A Little Good News

On Friday, my middle sister was flying in and my older sister and I planned to pick her up at the airport and give her the news.  But before the airport trip, it was “Generations Day” at our nieces’ preschool.  My hubby and I headed there with my mom to be the girls’ “generations.”  Each class sang one or two songs in a little show.  Then we headed to their classrooms to help them with a craft.  We switched back and forth between their two classrooms and they were pretty adorable!  

On the way to the airport I again had the rollercoaster feeling in my stomach, thinking about telling my sister.  When we picked her up, she immediately asked me how my time in Florida had been.  I couldn’t lie and said it had been “fine.”  “Fine?  Just fine?  Your Florida vacation!” she said (she is a very enthusiastic person!).  “Well we have some not good news that explains it.”  Our older sister and I relayed the news and events of the past few days.  She was, of course, surprised and concerned but very supportive.  We decided that lunch outside was in order and called my mom and hubby to meet us there with the girls.  It was a great restaurant but I just wasn’t that hungry – I hadn’t been since I heard the news.  

My dad called in the middle of lunch to let me know that he had received the pathology report that we sent earlier and his gyn onc colleague had reviewed it.  He was encouraged that the path was Grade I and thought that I would be a candidate for conservative treatment if I met the other criteria.  That was good news but I mostly just pushed my food around for the rest of lunch.  It was starting to hit me that vacation was ending and I was going to have to deal with this in the world of real life and my demanding job. Could I handle it all? 

My oldest sister told me later that she was feeling sick to her stomach at lunch after I spoke with my dad on the phone and came back and only pushed my food around.  She was worried that he had given me bad news about the MRI.  Thank goodness that wasn't the case.

That afternoon I called the gyn onc department again, trying to get an earlier appointment.  The appointment secretary was still out of the office but would be back on Monday so I decided to try again from home.  Then my dad called with the results of the MRI.  Good news!  There was no sign of invasion into the uterine wall, no sign of enlarged lymph nodes, and no sign of metastases!  That was a huge relief (to say the least).  

I was relieved but starting to feel really nervous about everything I had to get done when I got back home.  I am an anesthesia resident and I was scheduled to be back in the operating room bright and early on Monday morning.  That meant spending a few hours on Sunday evening preparing for my cases and planning by phone with my attending.  It also meant that I would be in the operating room all day with a 15 minute break in the morning, and a 30 minute break for lunch.  No time during business hours for phone calls (or chest x-rays)…  It was time to tell my program director and determine what level of support I would have.  

I gathered the courage to tell my first non-family member (and my boss!) and called.  She was incredibly supportive.  Right away she told me that the program and the department would support me however I needed.  If I needed time for appointments, they would help.  If I needed time off, they would work with me to provide this.  She told me that my health was the most important thing and that they would do whatever I needed.   And she gave me a nonclinical day on Monday so that I could ease back into work and organize all of the things I needed to get done!  

I felt a little more under control and not quite as terrified of returning to the real world. I even called my good friend that night (rollarcoaster feeling...) and gave her the news.  She came to visit right after my surgery so she had been the first to know about our struggle with infertility, and playing with her adorable 5-month-old boy had been a great distraction as I recovered.  She was floored at the diagnosis - I had told her the polyps were no big deal - but also optimistic.  

As I prepared to head back home, I knew that I already had support up and down the east coast. 

A Sandy MRI

The next morning (we are on Day 3 now, my diagnosis was Tuesday and this is Thursday) my sister, my husband, and I had planned to head to the beach for the morning.  I had my beach bag, my book, and I was planning to try my best to relax.  There was nothing else I could do now, right?

Wrong!  For some more background, I am a little shy.  I don’t like confrontation and I am not very assertive. Of course, my sister knows this, probably better than I do.  The night before, I had told my sister that my MRI was scheduled for 2.5 weeks from now. She thought that was unacceptable.  She told me that this was going to be a long process and that this was my life.  I needed to take charge, be assertive, and use all of my resources.  I was a med student and now a resident in my hospital.  I knew a lot of people with the potential to help me.  I promised I would do my best to take charge.  

On the way to the beach, she "suggested" I call my insurance company to see if they would cover an out-of-state MRI.  Ten minutes into the drive I had found out that they would (and with her prodding, I wrote down the name and extension of the nice - and competent - woman at my insurance company who had been really helpful).  Then we called my dad and told him that an MRI could be covered if we did it in Florida.  I felt like we had accomplished something and thought I could let myself relax for a few minutes at the beach.

We got to the beach - so breathtaking every time I see it - and parked ourselves on 3 chaise lounges under an umbrella.  We read for about a half hour and then my husband and I decided to take a walk along the beach.  We walked and chatted, for probably an hour.  When we got back to our chairs, my sister was nowhere to be found.  I figured she was walking or at the pool and sat back down to read.  Two minutes later she arrived, fully showered, but back in her beach clothes, out of the cabana, and announced that I had an appointment for an MRI in 45 minutes.  Seriously?  How in the world?  Must have been Dad!  I am very fortunate to have a father who is loved and respected all over his hospital.    

So my husband and I ran inside to at least try to rinse off the sand.  About 10 minutes later we were back in the car, headed to the hospital which was 30 minutes away.  Dad met us at the valet parking - he and my husband had a long-standing tee time that afternoon.  My husband tried to insist that he stay for the MRI, but I wanted him to be able to enjoy vacation at least a little.  My sister would stay with me while the guys went to the golf course.  

Picture this: my sister and I run across the hospital and to the MRI center in our beach clothes.  I was wearing a tank top, a short skirt, and flip flops.  My sister was wearing work-out shorts, a t-shirt, and flip flops.  We both had wet hair, smelled like sunscreen and were leaving at least a small trail of sand behind us.  We made it just in time and were psyched to see that HGTV was on in the waiting room!  Why haven’t more doctors’ offices discovered that this is way better than Fox News?  

My sister settled in to watch Designed to Sell with a cardigan she dug out of the bottom of her massive mom purse (air conditioning in Florida is freezing, especially with wet hair…) and a granola bar from my beach bag, while I was escorted to the back to get my IV and my scan.  It is a good thing my other sister wasn’t with us – she would have passed out at the thought of me getting an IV just a room away!  The guy was pretty good and it was only a small IV so no prob – I was already starting to get used to being poked and prodded.  Although, getting out of my tight tank top and into a hospital gown without pulling out the IV wasn’t the easiest thing I have ever done.  

I’m not sure if you have ever had an MRI before, but each time I have (2 others years ago for athletic injuries) I forget just how loud it is and just how slow.  They asked what type of music I wanted to hear on my headphones, but there was no way I could hear Kenny Chesney when the magnet started doing its thing.  I just tried to make myself relax in between repeats of “Take a deep breath.  Hold it…  Breath.”  Forty-five minutes later I was out of the scanner and we were on our way out of there with a CD of the images in my hand and one thing to check off my list.  I just had to get through the next day or so to hear the results. 

A Bagel and a Massage

Not surprisingly, I didn’t sleep very well that first night.  In the morning, I convinced my husband to go to his golf lesson, despite him offering to stay home with me multiple times.  We still had to take advantage of vacation down south!  My sister showed up at my parents’ house bright and early, after carpooling all three kids to their schools (and her husband to the train!).  She immediately started to cry when she arrived - I could tell she just wanted my life to be easy and smooth without such a big roadblock.  When she is worried, she doesn’t sleep, which meant that she had spent all night researching online.  She already knew way more than I did about endometrial cancer in younger women.  So my mom, sister, and I headed to our favorite deli for bagels and an update on all of her research.  

Here is the theme of what she found: women who meet very specific criteria can be treated with hormonal therapy.  If the cancer regressed, some women are allowed to try to get pregnant.  Most doctors recommend IVF because it is more likely to be successful and you are on a timeline to a hysterectomy.  Some women go back on the hormonal therapy after they deliver and based on results of endometrial sampling, may be allowed a second pregnancy soon after the first (hello kids close together).  But, a hysterectomy is the definitive treatment.  

Believe it or not, this was encouraging news!  I just needed to know if I met the criteria…  I decided to worry about it after my massage.  

The massage was heavenly but to be honest, I couldn’t clear my mind to relax as much as I would have liked.  When I left the spa, I decided it was time to start dealing with this.  On the initial phone call with my diagnosis, my doctor had asked me which local hospital I would want to be treated in.  She planned to call and speak to a gynecologic oncologist about my case.  An oncologist?  That sounded very real.  She had, in fact, called back the day before while we were sitting by the pool and had left a message.  She had spoken with a gyn-onc that I was familiar with from my job at the hospital.  She would be happy to see me as soon as possible.  Before my appointment, she wanted me to have a chest x-ray and an MRI of the abdomen and pelvis.   

I drove from the spa to my parents house and sat down to make phone calls.  They wanted the MRI before my onc appointment so I started there.  Two and a half weeks?  I had been hoping to have seen the gyn onc specialist and have some answers by then!  The chest x-ray I could just walk in for anytime.  Next, I took a big deep breath, and with my heart pounding, called the gyn onc department.  The first appointment they gave me was a month later!  Was I just supposed to sit with this cancer growing inside me for a whole month?!  The appointment secretary who was supposed to be aware that I would be calling was out of the office so I decided to try again the next morning.  

A few minutes later, my dad called my cell.  My dad is also a doctor and he had already been in touch with the chair of gynecologic oncology at his hospital.  The first thing my dad said on the phone was, “You don’t have to have a hysterectomy.”  His colleague had told him that hormonal therapy with megace can be used in young women.  Megace?  Wasn’t that the drug I had learned about in med school that was used as an appetite stimulant for patients with cancer and AIDS?  Yup.  This was definitely going to be an interesting process…

Telling my Family

To be honest, I don’t remember much about the evening at my sister’s house.  I remember feeling nervous.  I remember having a much needed glass of wine that didn’t taste as good as it usually does.  I am sure I played with my nieces and nephew and maybe even read a bedtime story or two.  

My sister always cooks gourmet meals but that night I could barely swallow my steak.  My husband was looking at me every few minutes, “now?”   I didn’t want to ruin their dinner so I was planning to wait until we finished eating.  Eventually, he looked at me with a “now!” look and I knew it was time

“We have something we have to talk to you about,” I started.  My brother-in-law immediately piped in with, “I knew it!” and a big smile, implying that we were pregnant, despite the glass of wine in front of me.  “No, please stop there.  It is not good news.”  We gave them the whole update.  They were shocked and supportive.  There were quite a few tears.  I’ll distinctly remember the whispered, “Do you have to have a hysterectomy?”  I didn’t know the answer.  I needed more information.  My sister said that she thought something was up - I hadn’t been myself that day.  

I am the youngest of three girls.  My middle sister was flying in for the weekend in 2 days. My mom, oldest sister, and I decided that I should wait until I saw her in person to tell her the news. 

After dessert (despite no appetite, my sweet tooth let me eat a piece of cake!), my sister said, “I am calling Yazmina right now!  You need a massage tomorrow morning".  A massage sounded good to me...

That night, my hubby and I lay in bed talking. The day before we had been looking forward to the year to come, and hopefully a pregnancy.  He loved his job and coaching hockey.  I survived medical school and my internship and was finally training in my chosen field.  And we had been planning to buy a house, moving from the city to the suburbs, in anticipation of starting a family.  Would we be able to continue all these plans?  We felt like our world had been turned upside down.