Tuesday, 27 September 2011

Forever a mystery

Quite a few people have asked whether the cysts could have had anything to do with the hyperemesis gravidarum (severe morning sickness) I experienced for the full duration of my pregnancy, and/or the placental abruption which saw Goran entering the world, for lack of a better word, abruptly.

It is something that I have been mulling over a lot these past couple of weeks, and the bottom line is: We just don’t know. A few cysts were picked up on my very first ultrasound – the one that visually (and aurally) confirmed the tiny life growing inside of me. But the fact of the matter is that ovarian cysts are found in nearly all pre-menopausal women, i.e. during their childbearing years, and in up to almost 15 percent of post-menopausal women.

Any ovarian follicle that is larger than about two centimetres in diameter is termed an ovarian cyst, and 95 percent of them are harmless. It is only when they exceed around five centimetres in diameter and/or start causing bleeding and/or pain that removal is required, usually via laparoscopy. Those particular cysts that we saw on that initial scan were deemed small and insignificant at the time, i.e. not worthy of surgical intervention, and a risk I’m not sure I would’ve been prepared to subject the fetus to at that stage anyway.

But in retrospect, perhaps things should’ve been monitored a little more closely, both pre and post-partum. During the entire seven months that I carried Goran, I gained only 6.5kg (1.78 of which was him at birth). This was due in no small part to the afore-mentioned HG. And honestly, if it wasn't for the discovery of Asic tabs, which I then lived on, literally, to help keep the worst of the nausea at bay and some of my food down, I probably would’ve gained even less. All that considered, I look enormous in these preggie pics, taken at 24 and 29 weeks respectively. And I cannot help but wonder if there wasn’t something besides a baby growing inside that massively distended belly…

Above: At six months

Below: At seven months

Otherwise, I’m glad to report that all is going well with my recovery. The most difficult and frustrating part of it all is not the pain at the surgery site, or getting accustomed to the ccHRT, but not being allowed to pick up or carry Goran (now 11kg). It is frikkin killing me. Especially because he is at such a critical stage in terms of mobility, i.e. on the brink of learning how to walk. I’ve worked so damn hard to get him to this point, and not being able to continue this shared activity of ours for four whole weeks puts a real spanner in the works. I am literally counting down the days till we can be a wholly functioning unit again.

Anyway, what’s done is done, and it’s a waste of energy dwelling on the past. I’d say if there’s one thing I’ve learnt over the past year, it’s that our female bodies are both fearsome and fragile things, capable of creating, and equally susceptible to breaking. Virtually overnight. From now on I will listen to my body. And I urge all women reading this to do the same. Do not take anything for granted, or anything out of the ordinary lightly. Abnormal bleeds, unexplained pain…have it seen to by a professional as soon as possible.

As frightening as my personal experiences have been, even more frightening is the knowledge that, had I not been rushed to hospital and gotten the urgent medical attention I needed at those particular moments in time, the outcomes could’ve been a lot worse.

Friday, 23 September 2011

Sliced & diced

Amazing how much one’s life can change in the space of a few days.

On Saturday 10 September I was rushed to the ER at Olivedale Hospital with excruciating abdominal pain. After a battery of diagnostic tests (first X-rays, then an ultrasound, and lastly a CT scan), I was admitted to a ward in the hospital itself, and prepared to go under the knife. The scans had revealed what was (initially) believed to be a giant pancreatic cyst, 16cm in diameter, which was too large for removal via a laparoscopy (keyhole surgery), necessitating the need for a laparotomy - going in through my not-quite-nine-month-young C-section scar.

When my Ob/Gyn eventually cut me open on Monday 12 September (Lee’s 36th birthday), she discovered waaay more than she had bargained for. Not a pancreatic cyst, but eight massive ovarian cysts - the largest the size of "a rugby ball", extending all the way from my groin to above my navel, and from which a litre of fluid was drained. Apparently this grotesque "honeycomb-like" mass of growths took up every conceivable cubic centimetre in my abdominal cavity. I ended up having a bilateral salpingo-oophorectomy (removal of both ovaries and Fallopian tubes, along with all the cysts). Thankfully the cytology and histology reports, which I received earlier this week, revealed no malignant cells. The official diagnosis from the biopsy read "a large benign cystic teratoma on each ovary".

A lot of people have asked what could’ve caused the sudden onset and mushrooming of all these cysts, and how did I not realise what was going on until it had reached these crazy proportions? The fact of the matter is I am a classic apple shape and an IBS sufferer, so having a disproportionately distended belly and looking permanently pregnant is nothing new to me. Until the pain kicked in, as a result of torsion (twisting) of the biggest bastard cyst, which cut off blood supply to the left ovary, I had simply put it down to my spastic colon and some serious bloating. As far as causes go, we believe it was as a result of coming off the Pill, which I had been on for so long (more than two decades). Besides its more obvious contraceptive properties, the Pill also has several health benefits, one of them being reducing the risk of developing and/or suppressing the growth of ovarian cysts. Shortly after stopping the Pill a few months ago, it seems, the little fuckers decided to erupt and throw a party in my pelvic bowl.

Anyway, besides the fact that I have now entered what is medically termed surgical menopause, and have to take continuous combined hormone replacement therapy (ccHRT) for the next 20 years or so, I am also finally back to my pre-pregnancy weight. Hallelujah!! In fact, the amount of fluid and tissue they removed from my body (around 3kg worth) weighed significantly more than Goran did at birth (1.78kg)! It may have been a rather drastic way to drop a dress size, but hey, at least I'm able to fit into all my old clothes again.

I really have been overwhelmed by the outpouring of love and support from friends and family during this entire ordeal, especially my mom. She has been up here in Jozi this past week helping me out with Goran (who I’m not allowed to pick up or carry for four weeks, rendering me virtually useless - as anyone with an active seven-month-old will attest to), and tomorrow we (she, Goran and I) fly down to Durbs, where I will stay with her and my dad in Westville for my third week of recuperation. By the time I get home next Sunday, I hope to be even further along the road to recovery, and (almost) right as rain again.

A visit from my little miracle man, a few hours before my surgery