I really wish I had kept my broken genes to myself!

Apparently this has become like a sleeping pill to me.  This is the place I go at night, to sort out all the emotions of the day before I can try to find some rest.  I can’t imagine that will do anything to gather more readers, but it is certainly helping my sanity.

I am trying to find the balance, for both my daughter and myself.  The balance between being properly scanned and “on top” of all our countless risks, while not letting doctors take over our lives.  Because the truth is, they don’t know a whole heck of a lot about Cowden’s Syndrome.  Most of them don’t care to find out, and the few that do, well – I will let you know.  I think we have 3 between us that seem truly willing to learn.

So today I took Meghan to the vascular surgeon.  The same doctor that has embolized the AVM in her knee 4 times.  The same doctor who in February, right after the 4th procedure, handed me the name of a doctor in Boston.  “We just drained  30 ccs of blood from under your daughter’s kneecap.  I don’t know why it was there.  You should go meet with this doctor and see what he has to say.  He will likely want to put a scope under her kneecap after she has healed.” 

After ascertaining it wasn’t an emergency, but not something we should sleep on, we met Dr. K in Boston over the April break.  He examined her, without the CD images that I had pleaded with the NY doctor to send up 3 weeks PRIOR to our appointment.  He said he wanted to keep an eye on it, and to repeat the MRI/MRA in 6 months.

So we did.  And on Monday the PA who had been in the OR with the surgeon and my daughter 4 times tried to tell me there was nothing in her knee.

Today, armed with a 2 page report and the paper the surgeon gave me in February with the Boston doctor’s name on it, we went for our visit.

I am still confused by the number of inconsistencies that happened in one small room.  The surgeon began by taking back his concern from February and telling me he just wanted the Boston doctor to get a baseline on Meghan “just in case.” 

Which, I though to myself, I am sure is true because I definitely would have made a 5 hour drive 4 weeks after a double mastectomy if he was so nonchalant.

Then, he held to his story that there was nothing in her knee.  Even as I pointed to an obvious bump he told me it was nothing.  I questioned him on the report, the one that says there is a stable 2.8 x0.7cm mass.  He told me he reviewed the CD and disagrees with the report.  Even as I told him I found the report to be strikingly similar to the December report, he offered to sonogram the knee to confirm “nothing.”  On sonogram he said there is a gathering of tissue (do I need to define mass?)

So, he said to bring her back in 6 months.  They will reevaluate.  Then we will repeat the MRI in a year.

Have I mentioned I cry when I am frustrated?

Well somewhere about 10 minutes into the conversation, when he was busy changing his story and disagreeing with the report I got overwhelmed.  Shouldn’t have done it, but I cried.  Fatal mistake.  I now look like a complete ass, when that is his job.  And he does it better than I ever could.  He actually had the nerve to lecture me that I would make my daughter upset.  I still can’t believe I took that.  (Still stewing!)  AND, I shot Meghan th evil eye to keep her quiet and remind her of her manners.

I HATE the crying thing.  I have been working on it for years.  UGH!

You know I wasn’t crying because i was sad.  I actually was really relieved at the thought that no surgery was necessary.  I was frustrated by arrogance, lack of clarity, and overall lack of concern for my daughter the whole person.

See, no one else knows the tears she sheds about this damned knee.  The things she can not participate in, or the modifications she has to make just to avoid pain.  She does them effortlessly.  Every day.  No one knows except me.  And it kills me.

So when we were leaving I tried to find the bright side.  I said, “See, at least you won’t need knee surgery this year.”  To which my far too bright, soon to be 9 year old responded, “I am not sure. To me surgery makes it worse, and not having surgery means no one is going to do anything to make it better. Guess my knee is going to feel this awful forever!”

Now I could have tried to tell her that maybe it will be better by itself, but I respect her way too much, because as much as I would love to believe it – I don’t.

AVMs are difficult to deal with anyway.  When you combine them with a PTEN mutation, they are ridiculous to control.

Just one aspect of a multifaceted disease.

I really wish I had kept my broken genes to myself.

The phone call continued….

After I left off on the last post the “nice” man had the misfortune of coming back ont he line and reminding me AGAIN, that I had NO IDEA how difficult this was to work out.

I made him wait before he put me on hold again. “In the fall of last year my daughter and  I were both diagnosed with a rare genetic disorder that no one seems to have ever even heard of.  The few doctors who have, or who are willing to learn, have put us through every test imaginable.  In March I had a mastectomy to protect me from breast cancer.  I was pretty surprised to find I already had it.  Last Wednesday I had a complete hysterectomy.  I am 38.  I was told the risk of NOT having one was too great.  My 8 year old daughter has grown 7 cm in the last 5 months.  She has grown 2 shoe sizes.  She now stands 4 foot 9 and 73 pounds, and will not turn 9 until August.  Her endocrinologist, the local one – not the cancer specialist she sees for the thyroid – has tried to educate herself about this syndrome.  She examined my daughter and said it may be precoucious puberty, but it may be too early for that.  Sometimes a tumor can hide and mimic puberty.  I know a mom whose 8 year old has Cowden’s.  She is 22 now, but at 8 had ovarian cancer. They had told her it was precocious puberty.  We are at a doctor, for something, AT LEAST once a week, usually more.  So, if you think I am crying because I am weak.  Think again.  I am crying because I don’t want to yell at you.  I am crying because I am exhausted.  But, if you tell me one more time “I don’t understand” how difficult this is, I WILL explode.  You think it’s difficult to schedule.  TRY LIVING IT!  This is MY LIFE!”


Still Silence.

Hello? Are you still there?

The “nice man” on the other side of the phone says simply, “Wow. I had no idea.”

“I know.  But you do now.”

Yes.  And I am going to make this happen as painlessly as possible.  I will call you tonight. (HAHAHAHA I thought)

The phone rang at 5:30.  The breast sonogram will be today, right after the pelvic.  Someone from the breast imaging center will walk over to where we are to oversee.  The results will be available to my doctor by Tuesday.  It will be a long weekend, but we are used to that.

Maybe he is nice man after all.

“Please Hold…”

I bet I can finish this post before they take me off hold.  I have been on this call for 28 minutes so far.  I have been transferred 4 times.  Finally I cried.  That got me a sympathetic male supervisor.  Sympathetic in that he has left me on hold for 20 of those minutes, but has checked in on me 4 times.

How do I do this when I am at work?  Fortunately I haven’t been at work much, but I understand how people lose their jobs.  I am a teacher.  I can’t spend a period with my cell to my ear waiting to be off hold while I teach.  It just doesn’t work like that.

The breast ultrasound.  No one wants to do it.  I get it. She is 8.  It’s odd.  Get over it and do your damned job!  No one wants to be responsible.  Guess what idiots?  We have to check.  And if you know what a normal breast looks like – this shouldn’t be so tough.

Anyone care that I don’t want to do this either?  The reality of it makes me ill.  Anyone care that I am only 6 days out of major surgery, my anxiety is at a peak, and  haven’t even told her we are going yet?  Anyone else give a shit that this isn’t just a weird scheduling inconvenience?  This is Cowden’s Syndrome.  This is our life.

The man (the call is at more than 35 minutes now) just came back to tell me he hasn’t forgotten me, but this is a lot more than I think.  REALLY?  He is lucky I don’t take the time to tell him what I think.  Maybe he isn’t so nice after all.

I am still on hold….  This sucks!

Motherly Worries

Her bloodwork was Saturday – the bloodowork to check the hormone levels.  Wednesday I will take her for a pelvic sonogram.  They are still trying to figure out who will do the breast sonogram.  Everyone is afraid.  No one knows what they are looking for.  Major NYC hospital, and everyone is afraid.  It doesn’t instill confidence.  When you have a rare disease, no one knows quite what to make of the realities that we face.  But this is my girl and I will not put my head in the sand.  Someone will do it.

She danced this weekend.  It was her second recital.  She will not dance on Broadway, but to her proud parents her smile was worth a million bucks.  Her ability to move – courtesy of PT and Celebrex, and her award winning smile.  For a few minutes on that stage, she was just like everyone else.  Sometimes its nice to be “normal.”

In a few minutes I will call to schedule the next MRI/MRA of the knee to check on the “leak” from the femoral artery causing her AVM.  We will do that the last week in June, just in case she needs more surgery, there will be time in July.

Of course all that depends on the hope that our June 14th appointment to check on the thyroid nodules is uneventful.  “They are precancerous.  They will turn.  We just don’t know when…”  At some point she will lose her thyroid to cancer.  And we can only wait.

Sometimes its good to be home.  To recover from surgery.  To make some phone calls.  Sometimes it just lets the worry fester.  I can accept that I have this damn disease… but why did it have to mess with my girl?  As a new internet friend eloquently said – eff you Cowden’s!