My Cancer Story: Oncology

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Apoointment

When you get cancer, words you rarely use  pop to the top of your vocab list.

“Oncology” is one of them.

My gynecologist said it first, but the word really hit home when I read it on the appointment letter from UNC Hospital:

UNC  OBGYN  GYN ONCOLOGY

I began to talk about MY oncologist.

Dr. Gehrig is the  head of the department, an expert in endometrial cancer and laproscopic and robotic surgery.

Hospital Signs

That Monday morning,  Cliff and I made our way down  a hallway with a huge sign shouting the word again:

Gynecological Oncology

First came registration and then weight, blood pressure, and a few other checks.

Next they ushered us into a small exam room. My eyes immediately caught this poster:

ednometrial-study

Prior to this, I most often used “survivor” in reference to the TV show. Add “survivor” to the updated vocab list.

UNC is a teaching hospital. I met with the Fellow, Dario Roque, who turns out, went to Davidson College. He partied with my kids! (and more importantly, studied hard with my kids).

Dr. Rogue brought out a chart of the female reproductive organs.

“From your pathology, we know you have an early stage, non-aggressive cancer on part of your uterine wall” (“pathology” being another vocab word I would use over and over in the coming weeks), “but we don’t know what types or stages of cancer we’ll find in the remainder of the uterus.”

Whoa.

I learned the difference between the type of cancer and the stage. “Stage” is how far the disease has spread.

“If the cancer has penetrated more than fifty percent of the uterine wall,” Dr. Roque explained, “you’ll need radiation.”

I asked about the dreaded chemo.

“With endometrial cancer, we only do chemo if the cancer has gone into your lymph nodes.”

He explained the surgery. Five incisions in the abdomen, one for a camera. “We pull the uterus out the vagina unless your uterus is too large. Then we have to make a bigger incision in your abdomen. We’ll remove nodes. We’ll test all of it while you’re still under anesthesia.”

Happily, my uterus proved, during the exam that followed, not to be large. Who knew?

Table

After the exam, Dr. Gehrig came in and went over my diagnosis and the procedure again, briefly.

“Bring a list of questions,” Cliff had told me over and over.

I was so nervous, I never brought out my list.

But I asked plenty of questions and got lots of answers. Cliff took notes.

Last, I met the researchers.

I agreed to participate in several studies, including the study from the poster above. For the first time, I realized I might help cancer patients who come after me.

Spankys

Cliff and I had an hour and a half before I was due in what UNC calls “Precare:” chest x-ray, blood tests, a talk with the nurse about hospital prep, and an EKG. We hotfooted it up to Franklin Street to restaurant row, right off the UNC campus.

We courted in Chapel Hill in the 70s. I was in grad school there, and Cliff was finishing his engineering degree at Duke. Back then my uterus was just a young thing, and its only problem was cramps.

We stepped into Spanky’s, on the corner of Franklin and Columbia Street.

I opened my menu.

My mind spun from the morning events. I liked the doctors and staff. I was scared, sure, but encouraged by what I learned about the surgery and expectations for recovery.

Cliff and I have been eating out together for years, lots of years. Festive outings filled with lively conversation and good food.

“Festive” is not a word I ever thought would go on my cancer vocab list.

Festive

But “festive” describes that lunch.

Festive since I love portabello mushroom melts and Spanky’s.

Festive thanks to the good vibes we got from UNC Hospital.

Festive because I sat across from a husband who knows how to make the best of a ninety minute break from medical vocabulary.

“Festive” comes from the word “festival,” which means “a time of celebration.”

“Celebrate” isn’t a word I thought I’d add to the cancer vocab list either.

But in the weeks to come, I learned I had plenty to celebrate, in ways that surprised me.

Stick with me! The story continues. Thanks for reading and for all your love and good wishes.

My Cancer Story: The Diagnosis

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D and C

During our period years, a bit of  spotting is usually no big deal.

But when that blob of blood comes in menopause, the panic siren sounds.

I saw my first bit of blood in October, for  a day. I panicked, somewhat, but decided to wait for more blood to appear before I went to the doctor  (which of course I shouldn’t have done and don’t you dare do!)

Next occurrence was January.

I knew I couldn’t ignore it again.

“All bleeding after menopause is abnormal and cause for concern,” website after website warned me. (But only one in eight cases ends up being cancer, the websites also said.)

At my first appointment, the technician conducted a  vaginal ultrasound.

“We couldn’t see your endometrium,” Dr. Fried said afterwards. “It may be so thin that it’s just not showing up on the screen, but we need to keep investigating.”

A thin endometrium, in menopause, is what the doctor wants to find. Thickening may be an indication of cancer.

Next came the  Sonohyseterogram. They shoot a saline solution into the uterine cavity to make the walls more visible. I had a couple of jump-off- the-table moments as the doctor moved the tube with the saline around. He and the technician kept an eye on the ultrasound screen. 

“There it is,” Dr. Fried said in minutes. “Most likely a fibroid.”

Damn, I thought. So much for the thin endometrium.

“The fibroid is probably the cause of the bleeding, but it’s obscuring part of the uterine wall,” he told me. “I need to biopsy that area because we can’t see it, and we need to make sure this is a fibroid, not a polyp.”

(Fibroids are rarely cancerous; some polyps morph into cancer.)

Next, came some frustrating months getting me on the right blood pressure medicine, so that I could have anesthesia for a D and C

(Lesson here: Don’t get behind on any aspect of your health. My blood pressure, which was elevated, shot up to crazy numbers at each doctor visit thanks to white coat syndrome.)

(Another lesson: I had only one more minor spotting incident from Feb. to June. I came close to cancelling the D and C. Glad I didn’t. Blood is blood, even if it stops.)

Chapel Hill OB/GYN offers an in-office D and C. Since having a D and C this way is cheaper, simpler, and for me, less scary, I opted for in-office over hospital.  (My doctor will not do an endometrial biopsy, BTW, without sedation. “We used to do them while women were awake,” he explained, “but we came to realize the procedure is just too painful.”)

D and C Day finally arrived. I’d never been sedated/put to sleep before.

I blinked and there I was looking at Cliff and the doctor in the recovery room (the same room, above, where we started).

“The fibroid is fine. It can live with you for the next forty years,” Dr. Fried said. “The uterine walls looked a little puffy though, and I found and removed a polyp.

Not the news I wanted.

But not, as the doctor then suggested, necessarily bad news.

The procedure was on a Friday. I was to hear in three or four days.

Monday afternoon, a sort of panic set in.

At the same time, I imagined the relief of sending a mass email to friends and family headed “BENIGN.”

Tuesday afternoon, the panic grew. But when five-thirty came with no word from the doctor, I figured I wouldn’t learn anything until Wednesday. I relaxed, somewhat, for the evening.

Cliff is on a major campaign to rid the lawn of magnolia leaves. I stepped outside to assist with some raking.

At seven-thirty, I came back in to find a message on my phone.

I dialed voice mail.

“Barbara, this is Dr. Fried. I’ve got your biopsy results, and there is evidence of a very early cancer. I hate leaving you a message this way. I think you’re going to be fine, but we need to talk.”

Dr. Fried said to call him right back at home if I could and that he would be in the office tomorrow if I didn’t reach him that night.

I had cancer.

Cancer.

Cancer.

Cancer.

Dr. Fried is a jokester. He tells stories, turns a clever phrase, and gives his nurse instructions in French.

But in his message and in the much longer phone conversation we had next, his concern was getting me the information I needed.

Shocked, sad, but oddly calm, I was able to take in the compassion in his voice.

I’ve learned a lot from my cancer experience. One of the happiest, simplest lessons is that kindness and compassion always help.

No matter what.

Always.

Capture

PS. Some friends have winced when they hear that my doctor delivered my cancer news in a phone message.

No! I appreciated it so much. He’d promised to tell me by phone, none of that “Come into the office to get your results stuff.”  As he said when we connected minutes later, “I hated to tell you in a message, but I knew if I just said to call me, you’d figure out the news wasn’t good.”

Yep. This way, he was able to reassure me a bit before I even returned the call. Thanks, doc!

Photo Top: My crumpled gown after the D and C

Photo Bottom: My doc is sporting the plaid shirt. He’s also the only man in the picture.

It’s Time to Talk About Sex after Menopause

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Its time t-clap logo FINAL

The Women’s Health Foundation wants us to shout it from the rooftops:

It’s time to talk about sex after menopause!

 Learn more about their campaign here.  (Bloggers, they especially want your support).

Missy Lavender, founder and executive director of the Women’s Health Foundation, gives us this advice about having those conversations:

It’s a question I get asked all the time — how do I broach the subject of sex after menopause with my health care provider?

 First, I tell women they’re not alone in needing some answers, but I know starting the dialogue can be difficult.

Dr. Corrado Altomare, the Vice President of US Medical Affairs at Shionogi Inc., a Women’s Health Foundation partner, recently wrote a blog on our website about techniques for starting the conversation.  He suggests opening with something like, “Is it normal for…” as a prelude to your question.  

Ask about hot flashes, painful intercourse or weight gain.

 Then end the discussion with another question, “Is there anything I can do about it?”

 If you’re afraid, try rehearsing your questions, or write them down and hand them to your health care provider.  

Always use your own words and don’t be compelled to use confusing medical jargon.  

I bet you’ll be surprised by the results.  Most doctors know it’s uncomfortable to talk about sex and often wait for patients to bring up the subject.  

So, don’t be afraid!  Commit to having that conversation today!

Me again: Here are ways we can support the Women’s Health Foundation in the campaign:

1)     Share this video, featuring menopause experts such as Dr. Susan Kellogg-Spadt, CRNP, PhD and Dr. Lauren Streicher, about the campaign and the importance of talking to your provider about sex after menopause, https://www.youtube.com/watch?feature=player_embedded&v=QiHjRZrRFxQ.

2)      Sign up via the crowdspeaking platform Thunderclap and commit to having “the conversation.”

3)      Leverage your social voice via Twitter, Facebook, and/or Tumblr and encourage your friends and followers to do the same – below are some sample tweets/posts:

The campaign kicked off on Independence Day, to celebrate the sense of freedom and empowerment the foundation hopes women will gain by speaking with their healthcare provider. It will culminate on September 1, the first day of National Menopause Awareness Month, a month that shines the spotlight on health issues facing menopausal women.

So let’s shout it from the rooftops:

 It’s time to talk about sex after menopause!

 

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MenopauseMop: A Giveaway!

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Mop

A menopause mop!

How cool is that?

Created by three Hot Flash Sistas!

Sisters

This is how they describe their innovative mop:

Description

Read the testimonials here!

Check out the colors and designs here.

Giveway: The Hot Flash Sistas are offering a mop to TWO Friend for the Ride readers. Simply enter a comment by September 1 saying that you’d like to be a winner. U.S and Canada only. Thanks, Sistas!