What to expect after an oopherectomy

Not that I knew this a month ago, but here goes:

When a premenopausal woman undergoes an oopherectomy (the surgical removal of one or both ovaries, and maybe the fallopian tubes too), guess what happens?

She goes into menopause.

Overnight.

All the symptoms that make menopause a little more difficult for most women happen ALL AT ONCE. So, overnight, there may be sudden and extreme hot flashes, chills, mood swings, unexplainable sadness, irritability, changes in moisture in the skin, hair growth, and other unmentionable changes in unmentionable places.

Overnight.

I’m coming out the other side now, but it’s been a bit of hell around here for the last couple weeks. Thanks for hanging in there with me, friends, for taking me belly dancing, putting up with my mood at book club, and basically tolerating my grumpiness. I think I’m finally coming out the other side.

One of the things that is totally helping me is reading all your submissions for The Challenge that I put forth last week — check out those comments on the last couple posts — they’re pretty wonderful! Submit yours now, if you haven’t already!

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Behind the Oopherectomy

So. An oopherectomy is a pretty intense surprise for the casual blog-hopper or twitter-friend. For me, and my mothers with cancer pals, it’s no big deal, but here’s a bit of the skinny, the story behind the story if you will..

Oopherectomy = removal of the ovaries and, often, the fallopian tubes connecting them to the uterus.

Oopherectomies are done for different reasons.  Sometimes they’re done preventatively, to cut a woman’s cancer risk.  If the woman carries the BRCA-1 or BRCA-2 genes that connect breast cancer and ovarian cancer, and the woman has already had breast cancer, the ovaries often come out right away.  Sometimes the uterus is taken too (a hysterectomy), but, as far as we know, uterine cancer is not connected to ovarian cancer or breast cancer.  The trick here is as far as we know — for scientists have only uncovered a few genes that predict cancer risk with any level of success.

So I opted not to even do the gene testing, and take the ovaries out preventatively.

Or at least I thought I did.

If you’ve been reading here for a while, you’ve heard me complain (sorry!) about an ache in my abdomen, where my ovaries are, that comes and goes but mostly is with me all the time.  On Saturday, the ache became more than just an ache.  It got stronger and stronger by the hour, despite the medicines that I took to dull the pain.  (The motrin prescribed by my GP (!!!!!) didn’t help.)  At about 5:00, a sharp stabbing pain in my pelvis took over all my thoughts, and I gave in and called my GYN.

He listened carefully and said, “Oh, Susan.  You shouldn’t have waited this long to call me.”

And with that, he sent us to the ER for emergency evaluation and probably surgery.

I called my mother and father to come watch the kids overnight, called L to see if I could drop them off for a dinner/playdate right away, called Stimey to ask for some help with the next day’s plans, and we got in the minivan and went.

WonderDaddy dropped me off at the ER to stand in line, then took the kids to L’s house.  When he got back (five minutes later), I was sobbing in a wheelchair.  The pain had kept increasing until it was almost more than I could bear (and I’ve borne a lot recently); a kind hospital volunteer noticed and tucked me in a chair, despite my protests (“I don’t want a chair. I’ve spent too much time in one this year.”)  But it was more comfortable, so I was glad of it.  When I got checked in, I was told that my GYN had called ahead, that the tests had been ordered, and I would be taken into the ER as soon as it was my turn at the ultrasound.

They were as good as their word.

A few nurses later (my GYN is AWESOME and feared by the nurses — when he walked in and one was mid-shot, he thundered, “ON WHOSE ORDERS?” and she scuttled out of the room without complaint.)(I later found out that as she left she leaned over to my husband and said, “I got a little into her — hopefully that will help with the pain while she’s having her tests.), we had had 7 vials of blood taken and were on our way to the ultrasound and the spiral CT.

The tests were easy (I mean, really.), and it was back to waiting.  I was finally dressed in the dreaded hospital gown, but I was in so much pain at that point (despite 3 rounds of the meds) that I didn’t care what I was wearing.  (Funny thing: when we were first brought back to the room, the nurse said, “Take off your shirt and bra and put on the gown.”  Confused, I said, “you do know the problem is in my ovaries, right?” and pointed to the area in question.  Rattled, she responded, “Yes, but I said to take off your bra and shirt.”  Okey-dokey.  And let’s not even get into the bra question.  (To hold WHAT up exactly?)  I did as I was told, as weird as it was to be undressed in the healthy areas and fully dressed in the part that HURT BEYOND BELIEF.)

Oh, this is getting long.  Sorry about that. I’ll skip over all the waiting part and just say that

six hours after the tests, I was admitted to the hospital for an overnight stay and surgery in the morning.

Not as fun as water balloons

Hi.  I’ve been kinda quiet lately, because there’s something on the horizon, and I (as usual) don’t really want to talk about it.

Except (as usual), really I do.

You see, I have these two rather large cysts stretching out my right ovary and causing me some trouble.  Not cancer — thank goodness! — but trouble and pain and grouchiness nonetheless.  One is 5 cm across, and one is 6 cm.  Or at least that’s what they were when the ultrasound tech measured them in July.  That’s kinda big, and, well, some days they hurt.

A lot.

The normal ovary is the size of an almond.  Mine?  Stretched to 11 cm across.  If you could see inside my abdomen (why not?), the cysts would look like water balloons, stretched out as wide as their circular membranes can reach.  They don’t feel like water balloons, though.  They feel like, well, like something heavy is in there that shouldn’t be.  And some days they feel like terrible cramping pain, and some days they don’t feel like much at all.

They’re totally not as fun as water balloons.

It turns out that nearly all premenopausal women have a cyst or two, they just don’t usually swell this big.  When a cyst reaches 5 cm, I’m told, the fluid needs to come out, one way or another.

So, because of the pain, and the higher risk for me for developing ovarian cancer (which has vague symptoms and is difficult to catch early), and because one of the cysts is not a simple cyst like the other, but segmented and divided into its own little structure, we’re going to have these puppies taken out.

One day soon, I’ll go in for surgery.  The surgeon will cut and sauter my fallopian tubes, seal the pathway to my uterus, and pull each ovary out through a tiny slit.  He’ll sew me back up and I’ll wake up a little later, a little lighter, and a whole lot happier because of my reduced risk for developing ovarian cancer.

It might even take away the pain, which I think is just the ovary stretching and bumping into other things down there (like my bladder), but there’s no guarantee.

In fact, I’ve read that there are pretty much even odds for all three outcomes: pain gets better, pain gets worse, pain stays the same.

But the CANCER RISK goes down significantly.

Goodbye, ovaries!

How to tell your mother…

How to tell your mother that you’re going through menopause (again), that it’s making you crabby (again), that the HOT FLASHES are crazy (again), and that you’re really, really, REALLY sorry that you complained about the incredible heat in her house the first few days you were visiting ….

Well, if you’re me, first you tell the internet.

Then you hint around for a couple days.

Then you wait until everyone is gathered at the table for a big, friendly, family dinner.

And then your husband tells everyone.

Lovely.

Hi, internet.  I’m in menopause.

Yes, I’m still 35.  No, I’m not in chemo again.  But I am taking tamoxifen, an oral chemotherapy agent that prevents my body from using circulating estrogen and using it to feed any remaining cancer cells.  It does wacky things to the body, including inducing menopause.

Again.

All this is making me not worry so much about the oopherectomy (removal of the ovaries) that looms on the horizon.  I mean, if I’m already in menopause, and I’m not going to have any more kids, what’s the big deal about losing my ovaries?

I think.