Growing up, when there was a difficult time, my mother would always drop this gem: “God doesn’t give us more than we can handle.” I am going to amend this and say that life doesn’t give us more than we can handle. For the last nine years of my life, God and I haven’t been on too friendly of terms. That is to say I am not sure the religion thing is my bag. I have spiritual belief, one that resonates more closely with Mother Nature, but I do not think an all-powerful being dictates the biggest and smallest happenings of our daily life. In general, life is what we make it. It’s important to some people to know they have control over their own path, their own destiny, versus thinking some sentient being is pulling the puppet strings. I would rather be held accountable for my own failings or my own accomplishments than pass off a part of the lesson or earned reward to some other thing. We get what we give in life, nothing is free, and everything is possible, as long as we put forth the effort and make the best out of any situation. These are not easy lessons to learn, and they are certainly not easy to swallow, especially when something blows up in your face and the only one to blame is yourself. I’ve been there. And to coin the old cliché, I’ve done that.
This past week has been difficult for me. Not only physically, but emotionally and mentally as well. For those of you who have read my blog for years, or for those of you who know me personally, it is a well-known fact that I am a mish-mash of physical ailments. I have had six surgeries, to date. Two for removing complex cysts on my left ovary, and four for repairing a fistula caused by the weakening of my intestinal walls. Those surgeries all took place in a condensed time between the years 2007-2010. It’s been two and a half years since I have had to contemplate going under the knife. That is until this past Sunday.
For anyone who has had ovarian cysts, you know the pain is not necessarily overwhelming. It’s like a constant ache settling in the small of your back, running the width of your abdomen and gnawing away, steadily, as the hours pass. It does not become hard to bear, outside of the constant pressure that slowly turns to something more. The danger of ovarian cysts is not the pain. Most women do not even know they have them. And up until this Sunday I was unaware of the one growing on my right ovary, despite its remarkable size. The threat comes from the size the cyst and possible ovarian torsion. What is ovarian torsion? It is when the ovary twists due to some outside force (oftentimes a cyst) and it cuts off blood flow to the ovary. When this happens, the ovary slowly will die. When it can no longer get oxygen, it suffocates. If the ovary remains twisted for an extended period, the ovary will die and the woman can lose not only her ovary, but a part of the fallopian tube, as well.
I have always been aware of torsion. Having had as many cysts as I have, the threat of it has always been around. For years every time I felt pain in my lower abdomen I would become increasingly afraid that torsion was occurring and oftentimes go to the ER and have a doctor tell me that it was just another cyst, or that my colon was just too full (yes, much to my embarrassment, that did happen). After awhile I stopped being so afraid, because statistics told me that chances of it happening was very low. It wasn’t worth the financial woes of doctor and emergency room visits. I went through at least a dozen types of birth control to suppress ovulation, to prevent these cysts from occurring. You see, when a woman ovulates she produces a cyst. It’s a called a functional cyst. Problems happen when these cyst do not rupture like they should and continue to expand. Every woman gets functional cysts. It’s part of their cycle. My body, however, is unable to signal the time for the cyst to rupture. I have had upwards of fifteen documented abnormal cysts. Most have been on my left side. As a result, my left ovary is now about one-fourth it’s beginning size, having been damaged and partially removed with two different cases of complex solid cysts (one having been removed and given to the dermatology department at UIHC). It rarely ovulates anymore (I have Mittelschmerz, it is a German term that literally translates to “pain in the middle of the month” that refers to a medical condition in which women have severe ovulation pain, and oftentimes can tell which ovary they are ovulating from).
Why am I giving all this background information? This past Sunday I had my first experience with ovarian torsion.
Whenever I begin to feel pain that I associate with my ovaries, I try to grit my teeth and ride the wave of pain until it crests. As stated above, I have a medical condition that causes extreme ovulation pain. Sunday was the perfect time in my cycle for me to start experiencing pain, so when it suddenly came upon me, I wasn’t too concerned. I took Advil, as is customary for me, balled up into the fetal position, began my meditative breathing exercises and coached myself through the onslaught of pain. My mother has also been a wonderful teacher of getting through this type of discomfort. So has my dad. He has been a continuous advocate of subliminal messages. With the Advil consumed and my body position in a tight ball, I began to breathe in through my nose and out through my mouth, telling myself that the pain was exiting my body through my fingers and toes, that I was going to be fine, that this would pass like it always does. This, my friends, is how I deal with the pain. And it usually works. I try not to cry, though it is severe enough, because working myself up only increases the tension in my body and therefore increases the pain. It is important to get oxygen, as well, because it expands blood cells therefore decreasing chances of constriction, which can cause more pain. Remaining calm is key. And luckily, I had my boyfriend there to rub my back, remind me to stay calm, tell me how strong I was and that I could do it, even when I felt like I was going to break. I lasted about two hours at home before the pain became unbearable. Nausea was creeping up on me and the pain itself was not decreasing, like it normally does. Fear began to sink in, and finally when it burst through my mental wall, I asked Gabriel to take me to the hospital. On the pain scale, I felt like I was at a 15 out of 10. I knew something was wrong.
Throughout the rest of Sunday, and into Monday, many doctors complimented me on my pain threshold. When we got to the ER Sunday afternoon I would have been happy if someone would have knocked me out or killed me. The pain was so intense that I was gripping Gabriel’s shirt front and pleading with him to make it stop. At one point I believe I screamed help at the top of my lungs and began to ram my foot into the gurney to defuse the pain or at least make me concentrate on something else. Additionally, the nausea that began was getting to such a pitch that I was dry heaving into a plastic bag the ER nurse gave me, while tears were streaming down my face. They gave me three doses of Dilaudid before I began to feel any change in pain level. And even though they gave me high doses of Zofran (an anti-nausea medication) I was still vomiting. We waited several hours before I was able to get a CT scan where they found an ovarian cyst that was roughly 8 x 8 centimeters (or in the ER doctor’s words, the size a grapefruit, or for better visualization, three to four times the size of a normal ovary). This is by far the biggest cyst I have had to date.
After the CT scan I went to get an ultrasound where they concluded that torsion had occurred, but somehow in the course of the evening my body had found a way to untwist the ovary and a small amount of blood flow was happening. The doctor admitted me for observation overnight because I was at high risk for it happening again. The size of my cyst shocked even me when I saw it on the ultrasound. I have been witness to some strange and abnormal sights when receiving ultrasounds, but nothing prepared me for the sheer size of this cyst. It consumed most of the small screen, and when positioned next to my healthy ovary, it looked like a giant dwarfing a small spec of an organ. My only thought upon first seeing it was: “holy shit.”
The doctor’s discharged me on Monday with the instructions to take it easy and to give serious consideration to having yet another surgery to drain the cyst, and remove any excess tissue and possibly a part of the follicle on my ovary. No matter what decision I make, I need to keep hunting for the perfect hormone treatment to suppress ovulation. If the cyst does not dissipate on its own, surgery is my best bet. I would rather have them skim a small part of my ovary than potentially lose the whole thing if it twists again. I essentially am on bed rest because there is no telling what can cause torsion again, and if it happens, I have a higher chance of them removing my whole ovary and not just a small part.
I am twenty-seven years old. My left ovary can still function, but it is one-forth its previous size. And damaged. And now my right ovary is at risk. Many people have told me that I should not let this define me. Being a woman is more than having ovaries. A mother is not defined by giving birth. And I know they are right. And their words help. And who is to say that this won’t resolve on its own before I need to make a decision. And even if they take a small part of my ovary, that does not mean I cannot go on to have children of my own. Many women do go through these things and they do have children and they have become mothers (both by adoption and through natural birth). I know I am not alone in this. And I have so many people who support me in whatever decision I make. And knowing that helps.
My mom was telling me about a comment my dad made that resonated with her, and that has stuck with me. He thinks that for whatever reason I am dealing with these ailments, the physical pain, the mental anguish, the emotional ups and downs, now because he believes it is saving me from something in the future. I kept using the saying “whatever doesn’t kill you makes you stronger” this past weekend and week, and I think it’s true. Life is testing me, and getting through this creates a toughness that will help me in the future, whether it is through my experiences or even possibly being a support for someone else as they go through this painful process. Life doesn’t give you more than you can handle. It molds you into a stronger, more resilient person.