It's now April 27, 2011. That's 13 days after I was told that I have cervical cancer, and finally going to the first available appointment with an oncologist. Today I would meet Dr. Tobias at the Cancer Center at Morristown Memorial Hospital. Dr. Tobias was highly recommended by my GP and a friend who works at the hospital.
Both my mom and Jimmi were with me for support, as I sat nervously in the waiting room. After a quick medical history review with the nurse, I was brought into the exam room to meet the doctor. He seemed nice enough until I heard the words "rectal exam" come out of his mouth. Wasn't thinking that was his area of expertise, but he certainly didn't hesitate on that one!
Feeling slightly violated, but glad to be done with THAT ordeal, I walked bowlegged back to the waiting area to be with Jimmi and my mom. Then we were all called into the conference room to talk to Dr. Tobias.
He came in very strong and confident, throwing around words like "hysterectomy", "radiation", "egg harvesting", "freezing embryos", "surrogate". It was all a bit much. I left his office in tears hoping I would hear better news from another doctor.
The week didn't get better...
Dr. Tobias' office set up an appointment for an MRI on April 29, 2011 to make sure the cancer hadn't spread to any other organs or the lymph nodes. I rearranged Jimmi's schedule, paid a babysitter to pick up the boys and headed off to my rush hour-timed appointment at the radiology center. I walked in and SUPRISE!!! No one from Dr. Tobias' office ever called to confirm the appointment, so they gave it away. PLUS, even if they could squeeze me in, no one told me that I needed to be fasting for the MRI with contrast dye, and since it was 4:30 pm, I'd had some food that day. DAMNIT!!!
After finding a way to squeeze me in on Monday, May 2 at 8:15 am, the radiology receptionist took my insurance card and said, "Oh, no. Didn't your doctor's office know you have Cigna? We're out of network. They'll pay for it, but they're gonna charge you at least $1000 out of pocket for your deductible." I looked at her with tears in my eyes and said, "It's 4:30 on Friday afternoon. Who else am I going to start calling NOW to see who can take me on Monday morning? I'll just have to pay for it."
So...Jimmi played Mr. Mom on Monday morning and got the kids to school so I could have the MRI. I then went back home to pick him up and head out to oncologist #2, Dr. Mensah, who had a cancellation and was able to reschedule me from my original appointment on May 19th.
Dr. Mensah was VERY nice. She had a much more caring bedside manner than Dr. Tobias, and she took the time to go over the entire female anatomy with Jimmi, my mom and I so we could understand exactly what was going on. She explained all of the options I would most likely have: hysterectomy, radical trachelectomy (where they remove the entire cervix and top part of the vagina, but leave the uterus there to make it possible to carry a baby, though it's high risk. Fun, huh?), or a cervical cone biopsy, which is the least invasive, leaves everything in place, but just removes the cancer from the cervix. Dr. Mensah assumed I wouldn't be a candidate for the cone biopsy, but was pretty certain I could have the radical trachelectomy and save my fertility.
After another exam...including a second rectal exam (what is it with these doctors?!?!?), Dr. Mensah told us that she definitely thinks I'd be a candidate for the radical trachelectomy, but she doesn't perform that surgery and urged me to go to Sloan-Kettering. Luckily, I already had an appointment there that coming Friday.
I felt a bit better after meeting with Dr. Mensah. She calmed me down and told me to call her with any questions at all, whether I went with her as my doctor or not. I was also pretty happy that neither Dr. Tobias nor doctor Mensah seemed to think I would need any additional treatments after surgery except possibly radiation if the cancer was deeper than expected.
Skip to May 4, 2011. Jimmi and I were up bright and early to meet with Dr. Drews, a fertility specialist at Reproductive Medicine Associates (RMA). After a long meeting, and an exam with, for lack of a better description, a dildo camera, Dr. Drews assured me that my ovaries were healthy and we can get to work on harvesting my eggs and freezing embryos for future use with a gestational carrier. Because it would be biologically Jimmi and my baby, they don't use the term "surrogate", but "gestational carrier" instead. The upshot of the entire ordeal so far was when Dr. Drews told me that they would do genetic testing on the embryos before freezing them to make sure they were healthy and viable. At that point, they would also know the gender of each embryo, and since I have 2 boys, and have ALWAYS wanted a little girl, they can choose to only implant female embryos into our gestational carrier. Ah, a small light in my dark tunnel.
So, after taking 12 vials of blood for preliminary testing, I headed back over to Dr. Tobias' office for the results of the MRI.
Good news! The MRI looked clear. It doesn't seem like the cancer has spread to any other organs or lymph nodes. But the good feelings only lasted a few minutes before Dr. Tobias explained that the pathologist seemed to think that my cancer cells didn't look like typical cervical cancer cells, and they seem a bit more aggressive. What does that mean? It means that I may not qualify for the radical trachelectomy and may need the full hysterectomy. Again, I left Dr. Tobias' office in tears.
May 6, 2011. The long awaited appointment with Dr. Leitao at Memorial Sloan-Kettering where Jimmi, my mom and I started to see some hope.
Lisa, Dr. Leitao's nurse took my background information and asked a bunch of questions. She said they looked at my biopsy slides and didn't see any cancer. "What??" She said, "The biopsy on 2/9?" I said, "That was the colposcopy. The LEEP on April 1st showed the cancer." She started frantically paging through my chart and realized no one had sent the slides or the pathology report from the LEEP. UGH!!!!????
But we proceed...Dr. Leitao gave me another exam, but my hopes of an anal trifecta were shot when he didn't give me a rectal exam. I liked him already! My mom and Jimmi met us in Dr. Leitao's office after the exam and he seemed very positive right from the start. Based on what he could see, Dr. Leitao said I definitely did not need a hysterectomy. I AM a candidate for the radical trachelectomy, but he said they've done studies on early cervical cancers and they think that even that could be too much surgery. He suggested trying a cold knife cone biopsy with lymph node dissection and removal to start. Basically, he would do a larger LEEP and remove more layers of my cervix, hoping to get all the cancer. On top of that, he would make 5 small incisions in my abdomen and shoot the lymph nodes with blue dye. If they turned blue, he'd take them out and test them. He said that unless the pathology report after surgery shows that he didn't get all the cancer, or if it had spread to the nodes, that would be all I'd need. Proceed on with my life and baby-making. If the tests weren't clean, he would then need to go back in 6 weeks later and proceed with the radical trachelectomy. The other option would be to ere on the side of caution and just go straight for the radical trachelectomy.
Dr. Leitao seemed very optimistic. The only thing he kept saying was, "I still haven't seen your LEEP biopsy slides. But unless they show something very different than what I'm seeing today, we can proceed with whichever surgery you'd like."
So, surgery was set up for June 14, 2011, less that 3 months before my wedding. Between now and then, I'd have time to harvest my eggs, just in case, and I'd have time to decide which surgery I felt more comfortable with, pending the results of the LEEP slides, of course...
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