Unshelved by Bill Barnes and Gene Ambaum
comic strip overdue media

Thursday, October 20, 2016

I'd said I'd update

although my neck pain is enough that I'll try to make this quick. Sigh. I'm still digesting the full-impact of what I was told, but here is the gist:
  1. The lining of my uterus is very thick, much thicker than normal, and that's a sign of possible endometrial hyperplasia.
  2. I have fluid inside my uterus, which may be some sort of fluid-filled polyp or the like.
  3. I have a couple of fibroids, nothing to worry about--they're benign--but they could be causing the bleeding.
  4. I have to have a biopsy of my endometrial lining to check for the hyperplasia, see what type it is, and check for precancerous or cancerous cells.
  5. The doctor tried to do a biopsy today, but:
    • I apparently have a very small, very closed cervix.
    • She could not get the instrument into it.
    • In order to dilate it, she will need to use another tool that will hurt. A lot.
    • Also, she might have to cut it somewhat, to get it open, so that will also hurt, a lot.
  6. As a result, I will have to have a hysteroscopy and D & C, so she'll open up my cervix, put a camera inside, take the biopsy, scrape the lining and remove the fluid. All of this will be done while I'm under, so I need a driver, and I'll need to take off work for a day, and I have almost no personal time off, due to going to doctors' appointments for me and a friend.
  7. Best case scenario: The endometrial lining is relatively normal, and does not show hyperplasia.
  8. Medium case scenario: I have endometrial hyperplasia, and have to have a special IUD placed inside my uterus for the next five years that will release progesterone, keeping the lining small, reducing the chance of developing cancer, and make my periods irregular and possibly stop.
  9. Worst case scenario: They find precancerous or cancerous cells, meaning I'll have to have a hysterectomy, be off work for two to six weeks depending on what type, may need a short hospital stay, and take care to recover well.
  10. I got sent home with a pill I'll have to use vaginally four hours before the procedure. Hopefully I won't lose it in the meantime. :) It will help my cervix loosen up a bit. They will call me with the appointment time and date as soon as it is scheduled.
I've always rather taken my lady parts for granted. Sure, I've had the hormonal imbalance found in polycystic ovarian syndrome all my adult life, but my periods were regular and everything seemed to work as advertised. I assumed that the symptoms I've described were the beginnings of perimenopause. I think my doctor's very good with instinct, and I'm glad she counselled having the ultrasound and getting checked out for this. At no point has any other gynaecologist even mentioned the chances of uterine cancer were higher due to diabetes, obesity, and PCOS. She said that was probably due to my lack of symptoms and regular periods. That's actually in my favour; the risk for cancer is there, but is much greater if you go for long periods without a period due to hormonal imbalance--too much oestrogen--(rather than pregnancy or breastfeeding, both of which lessen your chances of uterine cancer).

I know most likely it will all be okay. But this is the first time anyone has seriously thrown the 'C' word into play, and I'm a little scared. Scared of cancer. Scared of having minor procedure and then possibly major surgery, especially with so little time left in my job, almost no PTO (although my extended illness bank is great, so that would pay for all but three days of the recovery, so that's good), and with so little time left with insurance.

After I got back this afternoon, in the midst of the initial stages of panic, I called my best friend. Just hearing his voice was comforting. I knew he wouldn't sugarcoat anything, insist that everything would be fine, etc., but even though he is usually about as comforting as Sheldon from 'The Big Bang Theory', I find him comforting in times when I need him most. He calmed me down and urged me to take it one step at a time. Later, I went over there after work to help with a couple of things and he fed me; he's Jewish, what can I say, he comforts with food.

So I will not panic. I'll take information as I get it and weigh my options. Even if the cells are cancerous, I think the hysterectomy is normally sufficient, so long as it hasn't spread outside. Even worst-case scenario, it's not like I'd die the moment they tell me. But I have to admit, this just reiterates to me how precious time is.

I debated doing this update. It might complicate my job prospects, for example. I finally decided for one reason: if any of you are experiencing changes in your bleeding, spotting between periods, missing periods--even if you're of an age for perimenopause, I strongly urge you to seek medical advice. I'm glad that my gynaecologist, on my very first visit with her, immediately pursued this rather than just pooh-poohing me or assuming I was going through the change. I really appreciate her manner and candor. Her name is Dr Elizabeth Elkinson, with KentuckyOne Health.. If you're in the area, have these symptoms, or any of the reproductive system that just don't feel right, I would recommend her.

Okay, I think I'm going to go ahead try to relax, maybe listen to some music, and then turn in early. Good night.

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