Decisiveness is not my strong point. I realize that certain choices can have long lasting effects. One choice can start a major chain reaction, cascading through many aspects of life, for better or worse. I have difficulty evaluating which decision will yield the best results, or do the least amount of damage. In fact, I’m sometimes so indecisive that mundane, daily selections become a challenge. What to eat? What to wear?
I hope that I will never have to be faced with a life or death decision.
As a woman on a slew of medication and also of child-bearing age, this is a hot topic that remains fixed in the peripherals. I’m sure it’s something many women using pharmaceutical treatment for mental health think about. These are black box medications. What would I do if I got knocked up?
I’d love to have a definitive answer. In all fairness, this is a lot more complicated than your average abortion debate.
Yes, I’d keep the baby.
Taking a life is wrong. It’s not up to me to decide. If I took every precaution, and I still managed to conceive, then it was really meant to happen. I couldn’t imagine the heartbreak of losing a child, and the resentment toward myself for doing it purposefully. It would be an impossible decision to live with. Every life deserves a chance. Every child is a blessing.
No, I would abort the baby.
Sometimes, a woman has to do what is best for herself, the child in question, and her family. It would not be right to bring a child into this world that may likely have extraordinary special needs. It would be wrong for the potential child, cursing them to a life of physical and / or mental disability. It would be criminal to drain precious few resources from the rest of the family, such as time, money, and energy. And it may be extremely dangerous, if not fatal to both fetus and mother if I were to quit medication cold turkey.
This could turn to a very heated dialog. I have to cut it off at some point. We’ll cross that bridge if we get there.
That’s the only definitive life-and-death decision I can produce. There are thousands of scenarios.
I’m holding my husband by one arm and my son by the other from a ledge where they both slipped. I only have enough strength with both of my arms to save one. Who do I choose?
Life and death. It’s too big of a moral dilemma for me to ever want to handle. There are some moments where I could make a hard and fast decision. Giving my life to protect my loved ones? Yes. Taking a life to protect my loved ones? Only if absolutely necessary. Taking a life for vengeance? No.
Otherwise, leave me out of it.
Thanksgiving will hopefully be a day of thanks. It marks two weeks since the LEEP procedure. Since it falls on a holiday, my doctor’s office was kind enough to squeeze me in on Wednesday, Nov. 23. I’m sure the scheduling nurse I spoke with was aware that I’d have a Sword of Damocles hanging over my holiday table. It was kind of her to be so considerate. (Note to self: Be thankful for considerate, compassionate people).
The Healing Process
I was briefed after the surgery about care and restrictions. No worries – this is not going to get graphic. I’ll admit, it was not quite as I expected it. They likened it to a colposcopy with a biopsy. I know there is a huge difference between the two. One is a little snip and the other is more akin to taking a sizable section. Like trimming the hedges versus pruning a tree.
They under-exaggerate when they describe the more unpleasant parts of post-op care. I was in nearly constant, serious pain for the first four days. I would wake up in the morning in severe pain, because a full bladder likely pressed against the area. The more I moved, the more the pain increased.
Mothers will especially stand this next part. It is more akin to the physical sensations to about a week after labor and delivery. My bottom half was sore. It was pain like a T, across my hips through me, and into my back.
They don’t tell you the real story on a lot of it, although they are still defined within the parameters of “typical healing”. To sat the least, it was a lot more intense than I predicted.
The healing time takes longer than I predicted too. The doctors assured me that I’d be back on my feet, doing my daily activities in a few days. But, those activities are not to include any aerobic / strenuous activity. I haven’t been able to do any housework. No stairs, so I have to limit my use of them at home. It’s frustrating to leave something on a different floor.
I’m still not quite back to normal. I always feel like the doctors overreact when they give you restrictions. Possibly, it is because they know patients will not follow them to the letter. But, they weren’t kidding here. I’m moving better, but I am still in pain. I need extended time sitting. I’m tired.
The biggest thing they don’t tell you is the emotional rollercoaster that follows. I don’t know if it’s hormonal, but I have been completely out of whack. I described some of it in With This Pill. Manic Monday touched upon the subject in 2.5.
This is a conversation C.S. and I had on Friday.
I thought I was on the cusp of a depressive episode. Mobility is difficult. It is irritating and frustrating to be at the mercy of others. I am a control freak. I like things done my way, and I like to be an active participant at all times. But right now, I feel like a useless invalid watching life pass as I’m bound immobile, as much as possible.
I feel useless. I can’t take charge of classes because I have to meet them in their classrooms. I must have children assist me in classes by passing out lyric sheets and retrieving items for me from across the room. I hate asking people for help. Then, I start to feel like an inconvenience, a burden, if you will.
I was under the impression that they were going to poke in there and assess my healing. Then, they were going to report how much had to be excised, and what my chances of having more children is going to look like. What they failed to mention is that tomorrow is also the delivery of the results from the sample they took. What I thought was going to be a completely benign appointment turned malignant fast.
What the doctor is looking for is are Clear Margins. Essentially, if the tissue they collected has both the cancerous cells and a margin surrounding it of healthy tissue, then we can be assured that all of the cancerous cells were excised. However, if the margins are not clear, then cancerous cells still remain and pose a possible threat.
The course of action after that is typically to wait until the results from the follow up Pap smear come back. If they are positive, then we visit colposcopy land to see how bad it is. And, there is a possibility of yet another procedure.
You guessed it. This poses a greater threat to my future pregnancies. The more cervix that is removed, the higher the risk of miscarriage and pre-term labor. I have a plan, but I need to get C.S. on board. If the issue is forced, I want to make the Hail Mary pass in order to conceive another child before I would have another surgery. We have two months to make a decision, because after that, it’s do or die.
I really do want another child, even if it’s not at a great time. If I have to do it and take some risks, I’m willing to do that. However, C.S. has not expressed a great deal of enthusiasm about another child. I don’t want to come to blows over this. But, if there is a serious disagreement, I know it’s going to turn into a serious problem.
One bridge at a time, Lulu. One bridge at a time.
No. No big girl pants. No brave face. No confident words or bright sides. This is Lulu – crumpled in a ball.
Maybe the prospective consequence of this surgery I wrote about yesterday in Taking the Bullet didn’t have time to sink. Or maybe there was some kind of mental safety barrier I built around the subject. In any case, everything collapsed into a pile of rubble with a giant plume of dust and a flood behind it.
C.S. and I were going to make breakfast – a common occurrence on Saturday morning. But, in order to cook, some cleaning was required first. I offered to do it. I am painfully aware that I have been a little neglectful of domestics. But, C.S. insisted, and didn’t hesitate to be incredibly nasty while pointing it out.
“I’ve had a bad week.”
“You’ve had one bad day!”
I felt it building, like a swirling, chaotic ball inside my solar plexus. All of the emotions I’ve dampened and thrust inward boiled, as if a roaring fire was now ablaze under their container. Flashbacks flooded my mind. I was trapped in my head, still and gazing with an empty stare across a crowded classroom. I was lying on stomach, underneath three blankets, with a pillow wrapped around my head. I was intently watching the noon news report and cringing each time I heard a door open.
These are absolute truths from the very back, of the very bottom shelves, where the most volatile substances are stored.
“I am in no shape. Back off.”
“You know there’s nothing that irritates me worse than…”
I stopped listening. There is nothing more combustible to a situation than his deaf ear, narrow mind, and dug in heels. A major irritation paled in comparison to the tumultuous storm of explosive materials about to emerge. His complaints were a slow, low string of murmurs only punctuated by breaths to gain more steam. I stood at the counter, shaking so badly that I could no longer handle a knife.
And it rang as clear as a bell, “This is a routine procedure. They do thousands of them a day. It’s no big deal.”
“It IS a BIG DEAL!”, I screamed, tears streaming down my face. “If I hemorrhage, I could die! If my blood pressure tanks again and they can’t get it under control, I could die! And even if I don’t die, what happens if one of my adjacent organs gets a slice? I end up with a colostomy bag?!”
“It’s okay if you get a poop bag,” he joked.
“No! It’s not okay if I have to have a poop bag! It’s not okay if I lose a kidney or liver function! And it’s especially not okay if I lose my ability to have a baby! Nothing about this is okay!!! It’s NOT okay!!!”
My hands were flat against the counter with my arms outstretched. I heaved and violently sobbed. I squeezed my eyes shut and trembled. The tears poured down my cheeks and onto my chest.
Two strong, warm arms closed around me. He brought me against his chest in a firm embrace. I turned to throw my arms around his neck and bury my face into his shoulder. In that moment, I was secure. I was safe, at least from myself.
“Whatever happens, we’ll take care of it.”
I’m not okay. And, I can’t even attempt to pretend anymore. The integrity of the whole farce has disintegrated past salvageable. There is no footing along that path anymore. All I can to is come to terms with this.
November 10th or 11th, S-Day. Only 11 or 12 more days.
Honestly, I’ve been dodging this since I received word in May that my Pap came back bad again. I put off the colposcopy until July, as I mentioned in All the Pretty Things. The results of the colposcopy were among many things that triggered my breakdown in August, most noted in Meet Me in the Magnolia Tree. I was informed at that point that I would need the surgery. And I failed to go to both my August consultation and my September consultation. I couldn’t face what I knew she was going to say to me. I couldn’t hear that I may never be able to have more children. And after the debacle from my last surgery, mentioned in Leep-Into-Cin – Part II, I couldn’t fathom the idea of having to go through another one.
The Reader’s Digest Version
It’s a lot of history to take in all at once. I understand. So, for those of you that really don’t have the time, or simply don’t want to sift through all of it, I will provide the abbreviated version. I was diagnosed with HPV in August 2007 and had cervical dysplasia as a result. At the time, I was in my early 20’s and the doctors all insisted that it would clear up on it’s own. I got pregnant at the beginning of 2008 with T.D. and it only got worse. In fact, so bad that I had to have the worst colposcopy of my life when I was 34 weeks pregnant.
Due to some insurance problems, I wasn’t able to get another colposcopy until May 2009, when it was discovered I had CIN-II and III in some places. Essentially, I had the worst precancer before it became real cancer. I had a very traumatic cryosurgery done in June 2009, and that was that. For then.
Here we are, two years later.
My Worst Fears Realized / Speculated and More
From the moment I got the call, I’ve done my research. I knew the words that were going to come out of her mouth. And, I had face it alone. C.S. and I decided that it would be better to save that 1/2 day off, in case I need it after the surgery. Not that emotionally agree with the decision. I see the logic. But, I knew I’d need him there. In a way, I am hurt that he doesn’t consider my health more important than his work. I know he is only trying to make things stretch. But, I feel like if he cared enough, he would have been there.
Like I already knew, I risk cervical stenosis, scarring of the cervix and cervical canal, that may make natural conception impossible. I am at a higher risk for cervical incompetance, which may make carrying a child to term impossible. I risk infection, hemmorage, etc. But here’s what I didn’t know. I risk damaging other organs in the vicinity, such as the vaginal walls, colon, bowel, etc. And that made the whole ordeal so much worse.
All my doctor could say was, “The risks and complications are a possibilty. I can tell you that these risks are small, but I can’t make any guarentees about what’s going to happen.”
On the subject of future children, “Cervical stenosis isn’t as much of a concern as cervical incompetance. It depends on how much we have to remove. We can only determine that when you’ve healed. I’ll check at the 2 week follow-up and we’ll have a better idea then.”
My Aching Heart
I cannot get my mind away from the possibility that I will be incapable of having anymore children. I wanted one, maybe two more if I feel my biological clock start to tick later on. I cannot fathom the idea. It breaks my heart to think about. I may never have another child, ever again. I could end up barren with the thoughts of the child that I could never have. The child that would have been a sibling to T.D. and a child to C.S. and I.
Worse, is the possibilty of having multiple miscarriages. I had one, and I know it was my fault. I didn’t know I was pregnant until I miscarried at about 10-12 weeks. I was drinking heavily at the time. And that likely did it. If that child had lived, he / she would be 9 in January. It took me a long time to accept the truth about it. But, I knew it wasn’t meant to be. The day after I conceived, my boyfriend broke up with me. I told him a year later about what happened. His response was, “It was better this way. I wouldn’t have left her (his girlfriend) anyway. Now, we can all get on with our lives.”
It was cold-hearted, but he was right. I was in no position to be a mother. I was too young, with no college education, no income, and hardly a stable place to live. The child would have had a deadbeat dad, and I would’ve been outcasted by my family. This is not to mention that I was not yet diagnosed with bipolar disorder. That baby has a better home in the life beyond.
Will I have to go through the unimaginable pain of losing a child? Losing multiple children because my body just can’t do it? I’m terrified at the idea. I cry when I hear about it. How could I even begin to handle that?
My doctor tried to be reassuring and said, “Most of my patients who have undergone one LEEP have gone on to have successful, complication free pregnancies.” Most. Not all. This is my second surgery. I don’t know exactly what I will have left when all of this is said and done with.
The Worst Case Scenario of Them All
What if this LEEP doesn’t do it? What happens if the dysplasia grows back. I only have so much cervix. Do I have to face another LEEP? And if I do, that will destroy all hopes of another child. Beyond that, we’re looking at a hysterectomy. I’m too young to have my uterus removed. So what then? Hormone replacement therapy for the next 10 – 15 years? Or will I just have to bear early menopause?
That is honestly the worst of it all. Not being able to have children and having to go through menopause.
The Only Good News
The actual surgery isn’t nearly as bad as cryosurgery. I will have a cervical block, as well as IV sedation. Instead of being in the office, I will be at the hospital. The procedure is supposed to be painless, and afterward, I should sufffer no symptoms worse than a light menstration.
The after care is much like having a colposcopy, and heaven knows I’ve had enough of those. Literally, I’ve had four or five. With the last one, I wasn’t doing great the same day. But, within a few days, I was back to my regular self. I should be healed enough to resume normal activity within two weeks (like aerobic activity), with the exception that I’ll have a lifting restriction for a month.
The date of the surgery – November 10th or 11th. I have off on the 11th, so I tried to schedule it for then. But, I can take the 10th off, if needed. My doctor specializes in treatment for woman cancer. I trust her and really like her. She reminds me of the wonderful OB that delivered T.D., except she’s a little more forthcoming. She’s the only doctor that has sent my specimens to an oncologist for review. She is the only doctor that has been extremely proactive about this. And she is the only doctor that hasn’t treated me like I’m a case, or I’m insane, or anything else. She’s regarded me as a person every time.
I just want to get this all behind me. I want to be able to deal with the aftermath as soon as I can. And, I need to make the attempt to get pregnant as soon as I can afterward. Because, if I have to face another LEEP or hysterectomy, I’ll be damned if I don’t at least try to have another baby before we come to that.
Tomorrow at 11:45AM EST, I will be meeting with my OB/Gyn for my surgical consultation that I’ve put off for three months. And I’m more scared of this than I was of my induction of labor.
Tomorrow, I face my biggest fears.
I face a serious surgery, no matter how benign it may sound. I don’t like doctors. I am terrified of hospitals as a result of my most previous experience. And, I’ve never been put under before.
The surgical procedure alone presents enough potential threats. I have had a life-threatening reaction to an epidural. What will I do once I’m hooked into an IV? Will my blood pressure tank again? Will the anesthetic wear off? I’m not sure I can endure that pain.
Then, there’s the aftercare. The complications are numerous. Do I face a serious hemorrhage? Anemia over the Pittsburgh winter is unbearable. I may not be able to get back on my feet as soon as I’m expected to. How can I possibly take care of my son? Who can I call on to help? I do not have a great support network.
And then, there are future complications. I may have deep scaring. The surgery may cause me permanent future pain. And what about getting pregnant again? Studies indicate a small percentage of women have one of two fertility issues after having the surgery. In one scenario, I may suffer scarring that causes me to be incapable of natural fertilization. In another scenario, I may suffer miscarriages and / or premature births. If I can get pregnant, then I may never be able to carry to term.
And what will happen if this surgery fails like the last one did? How much many more times will I have to go through this? And what’s the next step after that? Hysterectomy, if it gets any worse. Can I stand the idea of losing any hope of having more children? I’m too young to lose my reproductive organs. I can’t be menopausal in my late 20’s. Do I face hormone replacement therapy for the next 15 – 20 years? How would that serious chemical shift affect my BP?
Worst of all, I have to face all of these unknowns alone. C.S. and I decided it would be more wise to save his PTO days for after the surgery. I didn’t agree as much as I had to accept. I am so scared of being alone for this.
I am terrified of being alone. If the news is bad, I’m going to be alone in that office. I am embarrassed to cry in public. But there I’ll be, in the heart of Downtown Pittsburgh, on the streets holding back. I’d be holding back from the office, to the stop, all the way back home, where I’ll have to face my parents. And when I get home, I’ll have to hold back some more. For my son’s sake.
But inside, I’ll be falling apart.
And that’s all before I even go through with the surgery.
At the very least, I have the whole day off to soak it all up, and likely cry it all back out.
It’s been five days since my last post. I realized the huge gap in posting and attempted to write something on the bus on the way to work quickly. That ended in my phone crashing the app and me seething over lost work. So, here’s an update on the RL that’s been eating my Lulu life.
Saturday, October 15, 2011
That was the day we held T.D.’s third birthday party. The morning started out with a breakfast buffet at Eat N Park. T.D. is an incredible eater. What made the buffet worth it was the fact that I knew he would eat an adult portion, though C.S. and I may not have.
C.S. and I put T.D. down for a nap when we came home. Then, we feverishly cleaned the house before our guests arrived. It’s not as if we keep a dirty home. In the past week, I’ve been sick, so the domestics got a little behind. Really, we could have gotten it done in about an hour, but we opted for the deep clean. I won’t bore you with the details.
T.D. had a lovely party. His Grammy (my MIL), Poppop (my Dad), and his Grandma (my mother who he actually calls “Gram”), all stopped by to open presents and have birthday cake. The rest of our guests weren’t able to come until later due to other obligations. But that was fine. T.D. considers our friends to be his friends, too. He has his favorites, and they all managed to make it. He really loved it. And I’m so happy that he had such a wonderful party.
Saturday, October 16, 2011
This is my little dedication to the birth of T.D..
We all must have partied a little hardy and woke up later than usual. We were sitting at the breakfast table when I noticed the time. I said, “At this time, exactly three years ago, Mommy was hooked up to all over her IV’s.”
I had an induction with T.D. at 38 weeks. My pregnancy was riddled with problems. Most of them were normal pregnancy symptoms – acid reflux to the point of vomiting, migraines, etc. When the doctor asked that Monday morning if I was ready to have the baby on Thursday, I was overjoyed! There’s nothing I wanted more than to not be pregnant anymore. My stomach was so big that I couldn’t even lean forward anymore, much less bend down.
I also had more threatening pregnancy problems. I had placental problems and cervical dysplasia at the time. Additionally, I’m a small woman. There was an issue with narrow hips, and the question as to whether I was going to be able to deliver naturally. On his last ultrasound, T.D. was about 6 and a half pounds and his lungs were fully developed. It looked like we were ready to go!
A little later in the early afternoon, while relaxing with some television, I noted the time again. I said, “At this time, Mommy got her epidural that didn’t turn out so well.”
The doctors and nurses urged me to schedule my epidural ahead of time so that I wouldn’t miss my window of opportunity. Personally, I didn’t want to get it until it was absolutely necessary. However, since I had to schedule, I had little choice.
They cleared everyone out of the room, and I panicked. I begged for my husband to be allowed to stay, but it was hospital policy that no one remain. Apparently, some had fainted at one look at the needle. I was scared. I tried to remember what other women had told me; “By the time I got the epidural, I was in so much pain I didn’t even feel the needle!” But I felt it. I screamed when that needle was shoved into my spine. The nurse and doctor were jerks about it. “It couldn’t have hurt that bad.”
We hung around in a silent room for awhile. Finally, I asked, “Why are we waiting around?” It was hospital policy that the doctor and the nurse administering the epidural wait for fifteen minutes in case something happened. Nothing did happen, and everyone was allowed to come back in.
It wasn’t even ten minutes before something did go wrong. I kept telling C.S. that I felt like I was going to vomit. I was spinning and everything blurred. A hazy black formed around the edges of my vision and enclosed in while voices seemed to drift away. In my mind, I thought, “This is what dying feels like.” I was brought back to with a shot of adrenaline. The epidural caused my blood pressure to tank out and I lost consciousness for just a moment.
Later on, more toward the evening, I noticed the time again. I mentioned, “This was the time that Mommy’s epidural wore off.”
My doctor and nurse expected me to have delivered around dinner time, and we had gone past that now. I was in absolute screaming agony and begged that my nurse get someone to give me more medicine. She told me to wait. Wait?! Wait for what?! Finally, my screams attracted enough attention to get a boost of epidural. It was a relief, but not enough to bring the pain down to a manageable level.
And this is where my memory gets a little fuzzy.
There was a clock across the room and a TV underneath of it. I was keeping time based on both the TV programming and the clock. I could have sworn that the doctor came in and told me around 10 that we were going to do some practice pushes. I know that’s the time that they cut me off from the epidural. But C.S. seems to think differently. To say the least, T.D. was born into this world after between 45 minutes and an hour and a half of pushing labor. They told me, “He’s out! He’s out!”
They rushed T.D. off to the little cart. I didn’t hear him crying at first. I asked, “Is he OK?” They assured me he was fine. But, I didn’t hear him. It was the longest minute of my life, but I finally heard his voice.
Today, T.D. is alive and well. And my hips remained two inches wider.