Did you know that chemotherapy can send you into early menopause? Yeah, we didn't either. At our initial visit with the doctors they mentioned that we might want to talk to a fertility specialist but we didn't really understand why. With everything else going on we sort of forgot until my nurse navigator called one day and asked if I had made the appointment yet. When I said no she gently suggested that I might want to do that right away. She said, "You will want to know when your period will return, if at all." Wait, what? Ok... I guess I'll make that appointment.
We made the appointment for the same day my MRI was scheduled. We showed up in the morning and filled out some paper work. After a longer waiting room time than we expected, we were ushered into an office with a desk and two chairs—and a lot of clutter. A younger resident came and took some initial information from us and then we sat in the room and stared at the awards on the walls and the 10 year old magazines on the desk. Soon we were ushered into another, less cluttered room where we stared at more awards with the name of the doctor we were about to see. She had so many awards that they filled an entire wall and the ones that couldn't fit were stacked up in her window sill.
The doctor came into the room after a few minutes and introduced herself. She was bubbly and had the kind of strange personality where you later say, "she was really weird in all the best ways". Throughout our appointment she would say things like, "So your body will look at your eggs and say, 'Hey good lookin', you're a nice juicy egg, I pick you!'" It was nice to have something that was really hard for us to be presented in a bit of a lighter way.
|Bill and I making smooshie faces after I got my hair cut|
She explained to us how chemo attacks all fast growing cells, which we already knew about hair, bones, nails, etc. But we didn't think about the fact that eggs would also be fast growing cells. The chemo puts your reproductive system to sleep and if the eggs are destroyed in the process you may never get your period again. So if there was any chance we wanted to have children, we needed to make decisions now.
Our options were laid out in front of us, starting with freezing embryos or eggs. This procedure would cost around $18,000 just to harvest and freeze the eggs and because it is considered fertility preservation, it is not covered by insurance. If we chose this option and did decide that we wanted children sometime in the future, they would start the process with in vitro fertilization (if only eggs were frozen) or implantation (if embryos were frozen), which would be more very high costs. This just seemed like such a drastic measure to take when we are unsure about wanting kids. We're just looking for a way to not completely close that door.
The next two options are filed under experimental. First she told us about a drug called Lupron that basically makes your body think that it is going through menopause, which "hides" your eggs from the chemotherapy. It has very good results but you experience night sweats, hot flashes, and all the fun stuff that comes along with menopause (we did later find out that I'll have these symptoms whether or not I take Lupron, it's also just a side effect of the chemo shutting down that part of my body). This option costs around $800-$1000 per month and is also not covered by insurance, BUT they submit it to insurance to see if it gets covered and if not the drug company often offers you a better price (and sometimes its free). The second experimental option would be to go to Northwestern Memorial Hospital to be part of a study where they surgically remove one of your ovaries, cut it up into tiny pieces, freeze 80% for you and keep 20% for the study, and if you decide to have children they would harvest the eggs from the pieces of ovary to start the process of in vitro fertilization. This option would be free because of the study, but again, just a little drastic when we don't know what our future holds. The costs that would come later, like in vitro fertilization would still likely be expensive.
This part of our decision making has been the hardest on me so far. I already feel like I am losing so much control over my body, and the thought of possibly becoming post-menopausal at 34 years old just made me fall apart a little. Also having to make such a difficult decision so quickly was really hard on both of us. The night before our meeting with the fertility specialist I found some information on what to expect to happen to my body during chemo and I laid on the couch and sobbed. When we went home after the appointment—after being told that we needed to make a decision by the next day—I cried again as I relayed the information to my parents and my cousin on the phone. By that evening Bill and I had talked over every possible option and decided to move forward with the Lupron.
|I don't have any images of the MRI since Bill couldn't bring his phone in, |
but here are some animations of fruits and vegetables imaged in an MRI because it's pretty amazing :)
More here: http://insideinsides.blogspot.co.uk/
Back at the hospital after our fertility appointment, we had to rush to make my MRI appointment. First we had to stop into registration and then we had to walk down the hall to the the imaging center. They had me fill out some paperwork and then brought me back into another room where I was told to get undressed and remove all metal from my body. Bill came with me and had to leave behind anything that was metal as well as his wallet so all his credit cards didn't get erased from the magnets. As we were sitting in the waiting room a very drugged up senior woman came out of her appointment and told us all about how she needed to get sedatives this time because last time the MRI made her sick. It was a pretty funny conversation. The tech called me over and placed an IV in my left arm, then flushed it with saline. We were escorted back to the MRI room. She explained that the test would take 30 minutes during which I could not move at all. She then had me open my gown from the front and helped me crawl onto the machine bed and positioned me face down with my arms over my head and my breasts hanging through 2 holes in the bed. And of course, no appointment or test would be complete without 2 different people touching and repositioning my boobs.
I was a little concerned about my arms being over my head because my arms fall asleep very easily in this position, but I thought that maybe the angle they were at wouldn't be so bad. I was very wrong. It wasn't long after I was up in the machine that I started to get pins and needles. The tech had warned me against moving or squeezing the emergency ball they put in my hand during an image. You can tell when an image is being taken because it makes a VERY loud pounding noise (so loud that I had earplugs in). I laid as still as I could and tried to deal with the sensations in my arms while also trying to not having a panic attack from the claustrophobia-inducing space. I thought about how Bill was probably loving the sounds coming from the machine because it sounded like a really cool noise recording (and it ended up being the first thing he said to me when we left the appointment). But halfway through the test I just couldn't take it anymore. I waited for an image to complete and squeezed the ball.
The tech reached her head into the machine and asked if I was ok. I told her that I couldn't handle the pain in my arms, so she brought the bed down and out of the machine. She allowed me to lift my arms a bit and squeeze my hands but said that she couldn't reposition me because it would ruin the test and asked if I could handle just 9 more minutes. I took a deep breath and said I could. I was pushed back into the machine and tried to turn off the part of my brain that was focused on the pain in my arms. During the last image they injected me with contrast dye so an uncomfortable cold sensation also entered my left arm. I'm glad that I didn't have any sense of time during all this because Bill said it was closer to 15 minutes—not 9—before they finished the second half of the tests. When I came out of the machine my arms were completely numb so it was a little difficult to lift myself up off of the machine, but with a little help I was able to get myself into an upright position.
I was proud of myself for having gotten through that but I definitely dread the day that I will need to do another—probably in about 6 months to check the tumor again. It's incredible to think about how much all this testing has already become just a regular part of our lives and I am constantly amazed at our ability to adapt to this insane circumstance.