When a Trip to the "Plumber" Makes You Really Think

You would think that my post about tampons would have satisfied any latent need I had for “oversharing”. Guess not. I just returned from my annual (well, sort of annual) trip to the gynecologist and have been deep in thought ever since. It’s seldom that regular check-ups rattle me. I’m quite healthy (thank God) and work fairly hard at keeping all of my systems in working order, so I usually expect little more than an “atta-girl” from the doctor or dentist (in fact, I love it when my dentist compliments me on my excellent home care - - weird, I know). Yesterday’s trip to my gynecologist was a bit different I’ve mentioned in this space and elsewhere that my mother is an ovarian cancer survivor. She was over 70 when she was diagnosed, so I considered it to be more bad luck than a family risk factor. Over the past several years, I’ve made many simple changes to my lifestyle in the hopes of reducing my risk for a number scary diseases (“compressing morbidity” in the words of Dr. Andrew Weil). Some of those steps include: 1. BRCA test to determine if I have the genetic mutation associated with increased risk of breast or ovarian cancer 2. Annual mammogram and pelvic ultrasound 3. Significant increase in my consumption of fruits and vegetables, particularly cruciferous vegetables 4. Significant reduction in my consumption of animal protein and limiting of that consumption to grass fed, organic, free-range, etc. 5. Sixty minutes of vigorous exercise at least 5 days each week 6. Annual skin cancer screening 7. Regular blood tests to be sure my cholesterol is where it should be (194 at last count with good ratios and triglycerides). So, you can understand why I was looking forward to another pat on the back from my gynecologist and a referral for my annual mammogram. Instead, my doctor (who truly is a lovely woman and an excellent doctor) rather casually said, “you should consider having your ovaries removed. They can do it with laparascopic surgery”. WHAT??? I’m only 46. Yes, I’m done having children . . . . but remove my ovaries and put me into menopause, on purpose?? Just back that bus up, please. I realized that I’d been busy with the early days of Puristics and had not been to see my gynecologist for two years, but did I really deserve this? My mind quickly jumped to all of the potential issues that menopause could introduce into my life - - increased risk of heart disease, bone loss, hot flashes and weight gain. Never mind the fact that I’d be leaving this earth with fewer parts than I had when I arrived. My reaction has taken me by surprise. I usually take a non-emotional, fact-based approach to healthcare. This one shook me. So, after several hours of wishing I had a sister close by to talk to, I’ve returned to my safe place of facts, figures and rational thought. Here’s my plan: 1. Quit relying solely on "noble lifestyle choices" and the luck of the Irish for longevity. 2. Meet with a gynecological oncologist to discuss my risk factors and choices. 3. Get a CA-125 blood test. CA = cancer antigen. CA 125 tests for an ovarian cancer marker. 4. Schedule my annual transvaginal pelvic ultrasound. 5. Think long and hard about what aspects of my health are within my control and which are not within my control. Screening options for ovarian cancer aren't great and only catch a relatively small percent of cancers with a fairly high risk of false results. - My genetic risk of heart disease is low. I eat a very healthy, largely plant-based diet, exercise regularly and have healthy cholesterol levels. Why am I more focused on the increased, somewhat controllable heart disease risk of menopause than the “silent killer” of ovarian cancer? - I take calcium supplements, drink milk and do weight bearing exercises. Why am I more focused on osteoporosis than ovarian cancer? - I watch what I eat and have a normal BMI. Why am I more focused on weight gain than ovarian cancer? - I have a beautiful family and am already too old to have more children. Why am I more focused on loss of child-bearing than on ovarian cancer? I think it really comes down to the body parts. It seems that our “below the belt” body parts are a bit of a mystery. As women, we don’t like to think much about them and often just hope that all is well. How quickly do we run in and out of the feminine protection aisle at the store and give little thought to our choice of tampons or pads each month (a behavior you should really re-think)? We just hope all is normal and keep moving on. To have a bilateral prophylactic oophorectomy (fancy talk for "yank out both ovaries") will mean that child bearing will cease to be a theoretical choice. There’s a big, heavy wooden door that will slam shut behind me if I choose to walk through it. What I’ve lost sight of is the fact that walking through that door also helps me to choose a long, healthy life with my family and friends. So, I take a deep breath and know that rational thought will prevail. If the doctors and the facts suggest that I walk through that big door, I will, once again, take control of my health. I’ll walk through the door to my healthy future.

M'lou Arnett www.scerene.com

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