Wednesday, May 27, 2009

Feminine

"Hello," I greeted the young doctor who entered, pretty skirt swishing about her knees. "I'm Katie. And this is my mom."

She started talking, voice quick and precise and I nodded as she explained. "So if it's a uterine fibroid, we'll go in, look at it and then come right back out. We'll only remove it if it's ovarian. Those masses can be cancer and can also be large enough to twist the ovary and cut off its blood supply. So it would come out."

"If you're going in," I replied, "I want it out. It's uterine - I know that."

"No," she interrupted me. "MRI isn't overly reliable."

"I disagree," I offered coolly, thinking of images I'd examined carefully for hours. "It's uterine. I can see the outer layer of the uterus stretching around it. I don't need to let you stick a camera through my navel. I know right now."

[Seriously, people - look at that! At the very bottom of that picture, you see that bright curve surrounded by a darker curve of tissue - that's the uterus. Right at the front and top of that, there's a large ball. Now, especially at the front, you can see the uterine lining wrapping around the fibroid. It Is Uterine.)

I think I mentioned I think ovaries are adorable - you can see the healthy one on the right of the image (it's my left ovary, but that's radiologic convention in the axial plane). It's the light gray circle-like thingie with the smaller white dots inside. The other one - for there are two - is smooshed behind the giant fibroid on the left side of the image. You can see it peeking out from below the big, dark mass. Said fibroid is destroying the healthy symmetry that should exist. And while I agree that the fibroid and ovary are located very close together, I do not believe they are attached, nor do I think the mass is coming from the ovary.

"So you don't think you can know enough through imaging," I sighed while Mom fretted beside me and Doctor perched on a small stool. "And I don't want surgery unless you're going to remove whatever the mass is. So what do we do?"

"It's your body," she said kindly. "So we do what feels comfortable for you and I'll tell you if I think you're taking unnecessary risks with your health. I'd like to check some hormone levels - that will give me some clues as to whether this might be ovarian. So you can get blood taken today or in a few days."

"She'll do it today," Mom decided and I smiled.

"I'm not afraid of needles anymore," I noted, tentatively proud. "I used to be terrified of them, but I got through it after giving blood."

"That's good!" she praised. "Some people never get through that phobia so I think that's great for you."

"It's just the surgery and multiple pelvic exams that freak me out," I offered with an apologetic grimace.

"Look," she said. "This was a good conversation. We got to know each other and I certainly respect your thoughts and opinions and feel like you understood what I was trying to say. At this time, I don't believe your life is at risk. I'm not going to force you into a decision because I don't think it's necessary. So we'll see what the bloodwork reveals, talk again and see how you feel about your options."

"Thank you," I said sincerely and walked over to the lab with Mom close behind.

After ensuring the young woman was good at her job (she said she'd use a smaller needle for me), I closed my eyes and turned my head as the needle pricked and blood flowed into three vials. I sighed with relief when she told me to apply pressure and wandered out to escape soon after.

I don't know if I'm more or less worried. I do understand that I have no plan. Without the goal of getting this thing out of me, I'm far less inclined to have exploratory surgery. If you want to explore my insides, I shall lie in a giant magnet and show you pictures. I'll even drink a bunch of water and let you push against my tummy with a transducer. If we can't agree on that plan, I'll take the time I was offered to mull it over and try not to freak out about it.

"Have you had a mammogram?" she asked after realizing I was 30.

"I've seen my breasts," I declined to offer that x-rays hadn't been used. "They're good."

5 comments:

hypoglycemiagirl said...

Your ovaries are pretty indeed, but your poor right right one needs to get back out there! I hope it will end well for you with as little pain and trouble as possible.

Jenn, PhD said...

What beautiful images. I'm glad you have the time to think over the options some more. Seems like you're dealing with competent health care providers and importantly, they're willing to listen to you and let you have a say. Hope the blood tests all come back clear.

Amanda@Lady Scientist said...

It sounds like you're doing the right thing by taking time to think about your options. It seems odd to me that they wouldn't just go in there and remove it (but what do I know?). I'm glad that the blood-drawing went well for you and I hope that all this resolves wonderfully for you.

Amelie said...

Having no plan is exhausting, I find. Take care, Katie.

cdavies said...

Katie

If it is a uterine fibroid and your uterus has not been stretched too large, there are other options for removal that don't require surgery. Email me or ask your doctor. I am surprised she didn't mention them.

Good Luck

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