Monday, 2 September 2013

Steps for future health

Tomorrow (Sept 3), I'm having laparoscopic surgery. This isn't urgent or life-threatening, it's something that needs to be done sooner than later.

Warning - this post is about women's health, what's going on with my health, and discussion of lady parts. I won't get explicitly detailed unless necessary.

In the last few years, there has been an alarming increase in cancer amongst the women on my mother's side of the family.

In 1986, my mother's identical twin passed away from breast cancer. A few years ago, another of my mother's sisters was diagnosed with advanced ovarian cancer. At the same time, I was having some post-menopausal irregularities. I went to my family doctor and he referred me to an OB/GYN. I had an ultrasound which showed ovarian cysts. My following ultrasounds showed that the cysts shrunk. I also had an endometrial biopsy that found a benign polyp.

Last year, another of my aunts was diagnosed with advanced ovarian cancer. One of the oncologists suggested that the women of the family start looking into genetic screening. I wrote up the family history of cancer, took it to my doctor, who immediately agreed to refer me.

Here in Calgary, I was referred to the genetics clinic at the Children's Hospital. If I were a character on a TV show, I would've been tested and had my results already.

In the real world, genetic testing is like looking for a needle in a haystack. The clinic needs to know what to test for - so one of my aunts with cancer would have to be tested first. Then I could be tested. Both of my aunts signed consent forms to share their records with the Calgary clinic. Aunt A had already agreed to be tested.

(There is another way for me to be tested - if I were exhibiting clear symptoms of having cancer, I'd be tested. While I have irregularities, I don't show distinct signs of having cancer. So yay for that.)

Many of us in the family started sharing medical information. I found out that another aunt and a cousin had hysterectomies after pre-cancerous cells had been found.

My arrangement with my OB/GYN was that I would see her every time I had a period. I entered menopause fairly young, so it's been possible that there are a few eggs left. I have yet to go twelve months without a period - the record is eleven months.

(Blood tests since 2010 confirm that I am in menopause.)

So I diligently saw her each time, and she diligently sent me off for another ultrasound. I had another period in March, then followed up with my OB/GYN. It had been over a year since my last biopsy, so she did another biopsy in her office (ouch!).

The pathology report showed simple hyperplasia in my uterus - the beginning stage of pre-cancerous cells.

So my choices were - treat it with progesterone to try and reverse the hyperplasia and have frequent biopsies to monitor the situation. Or - have a hysterectomy, and remove my ovaries at the same time, given my family history. It didn't take too long to choose surgery.

This appointment took place during my lunch hour. I went to the nearest Starbucks, and while standing in line, started to wonder what had just happened. Had I really just agreed to surgery?

So I walked out, and around the block, and freaked out. Then I pulled myself together. I have been very diligent about getting checked out so that I can avoid cancer. Now that something had been found, it was time to eliminate it. My friends and family have been very supportive.

The only negativity I've experienced was at an energy sharing meetup. One woman told me at length at how her daughter also has pre-cancerous cells but has been holding off surgery. Then she lectured me at length about what I should be doing, including herbal cleanses and eliminating all sugar. It was really unpleasant. (As are herbal cleanses - I tried one once, and had to stop it, because my energy dropped dramatically.)

By the time Aunt A's test results came in, her grand-daughter had a hysterectomy. Cousin J's pathology reports show uterine and ovarian cancer and she is about to undergo treatment.

Aunt A's test results showed a mutated BRAC2 gene. I was worried, because while waiting for my surgery, I didn't want to have to consider a mastectomy too, if I had the gene.

My genetics counsellor spoke with her colleague in Halifax who did the testing - and reported that the mutation is not directly linked to an increased risk of breast and ovarian cancer. (Whew!) It is a VUS (Variation of Unknown Significance).

So now the genetics team is waiting to see if Cousin J will undergo testing. They think Lynch Syndrome may be the genetic link between all the cases. Lynch Syndrome carries an increased risk of colon, uterine, and ovarian cancer at a younger age. Cousin J is about 10 years younger than I am. If she has it - then I'll be tested for the gene.

Right now ... I'm nesting. Preparing the house for me to just sit around and heal after the surgery. My sister will be with me at the hospital, and my mother is flying in to stay with me after. The cats will be happy to have me home, at least.

Tonight I read something on Cheryl Richardson's Facebook page that helped ease my anxiety. I commented about that, mentioning I was about to undergo surgery. She wrote back with this bit of loveliness:
Affirm: Every hand that touches me is a healing hand. I wake from surgery feeling peaceful & calm, I am cared for by a Divine Loving presence every moment of every day. I'm adding you to my prayer list. You are going to be fine.


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