First Day Back

I didn't sleep well last night; I think I can chalk that up to anxiety about returning to work today. It went fine, but then I did have a half-load of patients-there was plenty of time for charting. Tomorrow is the same, a half-schedule. Next week 6 patients a day, and then back to a full schedule of 8 patients a day. I had hoped to be so well recuperated that I would get ahead with projects today, some studying and reading policy that is required for the job, but I was moving pretty slow and didn't get ahead as hoped. Not much pain; I switched to Celebrex last night and it is working for me much better than Tylenol or Ibuprofen.

I was dog tired by the end of the day. I'm going to bed soon-glad to have not too much to do aside from work right now.

Yesterday I went to my post op visit with the surgeon and got a clearance to go back to work. She gave me a copy of the pathology report which informed me that my ovarian cyst was indeed a dermoid, and that as these can be  really any type of body cells-most famously teeth and hair-mine was mainly thyroid tissue. And apparently although the left ovary was normal, there was a cyst attached to the left tube. Ah the things that go on inside our bodies that we are never aware of-its amazing. I suspect that I'm going to feel better than I had before the surgery once I am all healed up.

My burning tongue which burned consistently for over a year has been quite cool now for several weeks. I pray that will continue. I'm almost frightened to mention it lest I jinx it.

Almost time to go back to work

I can't believe I missed writing for the whole weekend! I finally found the HysterSisters "Ovaries Only" forum and spent time looking to see if I could find another woman with a similar situation to mine who might give me a clue as to what to expect. Of course it's different for everyone, but somehow I still yearn to hear the long term experience of a woman who, like myself, was post-menopausal and feeling good before having this surgery. I haven't found her yet, so the blog continues to seem like a good idea, a potential source of info for someone who will come later. The writing itself is cathartic anyway, and interesting to review and to see what was on my mind last week, and soon, last month and last year.

I have had very little pain, and I think that in itself is fairly unique. It sounds like other women healing from laparoscopic surgeries report various pains and limitations that I haven't shared. I still have the occasional sharp shooting pains mainly at the naval incision, and some sort of aching, burning sensations around it. The skin feels funny in response to light touch, sort of bruised and semi-numb. But the pain is well controlled with OTC pain meds and only my stomach is really suffering, and not too very badly.

What I've noticed over the last few days as my activity level has increased is that it has a very thin boundary; when I crash, I really crash. I'll be cleaning the kitchen, talking on the phone, doing some computer research and then suddenly I'm asleep sitting on the couch, computer on my lap, unable to continue. That's the factor that makes me nervous about going back to work on Thursday. It sure would be embarasing to fall asleep with a patient! I doubt I'm in danger of that, but I am planning to come directly home from work for the first week, and I have scheduled in breaks that are long enough that I can go and lie down if I need to.

I gave a massage tonight to my longest-standing weekly client who has been patiently waiting for the last 3 weeks to resume his sessions; it was okay, with the most difficult part for me being the carrying in and setting up of the massage table. My pain went up a bit, but not too bad, and now I'll take some Tylenol-should've done that before I started the 90 minute session.

I am having some mild menopausal symptoms...sleeping hot if not actually sweating, hot flashes that have not been messy and dripping, but somewhat uncomfortable, as I just don't seem to adjust to the indoor temperature as rapidly as I used to. But it's not too bad. The sleeping has been a bit challenged so far-again, not as bad as during the big change, but not as restful as before the BSO. And a bit of vaginal dryness too...I'm trying to avoid using BHRT for at least the moment, as it seems that a cancer scare ought to trigger the desire to avoid them, and I haven't really tried to treat my symptoms with botanicals in a long time, and maybe now, this far past my menstruation days, it will be adequate.

Big day and some background

wrote this yesterday but fell asleep before posting. 

I had a big day today; got up and went to the hairdressers as I was way overdue for a cut and my somewhat complicated color situation - I use organic henna and indigo to dye my hair and that is a little more of an ordeal than contemporary hair dye. Lately, a friend who is a wonderful hairdresser has been putting the color in for me making the whole process so much easier, still, with the weather we've had lately and my recent surgery,  I've fallen behind on my cut-and-color schedule. I was glad to get in to see her today, but it made for an active morning and early afternoon with some shopping thrown in, and I was just exhausted by the time I got home.  I need to work my way back up to being able to tolerate a full day of work, so it's good that I pushed the boat out a bit.

I've been trying to come up with a format to tell a bit more about my background, as it was the lack of any information regarding a response to this surgery from a woman in my situation, specifically post-menopausal and with a first-and-second-degree relative having had ovarian cancer, that inspired me to write this blog.

So here's the start of my health profile
age: 51
height: 5'6"
weight: 152 lbs last time I checked; it has been up and down over the years, but this is around my average adult weight. It has been as low as 138 and as high as 179 in my adult life.
Heart rate: 60 bpm; Blood Pressure: 111/64 last time it was taken
Heart disease runs in my family but so far, my heart checks out great.
I have a swallowing dysfunction that sometimes makes it difficult for me to eat or drink, but I seem to be able to control it. I have had a condition called "burning mouth syndrome" for the last year and a half, but that has been completely under control since about 1 week before the surgery; I'm hoping that lasts!
I had a 2 tick bites last summer that made me very sick and I was treated with antibiotics; in August I came down with Shingles and that was the sickest I have ever been.
This has been a rough year.

Gynecological history: no children, 1 abortion at age 19; I used an IUD for birth control most of my adult life as I was always in a steady relationship. At one time I was diagnosed with Pelvic Inflammatory Disease with one of these IUDs and I had trouble conceiving after that. Miscarriage at age 33. Tried to use "the pill" for approximately a year and a half during 2 different trials, once in my early 20's and once on the "low dose pill" in my early 30's, but both times became severely depressed on it and was told that I was "not a candidate".

More later...

One week out

It's hard to believe it's been a week since the surgery. I'm still using the generic Percocet to sleep as my pain seems to crescendo around 8 or 9 pm with only momentary elevations earlier. During the day, it's just Ibuprofen. I'd like to get off of all of it, but I'm just not quite ready. And with so many pills to take - the antibiotic 4 x per day, 400 mgs of Ibuprofen every 2-4 hours, senna laxative morning and evening, Percocet 1 or 2 times at night, my usual vitamin and mineral suppliments (sans E until no more bleeding) - I'm keeping a log of each med at each time that it's taken, as I just can't keep up with it by memory. I'm afraid I'll miss a dose, or double up, and I really want to be conscientious about the narcotics and the antibiotics. Simethicone for gas pain was a great suggestion from a friend as well, as increased intrabdominal pressure at this time can lead to complications and spike the pain; I hear it's the source of much misery after pelvic surgeries, and I really haven't had a big problem with it.

Honestly,  it's not the intensity,  just the location of the pain - the soft underbelly, that vulnerable core area  - that makes it so difficult to bear. I've referred to it as "creepy" pain, not terrifically high most of the time but occasionally like a sudden knife in the gut, making me feel pulled toward the fetal position, protective of the vitals. I have to remind myself to stand up straight and tall, and I have increased understanding of the reasons that so many of my patients need postural coaching. 

I got bathed and dressed today and read an entire novel, a book with some very hot, sexy passages, and was happy to discover that I still respond to that type of literature as I did in the past, confirming that ovary-lesness will not prevent me being stimulated by passionate images, and reaffirming that the human body's main sexual organ is the brain.

Benign

I had been sure of it in my gut, and had wheedled the preliminary report information out of the clinic nurse on Friday, but today I got the official call-the final pathology report was in and the results were a wonderful, positive negative. Nothing in the core needle biopsy of the cyst, nothing in the peritoneal washings. The disease that cost my grandmother her life and that terrorized my sister will not take me! Whatever it is that gets me in the end, it will not be Ovarian cancer. The nurse said "it was just a dermoid", but I didn't ask if any endometriosis had been found, or anything else that might have led to the 2 bouts of bleeding I'd had, or the pain I've had in the right groin from time to time. I will ask at my follow up visit on the 24th.

In addition to the good news, I'm feeling WAY better today; the antibiotics have kicked in. I had started to feel kind of achy all over, not quite flu-y, but not well, with pain in the low  back that felt like aggravated kidneys, but today that has subsided and my energy seems much more normal.  My friend G. noticed it while talking on the phone today; she told me that I had been sounding  spacey up through yesterday, but today I sounded different, and I could feel it too-could feel myself finding words and finishing thoughts that had eluded me earlier in the week.

I feel that it's too soon to really be able to attribute any of my symptoms to the lack of ovaries....there are occasional hot flashes, and I've woken up sweaty a couple of times, but that kind of response comes from drugs and healing and infections, so I don't assume that I'm able to tell yet if any of these symptoms, which frankly have not been very difficult to deal with anyway, is a result of my new physical state.

I have fleeting moments of feeling less feminine, like a "fixed" dog, a bitch who will never come into heat. And there sure was a lot of heat in my youth; the sexual fire has been dampened for a few years now anyway, and I will never miss the painful periods. Mostly, when those thoughts arise though, I let go of them without effort. I feel good about this choice, and delighted that the results confirmed my gut feeling about my health.

So I'll keep posting, and will write more about my background, see if I can find a health profile of some sort to help offer some window of insight into my experience just in case it might be of use to someone in the future pondering this kind of surgery; I wish I had been able to find some information like that a couple of weeks ago when I was looking.

Sunday-Valentine's Day

I woke to find a Valentine waiting for me; it said on the cover "In the whole world, each person is assigned one other person to be their special soulmate, their valentine"-open the card and the punch line-"ha - ha!  you got stuck with me!" made me laugh so hard I was afraid I was going to do some damage to myself and bust a stitch.  I had wanted to make him a card, had started to do so several times over the last few days, but that was one of the casualties of the pain meds, one of the numerous things I started to do, becoming distracted midway and never completing the task. Dave tells me that I am his Valentine; he doesn't need a card.

It seems that I've developed an infection. Probably not a very bad one; last night I discovered a little seepage from the incision at my navel and noticed that area was somewhat tender, red and hot. I called that clinic and spoke to the on-call doc, and he prescribed a round of antibiotics which I started today. Friends had come and brought dinner, staying to eat with us, and I'd had to take a pain pill, making me kinda spacey. Guess the infection was the source of the spiking pain then and the previous day as well. Our friends noticed my exhaustion and left early, and shortly after that I noticed the drainage.

So back to the internet searching for meditations to calm my anxiety about the healing set back. I did find some on I Tunes and on the internet, including a guided Reiki practice that I find relaxing and seems very helpful. So I'm trying to stay calm, take my antibiotics, and be well. Somehow, I never even considered this potentiality-I stressed over the possibility of a malignancy, I continue to fret about resultant hormonal changes (no hot flashes so far), scar tissue, pain...but I just never considered that an infection might interfere with this best-case-scenario that I believed I was experiencing. And I may be still...I'm still hoping this will not cost me time.

My boss came by to visit me yesterday afternoon, and today one of my coworkers came and both brought groceries, flowers, books...I love my job and the staff of clinic where I work, and I want to be able to get back there at the time scheduled and planed for. So I'm meditating and taking my meds and doing some gentle exercises in the bed, although they do amp up the pain. I'm receiving no pressure at all from my employers, but I myself feel out of sorts being away from work, both the clinic and my private massage practice, and I feel a strong responsibility to my clients and patients. And I love my self image as a strong and healthy person; that sense was a major influence in my decision to do this preventative surgery in the first place, as I've always thought preventative surgery runs the risk of turning a healthy person into a sick one (for at least a while) in the effort to avoid future major illness, which may never come. It would be too ironic to find myself truly ill now; I won't have it.

Saturday

Yesterday I tried to get off the narcotics; I hate the way Oxycodone makes me feel-any codine medication really-and I felt like a narcaleptic on Thursday, alternately wired and suddenly nodding out in the middle of a sentence or an activity. So yesterday I took only Ibuprofen, 600 mg every 4 hours or so, but by late evening I was having bouts of intense, throbbing pain and was afraid I would not sleep without help in the pain releif department. So I took 1 of the generic Percocet 5-375 pills and slept pretty well. Today I feel intellectually ready to reintegrate into the world, but could not bear the thought of getting dressed and definately did not want to drive after taking that pill last night. I'm taking 400 mg of Ibuprofen every 2 hours today, with reasonably good results, but some mild nausea between  bouts of ravenous hunger.

A friend who recently had a hysterectomy gave me much advice in advance of my surgery, including some pre-surgical meditations that were very helpful in getting my usually-high anxiety levels under control, so I was very prepared for that part of this experience. I called to thank her for that and during our conversation, she warned me that many people she has spoken to have suggested that depression is a frequent follower of general anesthesia. I'm thinking that depression would be an unsurprising experience after any major surgery for numerous reasons-sense of aging, sense of frailty, life-changing event, the weakness of the healing time period-all of these experiences could be depressing. I am fighting regret-an emotion I rarely indulge in-and moments of sorrow, but mainly feeling frustrated that I am not yet feeling well enough to begin to approximate a normal day, and wondering how I will have the stamina to return to my job duties in just over a week. 1 day at a time, I tell myself, 1 day at a time.

An interesting symptom note: so far, the burning mouth syndrome that I have been dealing with for a year and a half is quiet post surgery. I can tell I'm clenching my teeth in my sleep, although less so than before the surgery, but my mouth pain has not been stronger than a minor irritation since Tuesday. I hope that particular situation will continue.  If I remember correctly, the meditation I did presurgery started to address the mouth pain and to send it on a downward trend. So is it completely anxiety-related?

Thursday

I'm losing track; it's 2 days post isn't it? Today is my sleepiest day so far. My bowels are moving again, maybe more than I'd really like! But I'm in and out of consciousness today. Enjoying just lying in bed and watching old TV shows on Netflix. What luxury. Friends drop by and flowers arrive. The dog keeps a bedside vigil. This doesn't suck, but I'd like to get back to work anyway.

Day after surgery

I slept pretty well last night, but was glad that I had swapped sides of the bed with my husband, putting me closer to the bathroom. I was able to get there on my own, but would have had a hard time having to navigate any further-I was very wobbly. Today I've continued to take Oxycodone and will probably keep that up through tomorrow, but hope I can transition to Motrin after that.

The surgery went great, but the big question, still hanging, is the result of the pathology, and that will probably not be known until the beginning of next week. That is the hard part-the waiting, although I feel in my gut that all is well, and my CA125 is very low at 3.6. 

It was a busy day, with numerous deliveries and a couple of visitors and I didn't get to rest or write much, so I'll have to get to the longer entries containing more of the background that led to this experience at a later date. For now, I'll just say that I decided to write this blog because I could not find very much information on the subject of Bilateral Salpingo Oophorectomy, or the removal of both tubes and ovaries, in women who are past menopause and who have family histories of ovarian cancer. That is my situation; my sister is an ovarian cancer survivor of 4 years, and our paternal grandmother died of the disease when I was an infant, before my sister was born. I have had a known ovarian cyst, assumed to be a dermoid, for about 10 years.

Even before my sister's diagnosis this cyst was being monitored biannually. It was tiny, they told me. I had no pain that I could attribute to it. I had the usual menstrual cramps and often felt that I was able to tell when I'd ovulated, but I never had to cancel appointments or stay in bed during my cycles. When my sister was diagnosed during the same time frame that my husband was being treated for lung cancer, I asked my husband's oncologist what he suggested that I do to manage my risk. He referred me to the gynecological oncologist at Vanderbilt University Medical Center (my current employer) and I began to monitor my situation with that doctor, Marta Crispens, at the helm. We agreed that if it ever changed, we'd take the ovaries out. And it never did, up through the pictures taken in August '09. But then in December, I had what seemed like a period. Then again in January. I was surprised, but not alarmed.

I'd already made an appointment with the endocrinologist in the Center for Women's Health at Vanderbilt to discuss my BHRT, the tiny amounts of vaginal estrogen and transdermal progesterone I'd been using, so I brought the bleeding to her attention. She at first thought I might have exited menopause, gone back to being menstrual, and I was kind of excited about that thought-I'd never heard of that happening before, although I had heard of women sometimes having a couple of months of bleeding when they start out on a new hormone suppliment, particularly progesterone. Well, blood tests disproved this theory, and then we did the ultra sound.

more tomorrow.

Surgery Day

I'm home; it's 7:30 pm here in Nashville and I've been back around an hour after waking up and then picking up a prescription for pain on the way back. I feel pretty good; but like I'm going to fall asleep in my chair at any moment. More tomorrow, but for now, it is just amazing that I'm awake enough to take a stab at this.

life before BSO

It seems like a good time to start this blog; the night before the surgery. I have been preparing myself all week intellectually, spiritually and emotionally, and today I have prepared myself physically by doing a bowel prep, bathing and rubbing my abdomen and thighs with the Sage wipes my doctor gave me. Wish I hadn't shaved, though; my thighs are itching now like crazy! Probably somewhere it said not to do that, but I guess I missed that instruction. Ah well, here goes something!

I was hoping to avoid this-to become an old woman with all of her parts intact- but prudence at this point leads me to this choice. I'm tired of worrying about it, tired of the bi-annual poking and prodding and picture taking of the organs to micromanage their progress as I try to live a carefree life. Or at least as carefree as possible. I've had a number of small health issues to overcome, some of which are so unusual that I think they will be of interest to a reader when I get around to writing about them, but for now, I'm battling fatigue and an Atavan that I just took; time to get sleepy, and meditate one more time before surgery day.