Wednesday, November 14, 2012

Does Everything Happen for a Reason?

Is it ok to say 'Everything happens for a reason' to someone who is facing a difficult situation? No, I don't think so either and yet many people have said that to me about getting breast cancer at twenty six years old. For some reason, I don't mind it as much when the person saying this five word phrase is a breast cancer survivor herself but regardless, I feel as though it's fine for me to say this or think it but when someone else says it I want to snap back with 'you have both of your breasts, don't you?' or 'You've never experience the wrath of chemo, have you?'.

I could go on about what people say when you have cancer (actually, I have gone on about it, many times) but instead I want to share a story with you that has made me a believer of 'Everything happens for a reason.'

About a year or two before I was diagnosed, I went to a nutritionist to discuss my weight. Within about 10 minutes of discussing my life, my weight and my lifestyle she had said that she thought that I had something called PCOS (Polycystic Ovarian Syndrome). In order to find out for sure, I needed to get off the pill for three months and get a blood test, neither of which sounded appealing so instead I just assumed she was right and looked into it further.

Two of the most common symptoms of PCOS are being overweight and rarely getting a period, both of which I had. While I was on the pill, I was getting my period of a regular basis but left to my own devices, I had maybe three or four periods a year. I came home after that appointment and did what any normal person does - googled the hell out of PCOS. I read that it was going to be very difficult to get pregnant because my absent periods had meant that I wasn't ovulating. I stared at the computer screen and cried. The more I read, the more I cried.

So what is PCOS, you ask? I took this right off of -
The ovaries, where a woman’s eggs are produced, have tiny fluid-filled sacs called follicles or cysts. As the egg grows, the follicle builds up fluid. When the egg matures, the follicle breaks open, the egg is released, and the egg travels through the fallopian tube to the uterus (womb) for fertilization. This is called ovulation. In women with PCOS, the ovary doesn't make all of the hormones it needs for an egg to fully mature. The follicles may start to grow and build up fluid but ovulation does not occur. Instead, some follicles may remain as cysts. For these reasons, ovulation does not occur and the hormone progesterone is not made. Without progesterone, a woman's menstrual cycle is irregular or absent. Plus, the ovaries make male hormones, which also prevent ovulation.

Anyway, I never ended up getting tested and just assumed that I had PCOS. I had prepared myself for a long road of pregnancy difficulties. What I wasn't prepared for was the unexpected obstacle that chemo was about to produce, or so I thought.

Fast forward to March 16th - my mom and I are with the oncology surgeon hearing all about my treatment. I ask if chemo will affect my fertility and she throws out a statistic of 40% - I only have a 40% chance of being able to have a baby after chemo. I burst into tears and the rest is a blur. I seem to black out for the rest of the appointment as I was trying to envision my life without children. I 'come to' in the parking lot as I laugh my way to the car (when things get really bad, I laugh, not intentionally, I think it's just my way of expressing pure frustration - some people cry, I seem to laugh) and saying 'mother f*cker' in too loud of a voice. My oncology surgeon referred me to a fertility doctor that I would see in April.

Keith and I head to the fertility doctor after my surgery but before chemo started. We discuss all of our options with the fertility doctor and I am sent for an internal ultrasound then sent to another doctor who reads the results.

Keith and I are sitting in Dr. C's large office while he reads my imaging results and we hear him say the word 'Excellent'. Keith and I look at each other and what I wanted to say was 'Don't eff with me here doc, I got enough on my plate. What could possibly be excellent in this situation' but I instead sat on the edge of my seat waiting for him to explain himself.

He started with, 'Well, you have something called PCOS.' I filled him in on my prior assumption, he said 'Well, it's no longer an assumption, you have it.' Okay, so?? He continued to explain that the average woman has 24 follicles on her ovaries and I had 60. It just so happens that it is the follicles that get damaged in chemo so even if fifty percent of my follicles get damaged, I will still have more than the average woman. Whoa, he was right, that is excellent!

He then said 'I don't mean to give you false hope but I really do think that you and Keith could have a healthy family after treatment without doing any preservation.' Holy shit, excellent was an understatement.

Months later, I spoke to an oncology fertility doctor and I told her about my situation and she told me about ovarian drilling. In EXTREMELY simplified terms, ovarian drilling is a procedure where a doctor 'damages' your ovaries in order to encourage ovulation. The way it was explained to me was, they go in and damage some of the follicles (because the 'poly' part of PCOS means 'many' and in many cases it means 'too many'). By damaging the follicles, ovulation is more likely to happen. She said essentially, chemo did what ovarian drilling would do for other women.

I kid you not, my periods came back about two months after chemo ended and I have gotten one every 28 days ever since - something that has never happened in my life prior to chemo. Needless to say, I am a bit of a believer in this whole 'everything happens for a reason' business.


  1. Holy crap--you're saying chemo may have improved your fertility?! I hope so and best of luck to you two.

    1. Ya, I know, weird, right? We have to wait another four years to test this theory, but yes, it could be the case.

      Hope you and Lenny are kicking ass and taking names!


  2. Oh my goodness Katie. I am reading this in tears. You just typed out what I've been through in the past 18 months.
    A year before I was diagnosed (so, 2 years ago now), we started trying to have another baby. I had stopped having periods - but was not pregnant. An ultrasound revealed the worst polycytic ovaries that my OBGYN had ever seen. This had never ever been a problem in the past. I wasn't overweight or present any other symptoms so he was totally stumped. I just had cystic ovaries that couldn't function. He tried 3 months of Clomid to get me to ovulate but the cysts wouldn't allow it. I finally went in for ovarian drilling surgery because it was the absolute last resort to clear up my ovaries. Well, it worked, and with the help of Femara (Clomid's sister pill), I got pregnant the next cycle. Only to have it end in an ectopic and be diagnosed with breast cancer 12 days later.

    All that to say that my cycle did return after chemo, and like you, I am getting it exactly every 30 days. It's insanity, like a reset button was pushed. A year ago (before my surgery) they couldn't get me to have a period at all. And now it's ironically coming like clockwork. I could probably attempt to get pregnant like tomorrow, but of course Tamoxifen poses a lil problem ;)

    I'm still fighting to find a doctor who will treat me/allow me to get pregnant in the next few years. Most I've talked to say it's not safe after breast cancer but I've found a few who are in my favor. I'm bound & determined to make up for that baby I lost.

    Sorry for the novel, I just wanted to say you aren't alone in this issue :) xoxo

    1. I should just ask for your phone number because we have so much to talk about...

      I am so sorry for your loss, that must have been so awful, I can't even imagine and then while trying to mourn him or her, you are then faced with a breast cancer diagnosis. Anne, you have been through hell.

      Here's hoping that somehow, we will have babies, once Tamoxifen is done and over with.

      I have met three other women who were on Clomid and then developed breast cancer. I am not suggesting anything other than could it be more than a coincidence? I have never tried to get pregnant so I have never taken the drug myself but I can say that I don't think I will ever try.

      I wanted to tell you that I have spoken to a few fertility oncology specialists who have told me that there is zero correlation between getting pregnant after breast cancer and a recurrence. And also, doctors are just starting to do extraction procedures in the middle of Tamoxifen (you go off of it for a few weeks, get your eggs extracted [you do have to take some hormones which is a personal choice], they make embryos with your partner's sperm, and freeze them). If your doctors aren't willing to look further into this, or are telling you that they won't do it, try to find a doctor who is up on his or her research because according to a doctor that I spoke to about two months ago, the latest research is saying that it's harmless to have a baby after breast cancer. I am not suggesting that this is right for you, but I have heard of women going through this procedure and it is possible so don't let anyone tell you that it's not.

      Thanks so much for connecting, I am so grateful that you took the time to comment...


  3. Haha, yes, we could have phone conversations for HOURS!! I am currently looking into a low-level-estrogen egg retrieval that ironically uses Tamoxifen. There is a Dr in NY who perfected the protocol so if that's my "safest" way to have a baby, then we'd do that & use a surrogate. Otherwise, I've been told I can take Tamoxifen for 2 years, get off of it to have a baby, and then take it for another 3 years. Lots of options. I've been told my risk of recurrence over my lifetime is 10%. And the Drs aren't sure what would happen to that number should I get pregnant. Yes my estrogen would be through the roof but that doesn't mean it would definitely return.

    As for the Clomid, I have my suspicious too. I have the BRCA2 gene, so I am like 80% predisposed to breast cancer all by myself. Well then throw in the fertility treatments and I think it DEFINITELY spurred something in me. I was getting estrogen & progsterone shots all the time to start/restart my cycle. So my hormones were sky high and all over the place.