This has been a whirl wind two weeks. It started on Monday, Feb 15 (2010). I am not going to post this until I get more news (hopefully good) or at least my options. So here is the breakdown of the past couple weeks.

Back when I had my PET CT, they had found that my ovary had lit up a little, causing a little concern for my Oncologist. (Lighting up means could contain a cancer mass). So I was sent to for a pelvic ultrasound. They found what looked like a simple cyst, so they had me come back in a couple of months. At the second ultrasound the left cyst was gone, and there was a right cyst.

NOTE: This is very normal in a menstruating women since the ovaries release eggs it can cause a simple cyst that gets absorbed back into the body.

So when I met with Dr. K the last time, she told me that when I go for my yearly "Well Woman" visit, that I should ask for another pelvic ultrasound. So Monday I finally got around to doing it. That is where our story starts....

Monday, February 15, 2010

I was called back with a FULL bladder (which is required) by the ultrasound tech. She was very nice and she had actually done both my previous ultrasound, although I don't think she remembered me. So she did her exam and told me that I do have a couple of cyst in my right ovary, they looked simple. In my left I had a complex cyst, with solid and mass in it. Nothing to get excited over, probably a hemorrhagic cyst or an egg that didn't release. She would probably see me again soon, to check on it and see if it was still there in a few weeks (4-6 weeks).

"And by the way," she asked me, "Are you in much pain?"

"Pain? No... Should I be?" I asked perplexed.

"Well it is kinda big and I am surprised you are not in pain."

"Nope, this uterus has held a 10 pound kid, no pain here."

I got dressed and left. That night I got a call from one of the Midwives from my OB/GYN practice. She told me that the radiologist had called her and I had an enlarged left ovarian mass. She then proceeded to tell me the same stuff the tech did, so I wasn't shocked, just a little worried that the Radiologist felt the need to call my midwife instead of just sending the report. But in the end my midwife said that due to my breast cancer history, she cannot help me with this, and I should follow up with my Oncologist (I know, kind of a crappy time for Dr. K to leave the practice huh?). And before she hung up?

"So are you in a lot of pain?" She asked me.

"Nope, none at all. Why?" I asked.

"It's rather big, and I thought you would be in some kind of pain."

"Nope."

Tuesday 16, 2010

I called and left a message with Dr. H (My new oncologist) and Vicki (front desk) answered the phone, told me she had the report and would give it to Dr. H for her to review. She would call me back.

I didn't hear back from her on Tuesday, but it is only a complex cyst right? No biggie.

Wednesday 17, 2010

As I was ordering food for my office in Wendy's and of course left my phone in my car. Dr. H called back and left this message...

"Hi Laurie, this is Dr. H____, since Dr. K has left the practice I will be over taking your case. I have read the report from the pelvic ultrasound and you have an 8cm mass on your left ovary. It looks as though it is solid and liquid. We need to a laproscopic procedure to find out what it is. I have called your midwifery practice and there are OB/GYNs on staff. You need to see one of them, not a midwife, to do the procedure and to discuss your options. You should call them as well so they can discuss it all with you and get you an appointment."

Uh.... I listen to the message again. Did she say 8 cm or 8mm, must be 8mm right? NOPE, listen to the message three more times. An 8cm mass on my left ovary.

I called my midwifery practice and spoke with the front desk and she was very nice and had gotten me an appointment for March 4 with her favorite doctor in the practice. I said that was nice, but I think my oncologist wanted to me to be seen before March 4th.

"What was your Oncologist's name again?" I told her. "Hold on one second, that name sounds familiar."

She was gone for about 3 minutes, came back and said, "I just spoke with the Dr. and she already knew who you were and had your report. Unfortunately, she doesn't feel like she could help you, she said you need to see a Gynecology Oncologist."

That cannot be right, an oncologist is for cancer patients!!!!! I know... I already have one.

Then came the kicker... "And she says that you need to be seen ASAP." Well this has gone from bad to worse really quick.

They gave me a name of an Gyno Oncologist. I called Dr. H (my oncologist) and told Vicki what they said, she said gave me another name of a Gyno Oncologist that is the "best of the best" and works very closely with Dr. H. I thanked her and asked her to please fax me my report. "No problem" she said.

She was as true as her word, I walked up to the fax machine and there was my report. I will only quote for you the interesting parts....

Findings:

Blah,blah,blah then... "The left ovary measures 8.0 x 5.8 x 8.4 cm. The left ovary is replaced by a large complex mass which has a 6.8-cm septated cystic component and a 5.7-cm hypoechoic nonvascular component with internal echoes."

Impression:

"...Although this could represent adjacent hemorrhagic/complex cysts, metastatic deposit cannot be fully excluded."

WELL CRAP!!!

I have an appointment with Dr. B (the Gyno-Onco) on Thursday, February 25 at 7:45am, so we can discuss options....

Of course this is all I can think of all day, but gratefully I was feeling a little better about it on my way home when I received a phone call from Sharon one of the midwives in my practice. She wanted to call to just see how I was doing.

"Seriously Sharon, it is that bad?"

"No," she said. I was just wanting to see how you are doing."

"Please," I said laughing, "I haven't heard from y'all in two years (since my baby was born) and you just now feel the need to see "how I'm doing?" Well other than the last two days, I have been great!!!"

"No pain?" she asked (now I get why everyone is asking, I have a mass the size of a grapefruit in my ovary).

"Nope, but let me ask you a question, the report said that the mass has replaced my ovary. Where the hell is my ovary?"

"It is either behind it, or has grown through it."

"So either way," I asked, "I am going to loose my left ovary?"

"I am afraid so," she said. "It is so big, they will need to take it out."

"So my only real question is if I let them take out the other one as well." I asked her.

"Why not just get it done with." She said softly.

"Sharon, thanks for calling." I said, back in my cancer stupor.

"Call me if you need anything, Laurie Jo."