The Hard Things

 Yesterday I had a laparoscopic bilateral salpingo-oophorectomy.

Yeah ...

In regular words - I had my ovaries and fallopian tubes removed through three little incisions around my belly. My oncologist believes that we are still having difficulty suppressing my fertile myrtle ovaries with the medication and that lab tests show I have measurable amounts of estrogen in my body. Her argument to me was that she strongly recommends the procedure because she doesn't want to have to decide efficacy of a "game changing" drug like Ibrance in a scenario where it's unclear whether or not it was effective because of the presence of estrogen. Since the cancer cells are highly receptive to estrogen, and the estrogen isn't fully suppressed, it could be hard to determine if Ibrance is doing what it's designed to do at it's full capacity. It's a muddy picture and she'd much rather I be in a state where we can really maximize the efficacy of the medication without interference.

So I decided that I agree with her and at 5 am yesterday, we were checked-in for surgery. We were home by noon. They made 2 tiny incisions over each ovary and one below my belly button, filled my abdomen with carbon dioxide, clamped my uterus in place and removed through the belly button incision all the bits that were to come out. They then deflated me and stitched me back up. I'm dealing with some lingering carbon dioxide in my abdomen - I can feel the air bubble thats trapped under my rib cage. It feels like a sharp stabbing pain ... that moves. The air should make its way out over the next couple days.

Needless to say, yesterday morning was rough. It was scary and there was a lot of talk about intubation and making sure there was enough space in my trachea to put down a tube without having to wake me up for it. Thankfully they got the tube down while I was fully sedated, but there was an area at the vocal cord site that was a bit narrow and there was some scratching that happened. So again, my voice is hoarse and scratchy and a bit weak. I'm supposed to rest it. Yeah - like that's going to happen with a 3 year old in the house. I remember crying while I was waiting to go back ... I remember being very anxious about the whole thing ... I remember being wheeled back into the operating room and asked to scoot to the operating table and from there it's blurry ... I don't remember much else until I woke up in the recovery room. I remember hearing them talk and shivering all over - teeth clattering shivering. I remember someone mentioning my shivering and a response from someone somewhere else that said, "it's from the anesthesia." I remember being given a Percocet at what I thought was 10:30 am but was actually 9:30 am I found out later. And then I slept. And then I was wheeled into the outpatient room and there was Mike.

Leading up to this surgery there was a lot of crying. I don't know why exactly. I mean - I understand the reason why I opted for this surgery and it all makes sense logically - but emotionally - I was discovering that I'm quite attached to my ovaries and tubes. Perhaps it's because it feels like they're the last bit of "woman" that I have left. I already had the bilateral mastectomy. If they take out my ovaries - what's left that makes me a woman? Do I just become a shell of a woman? A "used to be?"

It's emotional. I feel like I gave a lot of myself the first time around in 2010. And now I feel like I have to give more. I am giving more. I gave more. And it's hard not to be mad at that. Mad at the situation. I'm worried that I'll turn into this grumpy, unhappy version of myself because of the severe withdrawal of hormones ... so I apologize in advance to every and all if I'm bitchy. I honestly don't mean to be.

There are so many hard things you have to deal with when facing a dx like this. An aggressive treatment plan is hard. Multiple surgeries is hard. Just hearing the news of the dx is hard ... extremely hard ... even harder when it comes 5 weeks after you've given birth. It's hard to allow yourself to get fully connected to your new child for fear of the heartache to follow should you have to leave that child sooner than anyone could possibly anticipate. But you do it - you open your heart and you fill with amazing love for your baby. And it's hard. It's hard to hear of people you've met on this new journey going into hospice, their husbands taking over their Facebook posts because they can no longer do it. It's hard not wondering if every ache, twinge of pain, headache, muscle spasm, dizzy spell etc. is something that needs worrying about or if it's just nothing. And then it's hard worrying about something that might be nothing but ... are you just blowing it off because you don't want to be nutzo about it and it really is something? An endless cycle of worry and hard things jammed in the middle of every day life where dishes still need doing, clothes still need washing, toddlers and babies still need their faces cleaned and hands washed. It's hard. It's hard setting up a new home under the shroud of what might happen. But you push forward. You live your life as you would otherwise because there's really no other option. There is no treatment hiatus because treatment is indefinite. Thus you have to incorporate treatment into your life. You can't quit life's responsibilities just because of this ... and that's hard. It's hard not to wonder "what if" all the time. It's hard to talk about the future without a small shred of doubt always popping up in your mind.

But we do the hard things because we must. Because that is how we live with this ... how we thrive.

I'm recovering well from yesterday's surgery, all things considered. I have already switched to motrin instead of the norco. I try to really minimize the amount of pain meds I take. I like to know much pain I'm having and the one way to do that is to let it happen. I know it sounds wacky, and yes, I take pain meds when I really hurt, but for the most part - I'd prefer to feel the pain so I know what's going on with my body. I see it all as a message. It helps me determine what I need. So I listen, as best I can. And I continue to repeat my mantra in my mind regularly. I continue to call on my body to help do what it can.

My next PET CT and brain MRI is 8/19/16. Results will be reviewed with my onc on 8/23, Tuesday. I'll have completed my second cycle of Ibrance at 75 mg, five cycles in total. And by that marker I've had 10 more sessions of radiation, 45 sessions total. My ovaries will have been out for two weeks and two days. In the meantime, I'm going to enjoy having my mom is town for a couple weeks, followed by my beautiful sister and her trio for a couple weeks before school starts again for them. It's been a year since I've seen them and I can't wait. Before my own kids were born, they were my first kids and I love them to pieces.