It is the winter of 2013 and life is stressful enough for a self-employed writer and musician. Nothing dramatic has really changed with my condition of rheumatoid arthritis and daily challenges are the same old routine of managing pain and immobility.
One morning in the shower, I notice that my abdomen seems distended, as hard as a rock. I’d been experiencing symptoms similar to signs of a urinary tract infection, but the two jugs of cranberry juice and gallons of water aren’t making a difference. I make a beeline for the twenty-four hour urgent care clinic. The doctor on duty diagnoses a severe UTI and prescribes an antibiotic. I need a second opinion. Two ultrasounds and a C- scan later reveal that a cyst within a cyst is developing around my right ovary. We had just brought my mother home from the hospital after her mastectomy at the end of February. Am I next and do I have cancer too?
My family doctor reviews the CT-scan report with me, describing a mass 14 X 18 X 19 centimeters. He checks it again and even to his disbelief, states that it’s the size of a cantaloupe. There’s a tiny spot on the liver and one on the spleen, but he says that the urgent matter at hand is the invasion of this mysterious mass. I’m beginning to feel like a character in an alien movie. He immediately orders further testing with a gynecologist and wishes me luck.
The snow is beginning to fall as I exit the doctor’s office. I have a forty-five minute drive back home and take my time, much below the speed limit. Cars and trucks are passing me impatiently. The wind makes the flurries swirl across the road, as the day’s events are circling in my head. Phrases like “the size of a cantaloupe”, “hopefully it’s benign” and “how rare to see a mass of this volume” keep repeating. I have promised myself that I was going to be brave, but I feel a panic attack coming on. As my anxiety level rises, I’m getting closer to St. Joseph’s Cemetery where my father is buried. If I could just see it in the distance and then just get to the gate, I’ll be alright. I sit in the car watching the snow accumulate over Dad’s grave and lose track of time. I don’t have to tell him, he knows what is happening to me.
It’s the middle of March now. The patient room of the gynecologist’s office is small. Dressed in a paper robe, I fidget nervously on the exam table. After two marriages and two miscarriages, I have survived vaginal probing and pap smears countless times. What am I so nervous about? Trying to distract myself, I take inventory of the room. On the instrument tray, staring right back at me is the cold, stainless steel speculum that looks like a hand stapler. I look at the bin where the used gowns are tossed, the box of latex gloves, the lamp, the swabs and long Q-tips. They’re going to need blood. I’m certain of that, scrunching up my nose. My palms are getting moist. Man, I can’t run, I can’t hide.
My first miscarriage was the saddest. I was twelve weeks along, but not even showing. I definitely recall a long period of depression or as they softly labeled it, “the blues”. The second was diagnosed as a precipitation, but still required a D and C, medically known as a Dilation and Curettage, where they scrape the tissue lining of the uterus with a spoon-shaped instrument and pack you with a lot of cotton. Over the years, I reflect on the past from time to time, calculating how old they would be now. Rheumatologists have told me that the RA factor in one’s blood can be the cause of rejecting a fetus and I would most probably be childless. I wonder if this new OB/GYN will ask me if there was any possibility that I am pregnant. Then there is always the same question, “what was the date of your last period?” Let’s take a guess, maybe ten years ago?
Sitting on the cold, crisp paper, I realize that I have never felt my abdomen touching my legs before. Pondering over thoughts of what it must be like to be pregnant, I wonder how in the world women make it through nine months, let alone the labor. I’ve been having difficulty bending over to put on socks and shoes. How do women handle such a huge extension of their abdomen? How do they drive? I’m not pregnant of course, but cannot ignore the sense of disappointment that I’ll never experience motherhood.
Okay, I hear conversation in the hallway. Do they already know what’s wrong with me? Enter the doctor and she is smiling, saying hello, immediately giving me the sense that I’m about to begin a positive journey. I just have to make it over a rocky road first. “Now we just have to scrape for a tissue sample”, she announces, as the nurse hands her a tool that looks like a bottle brush. I take a deep breath when I know that metal thing is next. I am such a wimp. The vaginal exam, the blood test for cancer and a mammogram are complete, but they need one more ultrasound. The blood test shows no indication of cancer and the mammography report doesn’t reveal anything questionable. I have passed the first phase.
My next appointment is scheduled for one week later. The cyst is growing rapidly, unrelentlessly pressing against other organs. Attached like a parasite, its blood supply is my right ovary, causing me to feel weaker and anemic. I can actually hear my stomach growling from my lower back. The cyst is forcing everything to step aside. I’m eating less, as every meal gives me indigestion and sleeping less due to more and more discomfort. The greatest challenge is finding a pair of pants that will pull up over my distended belly. I surrender to one pair of corduroys that can’t zip up, covered with a big shirt.
On the day of the second ultrasound it’s cold and damp with flurries. The dark, gloomy winter lingers on while the cyst thrives in my body. I have to drink four eight-ounce glasses of water prior to my appointment. A friend drives me to the doctor’s office in her new Subaru with heated seats. She stops in front to let me out, but I just want to stay right there in the warmth and take a nap. Stepping out of the car, the snow thickens and the wind is blustery. Thank goodness the technician warms up the jelly for the ultrasound. “You look like you’re twenty-one weeks pregnant”, she says, shaking her head in astonishment. I can only sigh out loud. She’s done in a flash, and then the nurse leads me to the doctor’s private office where I’ll learn my fate. But first, I have to go to the bathroom!
The doctor’s private sanctuary is located in the corner of the building, wrapped with large windows and a view of the parking area, the bare trees and the falling snowflakes. Her office features blue carpeting and walnut woodwork. It’s a very soothing and quiet environment, not much different from any other doctor’s office. “The doctor will be with you in a few minutes”, whispers the nurse kindly and closes the door behind me. I sit down slowly and there they are, all around me! On the shelves of the large credenza to my left and the bookcase behind me are collections of clowns. There are clown figurines, clown mugs, clown heads, plastic clowns, ceramic and china clowns, clowns sitting, clowns dancing, clowns with umbrellas, sad clowns, happy clowns, clown portraits on the wall and even a clown swinging from a balloon inside of the desk lamp. As I wait for the doctor, my anxiety is growing and my bladder keeps filling. Oh boy, I have to go to the bathroom again.
I wish the clowns could make me laugh and feel a bit calmer, but they aren’t helping at first. Clowns made me uncomfortable as a child. I never understood why someone would want to be a clown or put on clown make-up. Each clown in the doctor’s collection seem to express a unique story of its own, not of tragedy or sadness, but of life’s moments that make you realize that you have to keep on smiling, regardless of the situation. No pun intended, but it’s funny how the clowns are transforming my anxiety into a sense of security. I realize even more that this doctor is someone who focuses on happiness, a positive attitude and success. A light-hearted approach is exactly what I need. Courage and determination is critical. I have come this far and need to forge ahead fearlessly.
The doctor explains the surgical procedure called an Exploratory Laparotomy in detail like a game plan. I sign the release form allowing her to remove the other ovary and fallopian tube if necessary. She assures me that she is a meticulous seamstress when it comes to closing up an incision. There will be three levels of stitches in one elegant line from just above the naval to the pubic bone. Her strategy will be to lift out the entire cyst in one piece and ship it off to the pathology lab at Ohio State University. A urologist will delicately assist, inserting two stents into the urethra, preventing any damage during surgery. There is no turning back now. I’m ready to go. Surgery has to be scheduled ASAP and set for April 1st. That’s right– April Fool’s Day.
(to be continued)