Life's full of surprises... as is your abdomen.

So, yesterday was the oophorectomy and the reconstruction continued (part 5?). I think at least 4 prep nurses came in, which was fine, since Dad and I are old hands at the pre-op prep. My name is Rica Mendes, I was born on June 20, and I'm here for thus-and-such procedure. I so wanted to tell one of the nurses, "My name is Inigo Montoya, you killed my father, prepare to die," but the last nurse to come in didn't seem like the "Princess Bride" type.

As always, Dr. Nordberg came in, on time, looking dapper in his suit and tie, pleasant demeanor, purple marker in hand. I felt like a road atlas after he was done with me - circles and squiggles all across my chest, under my arms, and a bit below. Dr. Ratner never came in - she had a procedure earlier in the morning that was running late. The anesthesiologist came in and explained he'd give me a TAP block, and additional local anesthesia to my abdomen to ensure the least amount of pain.

I never get over the walk into the OR. Not the actual walk through the hallway, but the entrance into the OR. The room is never as dark and calming as on "Grey's Anatomy." It's bright, you can see the sound-proof ceiling tiles, the floors are white with minimal splatters of iodine staining. Various nurses are attending to tons of trays, and the operating table is there, with arms out, a Hannibal Lecter looking mask sitting where your head goes, and the blue cloths all around. I get that flash of, "Why do I feel like I'm being mounted on a horizontal cross?" when the nurses help me up onto the table and put my arms out to my sides and tell me not to move. There is nothing to do but to stare at the ceiling and the four operating room lights with those weird handles in the middle of the bulbs. This anesthesiologist didn't play music like the others, so I can hear the clanging of tools and the tell-tale, "Ok, we're going to give you a little something in the IV and then some gas and you'll fall.... " And that's about it. I lose all sense of time. I lose all sensation. And I wake up in that awful fog.

I hate coming out of anesthesia. As a result, I'm usually fast to come out - once I start waking up, I'm up.

But not yesterday. I was in that loathsome fog for way too long. I was too sleepy for too long. I had no compunction to move. I couldn't stay awake. I was too unaware of where I was, and what was going on around me. I hated it. I forced myself to try and snap out of it. I saw my friend's little sister, Kara, a recovery room nurse, and called her over. I made her talk to me. But that wasn't enough. I felt bloated - like the blueberry girl in Willy Wonka. I was sore. Something wasn't right. I was parched. The saliva glands in my mouth were in pain. My lips were sticking too much to my teeth. My throat felt way too dry and scratchy. My dad and son kept coming in and out and I couldn't keep my eyes open long enough. I felt clammy. I felt sweaty.

I felt like shit.

Something wasn't right.

I asked to go to the bathroom, and I was walked to the bathroom. I could barely feel my feet. I didn't know if I was upright. I was overly disoriented,. This wasn't right. I got to the bathroom, and all I felt was cool. I started to feel a bit like myself. I didn't even have to go - I just needed to move. Walking back to recovery felt better.

It was too hot in the recovery room. It was too cozy. It was like a womb. I had to get out. Finally, we left, but I still couldn't wake up fully. I dozed off in the CVS parking lot as my dad and son got my meds. The warm, summer breeze felt good and lulled me back to sleep repeatedly.

Ironically, once home, I couldn't sleep. Percocet, Ambien and more, and I couldn't sleep. It was awful.

And today, forget about it. I felt inflated - still. My stomach hadn't been this rounded since I was pregnant. Something was just off. I spent time in the hammock. I couldn't go to the bathroom. I couldn't move without pain - pain focused on the right.

Finally, it got to be too much. I broke down and cried. I called the doctor's office, furious, that I still wasn't "right," that I was still bloated, that I still couldn't go to the bathroom after 2 days, and that she didn't bother to see me before or after the surgery. I was neglected and something was wrong.

After too long, earlier this evening, the surgeon called me. She explained that they inflated me with gas to be able to see my abdomen clearly, and that the gas would pass. She also explained that she had come to see me in recovery - she even drew me a picture. I have zero recollection. That sent me into a panic.

But then, the fun part - they removed a 3-4cm cyst along with my right ovary. That's not small. That's big. They were going to biopsy my ovaries anyway, but holy crap! I cyst! I panicked again.

Dr. Ratner explained they decided to check out my liver and other organs. All was clear. But that cyst on the right side was not easy to remove (hence, the extra pain). But the good news - it was benign. Everything was benign.

So I am further in the clear. But far less than whole.

Good? Bad?

Right now, I'm on Percocet, so I'm in no position to make any sound judgements.

Choices? Or a roll of the dice?

It was brought to my attention that I seem to be preoccupied lately. Honey, you don’t know the half of it.

I’m dealing with the typical, and atypical dramas of being a divorced mom of a pre-teen and a teen. I have an ex-husband who fights doing the minimum for his children and is causing them constant angst. I’m still forced to make COBRA payments to a former employer that are higher than many mortgages monthly as I’m still contracting and not receiving benefits. And, oh yes, I’m still contracting and not working in a full-time, permanent post. 

So, in keeping with my previous candor regarding my situation, I’m faced with an even more perplexing situation: to remove or not remove my ovaries right now. If I choose to, do I opt for a hysterectomy or not? Do I voluntarily put myself into an irreversible menopause, or do I gamble on my chances with ovarian cancer? And do I permanently, without question, kill any chance of carrying children ever again?

Let me make one thing clear. I already have 2 children. Two children that, though I love them with every cell of my being, I had too young (at least, too young for me). I’d had every intention of not having children until I was older, after I’d done much more traveling, established my career, following more dreams, etc. So, the fact that my son is only a couple of years away from graduating high school and with my daughter nipping at his heels, means that I’d have my freedom from parental responsibility that much sooner. The notion of having a baby, and having to delay my second shot at my 20s, isn’t high on my to-do list.

Perhaps it’s the concept of no more conceptions: That I may never experience that surge of adrenaline, fear, nerves and excitement when you see the window on the stick I just peed on change from blank to life-changing, nor will I ever have the joy of playing “poke the baby” with my own stomach and have my stomach poke back. Or, more likely, I’ve already had my breasts carved out, replaced with plastic goo, and the final remaining body parts that define me as female will be butchered.

Ok, so I may be going a little OTT, but I’m kind of not. I already removed one breast for the sake of prevention. Now, I’m venturing south in search of new organs to remove for the sake of prophylaxis.

My oncologist wants me to have my oophorectomy yesterday. My gynecologist says it isn’t an immediate need, but it should happen soon. I know I have a short window of time to make the decision before the alleged time runs out. I can’t figure out why I’m hesitating!

Maybe it’s that word, “menopause.”

I mean, we women all face it. But I’ve barely got my head wrapped around the fact that I won’t be going to anymore proms let alone that menopause is closer to me than my high school graduation naturally. Can you imagine how mind-blowing it is that, something I thought I had another 20 years to dread is knocking on my door now? Will I grow a beard? I don’t want hot flashes! Can you imagine me even more unpredictably moody and bitchy? Holy crap! I WILL turn into my mother!

But seriously, folks, it’s like when I was rock climbing in Colorado and I was faced with having to jump off the cliff to go rapelling – and I opted out, against my protest. I could make sense of the mastectomies. I could make sense of the chemo. I could make sense of losing my hair.

Why can’t I get myself to just have the oophorectomy? Why am I hesitating?!

(And, I gotta say it, why the hell is this procedure given such a ridiculous sounding name? Is that the problem? I can’t take this operation seriously because it sounds like something a cartoon character would blurt out when punched in the gut?)

"Welcome to Our Ool"

When I was in 5th grade, my best friend was an Israeli girl named Sigal. This was because in 5th grade, no one else in my class was willing to admit publicly that they were my friend. Hell, that was the status quo until we graduated 8th grade. I think some of them may be willing to admit that they were my friend, now, but back then, no way. You'd be branded a freak. A mutant.

I'm certain Sigal was the only one who was willing to admit it because she didn't know any better about the the fact that the stigma of being friends with the "corroded" girl would mark you for life. Then again, Sigal transferred out the next year, so she went relatively unscathed by being my friend, socially.

As a result, I went to her house for what seemed to be a daily play date. Her mom would make us falafel and chips (which, for years, I thought she made from scratch until I went to Israel and stayed with them for a free shabbat when I was 18 and I learned that her mom's falafel, in fact, came out of a box). And in the backyard, they had a pool. With this sign:

Unfortunately, it seems that my ancestral gene pool did not share the same philosophy as Sigal's backyard pool. And it would appear that it is my father's side of the family that subsequently peed in it.

Today, I got my genetic testing results. This testing determines whether or not my breast cancer is a hereditary trait, and if the possibility of recurrence as well as developing a slew of other fun cancers is greater than the average Joe.

Now, genetically speaking, I'm a mutt. On my mother's side, we have non-Jewish German (my grandmother, remember, converted to Judaism) and Russian Jewish. But no family history of breast cancer.

On my father's side, we have primarily Spanish-Portuguese Jews, and that had been the case for hundreds of years, until my grandfather decided to marry a German Jew. He was the black sheep of the family, I understand that family members stopped communicating with him as a result. This was a huge insult - to stray from the Spanish-Portuguese community. And who knew? His future generations would pay the consequences of his hereditary betrayal. It is his side of the family that has the history of breast cancer, seemingly, from my father's mother's side of the family.

I'm BRCA2 positive for a deleterious mutation, which means that gene that should safeguard my body against these kinds of cancers is broken. Defective. Yes, it's now official - I'm a mutant. Only this mutation doesn't qualify me to be one of the X-Men nor a member of the Brotherhood of Mutants.

It's a genetic tattoo. I've been branded "6174deIT," like a tattoo on the inside of my arm. Despite the Sephardi lineage, genetically, I'm an Ashkenazi Jew with a death sentence. I've been put into that line out of the cancer cattle car. The question is, what is my out? How do I escape? And how do I save my children?

Here are the "choices" I get to make, and the fates I've damned my children to. Call me Sophie:

• If I do not have a bi-lateral mastectomy, I have a 12% risk of a breast cancer recurrence within 5 years of the first.
• It is recommended that I have my ovaries removed ASAP, preferably by age 40, and without question, by age 45 as I have a 27% risk of ovarian cancer by age 70 if I do not have them removed. And there is no real way to screen for ovarian cancer until it is well developed.
• I have a 7% risk of pancreatic cancer by age 80, though, if there is pancreatic cancer in my family history, which will be tough to prove as many were lost before we could find out, that risk can be higher.

Therefore, while I haven't consulting my surgeon, the most logical, detached choice I have is radical, bilateral mastectomy and having my ovaries removed within the next few years.

And now, onto my children's choices. By age 20, they should be genetically tested and then they begin the roller-coaster.

• For my daughter:
• She has an 84% risk of breast cancer, as well as all my risks.
• She will have mammograms done annually from between ages 20-25 for the rest of her life.
• She'll be presented with the option, at an ungodly age, to consider a voluntary double mastectomy.
• She'll be asked to take our family history into consideration when it comes to the age at which she wants to start a family - she will likely not have the luxury of deciding to wait until she's in her 30s without taking serious precautions, as by 40-45, she will likely be told she should have her ovaries removed.
• For my son:
• He has up to an 8% risk of male breast cancer.
• He will have to have breast exams starting between ages 20 and 25.
• He has a 20% risk of prostate cancer by age 80.
• He has an increased chance of contracting other cancers.

I'm a Sephardi trapped in an Ashkenazi body. And a mutated one at that. And what's worse is that I've likely passed on this tainted genetic legacy onto my innocent children.

What have I done?