See the good, prepare for the best
I spent more than four months preparing for the worst. It was the conservative thing to do. By readying to do battle for my health, there wouldn't be any surprises.
My mouth wouldn't drop open when the doctor told me that, in fact, in addition to uterine cancer I also had ovarian cancer. Two, separate cancers. I wouldn't tear up when she told me I would also need to undergo chemotherapy and radiation. I wouldn't cry when I told my mom what my friends and I heard in my oncology consult. That's the accounting I had expected once the math was done on all my tests and scans and biopsies and surgery.
This expect-the-worst, prepare-for-the-worst, don't-be-surprised philosophy by which I tend to live was developed decades ago to ready for the unknowable. In this case, it made sense to me because at each turn in my travels from random, post-menopausal bleeding to cancer diagnosis, things were not what they seemed. Between each appointment, what was going on in my body seemed to change. The changes led to more tests. And it all happened pretty fast. I was fine one day. The next I was involved in a seemingly endless litany of doctor's appointments that consumed my sick time, meant I missed work meetings that actually were part of really fun projects with colleagues I adore, and that left me consumed with wondering what would happen next.
I first went to the doctor in early January after having a menstrual cycle about three years after my last one. Those of you who work with and hang out with me know that I've been having hot flashes for years, flashing like a cuttlefish at happy hour, having "personal summer" moments in work meetings that leave my brow dripping and wanting to lay my belly on the cool cement like a lizard in the blazing New Mexico sun.
In that first meeting, in early January, a pelvic ultrasound revealed a mass in one of my ovaries. A fibrous tumor in my uterus. Just stuff to monitor. Nothing too weird at that point.
I seem to keep learning that the funniest things in life also are wrapped in tragedy, or at least personal humiliation. This cancer story has some of that in it and it's about how I planned to return to work after the pelvic ultrasound. But all that probing from the ultrasound temporarily messed up my nerves a little. When I was getting dressed to leave, all this water came out of my body. I thought it was from the saline injection when they looked at the fibroid tumor. Nope.
I was peeing myself. A lot. You see, before the ultrasound I had to drink gobs of water so that my bladder was full. I can't remember why that helps the ultrasound, but it does. Between portions of the ultrasound, I was given a bathroom break. But, remember, I drank a lot - a lot - of water before the procedure. So, after another 45 minutes of probing and consultation, I had a full bladder. Now my damn bladder was emptying itself and I couldn't feel it! Pee ran down my leg and onto my tights, into my boots, into my socks. I stood there, watching myself whiz and laughing, because what the actual fuck?
Not to mention, I also had a big gob of ultrasound jelly all over my dress because I didn't know I had failed to get it all wiped off with the tiny scrap of towel I was given to clean myself.
There was no returning to work. I just pulled my jacket tight around me and skeedaddled on out of there, trying not to make eye contact with anyone in case I smelled like a used diaper tossed on the sunbaked roadside that now was being picked up by a Rotary Club highway clean up crew in the middle of summer ... (not that I ever was a Rotarian who picked up hot pop bottles full of pee on Delaware Avenue in the heat of an early spring).
I couldn't wait to tell several of my girlfriends about this latest tale of the vagaries of middle age. I knew we would laugh. Perhaps hard enough to have tears running down our faces. Maybe we'd gasp for breath and then wheeze out more laughter. And maybe, just maybe, we'd laugh so hard that one or two who have had multiple children would piss themselves from the storytelling.
But then, in early February, I had more spotting.
For those of you who are not biologically female or who aren't in mid-life, this bleeding is not normal. Once you've gone through peri-menopause, as I did in my mid-40s, and were in menopause as I had been for about three years, any bleeding is something to have checked out.
I sent a note to my doctor about the spotting. It was a Friday. On Monday, I was back in for another pelvic ultrasound (this time with no peeing on myself ... #winning).
A few days later, I saw my gynecologist. She shared that the mass on my ovary had changed. It was now feeding itself (my term, not hers). The lil bugger had started to draw in blood and to grow. It was eating. Since it had developed an appetite, it would have to get removed via surgery.
I was ready for the idea of surgery and I wasn't surprised when the doctor said the ovaries needed to be removed. I have to admit, I was getting ready to learn that I had ovarian cancer after surgery. You see, ovaries aren't biopsied before surgery. The only way to figure out what is really happening is to biopsy them after surgery.
The ovaries are a closed system. As I understand it, any pre-surgery biopsy -- the sticking of a needle into the organ to gather cells -- would open that ovary to the rest of the body. In other words, the needle creates a hole in the ovary and things can get out of that hole. You don't want that to happen, especially if there is cancer in the ovary, so you biopsy after the ovary is removed.
Knowing that surgery was inevitable, the doctor decided to biopsy my uterus lining. It was highly unlikely -- almost unthinkable -- that there would be anything in the biopsy because I'm young for uterine cancer and because my endometrial lining was normal in the first and second ultrasounds. Probably just needed my ovaries removed and then I'd roll on with life.
So, the doctor took the biopsy samples from my endometrial lining. That was not a pleasant experience. It didn't hurt as much as the excruciating nerve pain that left me crying and that I experienced a couple of years ago from a ruptured spinal disc. But it sure as shit hurt.
I felt a bit like what I imagined a zoo animal feels like: Closely watched, examined for all illnesses, observed for any odd behaviors.
When my test results from the biopsy weren't published online in 24 hours, like all my other tests, I knew I was right to have been preparing to hear "ovarian cancer." I anticipated hearing those words ... that ovarian cancer had launched itself from my ovary, across the gap to the fallopian tube and into my uterus to lodge in the endometrial lining and commence growing.
It was going to be some sort of sick version of pregnancy for a woman who was only pregnant once in her life and lost the pregnancy due to spontaneous abortion, also called "miscarriage," at 12 weeks. I'd have a tumor baby in my mid life.
I decided, as I readied for those words, that I'd let my hair fall out and no matter how knobby my noggin was, I'd be bald. My plan was to meet the questions head on, so to speak, and to use my illness to talk openly about cancer and death in a society that doesn't know how to do either. I wanted
to be an open book. I wanted to answer questions. I didn't want pity.
I hadn't stopped to contemplate what would happen if I got the best news possible. The. Best. News. Possible.
What would it mean to not be holding my breath until my finger tips went numb? What would it mean to stop putting on the brave face so that people wouldn't look at me with fear and pity in their eyes? What would it mean to just relax into good news?
I had no idea because I was ready to stare the worst diagnosis in the eye. To meet it head on. To fight like hell. To answer questions. To let people in.
So, when I learned that I had Stage One uterine cancer, I wasn't ready. I'm not kidding. I had no idea what to do. I just sat there when my gynecological oncologist said:
"You have Stage One uterine cancer. We will do a full hysterectomy -- remove your ovaries, uterus, and cervix. We don't anticipate you'll need any chemo or radiation. We also think the mass in the ovary is just a cyst, thought it might be a borderline tumor. We will know for sure when we do surgery."
I wasn't sure I heard right. Stage One! Stage One! That's the earliest possible "catch." Each cancer cell is a defined individual. Nobody is reproducing so fast they are clumping up into a tumor.
No chemo! No chemo! I'll get to keep all my dyed hair! No weird-flat-spotted-Weiss noggin' to answer questions about.
"My dad just told me at the beginning of the week to 'see the good and expect the best,' " she texted. "So often, we prepare for the worst."
Yes, this, Adrienne, this.
Had I known this was an option, I would have told myself that the ovarian cyst was benign and that, even if there was uterine cancer, it would be okay. Because that's just what happened.
When I woke from surgery, the nurses told me that my surgery was successful and that my pathology report was nothing but really great, fantastic, incomprehensible (to me) good news. The ovary had a benign cyst in it. It wasn't cancer. It wasn't even a borderline tumor. Just a trickster of a cyst.
The pathology on my uterus found only precancerous cells. Somehow, the biopsy found the most aggressive cells that I had ... the Stage One cancer. That means I mostly only had stuff that would become cancer and, because of the conservative approach by my health care team, they caught it so, so early!
The result? No chemo. No radiation. Just a party every three months with my oncologist for the next five years.
I can live with that.
 |
| My personal motto. Probably not a good one. |
This expect-the-worst, prepare-for-the-worst, don't-be-surprised philosophy by which I tend to live was developed decades ago to ready for the unknowable. In this case, it made sense to me because at each turn in my travels from random, post-menopausal bleeding to cancer diagnosis, things were not what they seemed. Between each appointment, what was going on in my body seemed to change. The changes led to more tests. And it all happened pretty fast. I was fine one day. The next I was involved in a seemingly endless litany of doctor's appointments that consumed my sick time, meant I missed work meetings that actually were part of really fun projects with colleagues I adore, and that left me consumed with wondering what would happen next.
I first went to the doctor in early January after having a menstrual cycle about three years after my last one. Those of you who work with and hang out with me know that I've been having hot flashes for years, flashing like a cuttlefish at happy hour, having "personal summer" moments in work meetings that leave my brow dripping and wanting to lay my belly on the cool cement like a lizard in the blazing New Mexico sun.
In that first meeting, in early January, a pelvic ultrasound revealed a mass in one of my ovaries. A fibrous tumor in my uterus. Just stuff to monitor. Nothing too weird at that point.
The humor of personal humiliation
 |
| Another personal motto. Explains a lot. |
I was peeing myself. A lot. You see, before the ultrasound I had to drink gobs of water so that my bladder was full. I can't remember why that helps the ultrasound, but it does. Between portions of the ultrasound, I was given a bathroom break. But, remember, I drank a lot - a lot - of water before the procedure. So, after another 45 minutes of probing and consultation, I had a full bladder. Now my damn bladder was emptying itself and I couldn't feel it! Pee ran down my leg and onto my tights, into my boots, into my socks. I stood there, watching myself whiz and laughing, because what the actual fuck?
Not to mention, I also had a big gob of ultrasound jelly all over my dress because I didn't know I had failed to get it all wiped off with the tiny scrap of towel I was given to clean myself.
There was no returning to work. I just pulled my jacket tight around me and skeedaddled on out of there, trying not to make eye contact with anyone in case I smelled like a used diaper tossed on the sunbaked roadside that now was being picked up by a Rotary Club highway clean up crew in the middle of summer ... (not that I ever was a Rotarian who picked up hot pop bottles full of pee on Delaware Avenue in the heat of an early spring).
I couldn't wait to tell several of my girlfriends about this latest tale of the vagaries of middle age. I knew we would laugh. Perhaps hard enough to have tears running down our faces. Maybe we'd gasp for breath and then wheeze out more laughter. And maybe, just maybe, we'd laugh so hard that one or two who have had multiple children would piss themselves from the storytelling.
The things my spots and I can do
 |
| Image from "Put Me in the Zoo." |
For those of you who are not biologically female or who aren't in mid-life, this bleeding is not normal. Once you've gone through peri-menopause, as I did in my mid-40s, and were in menopause as I had been for about three years, any bleeding is something to have checked out.
I sent a note to my doctor about the spotting. It was a Friday. On Monday, I was back in for another pelvic ultrasound (this time with no peeing on myself ... #winning).
A few days later, I saw my gynecologist. She shared that the mass on my ovary had changed. It was now feeding itself (my term, not hers). The lil bugger had started to draw in blood and to grow. It was eating. Since it had developed an appetite, it would have to get removed via surgery.
I was ready for the idea of surgery and I wasn't surprised when the doctor said the ovaries needed to be removed. I have to admit, I was getting ready to learn that I had ovarian cancer after surgery. You see, ovaries aren't biopsied before surgery. The only way to figure out what is really happening is to biopsy them after surgery.
The ovaries are a closed system. As I understand it, any pre-surgery biopsy -- the sticking of a needle into the organ to gather cells -- would open that ovary to the rest of the body. In other words, the needle creates a hole in the ovary and things can get out of that hole. You don't want that to happen, especially if there is cancer in the ovary, so you biopsy after the ovary is removed.
Knowing that surgery was inevitable, the doctor decided to biopsy my uterus lining. It was highly unlikely -- almost unthinkable -- that there would be anything in the biopsy because I'm young for uterine cancer and because my endometrial lining was normal in the first and second ultrasounds. Probably just needed my ovaries removed and then I'd roll on with life.
So, the doctor took the biopsy samples from my endometrial lining. That was not a pleasant experience. It didn't hurt as much as the excruciating nerve pain that left me crying and that I experienced a couple of years ago from a ruptured spinal disc. But it sure as shit hurt.
I felt a bit like what I imagined a zoo animal feels like: Closely watched, examined for all illnesses, observed for any odd behaviors.
When my test results from the biopsy weren't published online in 24 hours, like all my other tests, I knew I was right to have been preparing to hear "ovarian cancer." I anticipated hearing those words ... that ovarian cancer had launched itself from my ovary, across the gap to the fallopian tube and into my uterus to lodge in the endometrial lining and commence growing.
It was going to be some sort of sick version of pregnancy for a woman who was only pregnant once in her life and lost the pregnancy due to spontaneous abortion, also called "miscarriage," at 12 weeks. I'd have a tumor baby in my mid life.
I decided, as I readied for those words, that I'd let my hair fall out and no matter how knobby my noggin was, I'd be bald. My plan was to meet the questions head on, so to speak, and to use my illness to talk openly about cancer and death in a society that doesn't know how to do either. I wanted
to be an open book. I wanted to answer questions. I didn't want pity.
See the good, prepare for the best
 |
| Adrienne's dad is smart. |
What would it mean to not be holding my breath until my finger tips went numb? What would it mean to stop putting on the brave face so that people wouldn't look at me with fear and pity in their eyes? What would it mean to just relax into good news?
I had no idea because I was ready to stare the worst diagnosis in the eye. To meet it head on. To fight like hell. To answer questions. To let people in.
So, when I learned that I had Stage One uterine cancer, I wasn't ready. I'm not kidding. I had no idea what to do. I just sat there when my gynecological oncologist said:
"You have Stage One uterine cancer. We will do a full hysterectomy -- remove your ovaries, uterus, and cervix. We don't anticipate you'll need any chemo or radiation. We also think the mass in the ovary is just a cyst, thought it might be a borderline tumor. We will know for sure when we do surgery."
I wasn't sure I heard right. Stage One! Stage One! That's the earliest possible "catch." Each cancer cell is a defined individual. Nobody is reproducing so fast they are clumping up into a tumor.
No chemo! No chemo! I'll get to keep all my dyed hair! No weird-flat-spotted-Weiss noggin' to answer questions about.
What just happened?
What happened is something I should have done: See the good and prepare for the best. But I truly never even considered this as an option until Saturday when a friend, Adrienne, shared her father's wisdom with me."My dad just told me at the beginning of the week to 'see the good and expect the best,' " she texted. "So often, we prepare for the worst."
Yes, this, Adrienne, this.
Had I known this was an option, I would have told myself that the ovarian cyst was benign and that, even if there was uterine cancer, it would be okay. Because that's just what happened.
When I woke from surgery, the nurses told me that my surgery was successful and that my pathology report was nothing but really great, fantastic, incomprehensible (to me) good news. The ovary had a benign cyst in it. It wasn't cancer. It wasn't even a borderline tumor. Just a trickster of a cyst.
The pathology on my uterus found only precancerous cells. Somehow, the biopsy found the most aggressive cells that I had ... the Stage One cancer. That means I mostly only had stuff that would become cancer and, because of the conservative approach by my health care team, they caught it so, so early!
The result? No chemo. No radiation. Just a party every three months with my oncologist for the next five years.
I can live with that.
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