Last week, I went to the gynecologist. Now, most of you know that "going to the gynecologist" for me is neither easy nor simple. I've been searching for that special-unicorn-doctor who understands endometriosis (like, really), understands hysterectomy, understands surgical and early menopause, and is interested enough in these things to actually actively manage them with me over time. And maybe is also nice to me. Special, special unicorn, right?
Well, thanks to another life-saving tip from Casey Berna, I saw a doctor who just might fit the bill. She primarily works with women with gynecological cancers but has taken a real interest in working with and supporting endometriosis patients in recent years. Very exciting.
This post isn't about her though. (And, the jury's still out on the Doc. I'll report back later.) This post is about the super special surprise that we discovered during my appointment.
Are you ready?
I HAVE TWO OVARIES.
It took about 20 minutes to find both of them via a very thorough transvaginal ultrasound; but it's true, there are two ovaries inside of me. Now, if you remember just last week, I diagramed my lady bits for you all. There was one ovary on the diagram. Because that's what I thought was in there.
I was wrong!
This isn't actually completely unexpected, and I'll let you in on the details. Going into surgery, the plan was to remove one ovary (we anticipated removing the right one, as all signs pointed to it being the most damaged), and leave one in (probably the left one), so I wouldn't go into early menopause. Now, once my surgeon was actually on the inside, things were much messier than she expected. Here's an excerpt from the surgical notes:
I was able to free adhesions of the ovary [on the left] and the tube off the ovarian fossa and the midline pelvis. Though on the right side, the adhesions were far greater than on the left. The fallopian tub was knuckled around and encompassed in peritoneum overlying the course of the right ureter. It was very difficult to distinguish the right ovary from the right fallopian tube. They were completely scarred together.
[Later in the report...]
On the right side, it was much more difficult because the right fallopian tube and the right ovary were indistinguishable. This took much time, but eventually I was able to remove the right fallopian tube and sent it off to pathology. It was difficult to even tell if there was a right ovary or if it was part of the specimen I had removed. Throughout the entire surgery there was some constant oozing from all of the fibrotic endometriosis.
(That last sentence isn't really about the ovaries, but it's my favorite part of the report. Constant oozing! Gross!)
Now, my surgeon was always very up front about the disastrous state of my right side and her inability to really know what the heck was happening in there. I don't blame her for this. She is a very good surgeon who performs this type of surgery many times a week. Endo makes a remarkable mess of everything; she did great work and I trust her as a surgeon. In the end, we both assumed/hoped that the right ovary had been removed, as that was our intention going into the surgery.
But, it turns out that maybe it wasn't removed. Or maybe it was partially removed and then it grew back. (Ovaries are crazy like that.) Regardless, there are two ovaries inside of me. One of them may or may not be a zombie ovary, back from the dead. Heres' my new inspiring diagram of the current state my insides:
Now, what I am annoyed at is that my surgeons office did no follow-up as part of the post-op to understand the current state of my anatomy. Performing a follow-up ultrasound so we can know how many ovaries are in there is not that hard, and should frankly be a part of the process. No excuses. No surgeon is perfect, but there are far too many women walking around not knowing exactly what's in and what's out. And that's unacceptable.
Moving forward, I'm not really sure what this means for me, or if it matters at all. My estrogen levels are being retested (and I was off the NuvaRing this time), and I will get those results, along with other blood work in December. I also, for the very first time, was given a cortisol testing kit to illuminate my stress levels and their impact on my overall health. In seven years of seeing doctors about infertility and related diseases, this is the very first time anyone has suggested that stress levels might be impacting my body. I obviously have a lot of thoughts on this topic, but I'll save those for another day.
In the meantime, welcome back from the dead, Rightie! Try not to fuck things up too much, you little zombie.