The Three Words You Never Want To Hear Your Doctor Say: "I Found Something."
Perhaps, if I had gone to the doctor with symptoms, I wouldn't have been so astonished when, after my pelvic exam, she said, "I found something."
She gave me a moment to register what she said; then, she continued, " It could be nothing - maybe I felt some intestines. It could be a cyst, but she added, "at your age, (I'm 59) that is unlikely, and before she could say the third option, I said it for her, " Or, it's cancer."
"But cancer is the third option. I ranked them in order of probability."
The thing is, I didn't believe her. What I heard is, 'I found something, the chances of it being a cyst are extremely low, and, therefore, you have ovarian cancer.'
Maybe a more analytical person may have heard it the way the doctor intended. I'm not the analytical type. As my mind raced to absorb what she said, I really didn't believe the first option. In my mind, if she she thought she had felt intestines, why didn't she do a second exam, or better yet, ask one of her colleagues for their opinion?
To me, a double check in the exam room by another physician made a helluva lot more sense than scheduling a transvaginal ultrasound.
She didn't do a second exam, and she didn't ask anyone else to exam me. Instead, we scheduled a transvaginal ultrasound exactly one week away. We shook hands, and I left. If she said, "Try not to worry," I didn't hear her.
All I could think of was, "I've just done an Elizabeth Edwards, and I have no one to blame but myself." Like Elizabeth Edwards, who found out she had metastasized breast cancer after skipping her annual gynecological exam for three years, I too had been absent from the stirrups since 2007.
It wasn't intentional. The time just went by. I don't need to see a physician on a regular basis. I'm not on any meds, and I have a very high deductible. I think twice about calling a doctor.
The truth is, I didn't even realize it had been so long until I called to make the appointment. I thought I had just skipped last year, and the thought of missing a year of screenings was troubling enough. When I realized I had skipped three, I had a sense of uneasiness and doom.
According to statistics, an American woman has a 1 and 3 chance of getting some type of cancer in her lifetime.
So I realize that the odds are pretty good that I'll get some kind of cancer, sometime. It's just in my cancer fairy tale world, I get the kind of cancer that has a high-cure rate. I'm completely committed to fighting cancer, as long as I have a pretty good idea that I will be victorious in the end. As Gilda Radnar, who died from ovarian cancer once said, "I could handle having cancer if it were happening to someone else."
Ovarian cancer was never in my cancer fairy tale world. While I am hardly an expert on cancer, I know enough to know ovarian cancer is tough to detect, and if they can feel a tumor, it usually means it's beyond Stage 1.
When I realized how long it had been since my last mammogram, I scheduled one as soon as possible. The foreboding feeling was ever present that I had really messed up. I dreaded seeing the incredulous looks I would get from friends and family when they learned how badly I had screwed up. I knew that If Only would be indelibly linked to my name as a cautionary tale for anyone who gets sloppy with their cancer screenings. Being stupid and careless with my own health is so not how I want to be remembered. What the hell had I been thinking for the past three years?
It wasn't until 48 hours after the mammogram that I congratulated myself for dodging a bullet. The radiologist had not called. I knew if there were anything suspicious on that mammogram, they would have called within 24 hours. In my mind that meant I was home free -- for now.
Every time I go for a mammogram, I try to mentally brace myself for bad news. Because so many women get breast cancer -- 1 in 8 -- I wouldn't be surprised if I got it too. It's just in my cancer fairy tale world, I'm the one who gets to escape cancer with a lumpectomy and radiation. No chemo for me -- it was found early, thank goodness.
I also have prepped myself for the potential of colon cancer. While the odds are more remote -- 1 in 26 and the median age is a distant 71 -- I have confidence that the colonoscopy will find any pesky tumors before they have made their way to a lymph node. I know this is not always true. I know there are very virulent strains of cancer that all the screenings in the world can't help. But, I do have my cancer fairy tale world, and like all fairy tales, everyone lives happily ever after.
In my cancer fairy tale world, I always have a "mild case of cancer." No more a blip in my routine, than a head cold. But, my three years of medical neglect were turning my cancer fairy tale world into a nightmare. Not only was I facing the fact that I could have cancer, I was looking at a cancer with less than lovely outcomes.
Yes, the three year lapse in having any preventative screenings caused a mini panic attack, but after the mammogram results I believed I had lucked out. In my mind, I had escaped having to tell friends and family that I had metastasized cancer because of my own neglect. It was a huge relief.
With the mammogram behind me, I thought of my actual physician appointment as a mere technicality. In my mind, I was in perfect health. No aches. No pains. Nothing that would involve a long-term relationship with a physician. I asked if I could have a fasting cholesterol and glucose test done -- knowing that regardless of my cholesterol numbers, I had no intention of taking statins. For the record, my cholesterol is high, my good cholesterol is off the charts high, and my doctor agrees no statins for me right now.
For fun, I did the cholesterol screening at BlogHer10 knowing that the following Monday I would have a more comprehensive workup at my physicians. I was looking forward to comparing the two scores.
In the three years since I had been to see my OBGYN, they had done away with peeing in a cup. I was shocked. The nurse said insurance doesn't cover it anymore. I've never known what they were checking in my pee, but it was off-putting not to empty my bladder before jumping on the scale. I don't like getting on the scale with a full bladder. It was very disconcerting and, in my mind, against the rules.
As I met with my new physician, I felt light and breezy. I informed her with confidence that I felt great. I said I didn't have any medical concerns. I did mention I would like a bone density test -- somehow I thought they would just come in and do it while I was there. They didn't do it.
I said I would like the Shingles vaccine. Being that I was in a mind-frame of not pushing my luck, I decided now was a good time to make sure I never got Shingles again. In 1994, I had a case of Shingles on my facial nerve and it has left a permanent. Although the vaccine has been out for awhile, my MIA status from medical check-ups was making me want to take care of every thing I had neglected in my past healthcare life.
I also said that I would like to schedule my colonoscopy one year early. Technically, I'm not supposed to have one until the fall of 2011,but I still had that foreboding feeling that I would be punished for skipping my doctor's appointments for three years.The doctor stepped out of the room and came back to inform me that insurance would not cover a colonoscopy or the shingles vaccine until I am 60 years old. No peeing in a cup, no proactive colon cancer screening, and no shingles vaccine, even though I've had shingles. All this for $300 a month health insurance and a $6000 deductible.
Still, I was in an exceptionally good mood. I thought of myself as a very healthy person. My good mood ended with the words, "I found something." Maybe it was because I was numb that I agreed to the intravaginal ultrasound a week away. Anyone who knows me knows there is no way I could wait an entire week to find out if I had cancer. Not in my DNA.
I made a decision not to say anything to anyone until I got the results. I was feeling stoic. Very Laura Linney. That lasted about 45 minutes. First, I called my friend Darralu. I called her because I knew she would be pragmatic and not overly sympathetic. She handled it just the way I needed her to. She offered to go to the ultra sound with me.
Next, I saw that my friend Janie had sent an email asking if I had time to chat. I couldn't talk to her. I wrote her back that the "doctor found something." I told her I didn't want to talk on the phone.
She's too close of a friend, and she is a cancer survivor. She's the one who caught her breast cancer early and just had to have that lumpectomy and radiation. That was 9 years ago. I was pretty sure if we started talking, I would start crying.
In the meantime, my right ovary was talking to me. It hurt. Not excruciating, but definitely was painful. I laid down on my bed and started probing my abdomen they way I think a doctor would. I have no idea what I'm probing for but the act of probing feels good. When I press in the area where I think my right ovary is, it hurts. I take this as a very bad sign.
Janie writes back and says I should get the ultrasound sooner. I call the physician's office and say that my right side is really hurting. We schedule the ultrasound for the next day at the hospital instead of the physicians office. The doctor says it will cost more at the hospital. I so don't care.
I try to do some work, but Google can be unhealthy. I promise myself that I will get to work as soon as I do a little reading on ovarian cancer. I'm hoping that my attitude about ovarian cancer is old news. I'm hoping that they have great drugs now that can stop it in its tracks. I'm hoping that just because a doctor feels a tumor, it does not mean that tumor has metastasized.
Most of my perceptions about ovarian cancer are spot on. From Ovarian cancer//Pass The Wine...NOW!:
Awareness of ovarian cancer is very low. Only 16% of women surveyed in 2007 were aware of ovarian cancer. Two-thirds were not able to cite any symptoms of ovarian cancer or said they did not know or were not able to mention any risks associated with ovarian cancer.
According to the American Cancer Society the key symptoms of ovarian cancer are:
- pelvic or abdominal pain
- trouble eating or feeling full quickly
- urinary symptoms such as urgency (always feeling like you have to go) or frequency (having to go often)
I spend a lot of time looking at pictures of ultra sounds showing ovarian cancer. I have no idea what I'm looking at, but I keep staring anyway.
I read blogs. Lots and lots of blogs. Too many started out with a memoriam. Then I found Elana Waldman's website. Yes, I was drawn to her because of the similarities of our names, (she pronounces hers differently) but she is a survivor who says there is not a lot of attention on ovarian cancer because so few women survive.
Elana started It's Time To Shout, a website that provides a place for women with ovarian cancer to tell their stories.
Elana has survived for five years. She is not cancer free.
I take great comfort in hearing the stories on Elana's website. I hope that I don't have to share my story, but if I get bad news, I know that I will.
At 11:00 the next morning, 27 hours after hearing that I might have ovarian cancer, I shake hands with the technician who is going to do the ultrasound. Her first words to me are, "You know I can't give you a diagnosis."
I am prepared for that. I say that I just want to see the pictures. I have spent the last 24 hours looking at ovarian tumors, and I think that I will be able to tell if there is one on mine.
We don't talk much during the exam. I try to read her face. I get nothing. When we are finished, I ask if I can look at some of the ultrasound images. She looks at me, pauses and says the four words you really want to hear in a moment like this, "I didn't find anything."
48 hours later, the radiologist confirms the diagnosis. The doctor just felt some intestines. I exhale.
I think about Elana Waldman and the other women who did not get such good news after their transvaginal ultrasound. I now know that at 59, my risk of getting ovarian cancer is increasing, not declining. I now know more about the symptoms. I think I will now bite the deductible bullet and visit my physician if I have any symptoms that linger longer than a week or two.
But most of all, I want us to stop whispering about Ovarian Cancer and take the time to shout.
September is Ovarian Cancer Awareness Month.