Tuesday, January 13, 2009

Ovary Update 568

We saw Dr. Horbelt, the gynecological oncologist, in Wichita today. I feel a bit more encouraged. This blog is very detailed and may fall into the "too much information" category so the short version is surgery will be in about two weeks, Dr. Horbelt is pleasant, twitter came up, and I'm so thankful for the medical care I've had to this point.

The long version follows.

He examined me then he had us come in and talk to him. He said, "I am not happy with the radiology report, but your young age trumps that." Apparently, ovarian cancer in women under 50 is rare. I just turned 47 in late December. Another factor is that I was on the pill for a number of years. Being on the pill for more than ten years decreases your risk for ovarian cancer by fifty percent. I also have none of the symptoms - bleeding, irregular periods, etc. - other than the pain. So, that's all good. The CA125 level being normal is good, but there are cancers that don't raise that level. So, it's not a definite.

He said it is 20 centimeters. I've now heard everything from 13-15, to 16-18, to 20. It's big. Obviously. Twenty centimeters is about eight inches.  He said size has nothing to do with whether or not it's benign. Benign can be small or large, and cancer can be small or large.

The incision will be about at my belly button and go down. I have a little hernia in my belly button and they'll fix that too, as a matter of course in how they sew me up. If it's benign they remove it and that will be it. If it's not they will cut further up so he can explore. Obviously, that will affect my recovery time.

If it's cancer, a hysterectomy is a matter of course. If it's benign it's my choice what to do in that regard. Dr. Wesley, my general practitioner, encouraged me to consider that given my age. Although I have no signs of menopause, for most women it would happen in the next 2-3 years. It might well be later for me given that many women in my family have had babies into their 40s, including my mother, and ancestors on both sides of the family. (My great grandmother had a baby at 48 - long before there were fertility drugs!) But, it's going to happen eventually.

A hysterectomy would remove the potential for cancer in all of those spots in the future. So, ovarian, uterine and cervical cancer would no longer be possibilities for me. I'm going to have that done.

It's very odd to think that I've just finished my last period. It's a life passage that I'm not going to experience in the natural way. There will be some grieving related to that. But, I will grieve it a few months from now. This isn't the time for that. I understand the whole concept of how it's not natural to remove those organs and all of that. But I also understand that human bodies were designed for 35 to be a ripe old age. And, frankly, the last week hasn't been a whole lot of fun. I don't want to do this, or anything like it, again. So, I have a chance to prevent a bunch of similar things and I'm going to.

They will call me tomorrow with a schedule for surgery but it will probably be about two weeks. He needs a stretch of time to do it in and he's apparently in surgery every day. I will probably be in the hospital about five days. I'm not sure which hospital yet, either.

Dr. Horbelt should teach bedside manner. Generally I find specialists to be annoyed by the person attached to the body part they're especially interested in. The attitude is, "oh no... it's talking... make it stop talking... it wants me to talk to it... I don't want to talk to it... make it stop."

I'm very spoiled because Dr. Wesley has great bedside manner and I forget not all doctors are that way. But, Dr. Horbelt was wonderful - twitter even came up in casual conversation. I generally steel myself for any encounter with a specialist, but I remind myself they don't have to be pleasant, they just have to be excellent. Today I got both. Dr. Horbelt was charming from the outset. And, what I most care about, seems to be at the top of his game.

Today I've begun to realize how fortunate I am that Dr. Wesley didn't just blow off the pain I was having and insisted I get a pelvic sonogram. And I'm thankful Dr. Neuschafer referred me on when he didn't feel comfortable doing the surgery. It seems this is the right path.

Things can change day to day, of course, but I'm hoping we're on the way to resolving this.
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Anonymous said...

Thank you for the update and please don't feel you have to apologise for detail - its your life!

Patsy Terrell said...

Thanks, Janice... I just never imagined I'd be discussing my birth control methods on the world wide web. :)