Like Night & Day

That title describes my change in attitude after seeing my old oncologist last Thursday.

To refresh your memory, the other oncologist – Dr. K – said the cancer is back, and he just wanted to remove my remaining ovary and be done with it all. He said the cysts were too big to remove laprascopically. He basically poo-pooed my concerns about surgical menopause at such an early age and my concerns about taking HRT for so long. He was impossible to get information out of and I hated him.

He sent me into a month-long bout of sometimes serious depression, in which I was having a severe existential crisis and spent a lot of time wondering why there was even any point in continuing to live. I felt old. And I felt like a failure as a woman. And I felt scared and alone, because  my doctor didn’t seem to really care about me. I was hiding it fairly well most of the time, but the fact is, I was only getting out of bed in the morning by sheer force of will. I could easily have just spent the past month in bed.

Fast forward to my old oncologist, my original oncologist – Dr. H – whom I saw this past Thursday. He completely disagreed with Dr. K’s diagnosis. He was surprised, at first, to hear that I really didn’t like Dr. K and said that it was Dr. K who originally made him want to go into gyn oncology. I didn’t say it to Dr. H, but that surprised me, because I can’t see Dr. K inspiring anyone.

 When Scott and I walked into Dr. H’s office, he remembered us, even though it’s been 4 years since we last saw him. When we talked about the IVF as part of my medical history with my crappy ovaries, he asked about their success or lackthereof. When I said they were unsuccessful, he said he was sorry. And he was sincere.

r. H doesn’t think the cancer is back. His opinion is that we’re dealing with simple cysts. Non-functioning cysts, but cysts nonetheless. He has some small concerns about the fourth, smallest one, because of that debris, but he concurs with the original sonogram tech that it’s likely just old blood. He also thinks that, unless the biopsy in the OR surprises him and it shows cancer, there’s no reason to take out the ovary. He asked where we were with the IVF with regard to continuing, because he wanted to take that into consideration when he perfomed the surgery.

He cares about preserving my fertility. (Ha ha. Okay, stop laughing at the idea that I have any fertility at all. Seriously. Stop.)

And not just my fertility. He takes my concerns about surgical menopause seriously. We discussed at length the studies about prolonged HRT and the possible increased risk of breast cancer. His opinion is that the risk is lessened for a woman my age, because having estrogen in my body at 39 is natural, whereas the natural state for women of menopausal age is for there for be no esrogen. He believes it’s that unnaturally lengthened exposure to estrogen that raises the risk of breast cancer. So if I do end up on HRT, it would be gradually tapered off as I get older and closer to a natural age for menopause.

He has more concerns about progesterone than estrogen, so if it turns out that I have to lose the ovary, he’s recommending the removal of the uterus, as well. The reason for this is that you need to take progesterone as part of your HRT when there’s a uterus in place, so he would prefer to remove the uterus which would allow me to only take estrogen. But here he’s leaving the decision up to me, because of the possibility that we may try to use donor eggs. With no uterus, that would obviously be impossible.

So the surgery is 12/17 and I have an MRI on 11/26. The MRI will give us a better idea of what we’re dealing with, since MRI’s are very good at seeing cancer. Depending on the MRI results, currently only a cystectomy is planned. The cysts will be biopsied while I’m in the OR, and I’ve already given him permission to remove the ovary if any cancer cells show in the biopsy. I’m still considering my options about the uterus if it comes to that. If the biopsies do show cancer cells, he’ll also check some lymph nodes and possibly remove the rest of my omentum if he left any there the first time.

He was going to do it laprascopically, but Scott reminded him about the bowel perforation last time – which he would have discovered for himself later that evening when he reviewed my surgical records, which he took with him from Beth Israel – and he doesn’t want to risk another bowel perf or vascular damage. But there’s something else Dr. K was wrong about, since he said it couldn’t be done laprascopically. (Which, in retrospect, what did he know, since he doesn’t know how to do robotic surgery.) The good news is that he thinks he’ll only need about a 4-inch incision this time instead of the 7-inch incision he used the last two times.

To say that I’m more comfortable with Dr. H would be an absurd understatment. The relief that I’m feeling right now is palpable. Scott tells me that everything about my demeanor changed the second Dr. H started talking. It’s still possible I could wake up ovaryless, but now I know, with 100% certainty, that if that happens, it will be because Dr. H had to do it to protect my health, not because it was just easier for him that way.

If I could clone anyone in the world, it would be Dr. H. I would clone him and have each of his clones go into a different medical specialty so that everyone could have a doctor like this. He’s the absolute best.

And, one last thing, I think I’m going to like NewYork-Presbyterian Hospital better than Beth Israel. Beth Israel is a fine hospital, but NYP feels nicer.

Kim

9 Responses

  1. I’m so sorry to hear that you’re going through this but so glad that you found Dr. H. Having a medical partner you can trust is such a huge big deal and I’m glad that you have one!

  2. Fab news about Dr. H! And of what he thinks he can do for you. Isn’t it weird how we place our fertility at the center of what makes a woman? While I do have one bio child, the fact that I don’t have another sometimes makes me feel like a failure…more of a mother, but also as a woman. Hmmm…a topic to explore on my own blog. hugs & kisses chica. love you!

  3. I’m sorry to hear that the past month has been so hard for you. what relief you must feel to be back in the care of a doctor who seems to truly have your best interests at heart. I hope everything goes as well as possible. Will you be knitting some surgery socks?!

  4. I’m so glad Dr H was able to answer your questions and shares your concerns and priorities. I really hope your MRI goes well and Dr H is right that there is no cancer.

  5. Wow– the difference in doctors almost makes me wonder if Dr. K was tired that day or has given up on his passion for medicine. Dr. H sounds like one in a million and exactly what every patient deserves in a physician. I’m so glad that he’s there for you. Sending you love and hope.