The Warning Signs

Ascites was my biggest warning sign.
What is Ascites? It's the accumulation of fluid in the peritoneal cavity, causing abdominal swelling. A few days after this picture I had a paracentesis procedure. They removed 2.8 liters of fluid from my abdomen, which was found to be malignant. 

Virginia

Warning signs started way before 2020. When we moved to Virginia in 2013, I started having bad gynecological problems. It started with extremely heavy vaginal bleeding. One time it was so bad I had to leave work because my uniform was soiled in blood. After going to the Women's Health Clinic at Ft. Belvoir I was diagnosed with adenomyosis. Adenomyosis is a condition in which endometrial tissue exists within and grows into the uterine wall. I had all the symptoms, heavy or prolonged menstrual bleeding, severe cramping, pain during intercourse, or blood clots that pass during a period. I had a few uterine biopsies but all came back benign. 

Other symptoms included painful intercourse, constant bloating, and pelvic pain. In 2018 I finally got a Mirena IUD (form of birth control) to stop my menstral cycle. 

Let's jump to 2020!

Lets jump ahead to 2020! This is where it all really begins. I went to my primary doctor because I thought I was in some sort of depression. I told her all my symptoms, even the thoughts I was having of driving my car off a bridge. It was serious and I really needed help. I dealt with these feeling for quite some time, but this was the first time I had a civilian doctor I felt comfortable talking to. She ran some blood work on me to check my hormones and thyroid. Needless to say, I was going through menopause at 44 years old, and I had hypothyroidism. My testosterone levels were super low, and my estrogen levels were at ZERO! I was not producing any. So January 2020 I started BioTe Hormone Replacement Therapy (HRT). It was a minor procedure where she would insert hormone pellets under my skin just above my glutes. Within a month I felt my energy level pick up, I felt happier, and most importantly I didn't have thoughts of driving my car off a bridge. 
I read the side effects of HRT, and I was willing to take the risk to feel better. I knew it increased my risk of cancer but I thought, "Ah, that will never happen!" I'm not saying HRT was the cause of my cancer. It was a risk factor. 

Warning Sign: Digestive Issues

In September 2020 I started having really bad digestive issues. Every morning when I would drive into work I would feel this incredible stabbing pain in my lower, right abdomen. It happened every morning on my way into work. I would be driving and trying not to run off the road because of the pain. It would only last a few minutes, then it would stop. 

THIS IS MY EMBARRASSING MOMENT: One day I had the pain so bad I didn't think I was going to make it. I knew I had to run to the bathroom once I got to work. I parked, ran as quickly as I could and once I got to the bathroom and pulled my uniform pants down I couldn't believe what I had done. I literally shit my pants! I had no idea until I pulled my pants down. It had to be the most gross moment of my life. I did my best to clean myself up, jumped in the shower, then went back home. Luckily I am an early bird and only one person was around. Maybe one day she will read this and understand what happened that morning.

That same day I made a doctors appointment.

The Run Around

1st Appointment: Was referred to gastrointestinal doctor for colonoscopy. Diagnosis: IBS

24 Sept: Colonoscopy was good. No issues per gastroenterologist 

2nd Appointment: Follow-up appt. Stomach was bloated and pain on left side. Diagnosis possible Kidney Stones. Referred to radiology for CAT scan

1st ER Visit to Methodist Hospital: Pain was increasing. Received CT scan. Diagnosis Constipation and mild Ascites (Red Light-HELLO people!) Gave prescriptions for Golytely to clear the bowel and magnesium citrate

3rd Appointment: follow-up appt after ER visit. No sign of kidney stones. Tested Ascites, said it didn't seem an issue. Diagnosis: Gas. Recommended OTC meds. Referred to Radiology for vaginal ultrasound

Received call: ultrasound was normal

ER Meds: Drank Golyely to clear bowel of constipation. Made Ascites much worse. Was in extreme pain. Could barely eat at this point.

2nd ER Visit: Another CT scan. Identified Ascites was evident. ER doctor called on call gastrointestinal doc to see about draining Ascites. Doc said no, to make appointment with Gastroenterologist 

4th Appointment: Saw Gastro Nurse. Was Referred to lab for blood work. Concerned about liver damage due to Ascites and possible autoimmune disease 

*Referred to radiologist by gastroenterologist for paracentesis to drain fluid and send to cytology for diagnosis. Radiology drained 2.8 liters of fluid for testing

3rd ER Visit: This time I went to BAMC (Brooks Army Medical Center). I was still in a lot of pain. Ascites started coming back. Diagnosis concerned about liver once again. Sent home, nothing accomplished once again. No mention of constipation

5th Appointment: Saw Gastro nurse again. blood work was fine. No liver issues. Possible autoimmune. Sent home

14 Dec, 6th Appointment: followup with gastroenterologist regarding Ascites cytology results: Diagnosis CANCER. Referred to oncologist that did not take my insurance. Requested to be referred to BAMC

*Called gastroenterologist to refer me for another paracentesis because Ascites was getting worse. Drained 1.8 liters of fluid. Constant vomiting started after paracentesis

4th ER Visit: Went to BAMC again. Received another CT scan. Diagnosis: Swollen Colon, severe blockage. Needed emergency surgery

*Diagnosis after oncology biopsies: Stage 3C Ovarian Cancer

More happened along the way, but I hit the main points of my run around. 

This process to diagnose me with Ovarian Cancer took 4 months of warning signs.  CT scans did not identify the cancer. A vaginal ultrasound did not identify the cancer.
It took emergency colon surgery to identify the cancer.

We need better screening for Ovarian Cancer! Majority of the time it is identified in later stages, just like mine.         

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