November 7th is the date set for my surgery. For this past week I’ve been trying to come to grips with what is going on with my body. On one hand, I know all the various studies and statistics surrounding my diagnosis and that surgery shouldn’t be necessary, even when you take my age into consideration. One thing I’ve learned is that doctors really pay heed to medical studies that give them statistics. Statistics are supremely important when it comes to diagnosis and remedy. Even though the vast majority of women my age who develop ovarian cysts never develop cancer, there is a reason ovarian cancer is called the silent killer. For starters, small “bad” cysts don’t cause symptoms. Minor symptoms can be ignored. If a woman has greater symptoms, they can easily be dismissed or misdiagnosed as other mundane things (IBS for one). By the time symptoms are obvious enough for a gynecologist to pay attention to, the cancer is already far beyond the early stages. Survival rates plummet.
When symptoms warrant it, TVUs (transvaginal ultrasound) are what gynecologists use to find the cause of problems. In my case, symptoms have been developing for at least a couple years to the point where now I have daily *ache in my lower right back, *cramp-like pain that sometimes wraps around my right side to my lower abdomen, *pain when walking *increased urgency to urinate, *interior pressure, *bloating in my abdomen *tingling in my legs *fluid build-up in my right foot (sometimes in my legs also). Sometimes at night, my right leg/hip aches so much it’s hard to sleep.
Although some of the symptoms are deemed “classic signs” of ovarian cancer, they don’t match the ultrasound findings. In fact, my doctor said “You don’t have any pain, right?” I stared at him in confusion. Did he not read my chart? “Yes, I do,” I said. That’s what brought me here to begin with. He had just explained to me the ultrasound findings: an almost 5cm “simple” cyst, aka “unilocular cyst” aka “functional cyst.” Functional cysts do not cause symptoms unless they are large (over 10cm.) Source: Cigna. 90% of unilocular cysts are < (less than) 5cm and 100% are < 10cm. Mine falls into the 90% range, being just under 5cm. The risk of malignancy in unilocular ovarian cystic tumors less than 10cm in women 50 years or older is extremely low. The majority will resolve spontaneously and can be followed conservatively with serial (multiple) TVUs. Source: US National Library of Medicine-National Institutes of Health. Other equally reliable sources state simple cysts are almost NEVER associated with cancer.
So why do I have symptoms where there should be none?
Instead of managing conservatively with follow-up TVUs, my doctor thinks a procedure called a Salpingo-oophorectomy is the best option. This is an out-patient lapriscopic surgery (very similar to the one I had in 2010) that would remove not just the cyst but the right ovary and fallopian tube. His reasoning is that my age and medical/family history puts me at greater risk for developing ovarian cancer. He isn’t saying that my current condition is suspicious of ovarian cancer (in spite of the neon-sign symptoms my wee simple cyst shouldn’t have) but rather that the “conservative” management of my gynecological condition is to prevent future development of cancer.
I’m going to wander a bit back in time and talk about 2014/2015 because these seem to be two key years in terms of my health. At some point in 2014 I had developed tinnitus in my right ear. I went to my GP in December, but he found nothing physically wrong, except my vitamin D level was very low. Around March-April 2015 I noticed that my hearing was quite diminished in that ear. I went to an ENT who performed a hearing test and tinnitus test, then ordered a brain scan for a suspected acoustic neuroma (a non-cancerous brain tumor). The test was negative, but no determination could be made to explain my “unilateral sudden hearing loss.” In late 2015 I had started having night sweats and foot cramps. I think this was associated with menopause, even though I never really had hot flashes except a few times this year. I also had pain in my ovary area, in fact I thought I had a cyst burst and missed a couple days of work. Further, I had intermittent pain in my hip that sometimes caused me to limp. Another odd symptom was sometimes my feet hurt when I walked. The foot pain eventually became persistent. About 1.5 years or so after my brain scan, I noticed my hearing was worse. I had read good things about House Ear Clinic, so made an appointment for another hearing test. This revealed that indeed my hearing was further diminished and I’d lost about 40% of word recognition.
As a side note, I want to say this sucks, especially at work or when out shopping.
Dr House (yes, that really is his name) didn’t recommend another brain scan, but said if I developed new symptoms to let him know. All the while, the symptoms related to my ovary continued. In mid-August of this year, in the middle of the night I woke up with severe vertigo and nausea. It was so bad, I couldn’t walk unaided. I went to the urgent care that morning and was given medication, etc, but the vertigo lasted for two solid weeks. (I still have intermittent dizziness, btw) I called the House Clinic (in Orange County) and told them I had developed vertigo. Was that something Dr. House thought was related to my ear problem? He referred me to an ENT here in San Diego — and I have an appointment scheduled in October.
I don’t know what to think about all of these unrelated physical problems, but I am looking forward to their mysteries being solved at long last.