Monday, February 11, 2013

Unexpected Gifts

Since leaving girlhood, I have been plagued with varying levels of painful cycles. By the time I was twenty-four I was used to doctors considering me a hysterical (pun intended) woman. I was used to pain and there seemed no cause or solution. Then I had an appointment with a young, new doctor. My indication that something was different came when the first thing he said was, “I was reading your chart...” Not only had he actually read my chart, he put the pieces together from my history. He discovered I had adnexal masses- a fancy term for something wrong with my ovaries.

Various tests later, the ovarian masses were confirmed to be semi-solid and my Ca-125 levels high. At age twenty-four, with my favorite actor being Gilda Radnor's husband, I had a scare that I was going to die of ovarian cancer. My doctor was level-headed. He explained there are other reasons for these findings, but all can be definitively confirmed or denied through surgery only. I saw a second opinion- who had the same condescending attitude I had gotten used to and told me to “just go on birth control.” Been there, tried that, didn't work. I went in for my first surgery.
 
I was diagnosed with Stage IV endometriosis. Endometriosis is a mysterious disease, even after all these years of study. It is staged like cancer, invades body tissues in the abdomen and sometimes beyond, and can be debilitating. My innards were so innundated with this disease my doctor told me he would have diagnosed Stage V, if there had been a category like that. The normal treatment for Stage IV is complete hysterectomy. I will forever be grateful I had a young surgeon who recognized that very early, surgically induced menopause would be more devestating that the effects of this disease.

I was told that I would never be a mother. I could not imagine myself as a mother.

Three years later, I was on the surgical table again. Different surgeon. Same diagnosis. I had done research myself and knew that hysterectomy was not an option for me. I had learned the disease is estrogen-based, and removal of the ovaries does not cure the problem. Estrogen is still present, and surgically-induced menopause often requires hormone replacement therapy- putting that same old hormone right back in my body to keep the disease active.
 
Infertility was still the byword. My biological clock had started ticking.
 
Three more years, and my surgeon and I decided to take a different tactic to deal with the pain. I was going to try a hormonal drug first, followed by surgery. I had to call the office the day my period showed up. I waited. And waited. After a little while, a little nagging feeling convinced me to just try a home pregnancy test. I actually tried ten. When I called my surgeon's office and told him I was pregnant, he said, “No, you're not,” and sent me for bloodwork.
 
Yes, I was. I was going to be a mother.
 
I had an early ultrasound to make sure it was not ectopic. Everything was found to be healthy, though I still had large ovarian masses. While I was pregnant, the masses went away. So did the pain. The pain was gone for a total of six years- pregnancy through breastfeeding.
 
My surgeon was an obstetrician. I adored him as a surgeon treating me for a difficult and extensive disease. I very quickly discovered I did not adore his philosophy on pregnancy and birth. A scheduled cesarean section was offered at my first prenatal visit. I thought it had something to do with my disease and surgical history, but it turned out to just be a suggestion as women “get tired of being pregnant.” I switched to a homebirth midwife.
 
My daughter was born in a hospital after many days of labor necessitating a nonemergency home to hospital transfer. My back up physician was amazing. My midwives were amazing.
My daughter is amazing. Being a mother is incredible.
 
Two years ago, my pain level was becoming very high again. Tests confirmed one ovarian mass had returned (later the other was also affected). I delayed and delayed further tests and treatment, as I did not want to go through surgery again. I finally made the decision to see a specialist who would help preserve my lady parts, rather than assume I didn't want them anymore. Test results did not surprise me, being similar to previous experience. The chances of pregnancy were listed as very tiny.
I faced the anxiety of upcoming surgery. Worse was my anxiety I might lose any chance of ever having another child again.
 
Because of my age, and the extent of my disease history, the risk of cancer was higher. But all indications showed the same kind of tumors I had already had- endometriomas, which was reassuring. I had also had a pregnancy and had breastfed for years, so risk of cancer was reduced. I figured things balanced out, and made an agreement that I would only consent to a hysterectomy if cancer was found.
 
The day before surgery, I had this little nagging feeling.
 
Much to everybody's surprise, I tested positive for pregnancy.
 
I realize there is a theme here.
 
My journey into motherhood started with the dire prognosis of infertility, followed by an unexpected pregnancy and birth. Ten years later, aching for those baby years, knowing the devestation of endometriosis, adding in the term advanced maternal age, with my hopes fragile, I faced the prognosis of secondary infertility only to have another unexpected pregnancy.
 
I have the chance to treasure another child.
 
With this pregnancy, I am choosing midwifery care again. I know that a healthy pregnancy is not a disease. I know that my endometriosis will be helped by rather than hinder my pregnancy. I know that, with love and support I will be strong and capable. I hope that, should a medical need arise, I will find a physician who can be as caring and compassionate- midwifery oriented- as the back-up I had with my daughter.
 
My first born miracle is very excited to be a big sister. I look forward to the day I meet my second born gift face to face.