Cancer, Cancer Everywhere

No, I don't have an answer here. Saw the Urologist yesterday, one of the Washingtonian's "TOP DOCTORS" for a few years now. A bit chilly, not particularly friendly. Of course, my urogynocologist, also touted as a star in her field, was quite personable, and she totally missed the mass, so maybe personality isn't as important as skill. This guy found the mass with no effort and didn't even have to root around or make me hurt for it.

He says he feels confident it's not a diverticulum. That's in keeping with what my gynecologist (not urogynecologist) said, but he's in a better position to make that determination--he's a urologist, and he's seen the ultrasound results. He seemed lukewarm to the MRI idea, whereas my gyno and GP both want it done. So do I. He wants to do a cystoscopy (I was hoping he'd do it yesterday), and he wants to do it at the hospital so he can do general anesthesia AND do an excision of the mass, too. Get it out and get it to pathology.

That scares the shit out of me.

On the one hand, my brain cries that I want an oncological gynocologist, even though we don't know if this is cancer! On the other hand, this mass, whatever it is, is in the anterior vaginal wall, which means it's right up there with the urethra and bladder. One of the concerns my gyno had was not screwing up and damaging the urinary tract, so the uroligist is my guy, right?

Right?

He's got a gang of oncology experience, so he knows how to look for clean margins and keep track of what and where, and that was my concern with my gyno-that she'd be out of her league. So this is a good choice, isn't it?

Is it?

Shit.

I can't even express how terrified I am, how utterly tharn I've gone. I read and read and read, and nothing makes me feel any calmer or more optimistic. This feels bad, and I am scared half to death.

For now, I guess I hurry up and wait. My GP should be calling tonight so I can discuss this with her--I'm outta my league, maybe she'll have some insight about this approach, right? And then I wait on the insurance, make sure things are covered before the disaster hits. I'm already three grand into this, and that's before the gyno and urologist bills hit. Call it four grand. Add the MRI, surgery, and cystoscopy. IF those are clear, we can probably call it an even ten grand.

Oh, please.

But it's not just me. My beautiful Noodle-niece goes in for surgery next week for a recurrence of her thyroid cancer. She's 14 years old, and this is her second cancer surgery. If, at 46, I feel too young to be dealing with this, how's she got to be feeling? I'm scared for her, and I'm scared that, between the two of us, we're not ever going to get to see each other again.

How messed up is that, folks?

Another Doc-saster

So, before we left Utah, I went to see my gynecologist, get a clean bill of health so I wouldn't be looking for a new gyno right off the bat.

Or not.

The Nurse Practitioner, a nice lady named Mary, found a "mass in the anterior vaginal wall." 7 mm, give or take, possibly a urethral diverticulum. She described it as "firm, but not hard." My Gyno came in, rooted around, echoed Mary's opinion. Said it wasn't an emergency, but that, once I got settled and got my new insurance squared away, I'd want to see a urogynecologist. Not to be confused with a Eurogynecologist, who would likely charge less and serve wine and cheese.

Well, it turns out my new insurance plan only has one urogynecology office covered, and they were backlogged for months. So it was four months between Utah gyno and urogyno. I did make one attempt to see a local onco-gyno back in October, but he wouldn't see me because the letter from FEHB declaring me insured wasn't enough. He wanted a big wad of cash. Needless to say, I was utterly panic-stricken by the time December and my uro-gyno appointment rolled around.

Met my urogynocologist and fell in love. Well, not like that. But she was personable, warm, funny, and seemed absolutely competent. She got up there, rooted around, and declared me mass-free. Nothing there. My husband could still feel it?  Well, then, he was feeling something that was supposed to be there, and that's why they're husbands and not gynocoligists, right?  Sure, we could do a cystoscopy to make sure there was no diverticulum, but she felt confident there wasn't--it was obviously a cyst that had drained or reabsorbed. No worries! I made the appointment for the cystoscopy (for a month down the road), and felt a weight off my shoulders.

I got an inkling that weight was just hovering rather than gone when I had a menstrual cycle that lasted only 13 days. Yes, at 46, I am almost certainly perimenopausal, but that mantra has always stuck in my head--late periods aren't a problem, but earlier periods? See a doctor. So I wound up cancelling my cystoscopy appointment in favor of an appointment with my new GP to discuss my early period and possible fibroids. She did a pelvic (yes, that was something new and oogy), and concurred with my urogynecologist's proclamation that there was no mass in the anterior vaginal wall. Again, whew, right? She recommended I get a transvaginal ultrasound to take a look at the possible fibroids, and told me to get myself to a gynecologist.

Which I did. Today. And boy, was I right about the hovering weight. It's come crashing down in a big, big way, and I fear its many, crushing friends aren't far behind.

You see, there is a mass. Not only is there a mass, but my new gyno describes it as larger (1 cm) and very hard. If you've spent any time with gynecologists (or oncologists), you know those are bad things. You know that the moment she said (and she said it repeatedly) "VERY hard," she swept almost all of the more benign possibilities right off the table.

I don't blame my GP--she's not a gyno, and that made no difference, time-wise. But my urogynecologist? It's been a month-and-a-half since she told me there was no mass. I'd already know what's going on and be taking care of it (or coming to terms with it), had she been on the ball. But she wasn't. And maybe she would have done a better job of finding it if my Utah gyno's office had actually included NOTES about it in my FILE. But, according to the urogynocologist, there are NO notes in my file concerning a 7 mm mass in the anterior vaginal wall. Which is now, of course, a 1 centimeter mass, accompanied by uterine bleeding.

We won't even talk about the bastard who refused to see me because I couldn't cough up a bundle of money. That was almost four months ago. Four months this thing has had time to thrive.

Sunday, I have a pelvic CT scan plus an ultrasound scheduled. From there? Possible D and C for endometrial biopsy, visit to a urologist to make sure that any vaginal biopsy isn't going to screw up my urethra. And then who the hell knows, really? The treatments for vaginal cancer tend to be extreme, horrifying, life-altering, and often not particularly effective in the long term. So let's cross our fingers and clench our knees and hope it's not that, huh?

I love it here, you know. I was born here. I don't want to die here.