Marginally Clear

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 swear. A lot.

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.

Tomorrow’s Follow-up
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.

Radio Silence Breaks

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!”

“I know.”

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.

Leep-Into-Cin – Part III

Warning: The following content can be considered graphical in nature.  It may contain material that may not be appropriate for certain audiences.  Children under the age of 18, those of the male gender, and others faint of heart may want to take extra care while viewing this.  Use your own discretion.

Bringing in the Big Guns

After the experience where I was left stranded on an operating table, I had grown animosity toward that doctor that performed my surgery.  I refused to see her, and I refused to go through any more procedures.  It didn’t matter.  I had lost my insurance again and there was nothing I could possibly do.  The only other option was to return to the clinic so that they could slowly kill me with their negligence.

I did break down and go to the clinic, but only for a required Pap to receive birth control.  I took the call when it came.  ASCUS, same news, different month.  I couldn’t face it.  I didn’t want to do it all over again.  But as usual, Planned Parenthood didn’t really take this news seriously.  I didn’t plan on going back anyhow.  The nurse practitioner butchered me during that routine exam and left me bleeding for a week afterward.

Finally, I had good health insurance and went to Magee Hospital Womancare.  By chance, I was given to a doctor that specialized in woman specific cancers.  Upon our first meeting, I didn’t care for her.  She was cold, calculating, and blunt.  She reviewed my records, took a pap, and sent my samples off to an Oncologist – the first time a real cancer doctor had ever seen my file.  I was relieved, but I couldn’t stand her bedside manner.  Her words were few and her work was rough and quick.  At least it was quick.

I got the good news of my first negative pap in years!  I celebrated!  The dysplasia was gone!  I rejoiced at having that burden lifted from me.  No more would I worry about growing more cancerous cells, as day after day passed.  I could live without constant concern of death.

Until April 2011.

I had neglected to get my six month pap and was coming upon my yearly pap.  The office tried to contact me and I missed several appointments.  I was very busy now.  I had just been accepted into my first teaching job and was responsible in the spring musical as the Music Director.  The very night of the show, Womancare tracked me down.  I paced backstage and scheduled my appointment for spring break.  I realized the urgency and knew I was running out of birth control anyway.

The pap was bad.  ASCUS, again.  There was no infection or alternative explanation.  Another colposcopy had to be done to confirm all of our fears.  I scheduled it for the first week in June 2011.  I knew I would be laid off by then and would have plenty of time for recovery.  But, as you know from previous posts, I had developed the flu which turned into pneumonia.  I missed the appointment, and rescheduled for July 15, previously noted in “All the Pretty Things”.

What I didn’t mention was the nervous bus ride into the city.  Nor did I mention the walk alone through Downtown, only mitigated by my bravery to do it alone after C.S. once again failed to attend at the last minute and serenity found at the fountain.  I laid on the table in the familiar position – feet in stirrups, staring at the ceiling.  I felt the vinegar sting the tissue inside of me.  I sighed.  Then, there was a feeling of a stab, twice that of a shot, and enough for me to lose my breath.  I heard the doctor say, “That’s not enough of a sample.” and then came another unbelievable stab that had me seeing stars.  I cried out in pain.  Just keep breathing, keep breathing.  The tears flooded to my eyes and another slice that felt like a twisting knife in my insides.  Breathe.  Keep breathing.  I told myself over and over, but I was choked with tears from the incredible amount of pain.

The doctor was uncharacteristically sympathetic.  She asked me questions, but I could not speak.  I could not catch my breath to tell her that I just needed a moment.  She offered me a cool towel and I declined.  She offered me a cool drink and I accepted.  I tried to get up, but she insisted that I lie back down for awhile.  I needed time for the apoxy to take hold to cover the internal wound.  I needed time for the cramping to go away before I should move.  She knew more than anyone else in my life that all I needed was some time.  I sipped the water, caught my air, and said to her, “I don’t remember it being quite that painful.  Then again, I don’t remember it being quite that fast either!”  I was trying to save face, but it didn’t matter.  She had seen the twisted look on my face with my eyes squeezed shut.  She asked about my condition and I told her I was OK and that I still needed to catch my breath.

I was still choking back tears.  I was ashamed that I couldn’t handle the pain and cried.  I was so alone.  I was furious that C.S. had not made more of an attempt to be with me.  But more than anything, I was sad that I had been let down again.  And I knew I would have to drag all of that physical and emotional pain down the streets of Pittsburgh, back home with me, and into my home to face my son alone.

All alone.

The Anticipated Call

The office assured me that we would have a result by Friday.  I knew what they were going to say.  I had hoped that they would say that it was CIN I, and we could wait.  But I knew it wasn’t.  Just like I knew in the beginning that I would be in the 10% where this doesn’t resolve on it’s own.  Just like I knew after the cryosurgery that this wasn’t the end of it.  I wanted to believe differently, but in my bones, I knew better.

Friday morning, I took the call.  I was in my mother’s kitchen while T.D. was downstairs watching Spongebob for the gazillionth time.  CIN II.  This time they wanted to perform LEEP because of my advancing age, history with this disease, and my current grade of dysplasia.  Seemingly, it was progressing faster this time.  Or else, the cryosurgery just didn’t take.  I knew all of these things, because I often have the power of foresight.  At least when it comes to my body and my mind.  But, there is nothing that can actually prepare you for the news.  There is also nothing that can prepare you for what you are facing.

The nurse I spoke to wanted to schedule a surgical consult before we proceed.  I was puzzled and felt some looming threat.  I had never been offered a surgical consult before.  Apparently, the doctor and I have a lot to converse about.  In the meantime, I am left my with racing thoughts and full internet access.

A Rock and a Hard Place

Each surgery presents the problem with damaging the cervix with scar tissue.  If enough is amassed, that may pose problems for future fertility.  The statistics say that cervical stenosis, the narrowing of the cervical canal, is about a chance of 1-2%.  But the statistics are a little more unclear when it comes to cervical competency to bring a fetus to full term.  The more they take of the cervix to remove affected cells, the thinner the cervix becomes, which destroys its integrity.  In summation: If I have this procedure, can I have the second child that I’ve been trying to plan for?

But what are the chances if I wait to have the procedure until after my second child is born?  Will I develop invasive cancer in the meantime?  Will they have to take my uterus if I decide to wait?  What is the risk?

It would break my heart to lose the second child I so desperately want.  But it would destroy my body if I were to have a hysterectomy, or worse, to face death due to cancer.

Another waiting game lies ahead.  I do not have my consult until August so I cannot have any of my questions definitiely answered until then.

The sword of Damocles hangs over my head.

All because of two complete assholes that I trusted and loved.

To be continued . . .