Complex-icated

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A few weeks ago Dr. Ruby sent me for ultrasound to see why my pelvic pain has gotten so bad.

Ultrasound showed a large hemorrhagic complex cyst on my left (and only) ovary. The cyst itself was about the same size as my actual ovary. Dr. Ruby thinks that a second cyst may have ruptured and spilled, and likely explains my severe pelvic pain from January.

Dr. Ruby also tested my CA-125 (ovarian cancer antigen) levels. My levels are elevated. Fortunately, they’re not as elevated as last time I had them checked. The normal range is 0 – 38; my current level is 45. My prior levels—during my 2010 and 2012 surgeries—were in the 80s and 110s, so in comparison 45 isn’t so bad. It’s out of range, but not nearly as scarily out of range. Dr. Ruby suspects that my CA-125 is elevated because of return endometriosis, and possibly because the cyst is an endometrioma.

My follow-up ultrasound on CD7 showed the cyst has reduced by 75%. Excellent news, and I’m very relieved. My first ultrasound was taken on CD27, which of course means my lining was super thick, so Dr. Ruby wanted to recheck things post-menstruation with thinner lining. We’ll recheck it a third time in a few weeks.

Even though this is good news and literal prayers were answered, a larger problem still lurks, at least in my own mind. And it’s more than simply not seeing the silver lining in the storm clouds.

Let me explain.

I’ve spent the past three weeks wrestling with the unhappy prospective of another surgery. And even though another surgery is currently tabled, it might only be temporarily tabled. So while, through God’s grace, I’ve won this battle, I’ve not won the war.

I’m no doctor, but a large complex hemorrhagic cyst leaking/bursting/draining—or whatever it’s called when cysts “go away”—means that all of its yucky endometrial contents have spilled into my pelvic cavity, right? Which can mean more endometriosis legions. Which equal more pain + adhesions + endo, which = another inevitable surgery… this disease just cycles back on itself.

So I’m grateful. But long-term I’m only cautiously optimistic.

Jake’s very first words to me when I told him about the cyst were, “If you have to have surgery to take it out, then have them take everything else out with it.”  He doesn’t like to see me in pain, and he def hates seeing endometriosis’ tendrils near-constantly affecting my quality of life. And I can’t say that I disagree with him.

This big lesson this seemingly tiny episode is teaching me is that, emotionally, I’m not ready (yet?) for hysterectomy. During the really bad moments, I beg for hysterectomy like I imagine a laboring woman begs for an epidural: anything to stop the pain that seems to have no end. But no matter how appealing it can sometimes seem, when I’m faced with the reality of choosing hysterectomy, I’m not “there” yet. In the future if I’m faced with having to make the hyster decision—unless I had loads of time to prepare beforehand—I’d probably be a total mess and would wuss out.

Hysterectomy is NOT an easy choice to make, especially when I’m still ‘technically’ in my fertile years. So yeah, it’s complicated: I’ll be wrestling with this one for awhile.

Update on complex cyst to follow.

Peace.

Author: Marixsa

Resolving infertility as childless-not-by-choice and encouraging fellow endo warriors along the way.

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