First visit with the Oncologist

A couple of days ago we had our first visit with Dr. Ellis, who will be my oncologist for the upcoming months. He is housed in the brand new oncology wing at the Longview clinic part-time and works the other part-time days on Interstate in Portland, to make a fulltime schedule with Kaiser. The brand new oncology wing in Longview is quite nice and I'm as impressed as is possible for such a doubtful and scary venture. The following is a summary of our lengthy visit and then more (yes, more) of my pondering and indecisiveness about next steps. Your comments are appreciated.

The pathology, as mentioned before, has my ovarian cancer at a stage 2. Technically it's called 1A Grade 2 Staging. The agreement between all doctors is that the cancer could even be a stage 1 cancer (which is great!) however because the surgeon (Dr. Steiner) noticed and removed so many suspicious adhesions, they have decided to consider it a stage 2 cancer (even though those adhesions turned out to be negative for cancer and the margins were all clean.) Research trials are what Dr. Ellis uses to make his recommendations, and those trials are all based on pathological staging to determine outcomes.

Dr. Ellis said that it is hard to figure out treatment for someone in my position, with a possible stage one, but "talked up" to a stage 2 ovarian cancer. Should we do chemo? What kind? Should it be IV or peritoneal (sp?) How long to give it? He recommends that I do 3 cycles of chemo - each cycle 3 weeks apart. At stage 2, I currently have a 70 - 74% chance of being cancer free and it never coming back. Doing the 3 cycles of chemo can improve those chances another 5-10%. Doing chemo will attack the dividing cells and tends to do better early on (post surgery). He was careful to say that these numbers do not necessarily improve my survival rate. He recommends Carboplatin Taxol Chemotherapy, which he thinks will make me lose my hair. (Oh, my vanity. Damn it!) There are other possible side-effects, but none are known for sure until a person goes through it - except the hair loss. (Really?! Grrr...) It can cause nerve damage, but they are usually not permanent, and can cause nausea, vomiting, bone marrow anemia, increased susceptibility to infections, fatigue, tiredness, and so on. Yeah. Really talking up the case for the toxicity of chemotherapy there. He also said 90% of people with ovarian cancer are already fine with 10% going to do better with this chemo. (90% sounds good though - doesn't it?)

The only real way to determine whether the cancer returns is through potential symptoms (which would be hard to detect since many of the areas it would attack early on are already removed) and through a disease marker test (a simple blood work-up) called CA-125. Previous to my surgery, my CA-125 number was at over 500 - it should normally be under 50. We will also test my CA-125 every 3 months for the next 3 years to make sure that it doesn't adjust much.

We continue to ask each doctor the question of reasons for having had two cancers at such a young age and posed the same question to Dr. Ellis. He too had no explanation but was glad to hear of my referral to a geneticist, since a lot of research is based on heredity. He did say that there has not been much reliable research done on people with multiple cancers and the connectivity between those cancers. Most research is focused on specialty areas and are more easily done on single types of cancer. He continued to say that they know only the big stuff: don't smoke, don't drink too much, eat lots of vegetables, drink lots of water - but that it's harder to define who is more susceptible to cancers when it gets down to the details like where you've lived, what kind of work you do, and so on. (This conversation proves the need for more cancer research, so I plan to do some volunteering and donating to cancer research.)

He also talked to me about some of the foods/drinks that I can use to either stave off the cancer or to help with side-effects from chemo. For instance, 500 mg. of ginger root 3x a day will help with the nausea symptoms. Drink about 100 oz of water a day. He recommended a book by Keith Black, MD called Life Over Cancer and a few other resources.

I appreciate all the info from Dr. Ellis and particularly the sense of empowerment he gave me to make a decision about whether to even do the chemotherapy. Some people are shocked by my indecision over whether to do this chemotherapy and it would take a whole 'nother essay to explain all of my reasons, though here's a few: I told myself after my experience with radiation therapy during my bout with papillary carcinoma (the thyroid cancer) that I would never again do something like that. While I didn't promise specifically to never do chemotherapy, it WAS something that was in my head when I made that promise. I have a gut feeling too that makes me real nervous about introducing something as toxic as chemo to my body. I feel OK with the percentages that the doctor gave me without the extra percentages that chemo has to offer. I have also tended to feel that when it is my time to die, there's not much that I can do to prevent that - a few percentage points will not improve my overall chances (that doesn't make sense to the average person, only to me.) Stories of people on chemo are bad. People who do chemo die. (Yes, they also live, but the image is always of people dying. And no, they don't die because of chemo.) Chemo makes me lose my hair. Chemo scares the shit out of me. Seriously. I'm sorry, but it does. I don't wanna do it. BUT...then there's the other side, which is really pretty simple. I love my life. I love my husband, my family, my friends, my animal, my house, nature, me and everything else involved. I wanna live. I don't want cancer again. And that alone makes me think that I may end up choosing to do chemotherapy. I still haven't made my final decision. I'd love your feedback. I've gotta make this decision quickly, but I do plan to take as much time as I need in order to make the best decision for me.

So, stay tuned. More to come. And in the meantime, give me your comments and feedback. I'd love to hear from you.

Visits

I have a large amount of things to be thankful for - incredible friends and family, pets, my great health (minus one or two bleeps on the radar), Brian's job, and much more. Over my birthday weekend, we had many of my college friends come up for our annual reunion of types, and I often times kicked back for a moment and just watched everyone around me and considered how lucky I am to have such a great group to surround me. As I was laughing hysterically at whatever crazy topic we were discussing at the moment (farm names and logos!), I realized how much I needed their support -and yes, the casseroles have been great, but really it's just the simple act of conversing and laughing that I needed so much more.

I think of being a kid in grade school and the whole class was paired up with people in the nursing home. We would write letters and occasionally go visit. It was pretty scary as a kid going into the smelly nursing home and meeting strangers and try to come up with conversation, but it taught some valuable lessons. I learned uncomfortable conversation really wasn't as bad as I feared (I still have to relearn that lesson regularly when the phone rings!), and a whole host of lessons around respecting and learning from elders and compassion for others.

As I continue to heal but still am restricted hugely in my daily activity, I realize the value of these childhood lessons even more. A phone call, an email, and even better...a visit...mean so much. Getting to sit down and talk with my loved ones one-on-one is one of the small joys that I enjoy most in my day to day activities. Getting to see the people who have made a huge impression on my life and hear about their lives takes me away from the constant nagging worry of my health. It helps me to escape my own selfish mantra and to remember the lives that everyone else is living around me. I enjoy being a part of those lives and finding the humor in our everyday challenges. A conversation and laughter is the best gift you can give to me at the moment.

Others have asked about our needs and how they can help. At the top of my list, as I've just mentioned, are visits. Come see me! I may tire easily and have to take a break, but I love to visit with each of you. Food is another great way to help. I am unable to lift anything over a couple of pounds, so Brian is left to do most of our housecleaning, chores, and make meals, beyond his normal work schedule. For some people, that is a normal way of life, but for us it's a bit of a challenge. Having some food options in the freezer is helpful to take one thing off his plate (and to ensure that I'm eating healthy meals, not the Mac N' Cheese from the Kraft box.) Also, I appreciate all the emails and letters - it's great to hear from each of you about the normal going ons in your life.

Looking at the calendar, I have about six weeks left of healing before I am able to return to work and to most of my normal activities. I have started to research some family history and am trying to trace our roots back to Ireland wherever possible. While I was in the hospital, I fanagled a promise from Brian that we would vacation to Ireland within the next couple of years. (Note to self - hospital stays are a great time to get promises for things not easily procured in other circumstances) I would love to visit areas where my family once lived (County Cork and County Clare, as well as Dublin.) I really hope to be able to trace the family history to family still living in Ireland, but that will be difficult. Ancestry.com has been a great help in figuring out some of the pieces though. It's also been amazing to discover how many stories my family has typed up and left behind - I have a journal of one woman, Mary Matilda Surfus Park, who took the Oregon trail from Kansas and settled about 100 acres in the Willamette Valley in the mid 1800's. How cool is that?

As far as health, I have no real updates now. Last week we took out the last of the staples around the belly button. That part of the wound is not looking very pretty, so we'll have the doctors take a look at it tomorrow. I've been on antibiotics for weeks now, so no real infection should be a problem...we hope. Right now we're working on getting my Coumadin levels just right - apparently kale and spinach and green tea have a big effect on your Vitamin K levels, which screws with the Coumadin. Kale has something like over one thousand kg of Vit K per serving, where as most other vegetables have under a hundred. I have kale growing in my garden, so the nurse has promised to work with me to be able to implement small doses of vitamin K here and there.

The Follow-Up Appointment

We met with Dr. Steiner yesterday to go over pathology reports from the surgery and overall it's good news. We are still waiting for the reports to come back from a 2nd doctor, when hopefully things will be finalized. There are some conflicts between what was seen in surgery and what has been reported from pathology hence the desire/need to get a 2nd opinion to confirm all of this. So this is info from the first pathology report, but a 2nd opinion is still coming.

We discussed again everything that was removed, but I'll only mention the couple of new things that I learned here. The full list of everything removed is in one of my other blog posts. A couple of enlarged lymph nodes were removed (they were about 2 cm big!) but fortunately turned up negative for cancer. Those were particularly concerning in surgery because they could've indicated metastasis. There were some pre-cancerous cells found in the cervix too, meaning I most likely was headed for cervix cancer, but now that the cervix is removed, it is not much of a concern. We will do some follow-up testing to be sure that's OK, but after 3 negative pap smears, it will be considered OK.

One ovary that was removed had been twisted and tucked into a little "cave" (my words, not the doctor's!) and is the one that had become quite enlarged with a tumor and tested positive for cancer. It is the one my doctor was most concerned about in surgery and thought that it looked like a potential sarcoma. (This is when we all had our brief freak outs about mortality rates and prognosis.) The pathology shows it to be a normal ovarian carcinoma, not a sarcoma. That is the best news we could hope for and we cross our fingers that the 2nd opinion will concur with this pathology. The five year survival rate is 80% and gets up to 90% with chemotherapy. My doctor has suggested that we will do 3 - 6 "cycles" (appointments) of carbo/taxol chemo and that they will be about 3 weeks apart from each other. This particular ovary had become attached with fibroids to the walls in my body and was very difficult to remove. Even though the fibroids tested negative, the fact that there were so many make this a likely stage II Ovarian cancer.

The other ovary was negative for cancer however was filled with blood, which is indicative of endometriosis. So, the position of the cervix, the endometriosis in one ovary and the funky position of the right ovary are all possible reasons that I was never able to get pregnant. A certain clarity is gained through the fog now. Phew!

Brian asked the question about my immune system functions since I have now battled thyroid cancer previously and am now dealing with the above issues. Due to the lack of family information that we have, the doctor has decided to refer me to a geneticist to find out more information. Ovarian cancer can be linked to breast cancer and particularly if there is family history of either. Since we have scant information on my family history, a geneticist will potentially do some testing to find out more. I am actually excited about the idea of finding out more about my genes - I think we will definitely get more information about my health concerns (which could be scary too!) and how it relates to genetics.

I also asked about hormones and menopause - that's one of the joys of womanhood that I get to face early. I always figured I had another 10 years or more before I had to figure out the meaning of menopause, dammit! Basically, my doctor has recommended that we not look at hormone replacement until we see how the side effects are treating me. I forget specifically what she said, but basically the hormones could trigger the cancer, so we'd rather wait and see if it's really a necessity before jumping into hormone replacement. In the meantime, some of the fun potential effects of menopause are: brittle bones, hot flashes (and yes, I have started to have some of those, but they have been short in duration), lack of libido, weight gain, hair in startling places, memory lapses, and more. So many cuss words running through my head!

Lastly, a referral has been processed to an oncologist. I will soon meet with an oncologist and talk more about the future chemotherapy treatments. The Longview/Kelso Kaiser clinic has just opened a new oncology wing and Brian and I got a tour of it last week. It's very nice - modern and clean. However, I have to admit that it seems a bit scary too. There were several rows of brand new chairs set up next to each other - kind of like at a dentist office. They have their own spaces, where one could watch movies, or listen to music or play on the computer, but you could also just look next to you and see a long line of other people getting their chemo treatments. Freaky!

I've never liked the idea of filling my body with chemicals. I suppose I've been doing it my whole life, to a lesser extent - what's in that beef I've been eating, or the spray on those veggies, let along the alcohol I drink or the medicines I take. But the idea of knowingly allowing a whole lot of toxic chemicals that effect both the good and the bad cells of my body - that's scary. The wig section of the oncology department in Longview freaked me out. What's the likelihood that I could lose my hair? Holy hell! My hair is a strong identifier of me - but I better get used to letting that identifier go. I suppose this is a good lesson in letting your soul shine through - your outer appearance is something we all strongly identify with, but my appearance could become altered - it's all physicial. I am still me on the inside. And then again, some people don't lose their hair and have no real side effects from chemo. Which will I be?

Showing Character

I am finally home and it feels so good. I still am sore and have a large wound that we're working on healing. I am on blood thinners and potassium pills. I feel better and gain strength daily, but am reminded that I must take it slowly. The staples were taken out of my wound on Friday, but I have been too active and have reopened part of the wound. I must take a few steps backwards and just relegate myself to a chair or couch and let myself be served and not push myself too hard. I never knew how hard it would be to depend on someone else for everything - getting me a drink of water, helping me to stand up, and just grabbing things that are barely out of reach.

As I sit here, tired of watching movies and needing a break from books, I realize that I still know so little. I've had a hysterectomy; What does that mean to me? I'm about to enter menopause and I'll never have a period again - but what does that mean to my hormones? I have a cancer and most likely will need chemotherapy, but what does that look like? How will it effect me? Suddenly, I feel overwhelmed by how much I don't know.

My husband, lovely man that he is, felt compelled to point out the beginnings of a mustache to me the other day. Gee, thanks dear! And while it's kind of funny, it also strikes fear in my heart. Is this the start of needing to shave my upper lip and my beard? Will my body become pear-shaped and will I be prone to hot flashes? Will hormones make me a raving bitch?

I also come back to face the question in my first post about strength and fear. I continue to be told by others about how strong I am, and yet I feel this incredible fear for the next few steps. Chemotherapy has always sounded so scary, and yet I realize that I really just don't know much about the process. Maybe knowledge will take some of the fear away. I won't back down; that's not my style. I will admit fear.

They say that how you handle difficult situations is what really shows your character. That seems like a lot of pressure in this scenario. Of course I want to be strong and fearless and knowledgeable about my condition and never be known to complain or whine for my situation - that's admirable, right? But that seems like a tall order...and a little unrealistic too. Who has taught us that we must be all these things to be an admirable person? I want to portray all those characteristics and yet more importantly, I want to be real about my situation and honest in my emotions and communication, which may sometimes conflict.

The Surgery; An Unforgettable Affair

Laura and Pat came to visit the weekend before the surgery. They helped Brian and me to rototill the garden and come up with a plan for planting all the seedlings we started a few months ago. They plan on making me several meals worth of food that I'll be able to eat post-operatively to save us work and stress in the long-run. They also will stay and take care of the pets while I'm in surgery. Thank you so much for all the love and work you put into this, Laura and Pat. Your friendship is amazing.

Magnesium Citrate. Ick; Those are a couple of words you hope to never hear that you have to take. I have to clean out my system pre-op, so only clear liquids the day before and take magnesium citrate, which will have you close to the toilet for the rest of the day. Note to self: Next time, buy the cushiest toilet paper you can find to use in conjunction with the magnesium citrate. The eco-friendly toilet paper I buy (100% recycled!) is great for the environment, but not so good for massive amounts of usage.

Brian and I wake up early and head in for our 6:00 AM surgery check-in time. Brian is more worried than me. I'm still in shock. It's making me nervous that he's so concerned and that he's crying and trying to hide it from me. I am worried for him and don't want him to be alone for the whole day, but we manage to arrange a few family members to check in on him throughout the day.

Check-in happens and everything goes fairly smoothly. I meet with the lead anesthesiologist, who is extremely knowledgeable and has decided an epidural is the way to go for this surgery. She has me sit on the table...and that's all I remember until I wake up from surgery. Brian tells me he was brought in to the room around this point (I do vaguely remember him being there and saying some goodbyes) and that I was very enthusiastic about the skills of the anesthesiologist. Well, I guess that's good.

Coming out of surgery is such a weird experience. It's that weird place, kind of like I imagine pergatory to possibly be. You're coming out of a dream-state but never really sure which part is still the dream. There's glimpses of some real seeming things: heart machines, people in scrubs; But then there's the constant cloud of dreamy half-memories washing over you too. I look at the clock and am shocked to see it's 6:30 PM. Holy crap - that can't be good. Too tired to try and make sense of it all though.

Finally, around 8:00 PM, I get wheeled up to my room. Brian is there, Don, Barbara and Angie. They all clear out quickly, except Brian, who tells me what has happened. They tried to do the laproscopic surgery (which was a stab at hope), but found the mass to be cancerous. Dr. Steiner called in her colleague, Dr. Cappuccini, to assist with the surgery and they opened up the full belly. They took out the cancerous mass which was attached to the ovary and ended up taking both ovaries, the uterus, some fibroids, the omentum (fatty tissue that hangs over the organs), and some suspicious looking lymph nodes. Unfortunately, they nicked the vena cava in the process and a lot of blood was lost and had to be transfused - about 3 liters total. They brought in a couple of specialists, who happened to be next door, to also assist. Aiyiyi. Is that all? Now that lost time I'd been wondering about is starting to make sense. I am happy to be out of surgery, that I woke up on the other side of surgery, and am ready for sleep. Apparently no one else got that memo. I am woken up every hour to be tested for blood sugar, but then there's thousands of other nurses in and out of the room waking me up for various blood tests, changing of fluids, poking, prodding, and so on. So tired.

I describe my pain that next day as a 5 - mid-level. They want me to try and sit up, maybe walk to another chair for a little while. My body rebels with other thoughts of sitting nice and comfy right where it is. We force it into submission and sit on the edge of the bed, but that's as far as I can make it. I'm out of breath. My pulse is unnaturally high, I have a fever, and there's lots of other issues going on that can't seem to brought under control. I think to myself that I've just had a hell of a huge surgery - why shouldn't my body be rebelling against it all?

At this point that day seems like a dream, but I remember a lot of concern from my doctor and the nurses about how I'm doing. Finally, my doctor comes into the room, trembling and stumbling over her words. She's been concerned about how I've been doing and was talking to another doctor about it when he mentions that it sounds like something might have been left inside of me - a sponge, maybe. She is very concerned and orders an x-ray. Guess what? X-ray shows that there is a sponge still in my belly. Time to go back in to surgery. Less than two hours later, around 4:00 PM on 5/19/10, I'm back under the knife. They find some gauze that had been left inside and take it out. It's a quick surgery and I'm waking up by 6:00. I wake up with a smile. I feel 100% better. I am trying to figure out which part is real and which part is dream again, but I know that the whole air around me feels happier, better, more positive. I can rest.

The nurses have other ideas though. Poking, prodding, etc. My doctor, out of concern, has told the other on-call doctors to check in on me. They each have their own idea of what is wrong with me. The internal medicine doctor thinks that I need more fluids and vitamin K. OK, hook her up. The cariologist thinks I might need some potassium and something else - ok, hook her up. Several other doctors have their say so and I'm hooked up to more IVs. I've lost count at this point. Their over-concern for their screw up is turning me into a pumphouse of fluids. I have 4 IVs, and each of those have several things hooked up to them - I estimate that I have 18 lines of various fluids being pumped at one time, but that seems like it has to be an over-exaggeration. They can't possibly have had me hooked up to that many things; Could they?

That night they wheel me down for a CT scan. I'm incredulous. I just got out of surgery and you want to do what? Well, hell. The scan shows there might be a clot in one of my lungs. One more thing to be poked and prodded over.

I should take a second and talk about the nurses. There were a huge variety of nurses that dealt with my care, but overall I had some of the most incredible care I could imagine. Brandi, the super star of all nurses, discussed Buffy the Vampire Slayer with me - she brought in a movie for me to watch. She called from home to see how my health was because she was concerned about all the tests I'd been going through. That was/is amazing. I have a breathing device to help with my lung capacity that we call my plastic peace pipe. She makes me laugh and she is attentive to the nth degree. I feel relief under her care.

I quickly realize that my modesty has gone out the door. The doctors are great about making sure my chest is covered during examination, but there seems to be no regard for the fact that they keep hitching my gown above my waist to look at my belly suture. I don't really care at this point, but I find it humorous.

Nausea is a common experience while I'm in the hospital. Unfortunately the pain medicine makes the nausea even worse for about 5 - 10 minutes before getting better. I get so use to the feeling without the actual act of vomit that I think it's never going to happen...and of course, that's when it finally strikes. Same feeling but I ignore it, and then it happens. And the last little shred of modesty I had goes out the window. I have now done all the most embarrassing things I can think of (I've saved you a few gory details) and have had to be waited upon and cleaned up by other people. They treat me with the utmost respect and humility possible and I am grateful to them for making a humiliating experience more bearable.

Meeting Steiner

Originally I was scheduled for an appointment on Friday - May 14th with a normal gynecologist. I was not excited about waiting an extra day or two. However, my doctor also sent my pathology report to the specialist at the same time (a gynecological oncologist) who ended up calling and wanting to bypass the gynecologist for a visit straight to her (Dr. Norma Steiner) on Wednesday. Thank God.

Brian and I went in to the appointment and she confirmed being able to feel the mass through a vaginal exam. Next step: Surgery. Immediately. Next Tuesday. (Remember that blog post entitled "Oh, Fuck!") We're unsure what we're dealing with exactly, but the best way to know is to get in there, take out this mass, take a look around at the ovaries, uterus, and other things and take out anything that looks suspicious. The mass itself appears to be attached to one of the ovaries and to have twisted the ovary behind itself and be located closer to the intestine than normal. I think at this point is when the words "carcinoma sarcoma" are mentioned as a possibility and that's not good. So, my youngish doctor (she's a year younger than me!) schedules surgery for next Tuesday and tells me to plan taking at least 6 - 8 weeks off work starting immediately. I ask how many times she's performed this type of surgery and she says, very confidently: "Hundreds." I think to myself that I wish she had said "thousands."

I always dreamed of "having" to take work off for an extended period of time, but it didn't quite look like this. I pictured margaritas on a sunny deck, working in the yard and on my tan, getting buff from my exertions in the yard...not a sliced open belly and recovering abs, requiring no lifting, pushing or pulling of any weight. That ruins all the fun of having this much time off work. Damn it!

Oh Fuck.

Ha. I can't really imagine a name any more appropriate than that. Oh Fuck. On my drive home from work today, after hearing from my doctor that I have a rather large 10x10 centimeter mass in my belly, (oh, and it's bad news...it might be ovarian cancer) I kept thinking various profanities. Shit. Fuck. Well, mostly just those two profanities over and over again. I thought about posting something ominous like that to facebook, but that just invites questions and right now I just need to process.

I also realized that I like to be strong. I don't like to show weakness. I hate crying in front of other people. People have always told me it's ok to cry, but that's not really what society says. Not that society matters much at this point, but it's been ingrained into my head and I have always gotten more approval and admiration for my strengths than my weakness. I'm betting that's true for most of us. Though who's to say that crying is a strength or a weakness? Why does either label have to be attached?

What exactly am I writing about today? Let's just say that midnight is near at hand and that my mind is racing. I've always journaled in the past in similar circumstances and it's helped, so now seems appropriate to take this one step further. Why not let the whole world read what is in my brain, if they care to take a peek? I've told myself no holds barred on this damn blog. Can I do it? If you don't like what you read, then please stop. Don't talk to me about insensitivity or legalities - it's time for me to be completely honest. My life is on the line.

I suppose that seems a bit dramatic. I have had a penchant for drama in my past. (what a beautiful word, penchant.) But seriously, I am unsure what kind of turmoil I am potentially facing in the near future, and I'm scared. I'm strong and I'm freaked the hell out. Is it possible to have fear and strength? It sure seems possible to me at this moment. Ultimately I feel pretty sure that I'll be OK in the end, but what does that really mean? What kind of hell stands in between me and "the end?" When I had thyroid cancer (a much less scary cancer in that only like 3% of people ever die from it), it was much easier to be cheerful and make jokes. I'm sure I'll do that again this time around too, but am I hiding a fragility under those jokes? Could my face crumble at any second and the soft interior part that is afraid to give up my incredibly happy and blessed life become exposed? Yes, I think it could. I think it's already happening.

That feels like it should've been the end of this particular rambling blog post, and yet my mind says it needs me to keep going. So on we blog. Are you still following along? "Can you read my mind? Can you picture the things I'm thinking of?" (10 points to whoever guesses that movie quote!

I hate most of all that I can feel this thing inside of me. I'm constantly aware of it's push distending my belly of my sensitivity to touch in that area, and most of all of it's rumblings, gurglings, and the pain. My god, that pain. It brings me to my knees. I want to moan - I sometimes do. But the pain is fairly brief thankfully. Tell me this - How can you have that kind of intense pain and yet just a couple of ibuprofen make it better? While I'm in the pain, it seems like only morphine is going to be capable of making it subside. My insides are twisting and pulling and want me to bend to their will. But no...two (ok, four) little aspirin that won't even cure what ails most people seems to make everything better. How strange is that?

So, I'll summarize the first few steps of the journey since that's what I'm about to embark upon - a forced journey. Really I suppose it's just a chapter in an already quite large and amazing journey, but we'll save those stories for later. Had extremely intense pains on 4/11/10, took some ibuprofen, started my period. Didn't think anything more about it. About two weeks ago, I noticed some persistent odd discomfort in the belly, but didn't think much about it. Saturday night went out and noticed that I was having problems sucking in my belly and that I got full supremely quick that night...and I didn't feel like drinking. Now that's odd. Sunday morning, had a great morning with Brian, we decided to take a walk. I realized as I was walking down our driveway that the pain was getting bad, the one step outside our driveway I thought to myself "this is going to be a mistake", but pushed on. (I am stubborn too.) Made it about two blocks and had to turn around. Wasn't sure I would make it back. Made it to the recliner, which made things worse. Fell to the ground in agony. Got up and went to the bed. Brian bought me ibuprofen. I fell asleep. I continued to take pills as Brian directed to make sure that pain did NOT return, and it didn't, but I was scared. I had learned to be much more sensitive of the belly at that point.

I called in sick to work the next day 5/10 and made an immediate appointment with Dr. Macheria at Kaiser. I had a slight fever -99- and my pulse was a little high. She did a pap smear but couldn't find the cervix. Did a vaginal exam, said the cervix was very high. She felt my stomach, I winced in pain a couple of times. She thumped my stomach and said it sounded dull. She also worried about my distended belly. Silly me - I think it's part of my constant-potbelly-since-birth. Oh no, it's worse. She refers me to a CT scan - I schedule it immediately - the next day.

5/11/10 Go to CT scan. Get really annoying guy who keeps making jokes and I just want to get the damn thing over with. Makes me drink barium two hours before going in - I do, it tastes icky. I then get the pains really bad again one hour later. I decide I can't drive myself and Brian has to call in to work in order to get me to the appointment safely. He does with no complaints. Damn, my man is a saint. (You know what he told me before falling asleep tonight? He said he'd rather be going through this with me than be doing anything else. Isn't that the damn sweetest thing you've ever heard? It brings tears to my eyes.) Anyway, go through the CT exam and then leave. Decide to go to work for 1/2 a day - I know, I'm crazy, but I don't have much sick leave! Check my phone at 4:45 and Dr. Macharia has just left me a message to call her back. I call back, get ahold of her and she says that I have a 10x10centimeter mass in my belly. That means bad news. She says it's likely that it's ovarian cancer. And that there's fluid in my belly causing it to be distended (ha! It wasn't just a potbelly from bad genetics and beer!) She has a call in for a referral to a gyno with an "urgent" status. And that's where we are. I'm waiting to hear about an appointment.

I could conjecture on what next steps are, but it's probably best to just wait. We know nothing about this "thing." No one knows if it is cancer for sure. It seems pretty damn likely, but strange things happen all the time.

And that's what causes me to be up at midnight typing a first entry into a blog, debating about fear and strength. Oh Fuck. But know what? I at least feel a little sleepy now.