Hello Dr. Goodman,
I am having extreme anxiety over the results of the ca 125 blood test. My story all began with a miscarriage in July of 07, I went to the ER during a vacation for nausea. It was so bad I could barely lift my head. The diagnosis was a pregnancy that was short lived, as before I had a chance to leave I started bleeding. The ER doctor ordered a transvaginal ultrasound and a fetus could not be detected, but I did have to simple ovarian cysts. I then was released and was told to see my doctor when I returned home to California. Upon returing home I went to Gyn and he thought that I had an etopic pregnancy and did emergency laproscopic surgery. He found a right ovarian cyst and drained it. The fluid was sent pathology and came back non-malignant. I had had slight pelvic cramping in the months previous to this with rather large blood clotting during menstration. My Gyn thought everything was fine and that was that. A month or so later I went to my family doctor for abdominal pain and symptoms of acid reflux. She sent me for a transvaginal ultrasound and a small complex cyst was discovered on my left ovary. Again my Gyn was informed and thought all was well. Well, I went for a second opinion in November. This doctor decided to do another transvaginal to recheck the cyst and he also decieded to run a CA 125 blood test. The ultrasound was normal, but the blood test came back elevated at 52.8. This doctor thought everything was fine and wanted to redo the blood test in Feb. 08. In the mean time he said it was fine for me to go on my extended vacation (which would be six months). I went to Maine to see my family. In Maine I contacted another Gyn and she decided to do another transvaginal ultrasound and ca 125 blood test. The ultrasound was normal, but the blood test was elevated at 41. She too said everything was fine and that the elevation not worrisome. I was put on depo and did not have the pelvic pain during that three months. Although the pelvic pain had subsided, I spoke to my new Gyn about laporoscopy to evaluate the pelvis, due to the ca 125. Prior to surgery she checked the level again and it was at 47. I had a lap on 4/29 and the only thing that was seen was a small patch of endometriosis in the cul de sac, which she burned during the procedure. She seems to think that this was the reason for the elevation of the ca 125. All was great for a month. Then the pelvic pain began again. I realize that during this time I am not on depo and this could be the reason for the return of the pain. Since November of 07 my menstrual cycle has been a bit off. I contributed this to the stress over the ca 125 being elevated and then the withdrawal from depo. I have had very irregular periods since coming off depo. For example, on day 15 of my mentrual cycle I started spotting. At first the spotting was red, but quickly turned to thick brown discharge. I went back to my gyn today due to pelvic pain that I have had on two separate occasions. Both being 15 days after I had a bleed. She seems to think that since the depo stopped the pain previously and the pain is happening on the 15 day that it ovulation pain. Does this sound right even though I normally did not have this pain prior to the miscarriage. Considering the numerous transvagianl ultrasounds, an abdominal and pelvic cat scan with contrast, a negative lap, and serial ca 125 blood tests without a significant increase in elevation, do you think that it is safe to assume that the pelvic pain is from ovulation? And in your opionion would the small amount of endometriosis found during the lap cause the elevation in the ca 125 blood test? Could endo still be causing pain? Your opinion is greatly appreciated. I am so stressed out and do not know where to turn.
Thank you in advance for your time.