It's a good news/bad news kinda day...

I'm four weeks out of surgery now, and had my first big follow-up visit with my oncologist/surgeon down in the Bay Area today. There's good news, and some not-so-good news.

The good news is that *in general* I'm healing well, my incisions look great, my bladder function is almost back to normal, and I've been deemed strong enough to drive and do very gentle exercise, while still being on lots of rest.

The nasty infection I had in the vaginal cuff (basically the top of the canal where they folded it over and sewed it together after taking part of it out) seems to be resolved. I do not have any fistulas, which I was worried about. All the pathology came back clean and negative, including the pathology on two nodules of ovarian follicular cystic tissue that was growing into my sigmoid colon area! (no wonder I always hurt somewhere, huh?) I love it when doctors give me my own copies of the path reports.

However, the infection that I had at that evil vaginal cuff has led to what's called a dehiscence, or splitting open, of the top of the cuff. Basically, there's a hole leading into my insides, which isn't good! The doctor was able to see my intestines and bladder through the hole, but thank the gods, they are not prolapsing and attempting to escape at all. This is going to delay my "complete" recovery by a number of weeks, and will continue to cause me pain, which explains a lot. I'm to go see my gynocologist up here in Chico in 2 weeks to see that it's on the path to closing itself up, and then back to Dr. Pisani down in Mtn View just before Thanksgiving. In theory, it should be closed by then. In theory...

Once this nasty hole has healed, I will be having radiation treatments. Dr. Pisani is talking to the radiation oncology department up here at Feather River Hospital in Paradise, and it looks like I will get treated either there or in Chico or Davis. He plans to have me undergo both external pelvic radiation and brachytherapy, where very high-dose radioactive "seeds" or "rings" are placed internally, very close to the site. It allows a very high dose without subjecting the surrounding tissue to radiation damage.

The reason for the radiation is that one portion of the cancerous tissue that was removed was less than 1 cm from the "sidewall," for lack of a better term, with "extensive invasion" according to the path report, and that is closer than the doctor is comfortable with. The dissection was able to show how far it was progressing horizontally and vertically, but NOT in all the possible diagonal directions, if that makes sense.

Without radiation therapy, I have at least a 15% chance of a recurrance of the cancer. The way I understood things today, if I have the radiation, that risk goes down to <5%. I'll take a 10% improvement any day. My Medi-Cal program covers this kind of thing, so if it gives me even a 1% better chance, I will do it, no matter what it is. If I was much older, maybe my decision would be different, but at 37, I'll take the gamble on the better odds, despite the side effects.

And there WILL be side effects from the radiation-- I am not entirely sure what they will all be yet, but I know that general weakness, weight loss, nausea, fatigue and possible radiation burns are among the many fun options. I'll let all y'all know more on that when I know. Dr. Pisani assures me I won't lose my hair from this one.

I am very, very, very, very tired, achy and crampy after today's exam and massive time in the car, but I can do lots of resting for the rest of the week.

I THINK that is the update...I might be forgetting something, but if I did, I'll post it whenever I remember.

Now it's time for a little reading before I zonk out...G'night!