It's Been a Weird Week

You never really know what's going to come of a call to Dr. Academic's office.

I don't really call all that often any more, simply because I'm not having that many problems. I never called all that much to begin with, simply because I felt guilty taking time away from patients who could really use the help. I sucked up many of my complaints, and I was glad that, when they passed, I skipped calling for help. Going through chemo is like going through anything else: you get used to it. But even now that I'm through the worst, I nonetheless have to call in every now and again to get certain things taken care of---getting my vicodin prescription refilled is at the top of the list (due to idiotic Minnesota state law in regards to narcotics, you can't order a refill through the pharmacy, but rather you have to go through your doctor's office). Any time I have questions, though, they're pretty good about getting me an answer, even though Dr. Academic's main nurse, who is omniscent and omnipotent and is, generally speaking, AWESOME, has been on maternity leave since December and her absence has really been screwing things up. That aside, I called in the other day because, well, I've been having some pain in a place where I shouldn't be having any: my pelvic region. Particularly, in the area where all the trouble began.

I called in because, mainly, I was curious. It's not high-grade pain. It's very low on that 1-10 scale they use to rate your pain, and I was more curious about it than anything else. I thought, perhaps, this was me finally feeling the mysterious endometriosis, which I never knew I had until after I had my surgery. Dr. Academic had mentioned at our last meeting that he thought, perhaps, that the chemo hadn't killed it off, like they thought it would. Apparently, endometrial tissue is the cellular equivalent of a cockroach who's still putzing around after a nuclear war. I was told to keep an eye on things and to report in if I had any pain. I had pain, so I reported in.

The last thing I expected---and I seriously mean that---would be to receive a call back later in the day, telling me that Dr. Academic would really like it if I came in to give blood for a CA-125 test and to have another Pet Scan done, as well. Well, hello there sailor! Furthermore, even though I had my three month checkup already scheduled for next week, they wanted to move it up to a day when Dr. Academic was actually in the office. It makes your head spin, sometimes, when a doctor freaks out, and starts ordering tests willy nilly.

It had seriously never occurred to me that the cancer might be back, but even after this information had been related to me, I still had a hard time getting worked up about it. I really didn't think the cancer was back and was fairly certain that he was freaking out over nothing. Yet, I nonetheless went in for the CA-125 (and, man, was it ever weird being back in that office after a three month absence! All those worried, exhausted, sick people of whom I used to be one. It's just a sad place to be when you're well.), and the next day went in for the Pet Scan, and then went about my business. I knew that if the cancer was back, well, that didn't bode well. The odds are that if ovarian cancer comes back after an optimal surgery (which I had) and optimal chemo (which I also had), "Ovarian Cancer" would most likely be listed as the cause of my death on my death certificate. As in it would be inevitable, unless I died from getting run over by a bus or a Benz-driving Soccer Mom gabbing uncontrollably into a cell phone. That's just how it works. That's the point where a cure is forever put out of reach; you will simply receive treatment to keep you alive, but you'll eventually die of ovarian cancer, at some point in the future. It might be next week, or it might be thirty years from now, but it will happen. It's very sad, but it's very true, as well. Even knowing this, I just couldn't get worked up over it. It just didn't feel like cancer, which, I'll grant you, is ironic given my original OB-GYN said precisely the same thing before my surgery, but, still, it didn't feel like it. Cancer for me means lots of pain and fatigue that comes out of nowhere and demands that you take a nap. I'm not having any of that. Despite the fact I'm still feeling some of the aftereffects of chemo, for the most part, I feel great! My body is working the way it's supposed to. And while I'm absolutely certain that you can probably feel great and still have cancer, I was fairly certain that I hadn't recurred.

It turned out that I was right, too. The test results came back yesterday and the nurse called me first thing to relay them. My CA-125 is at 5.6, which is fantastic and the Pet Scan came back as normal, as well. I know we're no further along in figuring out why I'm having pelvic pain, but we can sort that out on Tuesday, when I have my appointment.

I suspect it's the endometriosis that's causing the trouble. I've been on HRT since July, and have been feeling some weird things in that region ever since I started up, but there's been no pain, until now. Endometriosis feeds on estrogen, which is, of course, what the HRT is supplying so I don't have to suffer through hot flashes and the like. But I'm also receiving progesterone, the anti-estrogen hormone (it's the predominant hormone during pregnancy, which explains why I'm fat, fat fat right now.) and that was supposed to combat anything the estrogen might do in terms of the endometriosis. Dr. Academic hypothesized that what I was feeling was probably adhesions, which were being charged by the estrogen in the HRT. Now, I don't know if they'll be able to treat it, so I can still stay on HRT, or if I'll have to give up the HRT entirely. It would be bad for me if I went off HRT, not only because I freakin' hate hot flashes, night sweats, and weeping like a ninny every time I turn around, but simply because thirty-seven-year-old women are not supposed to be in menopause. Without the hormones, your bone density deteriorates and the chances for osteoporosis go through the roof, and since osteoporosis jumps from branch to branch in my family tree with the greatest of ease, that's something I'd like to avoid. One of my greatest (and stupid) fears is that I'll shrink---and that one was already in play before I got ovarian cancer. It also means that my expected life span, which is pretty much back to normal since the cancer went on its merry way, would be diminished. So, I need the HRT until I reach the age when I should have hit menopause, despite what it might do to the endometriosis. The benefits, for me, are greater than any risks that might come with taking it.

But then again, I'm not a doctor, so I might be entirely wrong about this whole thing. It was this weekend last year that I was certain I was having a gallbladder attack and went to the ER for help---and we all know how well that turned out. The timing of all this aside (which, honestly, is one of the weirder coincidences in my life), I'd at least like to think I have a better handle on all of this medical stuff. I didn't freak out, like I did back in November, about receiving the results of the pet scan. Perhaps just having more distance between the rigors of chemo over the summer and now has helped. Maybe being at the hospital and getting over some deeply ingrained fears held over from the time I spent there has helped, as well. I don't really know. But, come whatever may on Tuesday (and I suspect something will come, even if I don't know what it is. I've learned that when a doctor freaks out like Dr.Academic did, it's generally something and something will generally come of it.), I've surprised myself this week by handling this pretty well.

Lately, I've thought that I didn't have a lot of emotional reserves left after battling cancer for the better part of a year. I freaked out at the least likely of things, and didn't really have a good grasp on that gift from God called "perspective." I made more of things than I should have. This week was a bit of a wake-up call in that department. Strangely enough, you can apparently bring the threat of cancer back into my life and I won't freak out. Oh, sure, I'll think about it a lot but, for the most part, I won't let it bother me. I wasn't paralyzed with fear. Mostly, as I told the husband repeatedly, I was going to be pissed off if the cancer came back. And I seriously meant that: all that...for what? Just to have to do it all over again? How fucking unfair would that be? What a load of hooey, I thought. I just don't have time for this crap! I feel well. I have been told repeatedly by all and sundry that it's time to get on with my life---only to have to put it on hold again because the cancer had reappeared? I don't fucking think so. And, yes, while I was relieved when the tests came back normal, it wasn't like the huge wave of relief that knocked me over when I received the same results in November.

So, it's been, on the whole, a very weird week. We'll have to see what happens on Tuesday, and on Friday, which is my one year anniversary, to see if next week trumps this one on the weirdness scale.

Posted by Kathy at February 16, 2008 12:27 PM | TrackBack