On Ovaries 2.0

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So I got a call this evening from my GYN-Onc’s nurse (who is equally as awesome as my doc for what it’s worth) about my test results that I talked about in my last post.

I had kind of figured the abnormalities were no big deal since I hadn’t heard from them in a few weeks and they know I’m a nurse and unlikely to freak out. Well, come to find out, I guess they are a little concerned. I was relieved to hear that they actually got to the same conclusion as me – that my shunt is causing peritoneal irritation which is in turn causing the lab elevation. But, in order to prove that it is, in fact, my baseline, I’m having another CA-125 drawn next week, six weeks after the original (yeah let’s talk about that… Six weeks?! When did that happen?! Seems like that was just yesterday… But at the same time forever ago!)

I’m not worried but glad she’s being cautionary. So one more trip to the medical center… I knew none till July was too good to be true! But it will be nice to confirm everything is okay.

I’ve been absent on blogging I know… Lets see I had lunch with Amy last weekend which was great as always. Her surgery went beautifully which is so encouraging to see. Also, I was so excited to learn that the teardrop-shaped “gummy bear” implants I want as my permanent ones were finally approved in the size I’ll need! I had moments of dread that I would be perpetually waiting for them. They’re the ones my plastic surgeon undoubtedly prefers (the shape is SO much more natural) but they were only approved in smaller sizes when I saw him. I realize that the exchange surgery is wayyy down the line, but it’s exciting nonetheless!

Life has been crazy busy… Lots of trips keeping things flying by! Got a couple more than a bit of a lull before they pick up again and then hey! It will be July
which I’m sure will fly by. Can’t believe the surgery countdown is already down to 130-something days!

Anyhow, I’ll update hopefully with the “all clear” after next week, but that’s the latest!

On Ovaries

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Time is such a crazy thing.  I seriously feel like I JUST updated this thing and bam! a week has gone by.  And at the same time, it seems like the MRI was absolutely forever ago.  Lately I find myself doing this trippy thing where I figure out how many weeks till my surgery (20 from today to be exact), then count backwards and see what I was doing that amount of weeks ago just to have an estimate of the time left… it’s bizarre.  And now that it’s at the point that my surgery is in a less amount of time than how long I’ve been in this new job… well that just messes with my head.  How it’s been almost 6 months is absolutely unreal.  So yeah.. 20 weeks ago was around the end of October.  Sounds like a long time ago, then I look at my calendar and that was the week of one of my most favorite people on the planet’s wedding.  And really didn’t that just happen?  No way! I keep being told “August will be here before you know it!” and what can I say? There’s some serious truth to that.  Sometimes I wonder if I’m crazy to be waiting till then, but no… it’s perfect timing.

Kudos if you made it through that word vomit… suffice to say, time is a funny thing, and I find myself thinking about it all the time (ha!) lately.  Just weird.

Okay moving on… topic du jour is ovaries.  And honestly this part is really for me when I look back and want/need to remember, but anyhow…

I found out the same day as my tests last week that my MRI was normal (woot! Still can’t celebrate that one enough – “no evidence of malignancy on MRI” was the official awesome verbiage!) but it was a couple days later I got the results of my ultrasound. So to backtrack just a bit, when I met with my gyn-onc we had an in-depth discussion about how screening for ovarian cancer basically sucks (in terms of finding it early) but at the same time we can’t just sit around and do nothing.  So we came up with the plan to do the two tests that are the best the medical world has to offer right now (transvaginal ultrasounds and CA-125s) and do them either every 6 months or a year, depending how things look and monitoring for changes more than anything else.  This I totally am okay with and I respect that she acknowledged the gap in efficacy and that research is being done to improve screening.  Also important to note is her explanation of how different BRCA1 and BRCA2 are in regards to ovarian cancer.  They get lumped together all the time, but BRCA1 carriers have a higher risk of ovarian cancer, and it’s usually earlier in life than BRCA2.  That coupled with my being on OCPs for more than 5 years continuously means my risk is even lower.  All good things.  So all that said, the day of the consult I had a CA-125 drawn (just a simple blood test). The low-down on the CA-125 is that basically, it’s not awesomely accurate and here’s why:

A CA 125 test measures the amount of the protein CA 125 (cancer antigen 125) in your blood.

Many different conditions can cause an increase in CA 125. These include uterine fibroids, endometriosis, pelvic inflammatory disease and cirrhosis, as well as pregnancy and normal menstruation. Certain cancers, including ovarian, endometrial, peritoneal and fallopian tube, also can cause CA 125 to be released into the bloodstream.

A CA 125 test isn’t accurate enough to use for cancer screening in all women — especially premenopausal women — because many benign conditions can increase the CA 125 level. What’s more, CA 125 levels are normal in many women with early-stage ovarian cancer.” (Mayo Clinic)

So normal is anything less than 35 and mine came back at 42.  Clearly not anything to be concerned about (the nurse in me says that’s like freaking out over a potassium of 3.4… not gonna happen!), however, it did of course catch my eye.  The only reason we drew one in the first place was to have a baseline, and now we have it.  However, it was interesting when I got my ultrasound report back and it read “1. Normal sonographic appearance of the uterus and ovaries.  2. Small amount of free fluid in the cul-de sac, a greater amount than is considered physiologic… likely related to the ventriculoperitoneal shunt, compatible with findings on prior imaging studies.”  YAY for the word “normal” but here we go with that darn shunt again!  Seriously I would have never imagined the thing could cause so many issues… I had it put in summer of 2006 and other than a couple minor issues when I first had it placed I have barely even thought about it being there since I don’t feel it!

I know I briefly described the shunt concept at some point but just as a visual… you can see where the fluid drains and ends up in the peritoneum (and also why there will be a neurosurgeon on call for boob surgery day…)

So to get to my point, doctor/nurse friends and I have this theory that the free fluid (which is obviously the CSF my shunt is draining) is causing the slight raise in CA-125 (peritoneal irritation, etc).  That’s the issue with the blood test in the first place – false positives abound, and often it’s not elevated when you think it should be!  Will be interesting to inquire if our theory has some validity come July, but it certainly does seem to make sense.

Anyhow, that’s the update to finish the last update.  So now everything really is good to go until July!  And for that I am grateful – work and life have been crazy!  Good crazy, but crazy nonetheless!  Though if you know me you know I love being busy… I joked at the FORCE meeting Saturday (more on that later) that I have such peace with everything that the surgery is simply another date in the calendar… a “surgication” if you will!  Tongue in cheek of course, but it bodes well for the planner in me.

So to finish with a bang… the most important part of this post is to wish my fabulous friend Amy good luck tomorrow with her surgery!!  I’m sure her tatas are going to look amazing, and I’m so excited for her to reach this part of her journey.  All good thoughts headed her way!!

Well that was “Fun”… but Worth It!!

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I’m drained, but… MRI and Ultrasound complete!!

It wasn’t even the actual tests that was draining – they really weren’t that bad, but my goodness the drama!  So my VP shunt was the issue before my breast MRI today… some shunts are metal but mine is not one of them.  I’ve known this since the day it was put in when they didn’t give me a “medical device” card because they said it wouldn’t affect anything, which is entirely true.  However, that’s not good enough for an MRI apparently.  And thus began the HOUR of attempting to get written documentation that I could have a freaking MRI without screwing up my shunt.  This was so frustrating because, while I haven’t had one myself since I had my shunt put in, I’ve gone to MRI at work countless times!  And they had CT scans where you could clearly see it’s not metal!  Thankfully the MRI tech was awesome and finally got in contact with my neurosurgeon’s office… since it was so long ago the records were difficult to get.  I was actually changed back into my regular clothes ready to go find medical records and reschedule when she finally got the approval… what a relief! I was so ready to have this behind me and waiting another MONTH was not what I was after.  Of course the actual MRI was painless and took maybe 15 minutes!  Basically you just lay with your boobs dangling and let the loud noises do their thing!

Then we headed over to another building for the ovarian ultrasound… really it was the best experience I could have asked for.  The tech was fantastic, it was quick, and while uncomfortable not at all like I remembered from years ago!  And with that it was headed back home… and hopefully not back to the medical center until JULY!  That’s awesomeness right there.

As I was writing this post I got a call from my breast surgeon’s office (what can I say? dudes are on it!!) and my MRI is 100% clean, no signs of malignancy! YAY!  Best news I could have asked for.  Not gonna lie when I saw the breast surgeon’s phone number pop up I had a moment of panic… not used to people being THAT on top of it… like results less than four hours later!  But yes, all GREAT news.  So I went ahead and scheduled my pre-op appointment with him so I’m all set from a surgery standpoint.  Oh and some people asked why I’m waiting till August and it’s purely a personal preference… the work I do is on an interesting yearly schedule, and it’s kind of (okay, really) crazy up through July, then slows down in August until mid-September when it starts again.  That leaves me a perfect amount of time to have the surgery and recover without any worries of missing anything.  So yeah… that’s the plan!

With that news I’m off to dinner with one of my favorite people… while celebrate might not be the exact right word, cheers to relief are in order!!

Thanks for checking in – have a wonderful rest of the week!