. . . ‘cause boy do I have a tale to tell.
Yes, I’ve been MIA for the past couple of weeks. (Thanks to those of you who noticed and tried to track me down, by the way.) I’ve been too upset/nervous/angry to sit down and compose my thoughts into any sort of coherent post until this afternoon.
To give you some background, about six years ago I was treated for uterine hyper*plasia. That is basically a pre-cancerous overgrowth of cells in the uterus due to not having regular periods. I spent my 20’s and early 30’s rarely having periods and not really caring about it. Less fuss, less mess. Yes, I might have heard something about women who don’t have periods developing uterine cancer but I was definitely of the “that will never happen to me” mindset. When I was 33, I started bleeding almost constantly, sometimes heavily and (TMI ALERT!!!) was passing huge clots. Scared the shit out of me, as it should have. I went racing to the gyn who did a biopsy and determined that I did, indeed, have the pre-cancerous cells associated with hyper*plasia. She put me on monthly Pro*vera to generate periods and to try and thin out that thick uterine lining. It took six months of Pro*vera and regular biopsies but eventually the lining was thin and the hyperplasia was gone. At that time, my gyn told me to remain on the Pro*vera and as long as I had a monthly period and no spotting or clotting between them, I was good to go. BIG HUGE sigh of relief!
That experience was one of the best things that could have happened to me because it completely changed my relationship to my health. I no longer let things slide. If I’m concerned about something, I go see the doctor. I am a much healthier person as a result and of course, I'm fanatical about having a period each and every month.
ANYWAY . . .
Flash forward to two weeks ago. I called my RE’s office on Monday morning to set up a day 3 blood draw and ultrasound for later that morning at the satellite office where I'm seen. Until that day I’d always been pleased with the care I’d received from the staff and the nurse practitioner who did my exams.
As you may remember, we’ve been unable to start injectables because the lining of my uterus is too thick – not dangerously so, but still thicker than the RE would like so that’s the first thing we check when I go in for my ultrasound. On that Monday, the nurse practitioner, who we’ll call “Totally Tactless”, was in the middle of the ultrasound when the following question came out of her mouth:
“So let me ask you this, how is it that you KNOW you don’t have cancer?”
Excuse me? You have something crammed up my ha ha and while peering at your little screen ask me how it is that I KNOW I don’t have cancer?
You can imagine the terror that shot through me at that moment.
So I explained (for the tenth time) about what my gyn had said – that the biopsies from several places in my uterus had come back perfectly clear, that the hyper*plasia was gone, and that as long as I had a period and wasn’t having any spotting or clotting between cycles, I was fine. TT responded with the following:
“Well, I wouldn’t feel good about that unless you had a D&C and biopsied ALL the tissue. And this is just me talking but if my lining were this thick, I’d be in for a D&C this month. You are a walking time bomb!”
FYI, my lining is the exact same thickness as it was when my gyn started us on Clo*mid back last fall. At that time she said I fell within a normal range. Also FYI, my lining is .4 cm LESS than it was when I started seeing the RE, so it’s not as if we’ve had some radical change from ultrasounds past.
I honestly don’t remember much of the rest of the visit – something about scheduling a SIS (saline infusion sonogram) and a D&C. Needless to say, I was completely numb and totally terrified as I left the office. While still in their parking lot, I called my gyn and got her first available appointment for a couple of days later, hoping and praying that I didn't have cancer.
Thankfully, my gyn wasn’t terribly concerned. She said that it was extremely rare for hyper*plasia to return while taking monthly hormones, that having a biopsy was an extremely good indicator as to the health of the uterus, and that she’d be glad to do another biopsy to alleviate my concerns. So she did. She also suggested switching to another RE practice if I was unhappy with my current situation. As I left her office, I made up my mind that I was definitely going to make that change. I truly don’t think that TT was trying to scare me. She seems like a nice person, and I’m sure she’s quite good at what she does. That being said, there was absolutely no way in hell I ever wanted to be seen by her again. Ever.
So I called my RE to have my records transferred and decided to have a conversation with the practice manager about the whole situation. It was not my intent to get TT into trouble but here’s the bottom line:
I am one of the least emotional IF patients you’ll ever find - I just don't have as many emotions wrapped up in the whole process as some others seem to. That’s not to say that O and I don’t want to have a baby. We do, but we don't have all our eggs in that basket. So my concern is that TT is going to inadvertently say something equally tactless to another, more fragile patient and is going to cause some real damage. After all, I spent years in the medical field, have confidence in my gyn, and have no current problems with bleeding but she scared me enough to send me racing to my doctor to see if I was eaten up with cancer! I didn’t want her to do that to anyone else.
So I had a very frank discussion with the practice manager. He was extremely apologetic and thanked me for letting him know what happened. He also said that he was sure my RE would want to talk to me and asked if she could call at my convenience. I told him that wasn't necessary but that I’d be happy to answer any questions she might have.
Not two hours later my RE called. I’d only seen her for about 30 minutes on our first visit to her clinic back in January, so it was a bit strange to be talking to her. She too was very apologetic and assured me that while TT hadn’t meant any harm, she knew I must be scared to death. So she made the following offer: If I wanted to, she would clear her schedule for the following day and I could come in for the SIS, which she would perform. (A SIS is a simple procedure done in the RE’s office. They inject saline into the uterine lining causing it to “fluff out” a little bit so they can see the shape of the uterus and can tell if the uterine walls are smooth or if there are any growths on them.) If they found anything, she would take me right down and do a D&C, which they would then biopsy, all in an effort to alleviate my fears. I was pretty blown away. I’ve never had a doctor offer anything like that before. So I took her up on it, just to get answers more quickly.
We drove to her office in Birmingham completely certain that I’d be having a D&C right after the SIS. But guess what? My RE came up between surgeries, did the test and proclaimed that everything looked fine and that my D&C was “one surgery she’d be happy to cancel”. She even hugged me as she left the room. She did say that the lining is still too thick to cycle, but she doubled my Pro*metrium prescription and we’re hopeful that will help. (Until then, those of you within a 50 miles radius of my home are urged to secure your food supplies. I am in the midst of a major oinkfest.)
Finally, I called my gyn’s office this afternoon and my biopsy results were normal. I was pretty certain they would be, but you never know. So I’ve finally been able to breathe a big, huge sigh of relief for the first time in a long time. I am so grateful that all is well but at the same time I can’t help being angry at the fear and uncertainty of the last two weeks.
So here’s my dilemma. Do I stick with this RE (and see another nurse practitioner in Birmingham instead of TT at the satellite office) or do I switch to a male RE that several of my friends use and seem to like? I really prefer a female but I can’t help having a bit of skittishness regarding my current RE practice.
Help! What would y’all do?
Thanks in advance for your wisdom, and for not falling asleep during this exceedingly long post.
