Wednesday, October 9, 2013

Land Of Fruitfullness Part III

I decided that I needed a little time before I wrote this. Yesterday was a rough day and instead of writing out of pure emotion I needed to take the time to process. Despite giving myself the time this post will most likely be informative yet also a venting session at the same time.

I went to Mass General to have a consult with an OB doctor that deals specifically with Medically Complicated & High Risk Pregnancies which once I am pregnant I will apparently be considered due to my history of lymphoma. I was interested in what he had to say mainly because even I don't know the specifics of how my chemo could have affected me. 

Here is my first vent. If you are seeing a new patient it would be nice to take the time to at least glance at my chart before seeing me. It is very disconcerting to sit and watch you read everything and your reactions to it. I lived once already I don't need to relive it every time someone needs to look at my chart.

Anyway we went through my chart talking about the effects having cancer had on my body, what chemo drugs I had, etc. There were only two drugs out of everything I had that he was concerned with. Considering everything I got that was some what reassuring. The first one is Cytoxin, because it is known to have the potential to be very hard on your ovaries. He is going to look into what my total dosage was so he would have a better idea how much that could be a playing piece in this game. The other drug he was concern about is Doxirubison which can have an effect on your heart. So at some point in this I have to have an echo-cardiogram to make sure my heart is strong and isn't showing any signs of weakness.

After hearing this I am not very concerned about my heart. The way I look at it with all the cardio I do I would think if there was an issue with my heart something would have come up by now. So I figure that is just a precaution.

I am more concerned about the cytoxin. Because judging by the issues that I have had which have lead to me going down the fertility path I feel as though there has been some affect on my ovaries but only time will tell. 

My issue with why this was a rough appointment is that I am not a person that lives in a fantasy world. I am fully aware of what this journey could bring and that there is always the possibility to not be able to have children using my own eggs. However while sitting listening to what he had to say I think he was trying to making me understand all the possible outcomes. He told me that the cytoxin could have zapped my ovaries but even with that I would be able to use an egg donor. He told me that people tend to worry that because I had all these toxin drugs in my body the likelihood of them having affected my eggs making them abnormal is not any greater than a "normal" women.  That 90% of miscarriages are caused because the egg has a chromosomal defect. So basically the bodies way of natural selection. These are all things that I feel don't need to be fully addressed until it comes to light they are an issue. You know the whole we'll cross that bridge when we get to it saying that pertains to this very well. As if all this wasn't enough it gets worse...

He proceeded to tell me about how my weight is an issue as well. That being obese can lead to developing diabetes while pregnant, it has a higher rate of miscarriages, and can be attributed to both under weight deliveries and larger weight deliveries. I wish there was some way to have a neon banner that pops up across my chart saying something along the lines that I am active, have lost almost 90lbs and am trying to live a healthy lifestyle. I (not being a shy person when it comes to this) informed him of my already huge weight-loss, my active lifestyle, being a triathlete and trying to eat healthy. to which his only two replies were, well if you are doing triathlons then I would think the doxiruison hasn't affected your heart. His other was that although my current weight-loss is significant I still need to work on lowering it to be closer to the normal range. He looked up what the normal weight for someone my age and height which would involve me losing another 70lbs. So to start with he would like me to lose another 50-70lbs. I think that was the biggest slap in the face. That I have tried so hard and done do much work to get to where I am and it still isn't good enough. I have no idea how I am going to lose that much more weight but I will give it a shot.

So I guess my real issue is that although you need to make sure your patients are informed it also doesn't help to try and address things that are not an apparent issue. All that does is create more stress and worry about things that you can't control or even know about.

However luckily I have my amazing NP from Lymphoma and she is so awesome that she called me after 6pm yesterday to talk to me about what happened. She made me feel A LOT better. I told her about all of the above and she said that although Cytoxin can be hard on the ovaries I only received 3 doses while some people have 6 so that is in my favor. Also that I am the abnormality (I know shocking) when it comes to patients because if he is dealing with high risk based on hypertension or diabetes most likely he has patients that are not very compliant. Where as I am very compliant and try my best to do what I can to be in a better situation. So that he probably works on the side of scaring his patients into compliance. Looking at it from that point of view made it a little more acceptable. So I decided that I will do what I can to work towards what they have told me but I am not going to starve myself to do it. I really can't thank Bri enough for taking the time to call me after an already long day when she easily could have just gone home!

So now I have to look forward to eventually getting an echo-cardiogram. Oh did I mention that when I had this done before I started chemo they had to use IV contrast and forgot to close one of the tubes and spilled my blood all over the floor? Hopefully we can avoid that this time. And I will see what Dr. Souter has to say about the OB's notes/concerns and where we go from here.

After all this the only thing that kept running through head was..."Cancer the gift that keeps on giving!" I am very lucky to have the outcome I did from having such a progressed disease but I guess the saying is right once you have had cancer it will forever affect your life.

Until next time....

Tuesday, October 1, 2013

Land of Fruitfullness Part II

We went today back to Mass General Fertility Clinic to meet with the Doctor. It was a very good appointment with a positive outlook and everything seems to moving forward.

The results of my HSG were just as the radiologist said, both Fallopian tubes are open with no blockages or abnormalities!! That was very exciting to hear! Lewis's testing came back saying that it seemed artificial insemination was going to be a good route for us to go vs. Invetro at least at first so that was also positive!

The extra good thing about this appointment was that it just so happened to fall on my cycle day 3 which is when they do some hormone testing. I had already had all this done but it was a random sampling because of the spontaneity of my periods. So it was prefect to be able to get a true reading this time.

As it stands right now I have to go see another OB/GYN that deals with High-Risk Pregnancies and Medical Complications so that I can be cleared to proceed. Basically I am going to have to talk about what chemo meds I was on what the potential was for that to have cause a medical complication and I am sure there will be some level of clearance received from my oncologist as well.

Once all that is complete the plan is to hopefully start with my next cycle which is very exciting! I will be giving myself (or most likely Lewis will be doing it) shots of FSH to help the ovulation process. Going in very frequently for ultrasounds and blood work. Once everything looks good  we will go in together. Lewis get's the fun job giving the sample and then I go through the insemination process.

so although this is a much shorter port then the first, this is currently where we are in the fertility process. I am very hopeful that things will go smoothly from here. Although I am aware of what a process this can really be!

Here's to hoping my positive outlook helps us through all this!