Tuesday, September 20, 2011

Radiation Follow-Up

I saw Dr. Sidebotham today. It's been just about four weeks since my last radiation treatment, and today was the day to check and make sure my vagina hadn't fused together. I know, I know. I'm exaggerating. The chances of that happening, while not impossible, were next to none. But I knew for a fact there would be shrinkage and the exam would NOT be fun.

Jimmi, my mom and I were called into the office on time and our old friend, Carlos, took my vital signs. After taking my blood pressure, he looked at me with scolding eyes, "Are ju dreenking enough, jung lady?" I put my head down in shame and answered, "I'm trying, but it's hard!"

I knew I was dehydrated and my blood pressure proved it. My heart has been racing for weeks. So much so, that I went to see my general practitioner yesterday to make sure there was nothing serious going on. "Dehydration and anxiety," was his diagnosis. "Push the fluids and salt to get your pressure back up." But, honestly, I'm still nauseous and that makes drinking anything very difficult.

Carlos asked me some standard questions and then he left the room. Shortly after, a nurse I'd never seen before let herself in. "Hi, I'm Maritsa," she smiled. After another series of questions, Maritsa brought out the familiar gown wrapped in plastic and said, "You'll need to take everything off so the doctor can examine you." I knew the drill.

Jimmi and my mom left the room so I could change. As I sat on the table, nervously awaiting the first vaginal penetration I'd had in over three months, Maritsa knocked and came back into the room with a pink and white box.

My dilators.

I stared at her as she opened the box to reveal a zippered, pink pouch that resembled a makeup bag. Maritsa unzipped the bag and pulled out a small tube. "This is the lube you'll need to use. Make sure you really lube it up." Oh my God. I can't believe we're having this conversation. I actually giggled as she pulled out the different sized medical dildos. "So, you'll start with the largest one you can handle without discomfort, because if it's too small, it won't really do anything." She looked at each of the five white cylinders as she pulled them out of the pouch. As she reached in and grabbed the largest of the group, her eyes grew wide and she let out a "Wow!" I grinned uncomfortably and quipped, "Yeah, I don't know if I'll need that one."

I glanced at the display of plastic sex toys on the counter. "So, what do I do with them? Just stick them in there?" Maritsa replied, "Yeah, pretty much. Start with the smaller ones and work your way up. You put it in and rotate it and move it in and out. Do it for about three to five minutes, three times a week. When you're a little more comfortable, you can even have your husband get involved and make it more exciting." I let out a loud, uneasy laugh, "Oh, that'll be fun."

When Maritsa had finished her dilator lesson, she left the room to find Dr. Sidebotham. Not long after, they both returned to start my exam. "Hello! How was the wedding?" Dr. Sidebotham asked with excitement. "It was great," I said happily. "I brought you pictures!" I was able to avoid the vaginal torture for a few more minutes with an iPad full of wedding photos, but I couldn't delay the inevitable forever.

"Let's get the hard part over with," the doctor said. "I'm going to start with just my finger first. Sometimes the radiation will cause adhesions where the vaginal walls will stick together in some areas. I can feel that with my finger and I'll be able to pull the adhesions apart before I go in there with the speculum." Wow. That sounds super awesome. I put my feet in the stirrups, scooted to the end of the table and braced myself for the pain. "I'm really lubing up, so don't worry. I'll go slowly." I think I may have heard that line in a dirty movie at some point in my life. Oh no! Here she goes! Relax or it'll hurt more!

I clenched my teeth and my face scrunched up as I felt her finger push past my born-again virginal opening. "Ouch," I winced. She went very slowly, pushing up higher and higher. Holy crap! If this is what a finger feels like, how will I ever have sex again? But, wait! Good news! At least my vagina wasn't fused shut. That was one of the reasons I didn't want to do the radiation in the first place. But I still had an opening!

After the quick exam, Dr. Sidebotham removed her finger and said, "Ok, I didn't feel too many adhesions, so we're good. I'm gonna use the speculum to take a look now." She took the plastic snoochie opener from the counter and headed my way. "It's gonna hurt!" I whined. "It's the smallest one we have. You should be fine. Don't worry." The doctor managed to get it in and open it up just enough to peak inside my love canal. "Ok, done! Looks good. There was a bit of blood from the adhesions, so don't worry if you see some spotting later. Now I'm just gonna use my finger again and make sure everything feels ok in your pelvis." Wait, didn't she do that already? No, apparently the first time she rounded third base was just to check for adhesions; this was the actual exam. She went back in again and did some pushing on the outside and some pushing on the inside, then she finally removed her finger. I was sweating and feeling faint, but it wasn't over yet. "I just need to do a rectal exam and then we'll be done with the hard part," she said nonchalantly. What? "But that side still hurts too!" I whimpered. "I know, but I need to make sure the lining is ok."

Oh, what did I do to deserve this?

The violations finally ended, and I was able to breathe again. "Ok, why don't you get dressed and I'll go get your mom and your husband,"Dr. Sidebotham said. I did as I was told, then sat there waiting for my support team to come back.

The two of them entered the room with the doctor and sat down. Dr. Sidebotham started, "Everything looks great. You're really in good shape down there. The biggest problem you have is that nothing's been in there for a long time so you'll need to really work at stretching it out with the dilators. There are no limits on your activities, as far as I'm concerned, so whenever you feel ready to have intercourse, go ahead. I will tell you that it will be very uncomfortable for at least the first few times. Maybe more. It'll be uncomfortable for you, Jimmi, because you'll feel like you're hurting her. And it'll be uncomfortable for you, Suzanne, because it will hurt. But, unfortunately, the only way to get past that is to keep doing it so you get used to it again."

Dr. Sidebotham explained that the more I use the dilators and the more we have sex, the quicker I'll return to normal. Well, as normal as I can be after radiation. Of course, the chemo next week will throw a wrench into my plans. I highly doubt I'll be in any kind of mood to do anything with my girly parts for a few weeks after that. But at least I know I'm allowed to try.

"There's one more thing we need to discuss," Dr. Sidebotham said cautiously. "I mentioned it awhile ago, but since the clear margin was so close to where Dr. Leitao sewed you up from the hysterectomy, I may recommend a few rounds of internal radiation. I'm still on the fence about it, though. We don't know for sure if it will make a huge difference in whether or not the cancer comes back, and the effect of your quality of life might not be worth it. You won't feel it like you did with the external radiation, but it could make the stenosis, or vaginal shrinking, even worse. I'm just not sure it'll be worth it in your case." My head was already saying, "Oh, HELL, no!" And then she explained how the internal radiation was done.

"The internal radiation is meant to go to a very specific location in the vaginal wall. We'll insert a large cylinder into your vagina - it has to be large to get to the exact area we need it to go. Depending on when the rays on the machine were changed, you could have the cylinder in you for five minutes or 25 minutes. While it's in there, a specific amount of radiation will be delivered to a specific area. We'll do it once a week for three weeks. Again, I can't say if this will make a difference or not, so I'm going to hold off on my recommendation until after you're done with chemo and Dr. Gorsky does your follow-up scans. Then we can decide what you want to do." I didn't hesitate, "I don't want to do it. I didn't even want to do the external radiation!" She nodded, "I know. Don't make any decisions now. Just think about it."

An hour and a half after walking into the office, my appointment was finally over. Jimmi grabbed my box of dilators, and we were on our way.

I was very quiet on the car ride home. My lower areas were sticky from leftover lubrication and sore from the beating they'd just taken. The thought of sticking anything in there again made me cringe, but I knew I would be in for a lot of poking and prodding over the next few months - mostly self-inflicted! I reached for Jimmi's hand and squeezed it tightly. "I'm sorry about all of this," I said quietly. He shot back, "Will you stop? There's nothing to be sorry about. You just have to get better!"

Get better. I'm trying so hard to do that. One more cycle of chemo and then we'll find out if I'm better.

Oh, please, God, let me be better.

I want to be better.

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