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.

Upcoming Surgery #6

Hello, all—if anyone’s still out there! My blogging has been slowly, s-l-o-w-l-y crawling toward the point of nonexistence, and I’m so sorry for being such a terrible blogger! But, life happens.

Alas, here I am. Still sometimes blogging and always still walking among the infertility trenches. But I’m beginning to climb out: I see a definite end in sight—even if that end involves bidding adieu my unproductive reproductive parts.

Blogging

In big news, part of my blogging absence is because Jake and I bought a house! Long story short, we bought  a townhouse, moved to the burbs, and are currently adjusting to the massive shock of our lives being completely uprooted.

The other reason for my blogging absence is because fertility/infertility hasn’t been much on my radar. For awhile I believe infertility became an idol in my life. It was all-consuming. As time passes, it slips further and further down my Top Ten list. Lately, at best I’m halfway interested in infertility’s role in my life. Mostly, I’m trying to move away from it, rather than digging in deeper. I want to move on.

Endometriosis Surgery

Back in October while scouring the internet for an endo specialist, I found a contender, right in my own backyard! Jake and I had a surgery consult with the doc, Dr. Lee, last week. Dr. Lee is an endometriosis wizard (wizardess?) and I think I’ll be in good hands with her for an excision surgery. She’s head of gynecology at a hospital in the city and know a lot about endo. Despite that her beside manner struck me as clinical and slightly cold, I still liked her because she plans to do a thorough endo cleanup on me.

Dr. Lee’s surgical plan is more involved than my last cleanup. Because I had a partial bowel resection during one of my prior endo surgeries, I have to meet with a colo-rectal surgeon. A pre-op bowel prep will also be involved (yech). Next week I’m having a pre-op pelvic MRI, which Dr. Lee also ordered. Then some other x-ray or specialist or… something… is involved. I basically forgot at this point what she was saying. I got hung up on the whole, “It’ll be a big surgery” part, and the rest was kind of a haze. There’s also a good chance I’ll spend a night or two in the hospital if my colon is involved again.

Surgery will be excision of endometriosis, removal of adhesions and any cysts, and cauterizing my cervix (again…) to try stopping its endless bleeding. Unlike my last two surgeries, this won’t be a daVinci robotic surgery.

Hysterectomy

Like every doctor before her, Dr. Lee reviewed my previous surgical reports and was all gloom-and-doom about my prospects for fertility and for long-term endo relief. She kept emphasizing my need to have a hysterectomy, and for the first time in many years I actually heard her out about it. Normally I tune out the docs when they start yammering on about the virtues of hysterectomy (although never the downsides… hmm), but I’m starting to wonder if maybe—just maybe—the docs are right.

It mostly comes down to quality of life: Do I want to keep a modicum of fertility, but live with ceaseless pain and bleeding? Or do I want to say goodbye to that sliver of hope/fertility, but finally have pain relief (and, dare I say, closure)?

I’ve reached a point where I can’t 100% confidently say that I want a baby badly enough to continue suffering physically and emotionally with pain from endo, pain and bleeding from a super-friable and inflamed cervix, pain from fibroids, endless ovary pain, pain from breast cysts (yeah, that’s a new thing…), painful intercourse, mega monster incapacitating cramps, and the icing on the cake: infertility. I just want it all gone… even if that means I can never be a mama. It’s a bitter pill to swallow. We’re praying for God’s leading on this. For now, I wait quietly.