My Private I

Neatly folded

The CA-125 tests came back within normal range.  However, my doctor forbid sex and exercise in the same breath as she explained that the results give us no certainty.

1. The CA-125 test only returns a true positive result for about 50% of Stage I ovarian cancer patients.

2. The CA-125 test is not an adequate early detection tool when used alone.

 3. The CA-125 test is more accurate for later stage cancers, making it a poor early detection method.

4. The CA-125 test should be done serially for best accuracy.

 5. Normal CA-125 levels can be a true negative, or a false negative result. Depending on what risk factors exist for the patient, follow-up tests might need to be conducted.

I'm officially follow-up. Somewhere tonight, sleeping in a file cabinet is a manilla folder denoted by a cryptic number code and inside, a stack of sonograms.  Abbreviated notes in the margin in thin black .5 ballpoint. Complex. Multicystic. Solid Mass.  And a definitely a question mark. But, I can't imagine trailing what word and where exactly.  I'm supposed to call and make another appointment for the week of June 5th but I've been procrastinating.  I've become so resigned to waiting, that impatience and worry have stopped their hand wringing.  They're still inside my head except they've grown tired.  Sitting neatly folded in my lap.

Inside Me

I got dressed up this morning for my gynecologist appointment- my second visit this month. White blouse over white spaghetti strap tank. Swirled colored Indian skirt that drapes down in a triangle, slits up the sides and sheer from mid-thigh to my mid-calf.  Brown leather sandals that show off my ankles and the top half of my first three toes. I even gave myself a pedicure. Put on eyeliner.

I tart myself up when I’m nervous. Either that or chew gum. Of which I did both today.

 Frankly, there’s nothing sexy about visiting your gynecologist. KY jelly spurts. Exam table stirrups covered in mismatched pot holders. Butcher wax paper. The blunt metal apparatus that penetrates, divides and retreats- a military strategy staged inside my vagina each year. I don’t wish upon any man the clenched teeth when-will-it-be-over mantra women endure flat on their back, legs spread eagle. Staring up at the ceiling tiles.

Three weeks ago, they found an ovarian cyst. Which after a two-day battery of gynecologic exams and blood tests monitoring my hormones, seemed benign. A fancy term for friendly.  Mine was the size of a mandarin orange. I assured that friend of friends had them in all shapes and sizes- grapefruits, cantaloupes, footballs.  It was no big deal. Fluid filled sacs co-existing peacefully inside us. Me. Best case scenario: It would go away by itself. Worst case. It wouldn’t. I’d be put on watch.

Today, an abdominal and vaginal ultrasound revealed that my cyst has morphed from a happy smiley blob to a dense, angry pod. It hasn’t grown much in three weeks but it’s dramatically changed appearance. Big or ugly are never good signs. My gynecologist suspects I may have ovarian cancer. The life-time risk of developing ovarian cancer is 1/70 or about 25,000 new cases each year.  I maybe that 1.  She ordered a CA-125.  CA125 could be a California vanity license plate or the name of an interstate but it’s also a tumor marker test for ovarian cancer. It’s not 100% reliable, but it’s an indicator that something is abnormal. Wrong.

It is often not possible to diagnose ovarian cancer for certain without a laparoscopy operation. Something my doctor sees likely for me.

The CA-125 results won’t come back until Monday, so I wait out the days. Commuting to work, attending teleconferences, making small talk. Eating food I eat but can’t taste. Listening to National Public Radio broadcasts about a world outside I’m suddenly deaf to because there is a crisis building. Inside me.