Friday, July 10, 2015

Initial Oophorectomy Consult

Welcome to my first post regarding my next oophorectomy.  What in the heck is an oophorectomy you might ask?  It's the removal of the ovaries to guard against my predisposition towards ovarian cancer, for which BRCA1 put me at high risk.  I'm technically having a prophylactic bilateral salpingo-oophorectomy.  That's a mouthful for,  I'm having both ovaries and both fallopian tubes removed.  So thanks, once again, to that not-so-awesome defective BRCA1 gene.  Take my breasts, take my ovaries and tubes, and while you're at it, put me into early menopause.  

So why remove my ovaries and tubes when I've already removed my breasts?  When you're BRCA1+, you're at an estimated 87% risk for breast cancer and 50% risk of ovarian cancer.  I think I'm pretty well covered now for NOT developing breast cancer since having the mastectomy, so we're moving on to making sure I don't get ovarian cancer.  Removing my ovaries and tubes takes me down to a 1.4% chance of getting ovarian cancer.  I'll take it.  When you've lived a life knee-deep in cancer stories, you do what you can to try and avoid it.  I'm lucky, I get to prevent it, hopefully.  

By Bfpage (Own work) [CC BY-SA 4.0
(], via Wikimedia Commons

Today was my second consult with my gynecologist, more in-depth than my initial consult in May.  She rocks.  If you watch The Mindy Project, picture my GYN as Mindy.  She's funny, she comfortable and she makes this whole "serious conversation" palatable.  I think I'm in good hands, once again, thanks this time to Dr. Tucker, my Singapore geneticist.  The only downfall, she's not on Twitter, but I'll work on that.  

When I walked into her office this time, she was shocked at how good I appeared after having my mastectomy.  She knew I was four weeks out and expected me to be far worse off than I was.  I'm beginning to wonder if East vs. West, when it comes to surgery, is really as different as it seems.  Two doctors now, here in Singapore, have been surprised by my surgical recovery and overall pleasing aesthetics.  

After raving about my recovery, she reviewed the previous ultrasound scan she performed on me as well as my CA-125 blood test, which measures the amount of protein in my blood, monitoring ovarian cancer.  Everything looked great.  She then dove right into the diagram drawing and explaining of the next step, the prophylactic bilateral salpingo-oophorectomy, planned for December 2015.  Once again, I have five months to wait for surgery, thinking, researching, over analyzing and thinking some more.  

She drew an abdomen and proceeded to draw three on my belly button, and one above each ovary.  These would be the surgical sites, with a half cm size port in my belly button, and all would be done laparoscopically under general anesthesia.  The ovaries and tubes will be pulled through my belly button to remove them.  I know, TMI, but I'm the one going through it, and you chose to read this. This all means more scars, however, I've got my InviCible cream from my mastectomy that I plan on using to keep the scaring to a minimum.  I'll spend the night in the hospital and go home the next day to recover over the next couple weeks.  This will be a much less invasive surgery, and will only take a little over an hour.

While its fantastic this surgery is available to me, the downside is that I'll be thrown into surgical menopause within the 24hrs after surgery.  According to my GYN, our plan is to treat side effects without hormones, using other methods.  We've practiced a lot of natural remedies in our household since I became pregnant with our first child eleven years ago, so going hormone-free doesn't bother me...for the time being.  If I need it, I need it.  We'll see when it happens.

So, what are the effects of menopause that I could experience?  Well, at one point she said, "some women want to swing from chandeliers and scream at how uncomfortable they are throughout the mood swings and hot flashes."  She then looked at me, laughed and said, "Heather, knowing you and seeing you, I just can't picture you doing any of this."  Ha ha ha, little does she know how emotional I am.  So yes, hot flashes and mood swings are a large part of it.

However, she didn't linger on the hot flashes and mood swings, her major concerns and what she monitors the most post op, are the heart and bone density.  I'll have a baseline bone density test in the next couple weeks,  and in November, another CA-125 protein blood check, as well as a cholesterol check and a baseline EKG, a month before the surgery.  After one year, we'll do them again, making sure my heart is staying strong, as well as my bones.  I'll be required to do weight bearing exercises to force my bones to build strength and be encouraged to eat as many calcium rich foods as possible.  I found this all very interesting as I had never even heard the heart brought up in conversations regarding oophorectomies.  

So, there you have it.  We're on another countdown to yet another surgery.  Cheers to December!

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