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Ovarian surgery...any advice?

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alli_esq

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Hi, everyone. I am writing at a pretty low time, so I am sorry if I sound very "poor me," but that is really how I feel at the moment. This will probably be a long post, but I have posted on here during some sad times in the past year, and it has really helped--so I am going to go ahead and post now...

I started feeling a pain in my lower abdomen a couple of weeks ago, but it wasn''t that bad. To be honest, for the first week, I really thought it was probably gas or something. But last Friday, it was still bothering me so I made an appointment at the gyno for this past Monday. I went, and immediately, the gyno found a very large cyst. "The size of a grapefruit," she said. I went to the radiologist, and they found it was about 10cm.

So, after a long week of going to radiologists and a surgeon, they have determined that is probably not cancer (thank goodness, though they can''t tell for sure until they remove the cyst and have it tested, which will take a few days), and that it will probably not go away on its own. The surgeon gave me the following options, and told me that the decision is up to me entirely:

1) I can have laparoscopic surgery, which will be a short recovery time (about a week out of work), but I will lose my right ovary

OR

2) I can have a laparotomy, where the surgeon will hopefully save my ovary while removing the cyst, I will be left with a 4-6" scar, and will be out of work for approximately 3-4 weeks.


So, a little background: I''m 27 years-old, I''m engaged, and I''m getting married in November. I want to eventually have kids. I graduated from law school a year ago, but because of studying for the bar exam, I have only been working at my job since August. I work for a lawyer who used to be a sole practitioner until he hired me, and we haven''t been getting along so well. I am making just about the exact amount that I need to make to pay my bills, but I am unable to save.

Also, there is a lot of infertility in my family, and I am polycystic, so I rarely get my period. I have always been worried that I was at risk for lowered fertility.

Okay, so. I have missed about half of a week of work this past week (I hadn''t taken off a single sick day since I started before this). I went in to my boss on Friday, and explained everything to him, and asked him what his position was--whether he might let me go if I take off 4 weeks for this invasive surgery, or whether he wouldn''t pay me, or what (yes, he is legally allowed to do that). I offered that I could probably work from home for probably 2-3 of those 4 weeks. He told me he would have to think about it, but I know him pretty well, and I have a feeling that not only will he not give me a straight answer, he very likely might let me go.

I would be so incredibly financially screwed if I lost my job--I can''t even tell you. NO ONE in my field is hiring (true of most fields, I imagine). I have a ton of academic debt. A ton. It''s insane.

Anyway, I am just very frustrated, very sad. My family and FI have been wonderful, but it''s just a terrible situation. I don''t know what to do. No one can make this decision for me, but I don''t know. I''m so scared about every possible bad thing that could happen.

I guess I''m soliciting advice...has anyone ever had anything like this happen?...
 

fogdancer

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Dear friend!
My name is Monica I am from Brazil, and I had some surgeries (in my tummy 6 and going to the 7th) after discover endometriosis, don''t worry about loose your ovary you can surely have kids and have a normal life with just one, ovaries are the responsibles by women hormones.
Laparotomy is never easy I must say, I had two, is important to rest, and take care wearing elastic body clothes to prevent problems in the abdomen muscles for 3 months, don''t carry heavy weights
Your doctor asked for the exam named CA 125 to detect cancer in ovary?; sad to know is 10cm so laparoscopy is not an option...sorry.
For sure you will be okay don''t worry.
I''ll pray for you, I''ve been in your place before, never ever had kids, endometriosis made a mess in my body, but show must go on, talk with your doctor, clear your doubts, keep in touch.

Hugs and one friendly kiss

Monica

P.S.: Your ER is gorgeous, your beau is lucky to have found you.
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PilsnPinkysMom

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Alli:

Hugs, thoughts, prayers, everything imaginable to you, in hopes that life begins to turn up again.

Jobs for lawyers are definitely sparse. There is the option for loan deferment if you are unemployed, and also income-contingent payment plans. It sounds liked you''re not enjoying this job very much at all, but are holding onto it for the sake of having SOMETHING. Perhaps if you explain your personal situation to your boss he will have some mercy. If not... and I know this isn''t comforting... but maybe it is a blessing in disguise? I am not a religious person, or a Christian even, but do feel that we learn, grow, and perservere through everything that occurs in life. I''m not saying this to sound harsh AT ALL... but you WILL get through this time. Even if you feel that there is no sliver lining, no light at the end of the tunnel, lie to yourself and say that there is.

As for the health concerns, my heart just breaks for you. My mother had PCOS throughout her teens and 20s and struggled severely with infertility... but ended up with two biological kids in the end. In 2003 she started to have bad cramping pain, eventually went to the ER and was diagnosed with intestinal blockage. That wasn''t the case at all... Turns out she, like you, had a grapefruit-sized cyst. Because of her age they did a complete hysterectomy, and found out that there were very, very, very few cancerous cells deep inside of the cyst... She never needed to have any sort of radiation or chemo. She just went back every few months for a checkup to make sure that nothing new had formed and that cells didn''t begin to grow elsewhere. Six years later, she only goes for an annual checkup and is 100% cancer free.

This is definitely a major decision that only you can make, with the help of your FI and your family. Have you thought about whether you desire a family down the line, and if it is important to try for your biologically-own children? If this is something very important to you (though I know pregnancy is still possible with one ovary.. but knowing about your pcos and such), I think a scar and loss of a job might be worth it. In the short-term, laparotomy sounds better... You''ll be back on your feet, but back to a job you''re less than pleased with.

And a personal opinion: While jobs are essential and important and income is crucial to living... I can''t say that I would ever want to work for an employer who would fire me over a much-needed surgery. I wouldn''t even tell him that the laparotomy is an option. Its none of his business. If he lets you go then he is a crappy person. My two cents.



I don''t know. I wrote too much, I''m sure its not helpful... But... My thoughts are totally with you 100%. I''m sorry this is happening to you, especially right now. Breathe. Read a book. Talk about something with your FI besides this. Give yourself an hour to just... relax, even if you can''t. Think about what your heart is telling you. Seriously consider the suggestions of your fiance and your parents and other close friends and family with whom you feel comfortable talking to.

Lots of love and hugs and wishes that you''ll come to the right decision for YOU and be at peace with it. I hope you feel better soon... Please keep us updated.
 

lulu

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How old are you? I ask because I was 22 and in my first year of law school when an ovarian cyst ruptured and also ruptured a blood vessel .They thought it was appendicitis and operated. No laparascope then. I had a paper due the next day and a contracts midterm in three days. I got an extension on the paper, but no reschedule on the exam. The law school suggested I recuperate and then redo the semester.

They saved the ovary. I got out in time and sat for the exam. I don''t recommend this, but I was jogging in 10 days. This was possible because I was young and motivated.(to not repeat the whole semester of misery.} It probably caused some adhesions, so don''t jog. But I think you do have the option of going back to work much earlier if you''re in good health. You will have to cut the band on your pantyhose to sit at your desk.
In my early 40s I had a complete hysterectomy and needed a full 6 weeks off just to regain my energy.

I know this seems extreme, but sometimes extreme circumstances call for extreme measures. They told me that losing an ovary
would not affect fertility, and 10 years later I lost the ovary anyway. I can''t say how much impact losing the ovary will impact your fertility, but we have drs. on the board who can probably tell you that. Whatever you decide, good luck.
 

Tacori E-ring

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I know we have talked about this before but I forgot to mention one of my mom''s tubes was blocked (so she basically only had one working ovary) and had three kids (one was a whoops) so I don''t want you to give up hope at ALL if that is the route you take. I personally would try to save it but only you know what is best. I would also suggestion Seasonale if you are prone b/c I used to have 2-3 cysts a year and have been cyst free since I have been taking it.
 

MichelleCarmen

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How many surgeons have you talked to? Have you gotten multiple opinions?

I've had a number of cysts over the years and only had one officially measured via ultrasound and it was 5 cm. The obgyn told me it would eventually go away on its own and it did. It's been the same with all of the ones I've had and I never bothered to go in to the dr. with any of the other ones because they've all gone away. I was told that when they shrink up/leak out, there could be and probably will be spotting.

Clearly I'm not a dr. and only a dr. should be giving you medical advice, but I strongly believe you should talk to additional professionals before choosing between 1 or 2 (because there could be an option 3 or even 4).

Maybe also see a natural path or midwife to gain a whole different perspective.

Best of luck to you.
 

swimmer

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Hi Alli,
Oh what a situation. I am so so sorry you are going through this. I''ve always felt that having pcos was like being kicked in the gut, so to have a cyst on top of it all, plus the economic considerations? That just sucks, so so sorry.

In the hopes of helping you decide what to do, here is my story. I had a laparotomy to remove a cyst that did turn out to be cancerous. Several surgeries later plus chemo I got to keep both ovaries, but the scar tissue encasing the area like kudzu might be too much to overcome as we''ve been ttc for 10 months now. Laproscopic was not possible for me at the time so I didn''t have to make your agonizing decision. Actually my insurance company at the time wanted me to have a hysterectomy -at age 21- they were very kind to let me keep my junk at all. Similarly, my college roomie had endometriosis and had to have one ovary removed in college. She got knocked up pretty easily. One difference we experienced was that with only one ovary she was offered fertility research and treatment immediately, whereas I (cancer survivor, pcos, age 32) had to document ttc for 6 months before getting any investigations or treatment covered by insurance. We both live in a state where ivf and everything has to be covered, so that is a big deal.

I guess my point is that there is a silver lining to losing an ovary, but that could just be BCBS? However, it would be terrible if you were going to be second guessing your decision later... pcos is a nasty beast, so unpredictable.

My heart goes out to you, such a difficult situation all around. Thinking of you and hoping you find the right decision for you.
 

tiffanytwisted

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Alli- I''m so sorry you are faced with this difficult decision. I have had both a laparotomy (to remove a uterine fibroid) and laproscopic surgery (to remove a ruptured ectopic) The recovery from the laproscopic surgery was MUCH quicker, and much less painful.
However, if it were me I would want to save the ovary.
I can''t believe your boss is such an a** that you have to worry about your job on top of making this difficult decision.
Good luck, and please keep us posted on how it turns out.
 

zhuzhu

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Hi Alli,

First let me give you a big hug and to say that I am sorry for what you are going through. It may not seem like it right now but believe me everything will work out in the end!

I do not have personal experience with either types of surgery, however I wold suggest that you talk to you fiance about your fear, and your joined plan for parenthood in the future. Even though with just one ovary you can still get pregnant, it may be a little more challenging. http://www.wisegeek.com/can-you-get-pregnant-with-one-ovary.htm Since you will be married soon, your fiance should be taking a part in your decision making.

As in your job difficulty, I would not let your work come before your health. You are still young and highly qualified for other jobs. Even if the job market seems bad right now you do have lots of time to grow professionally. It is most important to take care of your body and spirit first.

Take care and I will be thinking of you!

Zhuzhu
 

Phoenix

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Date: 4/6/2009 12:55:53 AM
Author: zhuzhu
Hi Alli,

First let me give you a big hug and to say that I am sorry for what you are going through. It may not seem like it right now but believe me everything will work out in the end!

I do not have personal experience with either types of surgery, however I wold suggest that you talk to you fiance about your fear, and your joined plan for parenthood in the future. Even though with just one ovary you can still get pregnant, it may be a little more challenging. http://www.wisegeek.com/can-you-get-pregnant-with-one-ovary.htm Since you will be married soon, your fiance should be taking a part in your decision making.

As in your job difficulty, I would not let your work come before your health. You are still young and highly qualified for other jobs. Even if the job market seems bad right now you do have lots of time to grow professionally. It is most important to take care of your body and spirit first.

Take care and I will be thinking of you!

Zhuzhu
Ditto.

Also, it may seem like it''s so important to hold onto yr job right now, for financial reasons. But you say that you''re not enjoying yr job and yr boss sounds like an a%*! So, I''d go for the option that''d allow my ovaries to remain in tact. I am not a doctor but am generally not in favour of surgeries that would take parts of yr body away. If it could be avoided, then that''s what I''d do.

In the long run, I think you''d appreciate this better than losing an ovary just to hold on to that seemingly crumy job.
 

swingirl

Ideal_Rock
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5,667
If it were me I'd want to keep my ovary. Jobs and loans can wait and you have the rest of your life to deal with those. Your health and future are most important.

I'm sorry for your pain both physically and mentally. It's stressful enough without a jerk of a boss to deal with.

PS I had laparoscopic surgery done to remove my uterus and remove adhesions from an old C-section. It was a breeze. I had a very quick and painless recovery. But I can understand the need for a laparotomy if they need a better look and can inspect your ovaries.
 

Steel

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Date: 4/6/2009 2:19:24 AM
Author: Phoenix

Date: 4/6/2009 12:55:53 AM
Author: zhuzhu
Hi Alli,

First let me give you a big hug and to say that I am sorry for what you are going through. It may not seem like it right now but believe me everything will work out in the end!

I do not have personal experience with either types of surgery, however I wold suggest that you talk to you fiance about your fear, and your joined plan for parenthood in the future. Even though with just one ovary you can still get pregnant, it may be a little more challenging. http://www.wisegeek.com/can-you-get-pregnant-with-one-ovary.htm Since you will be married soon, your fiance should be taking a part in your decision making.

As in your job difficulty, I would not let your work come before your health. You are still young and highly qualified for other jobs. Even if the job market seems bad right now you do have lots of time to grow professionally. It is most important to take care of your body and spirit first.

Take care and I will be thinking of you!

Zhuzhu
Ditto.

Also, it may seem like it''s so important to hold onto yr job right now, for financial reasons. But you say that you''re not enjoying yr job and yr boss sounds like an a%*! So, I''d go for the option that''d allow my ovaries to remain in tact. I am not a doctor but am generally not in favour of surgeries that would take parts of yr body away. If it could be avoided, then that''s what I''d do.

In the long run, I think you''d appreciate this better than losing an ovary just to hold on to that seemingly crumy job.
Thritto.

I am in a similar work position and understand your fear as far as that is concerned but I doubt you will look back on your life and wish you worked longer for your boss. But you might wish you did all you could to save your ovary and take care of your health.

Make sure you get a second opinion and get advice on egg harvesting. Do you have health insurance?

It is not the easy road. But it might just be the right route to take.

(((HUGS)))
 

alli_esq

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Monica: I am so sorry you''ve had such a rough time. Thank you so much for your support. You are so sweet to share your experiences--you are just lovely.

PilsnPinkysMom: I have discussed the whole situation with my boss very thoroughly, but he just very simply doesn''t see what the commotion is. I know I will somehow make it through this, but I am very very worried about my future.
I am so relieved to hear that your mother has come out the other side all right.

Thank you so much for your kind words. I have been speaking with various people in my life, and I am getting all kinds of advice. Of course, from my friends who don''t want children, none of them think this is a big deal or that i should miss too much work. They tell me I can get pregnant with only one ovary, and although I know it''s a POSSIBILITY, I know that it is LESS possible. I am concerned that because I am predisposed to cysts, that the same or similar thing could happen to my remaining ovary, and I might catch it too late--in this case, i could have overlooked this cyst until it ruptured, and I was told that if it ruptured, I would definitely have lost my ovary. Thank you again for your support.

lulu: I am 27. Maybe I will heal faster than the surgeon says. There is no way of knowing...I am sorry to hear that you''ve had such a difficult time, but I so appreciate your sharing your story. Thank you.

Tacori: that is a very interesting suggestion--thank you for sharing it. But, unfortunately, my mother has had a heart attack and a stroke, and because of that, they tested me to see if I was predisposed to blood clots...and I am. So I can''t be on any estrogen (I take a progesterone-only pill now)...but I do appreciate your advice.

MC: yes, my doctors all said that if my cyst was about 5cm, they would let it go for a few months to see if it went away. but, because it''s so large, they all believe that it is NOT hemorrhagic, and that it will probably not go away on its own. I agree with you about multiple doctors'' advice--so far, I''ve been to a gynecologist, a surgeon and 3 radiologists. I have an appointment this Wednesday to speak with another surgeon in another state, so I am still holding out hope that he can give me a more positive prognosis. The other problem is that I have a LOT going on in the next few months (one of my best friends is getting married a few months before I am), so if I am going to have the surgery, I want to have it SOON so that 1) I can be well for all of the fun times, 2) I can stop being in pain & 3) to give the cyst less time to rupture or twist causing blood clots and pulmonary embolism. thank you for your well wishes.

swimmer: thank you so much for being so sweet, and for sharing your experience. I am so sorry that you''re having trouble conceiving, but I wish you the best. lots of PS dust to you...

tiffany: I feel the same way about my boss and my situation. I am trying not to be bitter and angry, but that doesn''t come easily to me. Thank you for understanding and thank you for sharing your experience.

zhuzhu: thanks for the virtual hug--I could definitely use it. after coming in to work today, and getting two INCREDIBLY nasty and inflammatory emails from my boss, I am leaning toward your advice. I shouldn''t let my job interfere with what my ultimate goals are in life...even though one of my goals is, of course, to have a successful career. My FI has been wonderful and will be going to the surgeon with me on Tuesday (the same surgeon who gave me those options--he is going to talk with us about all the facts and try to help us make an informed decision). I hope things will be clearer to me by then.

Phoenix: it''s true, I hate my job situation, but I am lucky to have a job at all. I just know that if I lose my job, I will be in such a precarious financial position that I might not be able to even have children in the future because I can''t afford them. of course, my boss could fire me either way, so having the laparoscopic surgery isn''t a guarantee of keeping my job. thank you for your advice.

swingirl: I do want to keep my ovary. but I am worried about my financial future almost as much as my health...I am glad that your laparoscopic surgery went well. Thank you for sharing your story.

Steel: thank you for understanding...I do (thankfully) have health insurance...but the surgeon explained to me that although he could not harvest eggs from the ovary they are removing, he could feasibly create embryos using eggs from my other ovary and FI''s sperm--but my insurance does NOT cover that procedure or the freezing of the embryos, so unfortunately, that is far outside what I am able to afford. Thank you for your ideas, though--I do really appreciate it.
 

mayachel

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I''d like to offer two ideas as someone who has been in a similar position. 1st, make sure you get a second opinion-that includes a 2nd ultrasound to check that it hasn''t started to go away on it''s own, before agreeing to surgery of any type. 2nd-Given that they believe it is benign, sometimes it is possible to "drain" the cyst. This is a very very simple, 5 min out patient procedure. All your doctor would need to do is, stick it with a syringe and draw out the fluid (as much as possible) it will weaken the wall of the cyst, and hopefully cause it to degrade as well as relieving discomfort.

You are otherwise healthy. Why take such drastic measures as surgery? I wish you all the best, I know this is not an easy choice to make.

As for the job-if your boss does tell you to pack your things...yeesh. How can there not be a wrongful termination issue?
 

alli_esq

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I just wanted to update--since you were all so kind in responding to me when I was so down...

I had surgery scheduled for next Friday, but I went for my last-resort sonogram today--and the cyst is almost completely gone!!!
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The doctors said this might happen, but they were all very skeptical, since the cyst got up to about 11cm--but today, it was only at 3.33cm at its largest point!

I am soooo thrilled, you have NO idea. Aside from the anxiety of the surgery, I am sooo happy that I won''t have to risk any possibility of losing an ovary AND that I don''t have to deal with my a$$ of a boss.

HOOORAAYYY!!!
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tiffanytwisted

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Congratulations!! That''s fabulous news!
 

onedrop

Ideal_Rock
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OMG! I was just about to write about my experience, then I read your update, and lo and behold...your cyst is gone! Wow. I am really, really happy for you! Wonderful news.
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Steel

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I am so pleased for you. That is wonderful news!!!!!!!!!!

Thank you for updating the thread.
 

icekid

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Wow, that is the best possible solution. So thrilled for you, alli!
 

swingirl

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Wow! Great news. Any idea what made it shrink?
 

alli_esq

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Thank you all so much--you have NOOOOO idea how relieved I am! Now I can plan a honeymoon! (I wasn''t going to be able to take the time off if I had to take time off to recuperate from the surgery!)

As far as why it shrunk--it was probably just a normal corpus luteum that got outta control...the radiologist thinks it shrunk just in the course of normal ovulation, so YAY!!!
 

AGBF

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Congratulations, alli_esq!!! (Do you go by Alli?) I just found this thread and was able to read it through to its happy conclusion in one sitting! I had an ovarian cyst that wouldn''t resolve at around age 41 or 42, right after adopting my infant daughter from Colombia. I was sure that I had cancer and lost a lot of weight because I was so frightened. Eventually the doctor agreed to go in via laparoscopy and either remove the cyst or the ovary depending on what he found. My left ovary was a scarred mess and he removed it and my left Fallopian tube. I recovered instantly from the surgery. Then he and another OB-GYN I saw both warned me that despite my past infertility issues that there was really nothing wrong with me and to remember that I should take precautions if I didn''t want to get pregnant! I told the doctors that I would welcome another baby, but that was not to be! (I was in my 40''s and not trying!) My first cousin, on the other hand, who lost her right ovary to an ectopic pregnancy quickly got pregnant with one ovary...with her son, Ryan, who is now in his mid 20''s. He is an only child because of his parents'' choice, not their fertility!!!

AGBF
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