Life takes a sharp left turn

Ten days ago I was admitted to the local hospital with diverticulitis. I had spent a miserable night prior to that popping hydrocodone every four hours for the pain. My friend/neighbor took me to the ER the next morning and stayed with me while they worked me up and gave me lovely Dilaudid for the pain.

I was surprised at being admitted, but the doctor said I had a diverticular abscess. That first day was all about pain management and weird vitals. My blood pressure was very low (perhaps from the Dilaudid?) and my temperature was creeping upwards. I spent a lot of time sleeping.

By the second day the pain was minimal and my vitals had evened out towards normal, but I had an unstoppable headache and nausea. Both days I was on nothing but clear liquids, and I think that had a lot to do with my nausea and headache. Strong iV antibiotics + no food are not a good combination for me.

I also slept a lot on the second day, but was visited by the hospitalist and one of the surgeons. Surgeon talked about seeing something on the CT scan that was some sort of mass (maybe this was what they thought was the abscess?), but that I shouldn’t worry. He suggested it could be an ovarian cyst and that an ultrasound had been ordered for the next day. Since I already knew I had an ovarian cyst on the left ovary that had been imaged earlier in the year and declared unremarkable, I didn’t think much about it.

On day three a different surgeon came in and told me I could be put back on regular food (hallelujah!), although the gastroenterologist stopped by and said he preferred I stay on mostly clear liquids for a while (boo!). Apparently the surgeon won because the floor nurse came in shortly afterwards with some toast and honey. I could have hugged and kissed her.

I had my ultrasound on day three, too, and in the afternoon the hospitalist came in and said that they were just waiting for a gynecological consult. He said it was likely I would stay another night. At this point, I was off IV fluids (although they left the needle in my arm “just in case”) and was switched to oral antibiotics. I was walking the hallways regularly, eating real food (chicken! carrots! cake!), and helping my roommate with little things since I was so bored.

My gynecologist showed up at 8 PM that evening apologizing for being so late. Apparently the hospital hadn’t contacted her at the correct number, causing a delay. She went over the ultrasound with me and laid out the concerns succinctly.

That unremarkable cyst had ballooned in size in just a few months. In late April it had been a simple 2 cm cyst. It was now 9.9 cm and was considered “complex.” My CA125 was above the normal range, but not significantly. My c-reactive protein was very high, but that could have been because of the diverticulitis. (Later, it also occurred to me that this marker of inflammation could be high because I have I.C.E. Syndrome in my right eye, too.) The ultrasound report indicated that it was likely not a malignancy, but there was still a chance.

She presented me with two options: I could stay in the local hospital and have the ovary and cyst removed surgically. However, there was no gynecologic oncologist on staff at this particular hospital. The second option was to be released to consult with a gynecologic oncologist about an hour away who would do the surgery and evaluate if I needed further treatment. I chose the latter.

After leaving the hospital at 10 PM, I fell into an exhausted sleep at home. The next day I started putting my disrupted life back together (picking up the dog from the kind woman who boarded her quickly after I was admitted to the hospital, getting prescriptions filled, etc) and rested. I received a call from the gynecologic oncologist and set an appointment for the following week.

My second night at home I barely slept. I was worried and anxious. I kept thinking of things I needed to do to prepare for a surgery, because that was clearly in my near future. I needed to arrange for household help, dog care, short term disability from work. I realized I have no advanced directive or a will in place, either.

I logged into work after perhaps three hours of sleep and started making lists and notes of things that would need to be off-loaded. I arranged to speak with my boss and team lead, and tearfully told them what was going on. Since I had already missed two days of work they knew I had been hospitalized and why, but it was confusing to have things turn from “I have (yet another!) case of diverticulitis” to “There’s a chance I have ovarian cancer.”

Because I work for an awesome company with a fantastic team, I was fully supported to take time off as soon as possible. Of the few days I worked last week I spent most of the time on organizing projects to hand off to others.

Yesterday, I saw the gynecologic oncologist. I like him and he was straightforward, kind, and treated me as an intelligent human being. He agreed that the chances of this being a malignancy are low, but he explained to me what they would do if the pathologist indicates it is. In case of malignancy, he will remove both ovaries, the uterus, several lymph nodes, and some fatty abdominal tissue. But if the pathologist finds no indications of malignancy, he only has to remove the one ovary. I have two other options while I’m in surgery: have both ovaries removed, but keep the uterus; or, have both ovaries and the uterus removed. Either of those two options would put me in immediate menopause, and I’d start hormone replacement right away.

It’s a lot to take in, and I don’t have to decide until just before the surgery date, which will be December. 31. (Yep, I get to spend New Year’s Eve recovering from surgery. Hooray.) Recovery time from the more complete surgery will be longer, but I’m entitled to some generous short term disability, so I’m not worried about that.

That’s the long version.

Here’s the TL/DR: I have a 9.9 cm complex ovarian cyst that needs to be removed. It’s likely not malignant, but I won’t know until I have surgery on December 31 to remove it. I will be out of work for several weeks, and I’m coping pretty well. I have a positive attitude. I have  a bunch of supportive people around me, too. Despite having lived here only one year, I have made some good friends, and have received many offers to provide me with food/meals, help around the house, and companionship. People are awesome.