Friday, June 1, 2007

Meeting the Oncologist

I went to my OB's office to get my staples out from the c-section a week after the incision was made. She referred me to who would be my gynecologic oncologist for an appointment the next week. Things were moving so fast!

Fifteen days from the date my daughter was born I met the oncologist who I'd soon have a close relationship with. I actually still had some butterfly tape over my incision that she took off for me. She did the exam and frequently expressed how sorry she was for me. I didn't understand what I was getting into. Everyone felt so bad for me and I was just rolling with the punches. She let me ask questions and gave me all the information she had about the disease.

She told me that the chance of survival from this disease would be greatly increased if I had a total hysterectomy. In the surgery business, this is called something like a total abdominal hysterectomy and bilateral salpingo-oopherectomy, or a TAHBSO. That means the removal of my uterus, both fallopian tubes, both ovaries (I only had one left), and they would also take a lymph node or two from my pelvis and several other biopsies in my abdomen. They would also remove some fatty tissue on my bowels that cancer tends to gravitate toward. If there was visible cancer in my bowels, they would section it off and reattach it.

They gave me a "bowel prep kit" to drink the day before surgery and told me I couldn't have any solids for two days prior. I'm a vegetarian so I knew this part would be exceptionally hard, and it was. The surgery was set for April 9th, two weeks later. I wouldn't see my oncologist again until after surgery.

Thursday, May 31, 2007

The Story of My Diagnosis

My name is Hillary and I have Clear Cell Ovarian Cancer. Here is my story.

I've been living in my little bungalow with my boyfriend, Dan, for a little over 4 years. We have a 3 year old son, Tristan. We had been thinking of getting married but it hasn't been a priority in our lives since we have so many other things going on. I guess you could call us hippies.

We decided we wanted another little bundle of joy to add to our family in the summer of 2006 and, lo and behold, I found out I was pregnant by the end of the summer and the due date was St. Patty's Day of 2007. I had a pretty uneventful first trimester. During week 20 I had an ultrasound. The technician noticed a cyst on my right ovary that measured about 5cm in diameter, but said it was very common to have "pregnancy cysts" and that they would watch it but it would probably go away on its own. I wasn't really worried.

As I started to get bigger and rounder, I started getting more exhausted and my back started to hurt, just like any normal pregnancy. I didn't have any other complaints. I'd been through this before with my first pregnancy and I actually felt pretty good comparatively. During week 34 I had another ultrasound and no one said anything about the cyst. I had actually forgotten about it by that time. They did find that our soon-to-be little girl was transverse breech, meaning that she was not in the head down position, but she was kind of stuck sideways. No wonder I was so uncomfortable! I'm a pretty skinny girl normally, so the back pain now made sense. One thing I did NOT want was a c-section so we decided to try and turn her in a procedure called a version scheduled for the next week.

I was not looking forward to a medical intervention such as a version so I had been trying various methods at home to get her to turn on her own. I used a flashlight to shine on my belly where I wanted her head to go and a bag of frozen peas where I wanted her feet to be. I did this every night until our appointment and I believe I felt her move in the proper direction. When we got to our appointment at the hospital, they had to perform another ultrasound to see where she was and if she had turned on her own. The little bugger had! She was facing south. That was very exciting.

The technician kept asking us questions about if this was a normal pregnancy and if we had anything we were wondering about. She left the room to get the doctor who was originally going to perform the version and when he returned things started getting odd. He looked at the pictures taken from the ultrasound and said that yes, she had moved, but that there was a very large cyst on my right ovary. We had forgotten all about that cyst. It now measured 11cm in diameter (the baby's head measured close to the same at that point) and was covering the birth canal. He said we would have to have a c-section because he didn't think the baby would be able to pass through, and they would want to look at the cyst anyway.

I was devastated. I felt so out of control. For some reason I was most upset about not being able to deliver her in the event that I had to do it on my own, like if I got locked in a trunk, or got lost in the woods or something. I eventually got over it as best I could and started focusing on getting through the surgery and healing. By week 37 I was put on bed rest due to extreme fatigue and back pain because of the cyst and we scheduled the c-section for week 39. I was feeling healthy and ready to have my body back.

The c-section was so scary. I had never had surgery before, so I didn't know what to expect. They wouldn't let Dan in the OR while they were inserting the spinal anesthetic so I was really having a tough time with trying to relax. Once they got me on the table and Dan by my side, I felt better. My OB started the procedure at 10:30 and she was born at 10:37 am. During the time we were oh-ing and ah-ing over our newborn, Maja, and laughing about how we thought she'd be so big when she only weighed 6 pounds 15 ounces, my doctor was inspecting my ovary. She sent a frozen section down to pathology to be tested and was waiting on the results. It was taking a very long time for them to get back to her. I ended up being open on the table for somewhere around 45 minutes I could tell they were getting anxious to close me up. They finally did and I went to recovery. That was a Monday.

I was in some pain, but I recovered pretty well that week. I remember telling my doctor I felt like I could run a marathon. I was ready to go home on Friday. Friday morning at 7 am, my doctor came in and woke us all up. She said she had to talk to us. She told us that she had to remove the entire ovary which suspected she would, and that the results had come back from pathology finally. She said the reason it had taken so long was because the pathologist couldn't believe what he was seeing and had to do more tests to make sure. I had Clear Cell Ovarian Cancer which was a very rare form of Ovarian Cancer and it was very aggressive. The mean age of onset for this type was 57 years old and I was only 31. I could not believe what I was hearing. I didn't cry. I had a gorgeous newborn to add to my great family and I was so happy, how could I worry about myself now? I guess I would have to put off that marathon.

The Last Lecture