Wednesday, November 13, 2019

Teratoma

It's October 23 at 8 AM, and I'm having an ultrasound. I tell the tech that I'm there for irregular bleeding, some minor symptoms - that I'm worried my IUD might have shifted. I've put this off for too long - for one reason or another, it's been months since I decided to make an appointment.

A squirt of warm lubricant on my stomach, and there we go. It's strange, experiencing this without a baby on board. Things look different.

“What’s that big white blob?” I ask. “Is that my uterus?”

“No,” she replied. “Your uterus is right here."

"Can you see the IUD?"

"Yep, I can. It looks fine."

"So what is that big, white blob?"

"Oh - it’s all just part of your pelvis; the doctor will go over it with you. I’m not allowed.”

Within fifteen minutes, I'm back in the waiting room, reading my book. The doctor won't be in until 9 AM for the follow-up. I'm feeling very grateful Brian is able to watch the kids and guilty that I unexpectedly have this huge block of time to do nothing but relax.

A stream of easy-listening hits plays through the exam room speakers. The Band Perry sings, “If I die young, bury me in satin...” Two songs later, Joey and Rory: “But you’ll be okay on that first day when I’m gone...” Jeepers

Finally, at 9:25, the doctor enters, shakes my hand, and gets right down to business.

“You’ve got a ten centimeter mass,” he says. “That’s the size of a baby’s head.”

My mouth drops open. I hold my hands together to form the size of a grapefruit. “This is in my body?”

He's a young guy, long hair, casually dressed, and his demeanor is something between astonishment and amusement. “Yeah,” he replies with a smile. “It’s most likely a dermoid cyst- they’re full of hair and teeth and stuff like that.”

I am still slackjawed. "Whaaa-?"

He explains they'll do blood work today for cancer markers, then schedule surgery as soon as possible. “Because of its size, we won’t be able to remove it laparoscopically,” he says. “We'll make the incision at your bikini line. You’ll be in the hospital for two days.”

My facial expression has not changed. I cannot believe I have a mass of body parts sitting in my pelvis- completely invisible externally- and now to spend two days in the hospital? “What?” I must sound like an idiot.

“Some people get out sooner.”

“How did I not feel this in my body?” I hold out my imaginary grapefruit. 

He shrugs. “You must have a high pain tolerance.”

He shows me pictures of dermoid cysts. Disgustingly fascinating. Their alternate name is teratoma, from the Greek word teras, which appropriately means “monster.” Apparently, when I was just a plum-sized developing fetus, a germ cell (one of those delightfully versatile cells that can become any type of tissue as the fetus grows) attached itself to the wrong place- in my case, my ovary- and has been riding along ever since. And as ovarian dermoid cysts do, mine had begun growing in earnest during my reproductive years- though later, it occurs to me that it must have put on all its size since Mac’s birth.

I ask more questions:
What other symptoms can this type of tumor cause? Bleeding, cramping, bloating, weight gain, nausea, localized pain. (I suppose I have had most of those.)
Will my health improve after its removal? Laughing- Yes. (This feels like good news, since I haven't even been feeling that bad. Maybe I'll emerge from this with more energy in general.)
Who will do the surgery? I will- unless it’s cancer, and then we’ll send you to a specialist. 
How long do I have to wait to have it removed? As soon as the bloodwork indicates it’s benign, I’ll get you in my books; you’re looking at about two weeks. 
Can I have a tubal ligation at the same time? Sure. 
Will you be able to save my ovary? We are having a hard time getting a good image of it. I won’t know until I’m in there. 
You really don’t think it’s cancerous? I really don’t. 

I thought of more later:
Will I experience other health issues if you have to remove the ovary?
Will I be able to see the cyst after the surgery?
Should I not be exercising? What is the likelihood of torsion? Of rupture?

Driving home, I feel astonishment and bewilderment, as well as relief, horror, and amusement. Everybody laughs about the aunt in My Big Fat Greek Wedding- “Inside the lump he found teeth and a spinal cord.” I feel confident that the cyst will be benign; still, the idea of it is so disgusting. I want it out.

This doesn't have to be a big deal, I tell myself. I've been carrying on normally. Nothing has to change. But after the appointment, true to the power of suggestion, I discover I can very much feel the mass inside me whenever I move, and it makes me positively squeamish.

-------------

Two days later, after Googling my head off, I am in a more sober headspace. The stupid mass is all I can think about. I've told my parents and Elisabeth, but I don't feel like talking about it to anyone else. I'm now aware that a dermoid cyst grows relatively slowly, less than 2 mm per year, and I find myself focused on the same stupid deduction: this doesn’t add up and it’s probably cancer. The math isn't reassuring: I didn't have this mass less than three years ago, and now it's 10 cm.

I want those blood work results something fierce.

The office is working with me to schedule the surgery. Meanwhile, I recognize how much this ordeal is throwing off everyone’s busy lives. My parents, Brian, and Brian’s parents are all figuring out how to take time off. November isn’t exactly a great time for this.  We settle on November 19th for the surgery.
Thanksgiving is November 28th. When will I get ready for everyone?
Dad turns 60 on November 17th. What are we going to do for him?
This is totally derailing Brian's hunting season. 

I want those results. 

On Friday, I’m packing to leave for a church women’s weekend retreat. I’ve been looking forward to this for months, but today, I do not feel like going. Everything in me just wants to stay home, cuddled on the couch with my kids. I walk down to the barn to close the doors on Brian’s cooling buck, and I find myself crouched down on the concrete floor, crying. I can’t leave. My kids need me. I can’t leave them.

Saturday, October 26 - I'm at the women's weekend retreat. It's the first time our church has planned one of these, and it's amazing. Robyn is teaching us about inductive Bible study when my phone lights up quietly. I grab it and run out the door and up the stairs to the lobby. It’s my doctor. 

“You sound nervous,” he remarks when I answer the phone. “Don’t be. Your tumor markers came back low risk.” I know this test is not conclusive, but he explains it’s the best result I could hope for, until they can conclusively test the mass itself. He seems genuinely relieved for me. “So you’re good to go for the nineteenth,” he says. “Take it easy until then, and call or text me if you have any questions.” 

I feel like dancing. I text Brian. I head back down to catch the end of the teaching. As soon as it’s over, I beeline for my mom. When I tell her the test results are good, I'm surprised to find that I'm crying again, relieved tears this time. I don’t deserve good results, I think. Other friends are fighting cancer, and their families need them, too. But I am so very happy

Time to get comfortable with my monster baby on board. It’s gonna be a few short weeks until he comes out. I find that the word teratoma brings to mind the musical Oklahoma! and I discover myself frequently singing that theme song without realizing it.

Initially, I expect that the mass will constantly be on my mind, but as it turns out, I often forget it's there. I keep working out - Erin, Bayda, and I are completing the Morning Meltdown 100 challenge together - but no powerlifting, per the doctor's orders. Honestly, life seems so hectic and heavy that fitness has taken a backseat in general. I'm thankful for the challenge; without their accountability, I probably wouldn't be working out at all right now. The doctor told me no lifting anything heavier than 20 pounds - he surely doesn't realize I have a needy thug two year old who lives in my arms. I keep wearing Mac around, especially when he's sick and cranky. Life goes on, and people need you. It's reassuring.





I think about how this tumor symbolizes the apparent theme of my 2019- "hidden problems come to light." And those other life issues have a friendly little way of popping up during the wait for my surgery, so my mind isn't really on it. Frankly, I find myself looking forward to a good, long, anesthetically-induced sleep. Nana and Papa are coming all the way down from Charlevoix to help with the kids for a few days, and everyone is excited to see them- although last week Barrett spontaneously burst into sobs and, when pressed, explained that he was crying because: "I don't want you to leave - Nana and Papa aren't the same as you."

Brian's taking several days back in Montana to try to fill his tag, and while he's gone, it's prep time. I need to get my to-do list checked off, and it's about as long as my arm. (I'm keeping my fingers crossed that the recovery will be shorter than predicted because man, these days are busy enough when I'm quick on my feet.) He'll be back just in time for the surgery, and I'm planning for him to find the house immaculate, the laundry - shockingly - 100% done, the boys' school lessons printed and prepped, and everyone's extracurricular bags packed.

I'm excited to deliver this little monster. 

William at night

As I always do, I went up to check on William again before going to sleep. I turned off the story he was listening to and kissed him good night. Apparently, he had been doing some thinking, and needed to talk- we ended up talking for at least 25 minutes. I wrote down as much of the conversation as I could remember. (There was much more, and I get so frustrated at my memory that can remember lyrics to rap songs I learned in high school and not the random cute things I hear in present day.) When I finally came downstairs, Brian was like, “What the heck were you doing?” Talking to Will. “You should tell him you can talk in the morning!” 

But these things never come up in the day. There’s playtime and school and chores and chaos. There’s no chance to sit and spend half an hour talking to a little boy in the quiet darkness. And really, these nighttime conversations don’t happen often. I usually kiss him goodnight, reassure him that “it’s nowhere close to midnight,” and leave. So when he starts in like this, I pay attention. 

So, in short:

Mom, I’m a little bit afraid of God.

Why, buddy?

Because you know Mom, He could blow up the world with a snap of His fingers.

Well, He could, but we know He won’t, because the Bible tells us how the world will end. But it’s good to have a bit of the fear of God. It’s good to remember He watches and weighs the things we do. We obey Him because we know He’s watching us, and we love Him, and we want to do the right thing because we love Him. That’s called the fear of God. Do you member when I accidentally stole those donuts from Meijer? I really didn’t want to haul you guys all the way back into the store to pay for them.

But if you hadn’t, you would’ve gotten into huge, big trouble! The police would’ve come!

No, William, nobody even knew. Nobody would’ve even done anything at all. But I knew that God was watching and I knew it was the right thing to do to go back into the store and pay for the donuts. Even if no one else sees what we do, God sees it. And we need to do the right thing if only for the love of God. 

Mom, could God make our house fall down? Could He make my bunkbed lift up off the floor? Could He make the sun explode?

Yes He could, but he won’t do any of that. God gave us order and scientific laws. The changing of the seasons, the rotation of the earth, these things are predictable and orderly. God is not a little kid like you, you goofball. He’s not going to do crazy things on a whim.

But God sent his Son. And sons are little kids!

Oh Will! Jesus grew up, honey, into a man. He was around my age when he died.

Mom, why would God send people to hell who don’t know they’re supposed to believe in Jesus?

Will, I don’t think that’s true. I believe that everyone who wants to spend eternity with God will have that choice. The Bible says that God desires that no one should perish, and that God is rich in mercy. We don’t know much about hell. We just know it’s separation from God. And probably some people wouldn’t want to be with God. 

Mom - (referencing a weeks-old conversation) - how can you say that everyone is bad? We are good people! We don’t steal things! And there are really bad people who steal things! How can you say that everyone is bad?

Well buddy, we all have the potential for evil in our hearts. For some people, one little bad choice leads to another one, and then one even bigger, and before you know it, you’re doing all the wrong things. Other people were never taught how to do the right thing. What if you were born into a family where there was fighting and drugs and violence? And you didn’t have a daddy or mommy to teach you the right thing to do? This is why we need to fear God, and do the right thing ourselves, and have mercy on other people, and show them the love of Jesus because maybe they’ve never seen it before. You and I are no better than anyone else.

Mom, everyone says that the Bible is worth more than diamonds. A Bible costs like twenty bucks. How could anyone say it’s worth more than diamonds? Why don’t you wear a Bible on your finger instead?

Honey, it’s not the paper it’s printed on, it’s the words inside. They are precious and special. They show us the character of God and they help us to know the right thing to do. If I was in a jail cell - remember we read about Corrie ten Boom today? - if I was in jail like her, and I could either have my diamond ring or a Bible, I would pick the Bible. That would bring me a lot more comfort. The Bible tells us what God is like. That makes it really precious.

Mom, you know God could crush a rock like nothin’- He could even crush a diamond. Mom, can God do anything?

Nope. He can’t sin- He can’t lie- He can’t change. 

Mom, when did God make the world? 

I don’t know, Will. The Bible indicates that the Earth existed in the beginning. I don’t know when He made it. We can look at rocks to figure out how old they are. 

Mom, rocks are so cool. Is my crystal rock worth a TON of money? 

It’s probably worth some money, yeah - I don’t know about a TON, though. Maybe you’ll be a geologist someday, Will - a scientist who studies rocks. 

Mom, I think I know what instrument I want to play. The clarinet.

That would be really awesome, Will. But first you have to learn how to play the piano. 

I already know how to play the piano!