Another Scan, Another Problem

My illness is starting to feel like a long meandering river that you might see photos of in National Geographic Magazine, with a caption describing how it formed over centuries under the pressure of slowly receding glaciers. I know that probably sounds overly dramatic but the curves my body can throw at me seem endless. The farther I fall into life with chronic pain the more my body changes and the more I learn about the human body – my body especially – that I never could have imagined needing to know three years ago. Each test, scan, or invasive procedure reveals another unexpected facet of what could be THE SOURCE or at least a contributing factor to what is happening within me.

I recently had a series of appointments with one of my specialists. He’s the gynecologist who has been an incredible advocate for me. He managed many of my referrals, even though he didn’t have to, when I became his patient a few years ago, to make sure that I connected to the right doctors. He’s also the doctor who removed the offending growth from my pelvis last summer when it turned out that my MRI results were misleading and I didn’t have a rare congenital condition which could have led to the removal of most of my rectum. I suspect that as long as my pain continues, I’ll be in and out of his office a lot in the coming years.

The first appointment with him was at the beginning of April for my bi-annual check-up. After I detailed how things were progressing – or had not shifted at all – in the preceding six months and since the removal of my pelvic growth, he ordered some tests for me. He wanted to rule out the possibility that he missed any small growths during my surgery that could now be growing larger; or that the one removed was regrowing and causing me to have continued pain. The most dreadful of the tests he ordered was the abdominal ultrasound series. This ultrasound consists of two parts: an abdominal scan that starts near the diaphragm in the area just below my rib cage and works down to the lowest point of my pelvis; and a transvaginal scan, which requires the insertion of a condom-covered probe into the vagina. I dare anyone to guess which of the two scans is my least favourite – and probably so for most women. Just saying the word “transvaginal” makes my skin crawl, and having to endure the procedure with my existing pelvic pain feels indescribably cruel.

After having to reschedule the appointment for my scans because my body refused to cooperate long enough for me to make it to the hospital to have it completed, I was finally back in the gynecologist’s office at the beginning of June for my results. It was the same day I ran into the Doppelgänger of a former friend while trying to cope with some difficult feelings. Of course, the scan results added an extra layer of angst to that day. The best news was that there were no new growths clinging to the walls of my pelvis to cause concern, but images of my uterus told another story: the report detailed two objects in my uterus. The first is a small fibroid, a noncancerous growth found in the uterus that often appears during childbearing years, which my gynecologist said is so small it doesn’t merit much concern. Of course, my body being my body, there is another growth about an inch in size I do have to worry about, a uterine polyp. Uterine polyps “are growths attached to the inner wall of the uterus that extend into the uterine cavity. Overgrowth of cells in the lining of the uterus (endometrium) leads to the formation of uterine polyps, also known as endometrial polyps. These polyps are usually noncancerous (benign), although some can be cancerous or can eventually turn into cancer (precancerous polyps).”

This polyp could explain some symptoms I have in addition to my chronic pain that originated in my pelvis: my unpredictable and excessively heavy periods, and severe period cramps. My gynecologist believes that removing it can help to relieve these symptoms, which are probably my body’s way of trying to expel the foreign body in my uterus. So what are my options to deal with this inch-long polyp? I could continue to have it monitored at 6-month intervals to make sure it doesn’t grow or change in any other way or I can have it removed now. That’s right, more surgery. Because, although “[m]ost uterine polyps are noncancerous (benign)… some precancerous changes of the uterus (endometrial hyperplasia) or uterine cancers (endometrial carcinomas) appear as uterine polyps.” The procedure to pluck the polyp from my uterine wall can take place during day/ambulatory surgery, which means I shouldn’t have to stay in the hospital overnight. However, if my ongoing negative responses to physical stimuli and my body’s alarming reactions immediately after my surgery last summer are any indication I will most likely need to stay in the hospital at least one night for observation.

I have an appointment later this week to schedule the polyp removal and discuss the possible outcomes of the procedure. After the surgery, the polyp will be biopsied to make sure it’s benign. Then I’ll probably have a series of uncomfortable transvaginal ultrasounds scheduled to monitor whether the polyp makes a comeback or any others spring up. Plucking it out might not mean it goes away forever – there’s a rare chance it can recur –, but at least the physical symptoms, and the pressure and anxiety I feel while thinking about it taking up space in my uterus should lift – until the next thing shows up…

 

Billy Joel – Pressure