How much longer do I have?

I'm not going to lie; I've been feeling very depressed for the past few days. I don't know if it is the tamoxifen, the change in weather, or that the world is a very scary place these days. That we are essentially at war, one that is not going to end in my lifetime. Life just seems so... ugly. We all have personal struggles that we fight within ourselves, and I've been fighting plenty of my own as of late, but for what purpose? To get shot senselessly in the street or at a concert? So I can live to watch my children grow up in this terrible world?

Anyway.

We got a lot of snow last night and this morning, and as a result, we are all enjoying a snow day. I should be enjoying it more, I know, this precious time with family. Instead I've been moping around feeling sorry for myself, on the verge of tears for I don't know what reason.

My morning started off with a visit to my orthopedist, or more precisely, my orthopedist's nurse practitioner. I know a couple of other people who use this orthopedist, and they are not convinced he actually exists, because they have never actually seen him. LOL. I didn't realize what a rare event it was that he blessed me with his presence during my first appointment with him back in March. Fortunately, his NP, Shana, is fabulous; I like her a lot and trust her far more than pretty much any orthopedist I've ever met.

The orthopedic group is about as far away from my house as it can be without being in a different city, which made for a harrowing drive through the snow on icy roads this morning. It was probably not the best decision to go to the appointment, but the roads were not bad where I live, so I figured I'd be fine if I left plenty of time. It was only once I had gone about 10 miles north that the conditions got a bit hairy, and by that time I was halfway there, so I figured I might as well grin and bear it. Despite leaving 30 minutes to get to the appointment, I was 10 minutes late, so I was pretty stressed out by the time I got there, and wondering if I was even going to make it back home, as it continued to snow.

There were really no surprises during the visit. Being that she is very thorough, Shana noticed I had had a kazillion other tests run on me since we last met, so I gave her a brief synopsis of my cancer saga. Then she went over the MRI results from my left hip, and indeed, I have a 'degenerative labral tear' in that hip, too. Which essentially means that hip is on its way out as well. If I want a long-term fix to this, I need to have a periacetabular osteotomy followed by labral reconstruction on both freaking sides. She said that at this point, I would probably not even be a good candidate for a labral repair, at least not on my right side; I'd probably need a labral reconstruction, which involves taking tissue from a cadaver and making a new labrum. (!!!) So she re-referred me to Dr. Not Friendly, the doctor who does PAO surgery, and said that I should at least consult with him. But basically it would be something like this: PAO surgery on my right hip, followed by labral reconstruction a few weeks later. You have to be on crutches for, like, two months after the PAO, so you might as well fix the labrum (which requires one month on crutches) while you are at it. Repeat for the left side. That's a lot of freaking time on crutches and a lot of freaking surgeries. It's not possible to do any of them simultaneously because of the time that you would have to be under and the risk of blood clots, which is especially relevant to me given my history AND the fact that I'm on tamoxifen now.

Needless to say, my next question was, 'So if I do nothing, how much longer do I have before I can't walk at all?'

And this is the part that makes me cry. Instead of saying what I wanted her to say, which was Oh stop being a Drama Queen! We always have the option to manage this conservatively! she just looked me in the eye, and very apologetically said, 'I don't know.'

I don't know.

I pressed her more, 'Are we talking months? Years? Decades?'

I don't know, she repeated. There aren't enough data to know. She said my case was severe and complex, although I did have some things going for me - I'm not obese, I don't have diabetes, I don't smoke. Aside from the architecture of my bones, I don't have any risk factors for severe joint degeneration, so it was hard to say. But without actually saying so, she corroborated my worst fear - that if I do nothing, I will reach a point at some yet-to-be-determined time in the future where I really won't be able to walk. It's that bad.

I told her about my colleague's rapid decline and very sudden need for a hip replacement, and how that worried me. She said that usually in cases where people needed an 'emergency' hip replacement, they have arthritis, and I don't have arthritis (which is apparently some kind of miracle, according to what the orthopedist told me at my last visit). And while on the topic of hip replacements, she did also say that having the PAO surgery and labral reconstruction would not necessarily preclude the need for hip replacements later.

Awesome.

We did talk about conservative, non-surgical options, and while she was sympathetic to me not being up for any major surgeries anytime soon, she did not hide the fact that she did not see conservative options as a long-term, sustainable solution. However, she did agree to give me a prescription for meloxicam, which has helped me some in the past, and said if I wanted to make an appointment for a cortisone injection, I could do that, too.

Shana was also very concerned about the mass in my uterus that no one else seems to care about, and said that I really need to have a pelvic ultrasound, which I know. It's on my list. Yesterday I went so far as going to the web site of the OB/GYN practice that Dr. L recommended to me. It is a husband-wife practice, but I didn't like the looks of the woman (seriously, if you can't smile for a picture that you are going to post on the web advertising your services examining girl parts, it freaks even the non-smiley of us out) and male OB/GYNs creep me out. So there you go. Shana said she knew of a few new OB/GYNs in town 'who are supposed to be good,' and said she would refer me to one of them. After I got home, her assistant called me with the information and said that they would actually be contacting me to set up the pelvic ultrasound. I guess that is one way to get it done. LOL. How funny it took an orthopedic person to push this on me. Of course I promptly Googled the doctor Shana suggested, and it turns out that he is actually a gynecologic oncologist and is part of the same cancer center as my medical oncologist. I didn't know we actually had those specialists in my town, but I have to admit it does seem like a good choice for this particular problem, so I will try to get over the fact that male OB/GYNs are creepy, be a good girl, and go in for my ultrasound so I can get even more bad news.

Who knows, maybe all this hip nonsense will end up being a moot point. Please excuse all of the self-pity, but I'm going to sign off and go have a good cry.