Friday, March 4, 2011

1 week til Hysterectomy/oopherectomy

Weill, this time next Friday my hysterectomy/oopherectomy should be complete and I will officially be "post menopausal."  I am excited and anxious to have this surgery behind me.  I feel 100% certain that I have made the right decision about this surgery and feel really good about moving forward. I met with Dr. James Hall from the Blumenthal Cancer Center for my pre-op appointment last week.  Let me just say that I love Dr. Hall!  He is quite a character with his "harry potter" glasses and his colorful bow ties.  He has a sense about him that he seriously knows what he is doing and that everything is going to fine.  He also has a wonderful personality and takes the time to really talk to you.  He told me during my appointment last week that "He and I were going to do this little dance together and that I was going to be just fine." And, not exactly sure why, but I believe him.  Everyone who knows Dr. Hall professionally or has been one of his patients, feels the same way about him.  He answered all of my questions and confirmed that he will be removing my ovaries, fallopian tubes, uterus and cervix.  I will keep my vagina in its entirety.  I am Dr. Hall's first surgery next Friday and have to be at CMC at 5:30! I am super happy about that because I do better first thing in the morning, so I just assume everyone else does too! Dr. Hall stated that the surgery will start at 7:30 and will take 2 hours.  It will be done laproscopically and the organs will be removed through my vagina (like a baby).  He will cut my cervix from my vagina and sew me up.  He said that I will be under general anesthesia and when he comes by to check on my in the afternoon, if I am doing well, I can go home! My good friend, Richard, who is an anesthesiologist at CMC, has checked on who is going to be my anesthesiologist that day and stated that he would trust the one assigned to me to put his wife or children under, so I also feel good about that.  The only thing I was kind of surprised about was that even though this surgery should be way easier than my mastectomy surgery, I can not have a bath or swim for 6 weeks and I can not lift anything over 2 pounds for six weeks either.  There are risks of infection and hernias.  He does not want me to run or bike either.  That is seriously going to cramp my regular exercise routine, but I am grateful that it is getting warmer and I can go for as many walks as I want!

One thing I have been very anxious about was the changes I am going to undergo entering surgical menopause at my age.  I have read all of the symptoms of menopause and none of them are good, except that I will have no more periods!!!! Because I felt this way, I went ahead and saw a menopause specialist prior to my surgery.  My appointment was yesterday with Dr. McLoughlin from the REACH fertility clinic in Charlotte.  My mother came with me to this appointment.  I was not quite sure about going to the REACH clinic for my menopause appointment because all I kept thinking was that I was going to be waiting in the lobby with all of these women my age who are there trying to get pregnant and then I was going to be called back to see menopause doctor.  To keep myself from feeling too anxious about this, I really just had to smile.  I was pleasantly surprised that the menopause clinic was on a separate floor from the fertility clinic so Mom and I had the waiting room to ourselves since we arrived so early for the appointment.  I could not help but laugh a few times when we were in the waiting room and the office assistant and lab technician kept looking at my mother and asking her questions like, "Do you need to have lab work done."  Or, "The doctor will be with you in a minute."  They thought SHE was the patient since she was more of the appropriate age to be seeing a menopause doctor!

I was SUPER impressed with Dr. McLoughlin, the menopause specialist, for several reasons.  I was her first appointment for that day and when she came in to her office through the waiting room, she stopped and said to me, "You must be Levacy, my new patient today...I have already read your records."  Already, from that first encounter with her, I knew that she was going to be personable and prepared, two characteristics I admire greatly in others.  Another reason I was impressed with her was that when I went back to her office, she talked with me for over 1 1/2 hours!  I could not believe it! I was mentally exhausted after the meeting, but I felt that she told me everything I needed to know in preparation for menopause.  Among other things, she took the time to explain to me exactly what a hot flash was and what the different options I had for estrogen therapy, which range from creams, mists and pills.  She informed me of long term studies of women who have entered menopause and had hormone replacement therapy like I am going to have.  She assured me that going on a low dose estrogen supplement was going to decrease the frequency and intensity of all of my menopause symptoms and that going on estrogen only has not been proven to increase breast cancer risk! She confirmed that if I kept my uterus and cervix, I would have to go on progesterone too and that could increase my already 87% chance of breast cancer.  So, no thank you to that! She also stated that I will not be able to replace the testosterone that I am going to lose with my ovaries because the FDA has not approved testosterone for women in menopause.  There is a HUGE need for specific studies on BRCA mutation carriers and the long term effects of surgery in relation to their cancer risk and the effects of long term hormone replacement therapy.  Since these gene mutations were only identified 15 years ago and testing for them really has only been in larger numbers within the last few years, there are not that many studies.  I have never been one to join a scientific study, but I have entered a study through the University of Toronto on the effects of a decision aid on a BRCA mutation carrier's decision making process.  I hope to enter additional studies to make the science more accurate for future mutation carriers. 

In addition to all of this information that she gave me, Dr. McLoughlin also spent the time to ask me about how I came to my decision and what my concerns were.  She seemed very interested in a patient like me because she said there are just not that many of us out there.  She said she has probably seen about 20 BRCA mutation carriers like me in her practice.  Even though I feel really good about having the surgery, one thing that I am anxious about is not feeling like myself post menopause.  I am worried that I will not be able to fulfill all of my roles as a wife, mother, social worker, piano teacher, friend etc etc.  She did tell me that I will never be the exact same again, but that I would have a "new normal."  That was difficult to hear, but I am appreciative that Dr. McLoughlin was honest with me.  She told me that I need to focus on me this year and my physical and mental health.  She told me that I needed to simplify my life and things that I do not have to do, to stop doing.  That was hard advice to hear and will be even harder for someone like me to do, but I think she is right.  I also shared with Dr. McLoughlin that I have sensed some anxiety from my children about the upcoming surgery.  Nathan and I have been honest with the girls about what is going on.  I never want to lie to them and keeping something from them is lying to them in my opinion.  I have been very direct and positive about this explaining that I am having these surgeries to prevent getting cancer.  I believe that Gracie understands more what is going on than Sophie because of her age and personality. Most things just sail over Sophie's head, which is a lot like I was as a child.  Gracie internalizes things and thinks about things.  I have noticed that she has had more anxiety over this within the last week.  This make me extremely sad, but I have to keep telling myself that it could be much worse. If I wait around and get one of these cancers, then the anxiety level for me and my family would be exponentially greater and I do not want that to happen. 

I feel very grateful for the medical professionals-Dr. Hall, Dr. McLoughlin and many others that I will hopefully share about later.  I consider it one of the greatest blessings during this process so far to be under the case of doctors so skilled in their area.  I really feel that this is just one way God is taking care of me as one of his children.  Sensing God's presence and provisions during each step of this process reminds me of one of David's songs in the Bible. Psalms 139:1-11

You have searched me, LORD,
   and you know me.
2 You know when I sit and when I rise;
   you perceive my thoughts from afar.
3 You discern my going out and my lying down;
   you are familiar with all my ways.
4 Before a word is on my tongue
   you, LORD, know it completely.
5 You hem me in behind and before,
   and you lay your hand upon me.
6 Such knowledge is too wonderful for me,
   too lofty for me to attain.
 7 Where can I go from your Spirit?
   Where can I flee from your presence?
8 If I go up to the heavens, you are there;
   if I make my bed in the depths, you are there.
9 If I rise on the wings of the dawn,
   if I settle on the far side of the sea,
10 even there your hand will guide me,
   your right hand will hold me fast.
11 If I say, “Surely the darkness will hide me
   and the light become night around me.”

With God on my side, I am ready for what is ahead.


1 comment:

  1. Your positivity and strength astonish me. I am blown away by what a wonderful wife, mother, sister and friend you are, Lev!!!!!!