“There are moments that define a person’s whole life. MOMENTS in which everything they are and everything they may possibly become hinge on a single decision.”
― Jonathan Maberry, Rot and Ruin
Today I am remembering Sydney. And I am remembering the decision that would change my life.
One of my ovaries had a massive tumour in it, the other may have had one too but it was hard to tell at this stage. I was scared but I felt relief in finally knowing I wasn’t crazy, something HAD been wrong and now I was going to get it fixed. I was going to have surgery… the doctors would try and save the second ovary, they would succeed and then as soon as I started feeling better I would begin my own family, just a little ahead of schedule but that’s okay. I would look back many years down the track and bravely declare how the whole thing had been a blessing, fate had sent me a wake up call that it was time to get on with having my first child. It would be a tale I would tell my children about when they were older, the tale of how they almost ‘never were’. I guess at this stage, for whatever reason, I didn’t really understand that having a tumour meant I already had ‘cancer’…. I just had an ovarian tumour and they were going to take it out and I was going to be fine.
The royal woman’s hospital in Sydney was lovely, everyone was very kind. I was surrounded by loving family, flowers, support. I’d be out of there in no time. I was still vomiting every hour or so (up to four times each time) and the abdominal pain was starting to get very bad, none of the pain meds seemed to be able to touch it… but it was easier to deal with now I knew what was causing everything and I was getting it fixed.
Just before my surgery my surgeon decided to do some extra tests, notably, a colonoscopy. A precaution. My vomiting and abdominal pain were not consistent with ovarian issues. Probably nothing… but we just have to check. I thought nothing of it. The prep sucked. Tasted horrible and it was a long, long night on the toilet, but nothing major.
I understand colonoscopies are usually quite straight forward. I was given a drug that sent me off with the fairies. I vaguely remember parts of the colonoscopy, being told to please keep calm, gentle pats, a flash of something on a screen? Flashes of confused jumbled memory. But most of it is a blank.
I woke up in agony. I felt like I couldn’t breath. I was terrified.
Eventually things stopped hurting. I came back to earth. Become more coherent. From what I have learned since, just as a reassurance to anyone yet to get one, this isn’t normal, usually you wake up feeling fine. I think my issue is that because of the tumours I didn’t have much ‘room’ so all the extra air pumped in there was very painful.
I noticed people were looking at me differently, I didn’t understand. It was just routine right? What’s the big deal? Everything’s ok now, the pain has gone… it was just a bad wake up. Why is everyone looking like that?
A surgeon came to talk to me. I could see the pity in their eyes. This worried and confused me. The curtain was pulled and my partner held my hand. To be honest, I barely remember the conversation now.
The colonscopy. It found something. A primary. A big one.
I didn’t understand the significance.
So, I’ll just need extra surgery? That’s ok. Bit extra. That’s ok, right?
No. Look. It’s cancer. A primary cancer. You have metastatic cancer. It’s gone from your bowel to the ovaries. I’m so sorry.
Oh. But… wait. What about kids?
I’m so, so, sorry. No… no you can’t have kids.
It seems stupid now, but at that stage that was all I heard. The rest just went over my head. Not having kids was my worst case scenario. I was so busy coming to terms with the fact that I wouldn’t be a mum that I didn’t even process that having metastatic cancer meant I probably only had a few years left myself (if I was lucky!).
Eventually, over a few days I finally understood. I was stage IV. This was serious. This was a big deal. Forget about kids.
I might die.
The shock hit me like a tonne of bricks. The whole time after that was a blur. A haze of grief and confusion. I had test after test after test, never ending tests while they tried to get a better picture of what they were dealing with. I joke that I have had just about all the medical tests possible… but it’s closer to the truth then I care to remember. My partner stayed by my side every step of the way. To cheer me up, he bought some pretty paper and made me a new origami animal for every day I was stuck in hospital. It gave me something to look forward to. A break in the monotony. Soon the days added up and my room was full of origami animals, people started popping in just to see which new animal I had today.
Every day stretched into an eternity of waiting. I was aware of every passing second. The nights were always the hardest because there was no way to escape the thoughts, the fear. Every night felt like a year. There was a big outpouring of support, every day I got cards, presents, flowers, texts. My family traveled up to stay and they all rallied, they were amazing and I felt so loved. Some friends came out of the woodwork too and went above and beyond to show me they cared, others offered lighthearted cheer that probably did more harm than good, and others still just seemed to completely disappear. This is normal.
Despite all the love I felt distant from it all. I struggled with anger. Anger that this happened to me, yet everyone else was still fine. That my world had ground to a halt yet everyone else’s were still moving on like nothing happened. All I wanted was for the hospital to stop doing tests and start TREATING… I missed my animals. A friend went to visit them and sent me pictures and videos. I cried and watched the video over and over. I just wanted to go home. I became obsessed with the idea of going home.
One of the tests sticks clearest in my memory, I had to have the fluid drained from my abdomen because I had started having trouble breathing. The actual draining certainly wasn’t comfortable… but I was used to needles now. The real fear was the wait that followed. The fluid had to be analysed, and if it had cancer cells in it… I had weeks to live. If it didn’t, we had more time. Waiting for those results was one of the scariest things I have ever done. That small test would decided whether it was even worth pursuing treatment. That small test became the center of my universe. Would I live or would I die?
The fluid was clear.
I remember the joy. A bright spark in a dark time. My family and I rejoiced. I found I could still smile. I had an enemy I could fight now.
During the endless tests my surgeons had been taking their time designing the best plan. They were friendly, positive. Every time I spoke to them I felt more like I could fight this thing. My surgical gynecologist in particular was my hero. I idolised her, had complete faith. She would save me. She had to. A plan was made. Chemo. Followed by a Surgery where they cut out the cancers. All very straightforward.
Then everything changed. My uncle came to see me. He talked to me about an alternative. There is another surgeon at a different hospital. A surgeon that does a very different kind of surgery. A controversial surgery, but it might give me a better chance. I talked with my current surgical team. I loved them and I loved the hospital, but if a change could give me a better chance? They did not seem keen. The alternative surgery plan was extremely aggressive, extremely painful, risky. There is significant controversy as to whether it even works given that there is not a large amount of statistical research on it yet. That other surgeon was the only one in Australia that would do it, he isn’t well liked among other surgeons. The surgeon was Professor Morris and the surgery he does is called a Peritonectomy with Hipec. It is most effective for things like stomach cancer, but has been used in a limited capacity for colon cancer patients too. It is a nine hour surgery, known colloquially as the ‘grand daddy of all surgeries’, they cut right through your middle, pull out everything with cancer on it… but then they also rip out the full peritoneal layer… and then to finish things they pour hot chemo into the abdomen and flush it around for about 40 minutes. So. Ouch.
I felt safe with my current surgical team, but decided to go meet the other surgeon anyway. Just talk to him.
The hospital certainly wasn’t as flash as the Royal Woman’s. But the surgeon was charismatic, friendly, confident. I liked him instantly. He made me feel like this was something I could beat. However, I needed to hit it hard, my old plan was too conservative, it ignored the fact that there was likely peritoneal spread. Plus, the Hipec would get all the microscopic cancer cells. He could save me, I just had to have courage. I was convinced. He sent my partner and I on to meet his oncologist. The oncologist was blunt. Very blunt. The polar opposite of the Prof. Polite but impersonal. Businesslike. I asked him what my chances were with the surgery. Unlike everyone else, he didn’t evade the question, he didn’t sugarcoat it. I wasn’t used to this and it hurt.
With the peritonectomy surgery? Depends on your grade, but probably still less than three percent. Without it? Basically? Well. Zero.
I was in shock. I couldn’t breath. I am doing all this for less than three percent? Is there even any point? I am going to die. I am actually, seriously going to die. I fell into a black hole. I didn’t know what to do. I suddenly felt a terribly bad vibe about the peritonectomy, fear swallowed me up whenever I thought of the surgery. It was a big change to before. The original surgical team had made me feel so safe, so confident, I hadn’t feared surgery there and surely that means SOMETHING. My instincts telling me SOMETHING. But what if that safety was just in my head? Because the team was so much gentler?
The days that followed were excruciating. Haunted by those odds. Those terrible odds. I negotiated with the two hospitals. Both teams seemed to think the other teams surgical plan would not work.
It was an impossible decision. On the one hand, I had the Royal Woman’s with my amazingly supportive doctors, the loving team, the gynecologist that I connected with and trusted completely. The team that made me feel good, confident. It was a conservative route, but scientific, studied, careful, reputable. Safe. Why go down a dangerous experimental route unnecessarily? Can I even trust the other surgeon? Controversial reputations don’t come from nothing.
On the other hand, I had my radical surgeon. He was charasmatic, convincing. I didn’t like the hospital and I didn’t feel the same bond with his team because they forced me to see the harsh reality, how bad the situation was. I hated that reality, but did that mean I should hide from it? If I wanted to live, shouldn’t I try EVERYTHING? Take chances? I am young, I am strong.
In the end both teams said I had to be the one to choose. I didn’t know how. I changed my mind every hour. I didn’t have the medical experience to make a decision like this. How could I choose? When making the wrong decision would take my life?
In the end, my gynecological surgeon had the thought to bring in an independent adviser. He had worked in both teams, the ‘controversial’ team and the ‘conservative’ team.
Both teams are amazing, the adviser explained, both teams will do their utmost. But, look, if it were my sister… well I would want her to try the biggest route she could. Because when it’s like this? What do you have to lose. Both teams are trustworthy… the reputation is political, Prof is an excellent surgeon. He is experienced, you can trust him. So both your plans are good… but one is going to do a little… extra… go a little further… It’ll be harder… but… you know your odds aren’t great. Do you understand?
I understood.
It broke my heart but I left my beautiful team behind,the team that had made me feel safe… and signed up for a Peritonectomy. I still didn’t know if it was the right decision and I was so scared. But I was strong. I had to try to do everything I could. I didn’t ever want to be on my death bed and having regrets for not having the courage to take a chance.
I went home to prepare, to see my animals, to process. It was so good to be home.