Questions answered

My surgery is tomorrow morning. I should be nervous about the word ending in "-oma" but I'm not thinking about that. I should be worried about the surgery, but I'm not thinking about that either. What I'm really thinking - and what makes me hurt - is that with this hysterectomy I will be loosing my fertility forever; I will never have children again. It stings; it hurts; and I'm sad that this has happened now. Why? Why now? Can't this adenocarcinoma wait 9 months? Just give me this chance to be pregnant again...

Lovey & I were in process of In-vitro Fertilization again. I called the UofU, got on their calendar for the cryo-cycle, started the meds and was supposed to start Lupron on Sunday, October 24th. I'd have ultrasounds on Tuesday, November 16th & Tuesday, November 23rd to check my uterine lining, and then the embryo transfer would take place that following Wednesday (either November 17th or November 24th depending on the thickness of my uterine lining). The daily 10mg Progesterone intra-muscular shots (as thick as peanut butter or molasses - take your pick) would begin and continue for 12 weeks. I'd be on bed rest for 3 consecutive days following the transfer, and we'd know if we were pregnant on February 3rd - my mom's birthday! I had it all planned out, see, and I was on the calendar! The calendar! After 2 years of me and Tony talking about this, having a consultation and exam, declining a super awesome job opportunity because we were going to get pregnant, postponing the IVF processes for a year, having another consultation and exam the following year, seeing a perinatologist about my cervix and his 2nd opinion for a cerclage at 12 weeks (and bed rest after that), we were finally in the process! And on the calendar! Now I'm on a different kind of calendar - one for a hysterectomy, which will be tomorrow, Tuesday, November 16th.


I met with the Gynecologic Oncologist, Dr. Andrew Soisson, on Monday, October 25th. I pulled the pathology report from my biopsies and did some research before my appointment. The more I know, the more comfortable I am - regardless if it's good or bad information. I realized this with my dad's aneurysm, 2 open-heart surgeries, and Becca & Mary-Gail's 3-month stay in the NICU. Once I have all the facts presented to me, then and only then, will I disseminate the facts and determine what I am going to worry about and what I'm not going to worry about. However, even with my research I couldn't get the pathology results out of my mind: "...mitotic figures are very prominent...proliferation index {cell reproduction} is very high...best characterized as adenocarcinoma...no evidence of infiltration..."

I researched Dr. Soisson too - I wanted to understand his knowledge and experience with this type of cancer. He's the top dog in Utah. He works at the Huntsman Cancer Center {his address in SLC is "Circle of Hope," but after my appointment with him I didn't feel any hope}. We discussed my options: I could have more biopsies, removing more and more of my already compromised cervix, which would create serious complications for a cerclage, let alone maintaining a pregnancy; I could have a laser treatment, which has a 90% success rate. However, the cells on the internal part of the cervix are similar to hills and valleys - "rolling ridges" is how Dr. Soisson referred to them - and there is the possibility of missing the cancer cells on the slope of the "hill." Another treatment is to use a cream. Treating cancer with a cream? Are you serious? And then the final option...abdominal hysterectomy. Wait, what? I'm supposed to be putting embryos into my uterus and getting pregnant, not removing my uterus and going through menopause!


Very conflicted. And then Dr. Soisson said something I didn't want to hear. "Since you already have frozen embryos you can do surrogacy." Yeah, already thought of that. Actually, I investigated it 2 years ago; and then again last year; and then Tony & I talked about it some more and decided that because this would be our last pregnancy that I would carry the baby and confine myself to strict-bedrest. (BTW, Surrogacy is regulated by the FDA, which means the surrogate and her spouse/partner would be subjected to genetic testing, STD testing, and psychological testing for starters. Plus, Tony & I would be subject to psychological testing too. The price tag for all this testing is $10,000! The embryo transfer is $3,000 and then the meds are an additional $2,000 - $4,000. After all that, surrogates usually receive payment starting at $12,000 upwards of $40,000.


I researched my options, again. Brought home the Taber's Medical Dictionary from work so I could look up words I didn't understand and even those words I did. Wikipedia.com turned into my home-page. The cream option was a joke. The biopsies would preserve my fertility, but at what cost? I had 27-week twin micro-preemies. Could I handle having a 23-weeker? 24, 26? What if my pregnancy didn't even progress that far? Could I handle that? I volunteer at the NICU, and seeing the little babies covered in wires with tubes that feed them and machines that breathe for them; Seeing the bewildered and nervous parents; Not being able to hold your baby! (that was me and Mary-Gail. I was "lucky" with Becca - I was able to hold her 4 days after she was born). Not being able to hear your baby cry - Oh, I remember praying to Heavenly Father to just let me hear Mary-Gail cry. Let me hear her voice. I went to the NICU Tuesday, 10/26 & again on Tuesday, 11/9. I needed to go to see these little babies. To remind myself (not that I need reminding) but to re-live the trauma of micro-preemies and all the health problems associated with them. Could I have faith that the cervix I'd be left with, after having more biopsies, would be sufficient for a cerclage and pregnancy? And could I take a choice spirit from Heavenly Father, and knowingly make a choice that would impact this spirit's life forever? What about her progression though life? I would always feel guilt over being so selfish of wanting another baby that I threw caution to the wind, and now my beautiful child's life is limited - her experiences on earth have been limited because of me. No, I couldn't do that.


I still haven't come to terms with not having more children. I don't need to carry the child, or even birth the child (which is why checking into surrogacy wasn't a big dilemma for me). I learned a long time ago - 4 years ago to be exact -that carrying a child doesn't make you the mother; raising the child does. However, once I saw the determination on Tony's face that he would care for me, the girls, our home while I was on bed-rest, getting pregnant was all I wanted. Adoption? I would LOVE to adopt. International adoption is out of the question for us (I checked into that while we were still living in South Carolina). There cannot be a span of more than 10-years in the couples age; the couple cannot be over 50..and so on and so on. Adoption through LDS Social Services is very competitive. I have talked with the many women (who see the OB's I work for) who give their baby up for adoption; I know their perspective: they want their baby to go to a family that doesn't have any children. Private adoption is extremely expensive. So, I'm coming to grips that I will just have to adopt all the kids in my neighborhood and my church. Unless we're lucky, and a baby falls from the sky or is delivered to us by a stork.


Hysterectomy has a 98% success rate of eliminating the cancer, which means no chemotherapy or radiation therapy. I'll have some lymph nodes removed during the surgery so pathology can check them for cancer cells. The hope is that they will come back negative, and the pathology from my uterus will have "clear margins" (the cancerous areas haven't reached the edge/margin of my uterus & cervix). Clear margins mean the cancer hasn't spread; once it's gone, it's gone. And so are my hopes of having more children.


I'm morning the loss of a dream, a hope, an intense desire to have more children. A 2-year old desire (and that's not an exaggeration). I still have 6 embryos frozen from our 1st "fresh" cycle when we did IVF in 2006. It's amazing really, that we even did IVF. I didn't have any fertility issues myself; my husband had a vasectomy 18 years ago, and a reversal was out of the question (2% chance of sperm if we did the reversal). So we did IVF instead - ICSI (intra cytoplasmic sperm injection). On 6/6/2006, we extracted 22 eggs from me, 18 of which were perfect for fertilization. All eggs were a grade B+ or better and were fertilized by ICSI; 13 eggs fertilized, divided and multiplied into the blastocyst stage; 2 were implanted in me (which resulted in my perfect daughters, Becca and Mary-Gail!). We had 11 embryos left. 5 were lost due to over-fertilization/multiplication, and the remaining 6 were frozen for later use. We had hoped to use them this October.


Perhaps this is more information that I should knowingly disclose, but I feel that if I don't share this, then no one will know what a struggle this is for me, and why the timing is so ironic. Some might say this is a blessing that the cancer was discovered as a result of me going through the IVF process, and I can see their point. I just can't understand "why" it's a blessing right now. It's a struggle. And it will continue to be a struggle as I morn for a time. I'm changing how I handle things like this, and instead of pushing people away (like I typically do), I'm hoping that you will morn with me: "...morn with those that morn; comfort those that stand in need of comfort..." Please pray for me. I know my hardest days are yet to come, and I'm scared of coming home from the hospital - because then I will know that I'm done.