The Coming Surgery

I've mentioned that the other breast removal surgery is scheduled for 25 March.

There we were, steaming steadily towards this date with complete peace. Anticipation, almost, as it will be the last Really Big Thing we have to do in this marathon.

Then Dr. Science called at 5:15 PM on last Wednesday evening. He was on his cell phone, we had a terrible connection, and he was saying something about talking with a colleague (?) and then talking with Mayfield (why?) and then, at last: "Something you should consider is having your ovaries removed during your upcoming operation."

The rest of the call was a blur, except that he apologized profusely for having this conversation on the phone and not in person.

Well, why wasn't it in person? I had just seen him 2 weeks earlier, and he went through the whole song and dance about tomaxifin, the drug I'll take for 5 years that will block the estrogen from getting to any remaining cancer cells.

Except that it's "not as effective" as this other drug, which is given only to women who are definitely menopausal. And what is menopause? Medically speaking, he explained, it's terrifically difficult to identify. Even if the cycle has stopped, there may well still be estrogen in the body.

But at no time during this talk did he mention the recommendation to have my oviaries out alltogether.

At one point, I asked, "What is life like without estrogen?"

He said, "You've been living it since September" (e.g. when the chemotherapy threw me into "menopause.")

I said, "I gotta say, I was really looking forward to having estrogen back again."

He slipped into a special doctor tone called, "Help the patient see the big picture," as he said, "Look, I know this sucks. But as an oncologist I will never be able to tell you that there are no cancer cells in your body. There might be just one cell that is hiding, and 10 years from now, it will have grown to be detectable, and it would grow back in a place where you don't want cancer cells to grow. Given the size of your tumor and your young age, your risk for this is very high.

Estrogen coursing through your body is about the most dangerous thing you can have in your body at this point because your cancer is estrogen receptive. It will eat that estrogen and breed."

Sigh.

I told him, obviously, that Bryan and I would talk about it. Pray about it.

Bryan came home towards the end of the conversation and could kind of tell what the content was. When I told him, he cried and cried. We both did.

For him, it was mostly a child thing. We had hoped for a third. But number 3 didn't come along before the diagnosis. And we'd both been making the calculations of treatment schedules and time tables, and he especially carried a small hope that there'd be a window of time just big enough at the end of it all.

For me, it's a little bit of this. But more a grief over more loss. To be such a different person physically than I was a year ago at this time is still shocking. My figure is different, obviously. My hair is coming in gray. And now the chemical of a young woman will be gone from me.

We talked a lot about the recommendation. A clear and logical choice emerged. It's common sense, really. Just one little cell. Just one. It would be enough to kill me before the children we do have leave home.

And we haven't gone through all this treatment and surgery thus far only to stop short of completing a necessary step.

But.

But, but, but. . . This is a pretty big thing to choose. We're smart people, but we're not smart enough to know what is right for my body, my future health, our future family. We just don't have the knowledge we'd need to know for certain.

So we prayed that God would confirm the decision for us. Sometimes, all God gives is our common sense and faculty of reason. If this was all we'd have for this choice, then. . .OK. But we prayed on Wednesday and Thursday that He would let us see His hand on this plan. Or, at the least, that He'd work to stop us if my ovaries are to stay in.

On Friday, I talked to Dr. Markus again. This time it was a clear connection, and I had my questions lined up.

Q: Why had he not mentioned this earlier?

A: Because this is normally a conversation he has with a patient after 5 years of tomaxifin. It's standard protocol.

Q: So why now?

A: Well. . . The director of some big shot national cancer research and oncology project just "happened" to be in town on Tuesday night to give a paper.

Markus went to it, know the guy, and the two met afterwards as old colleagues.

Markus "happened" to mention my case: young woman, huge tumor, estrogen receptive cancer, and this big shot guy said that it is his standard recommendation now to advise that the ovaries come out, especially if there are no plans to have more children. The benefits of not providing the cancer cells a food source far outweigh the downside of not having estrogen.

Then on Wednesday, Mayfield "happened" to call to discuss a few patients they have in common. And Mayfield "happened" to ask if I was having ovaries out as well.

It's peculiar that he had asked this. I talked to Mayfield myself to make the surgery appointment, and he said nothing of it. But since scheduling it, he had been thinking, "Maybe she should think about this. . ." and he wanted to know if Markus had discussed it with me.

Following that conversation, Markus felt really compelled to call me right away about it. Because, after all he "had just had this conversation with the guy at the forefront of this research." Hence the phone call on Wednesday evening as he drove home.

All of this we take to be God's confirmation. No such thing as coincidence, especially not with this kind of timing, following the timing of our prayer.

It's made a huge difference to know that we're not just going with common sense. If it's OK with God that we won't have more children, that's a lot easier to bear than the feeling that cancer has robbed us of something.

Neither of us is crying anymore. Truly. It's all good.

Speaking of which: I "happened" to be studying the following Scripture during the week that this happened. Romans 8:28-39. I won't quote the whole thing here.

But the key part of it in relation to this development is this:

"Whom He foreknew, these He pre-destined to be conformed to the image of His Son"

This has been the greatest comfort of all. It's not my destiny--my purpose--to hold onto my youth for as long as I possibly can. I've been pre-destined to become more like Christ. And if my ovaries have to come out, then God's promise is that He will "use (this) for the good to those who love God, to those called according to His purpose" (8:28).

As for the details:

Mayfield called today to confirm that he found a Gyn to do the procedure with laperoscopy while I'm already under. The surgery stays the same day.

"And I'm going to be there for the whole thing to make sure he does it right." Uh. . . OK. "I'm serious, Amy. I am extremely protective when it comes to you and I will be watching every last thing to see that it goes smoothly."

Another great comfort.

We remain as blessed as ever. And more joyful--honestly, seriously: more joyful--than ever before.