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Which decision to make?

Dec 07, 2010 - 60 comments

I don't know what to do here.

Here is the story...I have a condition called VIN 3.  Basically it is dysplasia on the vulva area (some of you may remember I had this biopsied a while back).  It is most definately not cancer.  It is uncomfortable, and a fairly large area.

I have to have it removed.  This is done through laser, but is a bit more complicated then I had orginally been led to believe.  It means an overnight stay in the hospital, I will be put out, and my Dr. tells me a fair bit of pain afterward.  I am scheduled to have this done Jan. 13th.  Now, they wouldn't have done it if my pregnancy had continued, but due to the outcome, my OB/GYN thinks I should proceed and get it over with.  

I am not worried about the anesthetic (I have never had any kind of negative reaction) or the overnight stay.  I am not even worried about the pain afterward.  My mom is going to come for 2 weeks to help me out, help with Ryder, etc., and of course Warren is home after work and weekends.  What is bothering me is that my OB/GYN told me intercourse will likely be too painful for at least 3 MONTHS!  Warren and I are big kids, and again not a big deal except it means putting off ttc.  I don't want to do that.  They told me that the aftermath will feel much like a very bad burn, and I will require pain killers.  So it does sound like even attempting is going to be out of the question.

Now, I am not irresponsible with my health.  This is not currently a dangerous condition.  It's one of those things that IF left for 5 or 10 years might POSSIBLY turn cancerous.  I wouldn't leave it that long. It does however become more bothersome with pregnancy and while not unbearable is quite uncomfortable at times.  

So the question is, do I put it off one more year, or do I just get it done and over.  Honestly, if I decide to get it done now I might look into home insemination...another women on here did it and maybe that is the answer?  I know, I sound desperate, but I just don't feel like I can afford to put off ttc another 3 or 4 months.  I am going to be 42 in Jan. and have no idea how long that door is going to still be open.  Right now I clearly can still get pregnant and I want to take advantage of that.

I don't know what to do.  Warren said he is open to whatever I decide as long as it's not risking my health.  I would never do that.  I have a little boy and a husband to think of besides the fact that I do not want to battle cancer if I can avoid it.  So if there was any question as to how this impacts my long term health, it would be a very easy decision to make.  That is not the case though, and although my OB/GYN wants me to get it done, she is not overly concerned about waiting another year.

Opinions?

Comments
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1027304 tn?1333977006
by Alexis2358, Dec 07, 2010
You are in a tough position and I certainly don't envy it one bit.    I understand your hesitation in delaying getting pg, being 43 myself, I did want anything to stand in my way of that....however.....you really have to put your own health first and think of your current family...not the possibly in the future family.    Maybe this will wait 5 years to turn cancerous...maybe it won't.   If there is one thing any of us here on medhelp understand its that....there is NO exact science in the medical field.  

I would have the surgery, get it over with you so have peace of mind on staying healthy.    You can always do IUI for the next 3 months.

Good luck, I will be thinking of you and hoping for good news and good outcome for you.

127124 tn?1326739035
by have 2 kids, Dec 07, 2010
I think you should have it taken care of now.   As Alexis says you can't be absolutely sure it won't turn cancerous sooner than 10 years.   I know when you are trying to get pregnant 3 months seems like forever but it really isn't.  

I remember years ago someone came onto MH and talked about getting pregnant using a turkey baster so you could always try insemination yourself!!!!   You know I'm just kidding!

Everything will work out and you will make the best decision for you and your family.  Good luck!      

Avatar universal
by RavenT, Dec 07, 2010
Hey Amanda,

As with other things doctors tend to give us the worse case scenarios... Bad eggs... months of pain... no BD for months...

When I had my gastric bypass they told me the pain would be so bad i would be on morphine for days and maybe in the hospital for a week or with at least 3 days in ICU... I never touched a drop of pain meds except basic OTC and those I stopped once home.. I was in ICU for less then 12 hours and out of the hospital in less then 48 and only kept that long due to hospital policy...

You can choose and make choices about your own body... your own healing ability and how things effect you... Have you ever used visualization... My naturopath told me that the less pain meds I used the quicker I would heal... and that pain was just my body's way of telling me it was healing... I used visualization and 4 saying to help myself thru the surgery...

I would suggest you have the surgery and if the pain does last as long as the doctors say... and you and your DH play like kids then have fun and find interesting ways to the sperm where it needs to be...

1503363 tn?1461213106
by pooket, Dec 07, 2010
I think you should do the surgery and get it over with, like all the other girls said, I know everything will be ok with whatever you decide. you could do what alexis said and do IUI. well let us know what you decide to do.

764229 tn?1322523484
by Juliaschill, Dec 07, 2010
I am not sure what I would do, but I do wish you luck with the choice you chose and a speedy recovory from both the sugrey and the birth best wishes as always, Julia

377493 tn?1356505749
by adgal, Dec 07, 2010
Valid points.  I guess there is no way to be absolutely certain, and I 100% agree that I need to first and foremost think of my family as is.  I would never ever want to risk leaving Ryder motherless and I want to grow old with my husband.  It's just frustrating.  It's like one more stupid hurdle to jump.

I did however discover after my c-section that when I really really want something I have a pretty high tolerance.  Ryder was in NICU after he was born, and I had my c-section at 7:46.  I was in my room around 9:30pm and by midnight was trying to walk to the NICU.  They finally agreed to take me in a wheelchair, because one way or another I was going to be with my baby.  I would have crawled if I had to.  And the next morning I did walk there.  I refused the oxy they tried to  give me because it made my head fuzzy and I wanted to be able to hold him safely.  So I was motivated and was able to overcome the pain because of it.  Maybe it will be the same.

And honestly, I would research home insemination.  Dragon1973 did it and has journaled about it.  It worked for her.  

I guess I should just get this over, but what a pain and the timing could not be worse.  Right now it is scheduled, so for now I will leave the date in place.  Still, it's tempting to cancel for now.

Thanks for the input.  As always I appreciate it.  

377493 tn?1356505749
by adgal, Dec 07, 2010
BTW, this was new to me.  I do have HPV and know that cervical cancer or cervical displaysia is somewhat more likely for me which is why I am very on top of having regular pap smears, etc. But I had never heard of this.  I pasted this article in case anyone is interested.  If you have itching or skin discoloration, even what you think is warts that won't go away, it's important to get checked.  I never miss my physicals for this exact reason.

What is vulvar intraepithelial neoplasia (VIN)?

Vulvar intraepithelial neoplasia is a preinvasive skin lesion of the vulva similar to cervical intraepithelial neoplasia (CIN) or dysplasia, that can occur in the cervix and result in abnormal Pap smears. It is diagnosed on biopsy the same way that CIN is diagnosed, i.e., how extensive the abnormal nuclear changes in the skin are. If only the bottom third of the epithelial (skin) lining has these changes, mild dysplasia or VIN I is diagnosed; if the full thickness of the epithelium has abnormal cells, VIN III, also called vulvar carcinoma in situ, is diagnosed. Just like in the cervix, if these vulvar changes are left untreated for many years, some of them turn into an invasive cancer in later years. Therefore doctors recommend excising that abnormal tissue so as to prevent any cancer from developing.
How can I tell if I have any vulvar dysplasia or vulvar cancer?

Chronic vulvar itching and burning or a slightly raised skin lesion are the most frequent findings of this problem. Usually the itching has persisted for years with perhaps multiple treatments with various skin creams. Lesions may be pink, red, white or gray in color. About 25% of lesions are hyperpigmented, appearing darkened like a mole or freckle. These more advanced, but noncancerous changes such as VIN III (carcinoma in situ) or actual cancer tend to occur at older ages. The average age of VIN III is 45-50 years of age while that of invasive vulvar cancer is about 65-70 years of age. As you can see, it takes, on the average, well over a decade for the severe preinvasive stage to go on to cancer if it is going to.
What causes vulvar dysplasia (VIN) and cancer -- is HPV involved?

More than one infectious agent has been suspected as the cause of vulvar dysplasia. Herpes simplex virus, granulomatous STD infections, and human papilloma virus have all been shown to be associated. In fact 80%-90% of all VIN has been shown to have HPV DNA present. Interestingly, only 30-50% of invasive vulvar cancers have been shown to have HPV DNA in them. Some experts have postulated that patients with squamous cancers of the vulva can be divided into two groups that may have different causes for their cancers. Younger women (35-55) tend to have cancers associated with HPV infection and VIN. The lesions are usually multifocal over various areas of the vulva. Older women (55-85) have more of a history of vulvar inflammation, itching and burning for many years and lichen sclerosis, a whitening skin change. Their cancers are usually unifocal and do not show evidence of HPV infection or vulvar intraepithelial neoplasia changes in the surrounding tissue.
How likely is it for vulvar intraepithelial neoplasia (VIN) to progress to cancer?

Overall, studies have shown that only 4% of women with VIN have gone on to have invasive cancer. You must remember though, that all of these women received treatment for the VIN. In one small study, 7 of 8 women who had VIN III and went untreated, went on to have invasive vulvar cancer. It would seem prudent to treat all VIN lesions but being careful not to mutilate the vulva in the process since VIN is quite curable.
How is vulvar dysplasia (VIN) treated?

The mainstay of treatment is to remove all affected tissue with a margin of at least 2-3 mm of normal tissue around the VIN. For multiple lesions (multifocal), laser ablation is the most common treatment because it can destroy the abnormal cells without going too deep into normal tissue. For fewer or unifocal lesions, surgical excision is often performed to get a little deeper into the tissue and make sure there is not an early invasive cancer.
Is vulvar cancer easily curable or is it a "bad actor"?

Like many cancers, curability depends upon how early a cancer is found and treated. If a vulvar lesion shows less than a millimeter of invasion it is completely, 100% curable. If it invades more than 5 mm (about 1/4 inch), lymph nodes will already have cancer in them 40% of the time. Vulvar cancer spreads to the inguinal (groin) lymph nodes and when it does, it really changes the survival. Over 90% of women with vulvar cancer who have no lymph node involvement will live over 5 years. Survival at 5 years decreases to 75%, 36%, 24% and 0% in women with 1 or 2, 3 or 4, 5 or 6, or 7 or more lymph nodes positive for cancer removed at surgery. This poor survival is why doctors recommend biopsy of any suspicious lesion on the vulva to pick up a cancer early.




172023 tn?1334675884
by peekawho, Dec 07, 2010
Boy.  Tough decision.  Even if you have it done now, the home insemination might be too painful to attempt the first month.  And then you might face the issue, if you did conceive immediately,  of taking painkillers while early pregnant.  They might even use some steroids locally on the area to speed healing...then you might be worried about taking other meds for it.
So it might not be simple to do it and still ttc via insemination right away.

I understand your concerns with putting off ttc for several months, but having it done now and waiting 3 months might give your body a good chance to heal from your recent loss.  then you could move forward with a clean bill of health.

Waiting to do it is an option, but what if you have trouble conceiving, and in 10 months or so, are faced with the same question?

What does your doctor recommend?

973741 tn?1342346373
by specialmom, Dec 07, 2010
Well, I'll be honest.  I would put it off.  Yep, I would.  My desire to get pregnant would outweight taking care of it now and I'd always wonder if I did the surgery now and was out of commission for a bit and then if I'd didn't get pregnant (if I had to take the insemination route or didn't ever conceive) if I'd lost out on my chance.  I remember well the desire for that baby and the clock ticking and my peace of mind would say work on that first and do the surgery in a year.  You feel confident it will not turn cancerous during that time but the other is more of a mystery.  

That is my honest opinion and probably what I'd do.  

688845 tn?1325185836
by AmyG89, Dec 07, 2010
I guess I am going against the majority here but I would cancel the appointment for now. I really would. After recently suffering a miscarriage myself I know exactly how you feel with wanting to keep trying and I wouldn't want anything to get in my way if I could avoid it. I would give myself a time frame though. I would suggest to give yourself 6 months and if you are not pregnant by then maybe get the surgery over with. You can get pregnant clearly and you are more fertile after a loss so that would be my decision. Hope it helps and please let us know what you decide.

377493 tn?1356505749
by adgal, Dec 07, 2010
Honestly Peek, my Dr. has not really recommended anything one way or the other.  This type of condition does not turn to cancer all that frequently.  She does not consider me at high risk.  Higher then others without it perhaps, but not frighteningly so.  She also told me that this condition can be aggravated by pregnancy, and even if I have it done now, there is no guarantee I won't require it again, perhaps even several times in my lifetime.  

I absolutely would not ttc if I was on painkillers or steroids.  They did tell me painkillers would be necessary for a bit, but hadn't said anything about the steroids.  That is a new one for me.

Until recently I honestly thought that laser surgery meant a quick trip or two to the Dr.'s office...i don't know why I thought that, I guess i was thinking it would be like laser hair removal or something..lol.  So when they got into the details recently i was pretty surprised.  This actually has been booked for a bit, but when i found out I was pregnant obviously i was going to postpone it.  They will not do this while pregnant for obvious reasons.

Kay, that is the dilemma.  I don't want to risk being one of those few where it does progress quickly and suddenly I find myself with cancer.  But the reality is even if I never had it dealt with, chances are it would not become cancerous.  Now, i wouldn't do that, but putting it off is tempting.  I feel like I have time to take care of this issue, but my ttc timeline is not as long.  I have gone back and forth about 100 times on this and still can't make up my mind.

922048 tn?1387946184
by Sherri90049, Dec 07, 2010
Some of us are required to be on steroids throughout pregnancy to prevent immune related m/c. So I know that the risks from steroids are very low. (The weight gain is the worst part!) I'm not sure what I would do in your situation, Amanda. I did actually just take a couple months off for my fibroid surgery. It was 10 times worse than I thought it would be. So at first I was regretting it and telling myself that it really didn't need to be done that badly. But now that I have recovered, I do feel glad that I did it and got it out of the way. (In my case I think it might have helped my fertility a little by detaching one ovary which had been stuck to the pelvic wall.) Since they removed fibroids from the outside of my uterus, they said I would have to wait at least two months to TTC. At least with yours they aren't saying that.

I say go for it with the home insemination. Tons of women have gotten pregnant that way. There are expensive at home insemination kits. But on the internet you can find how to put a kit together yourself for very little money. Waiting 3 months is a little long, so if insemination will help you avoid that, then I think that's the perfect solution. I don't know if there is going to be a better time to do the surgery down the road. If you did conceive now and had your 2nd baby, I would think it would be even harder to do the surgery then. I'm just glad that insemination is an option for you! Or if you have coverage, an IUI would be the best! Good luck! Please keep us posted!

1415321 tn?1306973553
by blindbat101, Dec 07, 2010
Question -- is this particular surgery the only way to treat VIN?  Are there other alternatives which might be less painful that you could try and still ttc?  I'm personally one who will try just about anything to avoid anesthesia and invasive surgery (maybe because I've had quite a few surgeries) and would be looking for other alternatives -- if for nothing else but to buy myself time.  Given that the situation is not urgent and that you said you do not currently have cancerous cells I would totally wait.  The info you provided says that "some of them" turn cancerous after many years and that most women are 65-70 before it turns cancerous.  For me, that means there is very minimal risk at present, and that this is not something that is urgent in any way.  Obviously it's something to keep up with, but if there are no current cancer cells then why rush into it while you are busy ttc?  I would wait if it was me, and I would be hunting for alternative treatment of the irritation in the meantime.  I wouldn't risk wasting my best chances of ttc while waiting for a non-urgent proceedure to heal.  That's just me, but you asked for opinions  ;-).  

Hope you come to a confident decision and put to rest any conflicting feelings regardless of what you choose.

All the very best to you!
Linda

1021834 tn?1379295900
by naturschld, Dec 07, 2010
I would have to say I would probably put it off also.  Now if the dr was more worried; that might change my decision but weighing it out as it stands; I would lean towards what I felt was more urgent.  Just my opinion; good luck whatever you choose to do.  

377493 tn?1356505749
by adgal, Dec 07, 2010
I do have coverage for IUI, it's just that there is really only one fertility clinic where I live so the wait can be significant.  I honestly have no qualms about attempting home insemination...always up for an adventure..lol.

I thought about the new baby too.  Having this done with an infant and a toddler would also be challenging. However, I am fortunate in that I have a ton of friends and family that are and would be more then willing to help out.  It's not that I would be unable to function, just perhaps a little more slowly.  So I do feel confident I could pull it off with help.  My mother and my mother in law are always more then willing to come stay to help, and as I said I have a lot of friends who are there for me.  

Part of this is the fact that I know that being pregnant can aggrevate things, and I could wind up having this one now, then needing it again after another baby (note I  refuse to say if!  I am going to make this happen..told you I was stubborn..ha).

All of your input and comments are very helpful...I still don't know what to do though!  Sometimes I wish I couuld just get someone to make this decision for me.  

377493 tn?1356505749
by adgal, Dec 07, 2010
Blindbat and Natureschild...exactly!  If my Dr.'s were concerned there would be no question...I would do this as soon as possible.  As i said above, I do take the responsiblity to my family very seriously and would never risk my life to have another baby.  When I booked this, then found out i was pregnant again I asked all of those questions.  I have had this biopsied and it is not cancerous.  

The surgery is not really invasive.  It's painful apparantly, but it's is on the vulva, so nothing is being done internally, there is no cutting or anything like that.  They are burning the infected area off.  So while not pleasant, I am not really concerned about the actual procedure itself, just the timing.

And I always welcome opinions.  Many times I write these and someone points out something I had not considered.  So never worry about what you put here...even if you think it's not what I want to hear.  

172023 tn?1334675884
by peekawho, Dec 07, 2010
They would only use mild topical steroids if you had some difficulty healing, so you might not even require it.  The only reason I bring it up is to address all the " what ifs".   And what if home insemination is very painful right away?  I can't imagine sticking anything in there, no matter how small, right away.

I think it sounds like you are saying you want to wait on the surgery, which I can totally understand.  Go with your gut.  it's led you right before!

1439353 tn?1309291964
by Trying4Mommy, Dec 07, 2010
I wish you luck with whatever you decide....but I know if it were I, I would get the surgery overwith.  My Mother in Law has been battling cervical cancer since April of last year.  She is currently still undergoing chemo to get rid of a leison on her liver (all that's left of the cancer)....so this touches me a little deeper seeing what she has been going through.  I say get rid of it.  Get it overwith.  Good luck with whatever you decide!  

BIG HUGS GIRL!  XOXO

377493 tn?1356505749
by adgal, Dec 07, 2010
I really do want to put it off.  It is uncomfortable at times, but I can deal with that.  The only reason I am not jumping on putting it off is that niggling little "what if". What if my case is different and I find myself with vulvar cancer?  What would happen to my family?  It's a small "what if" as I do tend to put my faith in Dr's and science, and the research is there, but still...it's enough to give me pause and think maybe I should just get this over and done with.

377493 tn?1356505749
by adgal, Dec 07, 2010
Trying4Mommy, I am so sorry to hear about your mother in law. That is so hard.

If this were cervical, I think it would be a little more urgent (not sure, but I think so).  However, my cervix is clear and my pap is normal.  So I am ok there.  I think when it is on the vulva it is far less serious.  Not cancer, but the funny cells.  

1439353 tn?1309291964
by Trying4Mommy, Dec 07, 2010
Ok....and thanks for the kind wishes.  I wish you the best with whatever you decide....but if you do it now, there will be no more nagging "what if".....

Big hugs!

XOXO

Christine

Avatar universal
by brice1967, Dec 07, 2010
Not that you want to hear anything from a man in these circumstances, but if the "what if's" are something that are recurring thoughts, I'd get the thing taken care of.  If there is a chance that there could be cancer or it could become cancerous, I'd want to be as proactive as possible.  I understand the urge/want of a pregnancy, but this would be bothering me through the pregnancy.  Pregnancies are difficult enough, I'd see no need in adding stress to it especially with what you've already experienced.

(Dee Dee had numerous gynacological issues even before her pregnancies.  Both were considered somewhat risky.  AFter we decided that there were going to be no more pregnancies, she had a radical hysterectomy.  Dee Dee is the toughest woman I've ever seen....but after having her guts ripped out, she thought she'd die.  A couple of days later she felt a million times better, both the pain was subsiding and she knew that the potential for problems had been eliminated.  Nowadays her female health is far better.)

1191262 tn?1366766621
by enolia, Dec 07, 2010
I went thru about the same experience a year ago when my gastroenterologist said I was carrying HBV and need to have a lifetime treatement NOW, I was about to get married and that was terrible for both of us especially that we were dying for a baby and were not so young...Most recommendations were: do not get pregnant while on that treatment but we did it based on our dr recommendations and many women experiences even though the drug is pretty new in treating HBV, sometimes you feel like life is escaping from your control, it was so hard for me to decide if I should treat myself right away and have a baby with all the risks his health may take or have the baby first and postpone treatment...? Those equations are terrible, you have to go with your common sense and...have faith and keep hope?

What you are living is very tough but think about this scenario: You put your surgery off a year and ttc for the next 3 months with 'assume'' no success (sorry), how would you feel? I don't mean at all to be insensitive here but I believe you should take care of your health first, this will improve your whole physical condition and since you seem to get pregnant easily, why would this change dramatically after only 3 or 4 months wait? maybe less if you find ways (as suggested by other girls) I believe there is a part of destiny in all what happens in our lives. We just do our best guess and effort...
I would make sure though the surgery won't affect my fertility.

At the end, it is your health. Your family and yourself are the ones who will have to live with your decision. All the best and good luck.

803938 tn?1403751853
by Ecologic, Dec 07, 2010
Just saw your post.

I think that I would put off the surgery... by a year maybe? If the probabilities of cancer are very small, one more year probably will not change them? Surely they can do a biopsy routinely to make sure it stays OK.

If you can wait a little bit longer safely, then wait. Give yourself a date to do it if by then there is no baby on the way. 3 months is a lot when you try to conceive.

Good luck with your decision!

1169162 tn?1331235953
by nola0805, Dec 07, 2010
This is a tough one.  My first instinct would have been to wait, given the very low likelihood of it progressing to cancer (and the fact that your doctors are fine waiting) and given the more imminent ticking of the good ole biological clock.  Three months when you are approaching 42 might make a difference (my OB says that as we age, especially over 40, fertility can drop very quickly and is not a steady, slow decline - so a 3 month wait may have serious implications).  Then again, you seem to have no problem getting pregnant so waiting 3 months might be fine.  Also, home insemination is a great idea and a viable option for those 3 months, which reduces the main con to waiting.  

One factor to consider is given the fact that pregnancy can aggravate things, could you be in even more discomfort when pregnant?  Would it have any implications for a pregnancy or on your ability to be fully mobile when pregnant or to deliver vaginally if you wanted?      

To boil it down to the main points, I think the risk of the VIN turning to cancer is much lower than a risk to your plan of adding to your family (although that risk is still low), and this would have me lean toward waiting on the procedure.  Not to make this any harder, but the only thing making me lean toward advising to do it now, is my mother's advice of "which one would you regret more"  I am pretty sure that you would regret getting cancer more than not having another biological child. But, that risk is so, so low here - arghhh!!!  I see what a quandary you are in.  

Good luck with this decision.  I do think that in the end, either choice will be fine.





377493 tn?1356505749
by adgal, Dec 07, 2010
Nola, as usual you bring up excellent points.    Yes, it is likely I would be uncomfortable throughout the pregnancy. Even with this brief last one, the itching got worse.  But that is pretty much the extent of it...it's not painful, or at least hasn't been.  It is likely that a term pregnancy would worsen things, but I doubt it would make me unable to function or anything like that.  As for delivering vaginally, that is out anyway.  I had a c section with Ryder, so my OB is very against me attempting a vaginal birth, especially since they will most likely be very close together.  I am ok with that.

I really don't feel that there is much risk in waiting, nor do my Dr.'s.  When we found out I was pregnant last time they were not even remotely concerned about putting it off.  It is highly unlikely it will be problematic, although as with anything else, I guess there is a small risk. But I think it's pretty small.

Avatar universal
by teko, Dec 07, 2010
I think I might postpone it by about a year. But if you do that, you have to make a promise to yourself to get it taken care of after that year. No matter what!

Avatar universal
by sweetpea03, Dec 07, 2010
Why not write all the pros and cons down on paper.. then you can objectively see each side, which can help you make a decision. For me, I would take care of it right now and not put it off. I feel like with medical problems I've had, I'm always the one who gets things that intensify quickly if not taken care of. I put of a minor surgery before and then ended up having major surgery because of it. I would have more peace of mind knowing I am healthy and ready, then to ttc and put my own health in question. Just my own opinion.

1419501 tn?1320209910
by kellibubba, Dec 07, 2010
After reading your story me myself wouldnt get it done.. I have an early stage of cervical canser. Which requries me to have a pap smaer every month and when it does come back with something off i get a chunk of my cervix chopped off. And as of now i only have half my orriginal cervix.. I was told to get most of it taken off. But in doing that maybe wouldnt be able to have kids after. So after alot of thinking and thinking i have chosen to have my kids before i get the op done. As like you it MIGHT get worse. The drs told me that its not even 50% 50% but as a care giver she has to tell us the possibility.

My thinking is if its not getting worse and im not going to die i would give my everything to have kids. Then when this one is born i will have the op. If i cant have kids after thats ok. ill have two but if i can ill try..
ULTAMITLY its up to you..


377493 tn?1356505749
by adgal, Dec 08, 2010
Thanks again everyone for your input.  You gave me much to think about.  Sweetpea, I took your advice and made a list of pro's and con's.  I have decided to postpone this procedure.

I talked to someone today who actually had this, and it sounds like it is far more painful then I was anticipating.  She said it was morphine painful...to me that is the worlds worst painkiller..had it once years ago when I had bone surgery on my foot, and no thank you very much.  That isn't the reason I am postponing though, I mean, I will have to have it done eventually.  But if it is that painful it sounds like even home insemination will be out of the question for a while.  I just simply do not feel I have time to put ttc on hold.  Right now I still conceive rather easily...I have no idea how much longer that will be the case.  After much reading it really does not sound like there is any real danger in postponing this.  It is highly unlikely it would ever turn into cancer, and even if it did, not for a very long time.  The biopsy I had recently has already shown it not to be cancerous, and I am truly not that worried about it.  So it seems to make the most sense to put it off until after I have my other baby.  DH is in agreement, again, as long as there is no danger to my health.  And there truly isn't..I would never in a million years risk not being around for Ryder growing up.  Besides, no suicide wish here...I love my life most of the time.

So, that is what I am doing.  Thanks again, I appreciate you taking the time to give me your thoughts and your input. It all helped a great deal!

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by melimeli, Dec 08, 2010
Personally I would wait and get it done later... TTC is a ticking time clock and well we know how hard it is...

That being said after my full tummy tuck, breast life, lipo combo they said I would be sex free for at least 6 weeks...  ummm it lasted 6 days before we found a way to do it haha... even though there was pain, ummm when you are really into it pain is not always felt as bad hahaha  little devil I know....

anyway do what you have in your heart!

Avatar universal
by Allip77, Dec 08, 2010
Sorry that I'm late in seeing this but if your decision isn't final, here's my input.  I would do the procedure now.  The only reason I say this is because my best friend dated a man whose former wife had died one month after her one and only baby was born because a cancer that she thought she'd gotten rid of ended up spreading like wildfire during her pregnancy.  It was tragic, and I'm sure rare, and I hope it doesn't upset you that I shared that with you, but it changed my perspective forever about life; it's no guarantee.  She was 40.  You are lucky to have a son and a husband.  Even though you'd probably be just fine no matter what, I would not put your health or your family's future at risk.  

This is just what I would do.  However, I am 42 and I did "run out of good eggs" before I being able to have a second child so I know the risk you'd be taking if you delayed ttc.  If you do decide to postpone the procedure, I completely understand.  You have a tough choice in front of you!  Best of luck.

Avatar universal
by pertykitty, Dec 08, 2010
i would ttc now.  the drs are not concerned, and you dont have to haveit done right now.  there are chances in cancer by breathing the dirty air and drinking water from plastic bottles.  i dont have time to write anymore right now but i will check back to see if you change your mind

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by adgal, Dec 08, 2010
Oh Alli, how sad.  And no, of course I am not upset that you shared that with me.  I know you are just looking out for me.

The big difference is this is not cancer.  I have never had cancer or even any sign of it.  My understanding is that they biopsy this for the same reason they biopsy pretty much any small lump in the breast. Just in case, even though they never did believe it was cancer.  It is just very rare for this to become cancerous, and it just doesn't happen all that quickly even if it does.  And even having it removed now, there is a fairly decent chance I would have to do it again later on.  Which of course I will.  I would just never take a chance like this if I believed, or had any evidence that this was a problem.  

My regular OB found this at my 3 month post partum check up.  She took a biopsy. Even then she knew we were planning on ttc soon, and said nothing to persuade me not to.  She referred me to another OB/GYN who specializes in this (My regular OB is more an OB then a GYN, so she felt better sending me to someone who saw and did more of this sort of thing).  My first appointment with her was the day I thought I might have a BFP.  She was not even a tiny bit concerned.  

I don't have to see an oncologist or anything.  This is just one of those things that has in some cases been linked to vulvar cancer later on in life.  I have HPV, this is just reality for me, and one of those things I will have to live with. I am diligent and make sure I don't neglect any tests, never miss a pap, that sort of thing.  But as I said, if there was any chance this could be a problem short term, I would get it done.  I really would.  

Right now I am sticking with my decision to postpone.  I will discuss it further with the Dr. and if they feel that it is in my best interest health wise to have it done now, I will. But it just doesn't sound like that is the case.  And I feel like if I do not attempt that second baby now, I will always regret it.  

Thanks so much again everyone, always appreciate the input.

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by nola0805, Dec 09, 2010
It sounds like you made a great choice!!! Congrats.

Avatar universal
by Allip77, Dec 09, 2010
I understand, Amanda, and I'm sure you're making the choice that's right for you.   I wish you the best of luck, and I will be looking for updates!  (on the next baby :)

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by adgal, Jan 04, 2011
Just thought I would update this journal as things have changed.  I had a follow up with my OB after my D&C and also talked to her about this procedure.  Even though this is not a life threatening issue unless it turns cancerous (which is unlikely), she feels that given that it is stage 3, I should have it taken care of now.  Plus, it is uncomfortable at times.  So, I have changed my mind and will be proceeding on January 13th.  I only have to spend one night in the hospital, then my mom is coming to help me with the baby, help with meals, etc.  Warren can't really get any time off, and I need help for at least 2 weeks they said.  Chances are this puts off ttc until March/April at the earliest, but at least this will be out of the way.  I am nervous...not about the procedure as it's pretty straightforward, but about the pain afterward.  I have not heard positive things about how it feels afterward.  

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by specialmom, Jan 04, 2011
Thanks for the update!  I've been thinking of you and am glad that a decision was determined with your doctor's help.  The best thing then!  Wishing you lots of luck with surgery and that the pain is over exagerated from the stories you've heard.  Peace!

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by TrudieC, Jan 04, 2011
Amanda, hoping that all goes well.  You are an amazing woman!

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by AnnieBrooke, Jan 04, 2011
I'm glad you decided to go ahead.  I don't know why some miscarriages happen, nobody knows (so many are a mystery), but I would never want to wonder even in the back of my mind if my body somehow sensed that there was an issue and didn't want to cope with a pregnancy at the same time as this issue, so closed off the pregnancy.  I'm not saying this is what happened!!! (but being me, I would always wonder).  Good luck on the 13th!

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by mum2beagain, Jan 05, 2011
Best wishes Amanda, hope it is a speedy recovery for you. X

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by rockinrobin32, Jan 05, 2011
I had this..and had this procedure done years ago..it was not a big deal   I only had some minor pain afterwards, no pain meds needed though.  Was able to have sex in a month.  I would go ahead and have it done if I were you.  (my sister had this too)

I think you'll be perfectly fine..:O)

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by rockinrobin32, Jan 05, 2011
My situation sounded alot like yours.  It was found upon a checkup after having my second child.  I was terrified of the whole thing.  Later, I was like, "I was scared for this?"  I'm sorry nobody has had good stories to share with you on the subject but ofcourse everybody is different and have different experiences.  My sister did have this too...I just didn't know it until after the fact..when my procedure was already done.  I didn't ask around about it, I just did it.  We both had good experiences with the laser surgery.  So, please try not to worry.  You will be around in no time working on the next baby:O)

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by adgal, Jan 05, 2011
rockinrobin, I cannot tell you how much I appreciate the words of encouragement.  To be honest with you my biggest fear is that the pain will be so intense that I won't be able to try to conceive again for 3 months.  That is what the specialist told me. I also will not take narcotics if I can avoid them (I hate the way they make my head feel) and they told me I will require oxycotin for at least a week or so.  They made it sound pretty bad.  Now, I actually tend to recover from things quickly.  Years and years ago I had bone surgery which is also supposed to be exceedingly painful.  I did need to be in a wheelchair for a bit (it was on both my feet), but I was off the narcotics in 24 hours.  Same thing with my c-section last year.  I was up and walking in less then 12 hours, and only needed tylenol 3 for pain.  Even that I was off very quickly.  So I do hope that my recovery is like yours because quite frankly they have me scared to death.  I am not afraid of the procedure, or even of it turning to cancer as I know that is rare, but just the pain afterwards and having to put my plans on hold.

Thank you again for taking the time to write here.  Your words are very reassuring.

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by Cherie762, Jan 06, 2011
Hi

First I am sorry for your recent loss, I have been through that twice and it is not easy, As for your condition Im going to just be honest and say what I would do. I would have the surgery, in the grand scheme of things three months is not that long. The possible "what ifs" even if small percent , to me would be too worrisome.

Drs always over state amount of time to cover their rear ends..by this I mean yes it sure makes sense that anything in vagina after surgery for 6 weeks would hurt...Im CL of the hysterectomy forum and 6 weeks is usually the time when ladies can resume sex after a hysterectomy. so I sure am not a dr but be open to the possibility that 3 months may be a over statement.

I wish you the best and as someone above siad ( think it was peek) follow those womanly instincts, they will lead you to the right choice.   Also I would urge you to get one more opinion on this , dont feed the secon dr too much info as to what first said...it would be interesting to see if second said same...if that was the case Id be even more inclinded to have the surgery.

good luck and big hugs

Cherie

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by Emily_MHManager, Jan 06, 2011
I am way late to the party, but a friend of mine had this done, and while I don't know the intimate details of her life, I don't remember her saying it hurt that badly for that long.  Of course, everyone is different, and yours might hurt less or more, I know.

If you have one IUI place, and there is a wait, can you make an appt now for a few months down the road (or whenever they can get you in), and at least you'll be healed by then?  If you happen to heal faster, and can tolerate intercourse, and get pregnant, no harm done, and another woman can take your appt.  

Best of luck!

Emily

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by adgal, Jan 12, 2011
Thank you again everyone for the good wishes and the positive comments.  This thursday is the day!  My mom got here from Ontario today and will be here for 2 weeks.  I also have two very close friends who are currently unemployed who are going to help out....I worry a bit about my mom getting overtired as Ryder is a very very active baby...lol.  Warren is of course home 5 to 6ish every night, and home weekends.  So I have lots of help for which I am so grateful.  Funny...I am almost 42 years old, but when I need help, I still turn to my mommy...lol.  And you know what?  She never lets me down.  I am so grateful to her for coming out.  

I am nervous, mostly about the aftermath, although I don't like being put under. I have never had a bad reaction or anything, but still don't like it.  I guess no one does.  I will be so glad when this is just over.  Typically the anticipation and worry is far worse then the reality, and I have no doubt that will be the case here as well.

Then it's full steam ahead!  We have our appointment with the RE set for March 11th, and if all goes well, by this time next year I will either be awaiting the birth of our second child, or celebrating his/her arrival!  Warren and I laughed today...we almost have to have a second child in January.  His, mine and Ryder's bdays are all January, so if we don't plan this correctly, our next child will feel like the odd one out!  I am staying focused on this goal, and just looking at this procedure as one more step in getting there.   I just want it over!!!

Thanks again..the notes, pm's and comments on this journal mean a great deal to me.  It's always so comforting to know others are thinking of you, and some even saying a little extra prayer or sending a positive thought.  I appreciate it a great deal.

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by adgal, Jan 14, 2011
Well, it's done.  The procedure was yesterday, and I came home late morning today.  There is no question the pain is intense...it's not a whole lot of fun right now.  I am taking 2 tylenol 3 every 4 hours, and 1 hyrdromorphone every 4 hours, but 2 hours apart.  So tylenol 3's at 2pm and 6pm, hydromorphone at 4pm and 8pm.  So pretty out of it.  Also taking gravol as the narcotic makes me sick to my stomache.

The pain is not as bad as they said, but is certainly bad enough.  I am so glad it's over, and extra glad that my mom is here helping me out.  Right now I can't even pick up Ryder, plus am not comfortable doing things like bathing him etc. on all of these drugs.  

I keep telling myself it's a healing pain. Hoping to be off the hydromorphone shortly as I hate the way it makes my head feel.  I am so very glad it's over.  Thanks so much for all the ntoes and messages...you ladies are the best!

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by TrudieC, Jan 14, 2011
So glad it is done and you are now on the mend.  Give in to the drugs and just sleep and heal.  

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by peekawho, Jan 14, 2011
You are an AMAZING lady.  Please, don't overdo, rest up, and just let your body heal.  Visualize just as you're doing..healing pain.  

Sending hugs and good wishes to you.  Be well.

Peek

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by adgal, Jan 14, 2011
Thanks ladies. Peek, I thought about you this morning and all the other people on here living with chronic pain.  I cannot even imagine having this on a daily basis...I think I would go crazy.  I truly hope that for you and all chronic pain sufferers they find answers soon.  I have a much better understanding now of what that must be like.  

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by Helen72, Jan 14, 2011
Amanda,
I am glad the surgery is over and you can move on.  Hope the pain leaves you soon.  
Wishing you a speedy recovery,
Helen

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by adgal, Jan 16, 2011
Thanks Helen.  I too hope the pain is gone soon.  I actually expected today to be better, but it`s not.  The worse part is thsoe drugs make me sleep all the time and my mom is pretty much doing all the things for Ryder I would normally do.  I am grateful to her, more then I can say, but it`s so hard not being his primary care taker.  I miss bathing him and changing his diapers.  I know, weird, but I do.  Hoping tomorrow I can drop the narcotic and just use the tylenol 3`s.  I still won`t bath him by myself on them, but I will be more `with it`I think.  I can`t even cuddle in bed with him as it`s not safe while taking these meds.  Ok, I am being whiny I know.  Soon things will be back to normal.  I am having fun though planning his birthday party for next sat.  I can`t believe he will be 1 already!!  I think I am going to do a jungle theme, but we are keeping it simple.  About 10 - 15 friends and of course my parents are here.  Cake, ice cream and munchies.  I will put up a few balloons and streamers, get some hats ,etc. but nothing too crazy.  i cannot wait to watch him dive into his cake!!  So exciting.  

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by Helen72, Jan 16, 2011
OMG, Ryder is one and Anna will be 2 next week.  Where did the time go????
I am so excited for you and hope you will be able to enjoy Ryder's b-day pain and drug free.
Can't wait to see his birthday pictures!!!

Avatar universal
by spade22, Jan 16, 2011
Sorry you are in so much pain but glad to here you have had this taken care of and are now on the road to recovery!

Wow, ryder is about to turn 1!  They grow so,so, quickly don't they? Jazmine had her first experience with cake on her first b/day and had a major meltdown which I think was caused by too much sugar. Lol

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by adgal, Jan 16, 2011
Lol, he has never had sugar, at least not in any major quantity, so it should be interesting.  I ordered a large cake for everyone and a small one that he can dive into.  You all told me how fast time goes by, but it really is unbelievable.  It still feels like yesterday I was going in to labor.  Then other days it feel like he has been with us forever. I can`t remember what I used to do with all my time..ha.  Helen, what is Anna`s birthdayÉ  Ryder`s is the 22nd.

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by DollFacePR, Jan 16, 2011
Hey, I read in one of the girl's journal a situation similar like yours, her id is Dragon1973, and I'm enclosing the link of her post. Hope it helps

http://www.medhelp.org/user_journals/show/238956/SELF-ARTIFICIAL-INSEMINATION-For-those-who-want-to-know?personal_page_id=1186587



Avatar universal
by A_n_M_s_momma, Feb 04, 2011
This response may be a bit late but I hope it helps.  I too have had VIN 3.  I saw 4 different doctors about it and every single one said have a vulvar excision NOW as soon as you can get into the operating room.  It may be years or decades even before it turns into cancer that can spread,but it may be tomorrow.  They just don't know. VIN 3 is carcinoma in situ (cancerous cells that just haven't metastisized or spread).  I researched this issue thoroughly.  Take no chances with VIN 3.  Remove it ASAP.  I had a vulvar excision....very painful, like a horrific burn.  I had sex about 5 weeks later.  (Doc recommended at least 6 but I got to admit we just could't wait LOL).  First few times of having sex were really painful but it got easier quickly. Good luck with it.  In the grand scheme of it 5 weeks isn't a long time to wait to ttc but I know it feels that way.

Avatar universal
by A_n_M_s_momma, Feb 04, 2011
Just read that you had the procedure done, I'm soooo glad.  I know how painful it is and how hard it is to have a little one that you want to take care while you're going through all that pain.  I had it done when my kids were 2 and 4 and I'm a single mom.  All the mom's in my community stepped up and helped me take care of my kids for a few weeks.  The hardest things was not being able to care for the little ones on the pain meds.  Good luck with everything and I'm super proud of the decision you made.

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by adgal, Feb 06, 2011
Thanks A_n_M_s.  It has been a very painful recovery, but gets better every day.  I am glad it's over and done with and one thing I no longer have to worry about.  Curious...did yours ever come back?  They told me that is a possibility, and some women wind up having this procedure a few times during their life.  Good Lord, I hope not...not fun at all!  Glad all worked out for you.

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