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Dr. M, Why would pelvic change doc's mindFrom: anonymous@obgyn.netSun, 14 Nov 1999 23:44:21 EST
Dr. M, I went 11/5 for surgical consult for a large (grapefruit size) mass that was discovered 10/15 on my left ovary (it wasn't quite that large then), presented with having constant pain in pelvic area, mostly left, but some on the right, persistent nausea, distended abdomen (although it is mostly soft) - I now look about 5-6 months pregnant and am 5'7, and did weigh between 125-130, although in the last month have dropped to 117, yellow cast to skin, although not deep like what we see in Hep B or cirrhosis (Hep screens were negative, liver panel borderline at that time), inability to really tolerate food - feeling very full after only a few bites, constipation (only during last few weeks) and horrid heartburn when I did eat (never have had heartburn before), some achy kind of pain in last couple of weeks in lower back, through hips, and upper thighs, and I run a constant low grade fever, never less than 99.6 and usually up to 100.8 despite taking the Percocet regularly which has acetaminophen in it. Ultrasound on 10/22 showed of course, large left ovary mass, mostly fluid, although some parts looked solid, with something called compartments (what are these?) which the radiologist report said could be suspicious. Also had informed him that my first cousin had died last year from ovarian cancer, and that in late spring my lymph nodes had all enlarged, although wasn't sick, and hadn't been sick, after following them for a few months and trying different antibiotics, removed 4 from shoulders up, which besides showing that they were indeed enlarged (all over 5 cm), no etiology as to why they were enlarged. I was so grateful not to have lymphoma or something, I didn't push for any further testing and they are still enlarged. Prior to the pelvic exam, my doc was talking about waiting and doing a repeat ultrasound in a couple of weeks, yada, yada, yada. We then did the pelvic exam - which was EXCRUTIATING to say the least - during which I was explaining to him that all of these symptoms started out so mild, that I they were easily explained away to thinking my ovaries were enlarged due to ovulating, thinking that I must be trying to come down with gastritis or something, to having been so busy working (I am a nurse) and no time to go to the gym, and was now 33, that I wasn't able to do my usual exercises that kept me toned. (In July of this year, actually had very very flat tummy, always have), but the symptoms gradually increased to where I had to take Darvocet for the pain, which didn't become continuous until several weeks ago, and has now reached the point that only Percocet has any effect, and sometimes, depending on how much I've been on my feet, even then it only turns it into a slight pain, but pressure, and from having to take phenergan at intervals, to having to take 12.5 mg every 4-6 hours, to now having to take 25mg every 4 hours, and urinating like one does when they are pregnant - very often, good amounts. (I knew I couldn't be pregnant because I had a TAH 12 years ago due to severe endometriosis, leaving my tubes and ovaries, which have never given me a problem since then). So this he already knew prior to the pelvic, and like I said, prior to the pelvic was talking about waiting, watching and doing a repeat ultrasound in abut 2 weeks. Immediately after the recto/pelvic, when I went back into his office, he had a total and complete change of heart, saying that he now wanted to do surgery as soon as possible. When I asked him what he thought, he told me, I guess as compassionately as possible, that he didn't want to scare me, or dim my hopes, but that he felt like we were not only looking at cancer, but that it has very possibly already became invasive. I was so distraught, and had that feeling like you're on the outside looking in, that I went brainless, and didn't ask a lot of questions after that, although we discussed the procedures, etc.... My question is this, what could it have been about the pelvic that brought such an obvious change? Can you guys really tell things like that just from a pelvic? I can vaguely remember him saying something about the right ovary, bladder, tissue, that combined with the ultrasound results, my phyiscal signs and symptoms and the pelvic, we needed to do the surgery right away. He did agree to give me this past week at home with my children, as they were out of school for the week, and considering what he had just told me, if his suspicions are confirmed, that not only would I be having major surgery, but would be sick afterwards to. He agreed, and has called several times checking on me, which I thought was nice. Surgery is this wed, the 17th, and is to begin laproscopically, with of course, opening me up depending on what he sees when he gets in there. Feels like he can remove the mass if it is an endometrioma, but says due to the involvement of the ovary as it shows on u/s, that probably wouldn't be able to save it, not that I'm even concerned about that. I guess I just can't understand what about a pelvic could make such a difference, when he already knew the signs and symptoms and ultrasound results prior to and was talking about waiting/watching, doing a repeat ultrasound in a couple of weeks. I thought maybe you might could enlighten me, as I don't know what pelvics feel like to you guys, or what something could feel like that could feel so bad that it could cause such a 180 degree turn around. I know no one can know until we get in there, but it does frighten you when the doc feels that way, because having worked with docs for over 10 years, and most of that time as a peds oncology nurse, I know you guys usually won't tell someone something like that if you aren't pretty sure, otherwise, it would be something like "well, there's a chance, etc..." He did mention the fact that it could possibly be an endometrioma, but didn't feel to positive about that. Couldn't that cause "spots" or whatever it is he felt in these other places? Thanks, and I apologize for this being so very long. Any response would be appreciated, and any advice would be too. As this has become quite real, quite scary, very quickly. My younger brother just died several years ago from cancer - Ewing's Sarcoma. And we of course have ovarian cancer in our family - but it's only in my female first cousins (2 have died) on my dad's side, none on their mother's side, and my paternal grandmother is 93 and as alert and healthy as I am, well, as I was, although great-grandmother died at a very early age, but no one knows why. Have a great day! Vicki
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