In 2015, I was seeing a gynecology nurse practitioner near my home. I was not good with keeping up with my gynecological health, at least for about 15 years or so? Maybe less, because I had some issues in my twenties and I was seeing a gynecologist that I loved. Unfortunately, when I got sick in 2001, my general health became front and center for me. I made the rounds of almost every doctor specialty there was, except for the gynecologist, seeking understanding and treatment for my new chronic illnesses. When I found out what was wrong and how I could treat or live with it
I had my final appointment with my gyn oncologist last month. It was a month late due to COVID, but I ended up going to the office to get a final physical exam. And to say goodbye to my gyn onc doctor. I don’t know how to explain what this doctor did for me, and not just in a surgical way of removing my cancer.
I actually met this particular doctor probably five years (or so) before my actual cancer. I’d been seeing a gynecologist near my home, someone new to me but in the practice I’d been using for a couple of years. I met with this new gynecologist, explained the issues I’d been having (odd bleeding patterns, major cramping and pain, etc). The doctor told me I likely had big fibroids that were causing my issues, and if I wasn’t “planning to use my uterus”, I might as well get rid of it. I was in my thirties and the truth was, I was not planning to use my uterus. But to have a doctor who had barely examined me, didn’t run any bloodwork or ask for any images (I had an ultrasound on file from one of the other doctors in the practice)…she was suggesting a traditional hysterectomy. I was shocked and afraid, and I remember her saying to me, “I’m an excellent surgeon, I got this. I got this, no problem, you’ll do fine.”
I’d never had surgery before, I had only been in the hospital once overnight for a combination of mono and strep throat. I was not taking any medications at this point (I was in a very medication-phobic existence), I was terrified of surgery, and I didn’t understand why she was so willing to rip organs from my body. At a first meeting. Yikes. So after I went home to think about it–and cry hysterically–I decided to get a second opinion. I went to the internet and researched the best gynecologists in my state, and found someone who had been rated in the top ten for most of the years those lists existed. Not only was he rated as excellent, he was also skilled in robotic hysterectomies, AND he was actually one of the few gynecologists who was also teaching the robotic surgeries, and was on the hospital panel for robotic research. And he was an hour away. And taking new patients.
I made the appointment to go see him, and when Hub and I went to his office, we were extremely impressed. Not that the offices were fancy–they were very homey–but that this very tall, big man, was gentle. He had a kind face, kind words, and compassion ooozed from every part of him. He did an exam, reviewed my previous ultrasound, and then he sat down to talk to both of us. As he spoke, he gave us options, telling us it was very appropriate to “wait and see” at my age and with my imagery. If we wanted to consider surgery, he recommended robotic, but he wasn’t convinced it was necessary immediately. I felt immense relief, and I said to him, “If it changes in the next year or two, can I come back to you? Will you see me again?” He smiled and it was like a reassuring hug from a relative. He told me he would be there, and they would keep my charts and I would be treated like his regular patients. No long waiting period, no new patient appointment again. We left his office feeling like we had a plan, and I was planning to get a regular gynecologist near home for annual exams.
I did get regular annual exams and the gyn knew about my fibroids. She kept saying if I could manage the pain and unusual bleeding, they would just keep track of the size of the fibroids. But a few years later, there was a new issue, and the gyn wanted to get a biopsy of my uterine lining. This was an out-patient procedure, but I was still terrified. I took no medication, they did the biopsy, and I went home to wait. I wasn’t comfortable, but the pain was manageable. The biopsy came back as benign, but my current gyn recommended a hysterectomy, saving my ovaries so I didn’t go into an abrupt menopausal state.
I knew I wanted to go back to the other gynecologist for a second opinion. I made an appointment and went with my test results. He agreed, saying he could do a robotic surgery where I would be in and out of the hospital the same day, and that recovery would be MUCH easier than a standard abdominal hysterectomy. Knowing his expertise and experience, I trusted him and went in for surgery 10 days later (uterus and cervix were being removed, because the cervix can actually regrow fibroid). He stopped in to see me before surgery, and then he came back later in the day before I was released. Both time he was kind but confident, just as he had been in our initial meeting years prior. It wasn’t an arrogant kind of confident, it was a confidence borne of training, experience, and hands-on knowledge.
I had a few follow-up appointments set, so that my incisions (internal and external) could be watched. After my first appointment, on a Sunday at dinnertime, our phone rang. It was him–not his office or his nurse–calling to break the news that the routine biopsy of my uterine tissues had come back as cancerous. It was very early, stage 1a, and he was confident that in removing my uterus and fibroids that the surgery had successfully removed the cancer. However, the type of cancer was estrogen fed and he wanted to remove my ovaries and tubes to get rid of the hormones and anything else that could grow tissue. The compassion was clear as I spoke to him, and his confidence in my ability to undergo and recover after another surgery made me feel relieved. The worst had happened, I had cancer, but he had taken care of it, and would finish the work in the second surgery, including a pelvic wash to test for any lingering cancer cells.
I managed the second surgery six weeks after the first. I was on the schedule for follow-up appointments, and I went with questions about how I was going to be followed for potential recurrences. The doctor spent as much time as I needed answering questions. He wrote notes for me, he drw pictures, he discussed percentages of recurrences, of metastases. He talked about “connected” cancer organs (breast and colon), he said he’d be seeing me every six months for five years, with CT scans every year.
At every appointment, he was kind and patient, compassionate, knowledgeable, current on new technologies and studies and medications. When my mother passed, he spent time with me, asking about her cancer and her treatment, giving his reassurance that it sounded like everything that could have been done was done. It was silly, but I looked forward to seeing him because I felt like I was getting a periodic dose of OK. You’re okay, you’re going to be okay, things will be okay. You will recover, you will do well, you will have a life to live. The drive to see him sucked, especially once my migraines recurred, but the appointments were worth it.
This past August was my very last appointment. I made him a gift (I crocheted him a uterus and fallopian tubes) and he said it was perfect. I was really pissed because COVID robbed me of being able to hug this person that had been such a big part of my adult life. He’d been my safety net, my cheerleader, my support system. I know it sounds weird, but now that it was over, I was sad and going to miss him.
I could continue to see him as a regular gyn patient, but the truth is there are many competent doctors I could see closer to home. And by letting him go from my life, it opens him up to other people who need him the way I needed him. Although I hope to never see him again, I do regret not seeing him again. Maybe I’ll change my mind in the spring, when I need to have an annual exam, so who knows.
I’ve been “released” from my cancer watch after five years of living in six month increments. I told my therapist I’m not entirely sure how to live without this safety net. There have been so may changes in the last four years, including losing my mother and my neurology nurse practitioner (another blog), and now my gyn oncologist. I told my therapist if she moves away, I’m not sure I’d recover from all the abandonment issues.
This turned out way longer than I expected. Thanks for taking the trip with me.