Well, since getting my period, life has been a little crazy. First thing Monday morning I was in contact with Cynthia at Dr. Evans office. She was very helpful with all of my questions and sent me an email regarding my cycle schedule. The daily schedule is a little overwhelming, but I plan to take things day by day.
She also scheduled for me to come into the office for the initial "cycle" visit on Tuesday, October 16th at 9:45 am. She also instructed me that Freedom Pharmacy would be calling me soon regarding the medication order that was not included in the Fertile Hope grant. Later in the day, Freedom Pharmacy called and payment for the medications and delivery was taken of. The medications were $635.00 in total. My insurance company decided that they would pay for one of the medications, and guess which one, the one that was only around $6.00 per pill and only 6 pills were ordered, let me see, $36.00 of the original. I wonder if I should send them a "thank you for your generosity" card?!? Anyway, they are sending the medications over-night via Fed-Ex since I was scheduled to start my medication cycle the next day, Tuesday.
Tuesday arrived and Clayton and I went to my appointment with Dr. Evans at 9:45 am. At the visit, she performed a vaginal ultrasound to see the state of the follicles and everything else. During this exam, she noticed a cyst on my left ovary measuring 2.11 cm. She stated that the cyst was growing due to the increase in estrogen in my body (if I understood her correctly). Anyway, at this point, she stated that it was important for her to know the location and size of the cyst so that when it came time to retrieve the eggs, she would not mistake the cyst for a follicle since they look the same on ultrasound. She said that normally we (being the patient and the doctor) would wait to continue with the cycle until after the cyst went away on its own or until it could be removed, but we do not have the luxury of time at this point because of my need to start chemotherapy. I trust the doctor and her recommendations, so I guess at this point the cyst size and location was noted, and the show must go on. After the ultrasound, I had blood drawn for analysis and I was also instructed in how to inject myself with the medication and how to properly prepare the medication before injection. The needle that I will use is the same as a diabetic needle which is small, so everything should go okay. They instructed me to begin this medication today. The only thing I had to do was to make sure that I took the medication at the same time everyday, so I decided that I would take it at night so that I would not be rushed in the mornings.
At about 5:30 pm this same day, I received a call from my physician. She stated that the blood work showed that my estrogen levels were higher than she had expected for this point in my cycle. My estrogen level was around 120 and she had anticipated the level to be at around 60. She told me at this point to hold off on taking the medications for now and wait for her to call me back. She said that she is determining what to do because the levels are elevated because of the growing cyst and also due to the fact that my cancer is ER+ and I have not yet started my chemotherapy regimen that would kill off any remaining cancer cells. So for now, the waiting game has returned. She said that she wanted to confer with a couple more of her colleagues regarding what to do at this point and she would be in touch with me later in the day, just DO NOT start the medication.
Dr. Evans called again at 6:30 pm. She said that she had decided that the cyst needed to be aspirated in order to get rid of the cyst and its associated cells. She said by doing this, and starting a different medication, my estrogen levels should drop and we would be able to start from scratch, the cycle all over again in about 3 days. So... she scheduled me for the aspiration procedure for 6:15 am in her office. She stated that this would be done with local anesthesia and would take about 30 minutes with an additional 45 minutes recovery time. By now, it just feels like, here we go again. Just tell me where to be and at what time, I will be there and do as I am told, but with questions asked, of course.
Well, as scheduled, we were at her office at 6:15 am. Clayton and I were both so tired, but the doctor had to be tired as well. She is such a busy lady. She took me back without Clayton and performed the procedure. I could see the cyst on the ultrasound screen before it was aspirated, then after the procedure, it was gone, just that simple. The only discomfort was when she numbed the area before the aspiration, but otherwise, definitely no complaints. I was then given a new medication to take that would "kill" my cycle, Cetrotide 0.25 mg (cetrorelix acetate for injection). I am to start today by giving myself injections, one a day for three days straight. We then have to return to her office on Friday, October 20th for blood work and then again on Saturday for another ultrasound and additional blood work. So, this has been added to the ever-changing calender.
And, if you remember, this is also the day that I get the biopsy results on the "cyst" removed from my face. Clayton and I went to see Dr. Martin Kay this same morning at 11:15 am. He explained to me that my biopsy results came back positive for basal cell carcinoma. He stated that if you had to have skin cancer, this was the best to have. It does not metastasize and is easily managed. He stated that he recommends a procedure called Mohs procedure. During this procedure, the area is excised in small portions and each sections is looked at by pathology, frozen section biopsy, once the area has clean margins, the area is stitched and the procedure is over. He said that it should take 2-3 hours. I explained to him my current battle with breast cancer, egg retrieval, and awaiting chemotherapy in order to explain my urgency is getting this taken care of on my face before my life gets even more complicated. He agreed, placed URGENT on the authorization request for the insurance company, and scheduled the procedure for Monday, October 22, 2007 at 3:00 pm. The way I see it now, just one more thing, and one step closer to being back on my feet again!!!
Today is Thursday, and I honestly do not have any doctor's appointments. YEAH!!! I get to be normal for a day. The things we take for granted. But for now, I am just enjoying my day off.
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