Right now, this is the schedule for the rest of my fertile life:
- Discontinue birth control use (one more week).
- Begin Lupron, 6-12 months.
- Low-dose progesterone-only birth control (such as Depo Provera) for a maximum of three years.
- Have children, as close together as possible.
- If symptoms return, hysterectomy.
Lupron is a treatment which essentially induces premature menopause. It regulates a woman's hormones, keeping them artificially low. Which means I'm going to be going through hot flashes and night sweats at the bright young age of twenty-two. You know, they already say fibromyalgia instantly ages the body twenty years...
That is done for six months, unless symptoms return immediately after it's stopped, in which case it's continued for another six. During that time I am going to have to have my bone density regularly monitored because I will be at high risk for osteoporosis.
After that comes the Depo, which I can't use for any more than three years, because at that point the risk of osteoporosis begins rising. I could use a low-dose oral contraceptive pill, but even Mircette (the one I use currently) contains 20mcg estrogen -- and estrogen is the hormone which inflames the endometriosis, so we're wanting to avoid that if at all possible.
Then kids. If we don't have trouble conceiving. If pregnancy doesn't turn out to be too hard on my body, or even outright dangerous. If I can handle birth. If I can handle raising a child -- much less two or three. If. If, if...
By this time, I'll be in, what, my late twenties? Letting my cycle take its natural course (which, uh, is rather required if I want children) is only going to inflame the endometrial implants, because my estrogen levels will be that much higher.
Hopefully the Lupron will shrink them enough that it isn't a concern for me anymore. They are, after all, not large, just very diffuse. But there's already scar tissue that's pulling on the back of my uterus and lower bowel in several places.
But if I'm not so fortunate, and my former symptoms return (I can't afford to be indisposed for several days at a timeif I've got kids about)... pretty much my one option at that point would be to remove the uterus altogether. I won't be able to return to something like Depo, and again, the low dose OCPs have still been inflaming the endometriosis over time, low dose or not. And the average age of menopause is, at current time, fifty-one. That's a full twenty years -- twice as long as I've even been fertile so far.
This is just overwhelming. I don't know if I can handle it.
I'm used to the fibromyalgia and even my anxiety -- I've come to a point where I understand them, for the most part, and I've found a good pace so that I can manage them effectively. But both are, for better or worse, conditions that are "all in my head," by conventional wisdom. And, for better or worse, I've internalized that. I know that they're all too real, and can be outright disabling if I don't manage them correctly, but I know that most people don't really understand either condition and are more likely to dismiss it than try to learn.
But this? This is real. It's detectable. I have the pictures to prove it. And unlike the other two conditions, which are disabling in a nebulous, hard-to-explain sense, this is a disease that can fuse your organs together. That shit is just fucking scary, I'm sorry.
I'm not used to this. Not at all. I was on knife's edge for the last couple days, and though the angry irritability has calmed down now, I'm still... unsettled. Very.
