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.

It’s Not Okay

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.

Fear and Loathing in Pittsburgh

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.

A Peach and A Catalyst

This one was inspired by Colonial Punk’s Post.

Stress.

A one syllable word that is so commonplace in everyone’s life. When am I not stressed? I can’t answer that. It really is always something.

It’s more about how stressors are processed that produces the effects and thus, the consequences. I’m probably not a prime example of how stress is interpreted. I have been known to buckle under the weight. I am guilty of allowing my situations to become critical.

How stress manifests for me is a complicated thing. It depends on the particular stressor and the source that it is coming from. In addition, it depends on my particular mood, the emotion, and the intensity of emotion that the stressor produces at the time.
I’ve been running a little high lately. I’m out of the hypomanic episode, thanks to a virus or something. But, if I had to describe the state I’m in right now, I’d call it a 6 or 7 on the mood scale with panic attacks. (In all fairness, this started before the abnormally high stress). Honestly, I’m used to running at about a 4.

I mentioned in Just Got Served, But It Wasn’t Dinner that C.S. is being sued. That was Thursday. That comes with a whole host of problems for both him and me. We finally have the name of an attorney. Any further than that and I’m really not at liberty to publicly detail the rest. Legal problems are at least in the top 5 of my “Worst Things That Could Happen List”. (Medical is number 1. We’re getting there.)

My typically benevolent boss is coming down on me. I understand her concern. My boss has a difficult time delegating and the Winter Concert is in my hands. Her anxiety has to be off the charts. It would be absolutely embarrassing if this project flops.

The electric company has recently determined that we are financially ineligible for services. Now, we’re stuck with a budget amount of $430 a month. That’s up $200 from what we were paying on a “just making ends meet” budget.

T.D.’s Early Intervention services ended October 16th, when he turned three. This is complicated, so try to stay with me. He was supposed to have transitioned into school-aged services at this point, but it didn’t happen.

Adding fuel to the fire, C.S. isn’t sure if he wants to take this promotion on the cusp of some serious financial detriment and before the holidays.

I mentioned problems with T.D.’s pediatrician giving me some serious trouble in The Farris Wheel. I won’t go into the complete story, but I have a ton of things I have to face now with his health and development.

And I have this surgery looming.  My consult is finally scheduled in stone for October 28.  We’ll just have to wait and see.

Blah.

The reactions varied. When I saw the papers for the suit, I sprang into action. It was an insult. I was angry.

When my boss came at me, I flew. It shook the very foundation of my work experience. I’ve always considered work to be a safe zone. I became so anxious that I responded with annoyance, fear, and paranoia.

All of T.D.’s things are overwhelming. I’m treading into unknown territory and I’m not sure how to proceed. It froze me in fear to know that my child has something wrong. And I felt like the worst mother in the world.

I’ve never had a major surgery. There are a lot of unknowns. I’ve been dodging it because I don’t want to walk around blindly. Too many what if’s. How am I going to handle news that something bad has happened?

And as for the bills, what am I going to do? We can handle it, but we’re going to be on a tight budget. We might have to make some heavy sacrifices. I am upset. I can’t stand the idea of living in extreme poverty again. I am almost to the point of tantrums. I still need a couple new staple clothing items (white t-shirts), new contacts, and new glasses. When will these needs be satisfied, if at all? Rawr!

So, as you can see, stress produces a wide variety of responses. But, the end result varies. Either, I crumble into a depressive episode because of the feeling of helplessness and hopelessness. Or, I go manic and power through with serious ferocity. Or, I am frozen with anxiety, and if I approach the situation, I’m overcome and retreat.

Spin the wheel. It’s hard to tell what stress will trigger with bipolar disorder.

Take two, three or four pills and call back in the morning.

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 . . .