The world of medicine is like a bubble. A lot of people THINK they know what goes on there, but unless you're down in the trenches it's unlikely you do. So here is my semi-anonymous blog, here to tell you what really goes on in the life of a medical resident.

Thursday, March 02, 2006

Sometimes, life just isn't fair.

There is a patient in the family practice where I work-- I'll call her Mary, since it's the most normal name I can think of right now. Her and her husband have been trying to get pregnant for several years. They are both in their early 30's.

(As an aside, I can't believe how many young, healthy people suffer from infertility these days... until about five years ago, I figured that anyone who pulled the goalie would inevitably get pregnant within a few months. Has getting pregnant gotten a lot harder in recent years or is this just another subject upon which I've apparently been burying my head in the sand?)

So back to my story. So Mary and her husband have been trying to get pregnant. A lot. They've both been investigated, and neither of them has any physical reason preventing them from conceiving. So they're still trying.

A few months ago, at a routine physical, Mary has an abnormal pap. Not "Oh-My-God" abnormal, just "Hmmm" abnormal. So she gets sent to the gynecologist for colposcopy (where they take a microscope of sorts and take a closer look at the pathology in question). She tells the gyne that they're trying to have a baby, and asks if they should put their efforts on hold while this whole cervix thing is being investigated. He poo-poo's her concerns, and tells her that 99.9% of the time this kind of thing turns out to be nothing.

Not so much.

Invasive cervical cancer. The good news? Largely curable with a cone biopsy of the cervix. But only if it's done right away, before the cancer has a chance to spread to the uterus. Because if it spreads, then she'd need a hysterectomy and any chance of biological kidlets would be gone. So pretty straightforward, eh? Send poor Mary for a cone biopsy!

But oops. Mary hasn't had her period since mid-December. Mary is pregnant with the desperately wanted baby that they've been trying so hard to conceive.

What a horrible situation. She could still opt for the cone biopsy ASAP, knowing that it could compromise the integrity of her cervix and put the pregnancy at risk. Or, she could hold off until after the risky first 12-15 weeks (when most miscarriages occur) and have the cone biopsy done then, knowing that there's no way to tell if the cancer would have spread to the uterus in that time frame. Or, she could opt not to have it treated at all until she gave birth, but the pathology showed a cell type aggressive enough to think that this option may put both her life AND the baby at risk.

My heart was breaking for Mary and the decision that she had to make.

In the end, she opted for what I would have done under the same circumstances. She opted for the cone biopsy. She had it done two weeks ago. So far, so good. But when I saw her today and asked her about her pregnancy, she said she hadn't thought about it... she was scared to death to grow attached to the little being inside of her, knowing that there was a good chance it would never see the light of day.

I don't know about you, but I'm crossing all of my fingers for her.

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Blogger Nikki said...

Man. My fingers are crossed, too. What a horrible situation to be in.

If there's one thing a medical education is giving me, it's an appreciation for how fortunate I am.

10:12 PM

Anonymous Anonymous said...

This same type of thing is happening to a woman on WB. She has been partially treated for uterine cancer and needs a hysterectomy asap. But, she opted to go for a baby and delay the hysterectomy until after the birth. She had a poor prognosis from the beginning. She is pregnant with twins.

Myself, I am 29 and have and advanced cancer and have had to make the decision not to have children,not because I can't physically, but because my 5 year survival rate is only 20%.

Cancer sux.

3:11 PM

Blogger Gabbergirl said...

That is horrible. How sad. I can't imagine having to go through that once you were finally able to conceive after trying so hard. I'm sending positive thoughts to poor Mary and hope that everything turns out okay.

5:52 PM

Anonymous Sandra said...

Cross my fingers, knock on wood and pray to God.

8:02 PM

Blogger ArizonaDB said...

Wow, its stories like that that make me scared about trying to have kids. I guess my wife and I have always taken for granted that when we are "ready" and want to start having kids we will be able to conceive.

I wish her good luck, and what ever decision she makes will be the right one for her and her family.

Desert Imaging

7:48 PM

Anonymous zole4 said...

Oh my god, I want to cry for her. I really hope it all works out, that her situation resolves successfully, and that her baby is born healthy.

My thoughts are with her and her hubby.

If you can, please update us.

8:14 PM

Blogger Charmsy said...

Oh my god. That is so heartbreaking. Gah, I bet it's those kind of situations that keep you up at night.

12:16 PM

Blogger Kim said...

Pray, pray, pray....
That's what I'm doing for Mary...

I always thought that 80% of women having unprotected sex would be pregnant within a year.

All I had to do was THINK and I was pregnant.

It seems infertility is so much more prevalent.

3:08 AM

Blogger MustangSally said...

Infertility is bad enough even when you don't have cancer. Very very sad. Definitely let us know the outcome if possible.

9:03 PM


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