Monday, March 27, 2017

Health History and Infertility Struggles

So I haven't written in my blog for 5 years.  I had set it up originally to post about some of our travels in a way that we could share our adventures with friends back home, but with the increasing popularity of Facebook among my friends and family, the need for a blog seemed redundant.  
Now I find myself in a completely different place in my life and I need to pour out some of my thoughts and feelings into a journal.  I think this is for myself more than anything else. Maybe I want to have somewhere to look back in the years to come and say "Thank God those days are over."  Maybe I want to share my feelings with others who may also be going through these things.  If one person gains hope or courage by reading my story, then it won't have been for nothing, right?
So for years I have struggled with infertility.  I was blessed in 2003 with my beautiful son, Mehmed.  I have prayed for years that God would bless him with a sibling.  Most of my efforts in that regard were relatively passive; the most aggressive attempts I ever made were going for testing to verify that I did indeed have at least one functioning Fallopian tube, and trying a few cycles of Clomid.  I never went as far as trying IVF because I couldn't forget the fact that Mehmed's conception was nothing short of miraculous.  I clung to my belief in destiny, hoping that if it were meant to be, it would happen no matter what effort I put into it. 
Fast forward to 2015.  For many years I had been struggling with my weight, fatigue and low levels of motivation that I now look back upon and realize was a form of depression.  I struggled with PMS symptoms of bloating and ovulation pains. I believed that there was a physical cause to my low energy, but all I could do was spend all my time and energy on trying to get through each week at work.   
By the end of the year, my fatigue had hit a new low.  I found myself experiencing difficulty with concentrating and genuine issues with brain fog.  In January of 2016 I booked an appointment with my family doctor and saw her in February.  Even though I was also experiencing problems with PMS and weight loss, my focus at the time was to address my debilitating fatigue, so when I saw my doctor, that was the only issue I really addressed with her.  She ran a battery of blood tests and found that I was severely deficient in vitamins B12 and D.  
Knowing that vitamin B12 deficiency can take months to recover, I set about to do that.  I saw a naturopath and tried making minor modifications to my diet. After a month of sticking to my vitamin regimen, the brain fog started to lift.  After 2 months, I started to feel happier and more energetic. Around that time, I experienced a pinched nerve and excruciating pain in my neck that extended down my shoulder and into the tips of my fingers.  Again, my PMS and weight issues took a back seat.  I went for X-rays and an MRI that confirmed mild osteoarthritis and some bulging of the disc in my neck.  I went for physiotherapy and saw a chiropractor.  The pain eventually subsided and I felt fairly well through the summer. 
 I finally felt ready to overcome my hormonal issues.  By then, I was experiencing extreme PMS bloating from ovulation to period, but only about every three months or so.  In August, it was so severe that it caused constipation and frequent urination.  I looked (and felt) about 5 months pregnant.  My sister had previously been diagnosed with PCOS, and my research into PCOS had me convinced that it was the culprit behind my issues and inability to lose weight.  I also thought that maybe my right ovary had decided to adhere itself to my bowel again (in 2002, an ob/gyn had run a dye test confirming 2 blocked Fallopian tubes and had freed the right ovary from adhesions due to my ruptured appendix as a child). 
So I prepared a careful list of my symptoms and finally approached my family doctor for help.  I was determined to get a proper diagnosis and to follow a proper PCOS diet.  I hoped that if I could lose the weight, balance my hormones and perhaps fix my painful right ovary, I might even finally take the leap and try a round of IVF.  
My doctor did an ultrasound and notified me that they had found a large cyst.  She ordered an MRI and referred me to an OB/GYN.  She also ran a test for CA125. The CA125 came back normal.  Once again I researched CA125 and large cysts on Dr. Google and felt reassured that most large cysts are benign.   
I didn't get in to see the Gyny until the end of November.  He advised me that the cyst was 13cm and that a cyst that large would need to come out quickly.  He booked my laparoscopy for December 15th. At no time did my family doctor or the gynaecologist ever warn me that they thought the growth looked like cancer.  In retrospect, I think the gynaecologist knew, but he let me stay on my naive assumption that everything would be fine.  If anything, I was happy that I would finally be getting rid of my bothersome right ovary. 
At my pre-op appointment, it occurred to me that for months I was assuming this growth was on the right.  It was the ovary that had adhered to my bowel, had a blocked Fallopian tube and caused me a lot of pain.  So I asked for confirmation. I was stunned to learn that I was wrong. The mass was on my left ovary.  I was devestated. I had thought that my left was the only good ovary I had left, and he was going to be removing it. My dreams of getting hormonally healthy and losing weight began to fade.  I had managed to lose about 10 pounds since the summer and my optimism about my health progress began to fade.  
I promptly booked an appointment to discuss it with the gynaecologist before my surgery.  I wondered about why all my pain was on the right.  He said that I also had a smaller cyst on the right ovary, and I might be experiencing some referred pain.  His solution was to offer to take out both ovaries.  I balked. I'm 43 years old.  I was finally getting healthier.  I didn't want to go into menopause and give up my chances to try IVF at least once.  That was the first hint that he really gave that my growth could be cancerous.  "You realize that if it turns out to be cancer, we would have to do another surgery to remove everything?" He asked.  Of course. That makes sense.  But that only happens to a small minority of women.  That wasn't going to me me. 
So December 15th, Orhan and I went to RVH for my scheduled appointment.  We had to wait for hours, since my procedure was scheduled as the last one of the day.  I was nervous about the nausea I knew I would be feeling upon waking up.  
I will never forget that feeling of waking up in recovery.  Nausea washing over me.... I had to ask the nurse to bring me a cold cloth.  Orhan had been called, but hadn't arrived yet. As I sat there struggling to come around, Dr. M came around to give me his report.  He looked at me with such a pitiful look, and said "It really didn't look good.  I think we're going to have to go back in and get it all."  
My head reeled through the dizzying nausea.  He promptly left, and I was left dazed and confused. I found myself asking the nurses and a passing anaesthesiologist what that means.  But deep down, I clearly recalled my conversation with him only days before - that if it was cancer we would need to do a full hysterectomy.   That was the moment that the reality came crashing down.  My 13 cm cyst was no ordinary cyst.  It was cancer. 
Through the following week, my attempts to improve my overall health redoubled.  I quit drinking coffee and gave up sugar and gluten, in the hopes that I could starve whatever cancer cells might remain in my body.  When Dr. M called me 2 weeks later to confirm the pathology, I was not surprised. I was sad, but not surprised.  And that was how I celebrated the end of 2016.  
Stay tuned for the continuation of my diagnosis, diet, more surgery and start of treatment.  

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