Planning for the unknown: An impossible (hypothetical) decision

 Preface:

The following post was written a couple weeks ago when I was just beginning to think though everything.

I have been thinking about if I want to post it. I don't want to change it because it was what I was thinking about at that time and I don't want to lose that. But, in another sense I realized while much of what I was saying was true, it really was hypothetical. Pretty much all of the facts I know now are the same, but at the time I didn't take into account how much feelings and emotions can play into a decision. I didn't REALLY believe it would happen, so I wasn't too emotional. I felt the stress and emotion that comes with  the possibility of having to make a decision of that magnitude, but not the full range of emotions that comes with the decision itself. The hypothetical is a much easier decision than the reality. 

I didn't plan for the fear and other emotions that have come into play. They aren't rational, but that doesn't mean they aren't important. We are given emotion and instincts for a reason. I don't think that means the rational needs to be removed from the situation, but how you feel is just as important of a factor. During my last pregnancy I had a strong feeling my son was a boy.  There was no tangible reason, but that doesn't mean I didn't know. 

In that same regard, ever since hearing the news, my mama bear instincts and/or fear and/or some other unnamed emotion is making me seriously doubt what I want to do. I can't tell if it is a gut feeling I should listen to or just fear. I plan to move forward with a second trimester surgery at this point, because I can always change my mind and push it back. From now until surgery I will just keep doing what I have been doing. Waiting, and thinking, and praying, and getting more information. And I pray that at some point between now and then, I get peace about a decision. So far that plan has never steered me wrong and God has always given me peace in those decisions. Although I will say, this decision feels much different and more difficult than any decision I have had to make to this point.

Planning for the unknown: An impossible (hypothetical) decision

How do you plan for a hypothetical? I am a planner. It is what I do. It is my job, it is how I handle things. But how do you plan a hypothetical. I have to plan. If I decide to have the surgery during the second trimester it will be at some point within 10 weeks from the day I find out I need it.

Thankfully I have a great boss who both understands my need to plan, and understands the uncertainty of the situation so I have been able to talk out different options and eventualities with her. She has been great at letting me know that anything from work is the very last thing I should be worrying about (unless it helps me in any way and I want to).

So I have been weighing out my options, and trying to think and plan the best I can for the future with everything I know and Dr. Google can supplement. (Outside of the obvious, hopeful future of: do nothing except continue with a happy healthy pregnancy with a random moral support nodule my thyroid decided it needed.)

Option 1: Have surgery during my 2nd trimester.
Option 2: Have surgery a "couple weeks" after baby.

Here is how I think about it: (I was going to insert a table here, as spreadsheet as how I think about things, but apparently most bloggers don't use tables so I don't have that option. So you get more stream of consciousness...)

First thing I consider is the risk.

 If I do it during the second trimester, then there is increased risk to baby. The biggest risks of surgery are miscarriage and pre-term labor. After the first trimester, the risk of miscarriage goes down significantly. As for pre-term labor: The two most common causes for surgery during pregnancy are appendicitis and gall bladder; therefore a disproportionate number of surgeries they can pull statistics from are abdominal, and would logically lead to an increase risk of pre-term labor. My surgery wouldn't be abdominal, so I feel this risk would be lower. I can also possibly wait until 25-26 weeks when baby would be viable.

If I wait, then I am risking my health. While overall prognosis remains the same (ie probably still won't die) the risk of it spreading to my lymph nodes and needing more invasive surgery and treatment increases.

Then I consider the recovery. 

If I have the surgery while pregnant, I would only have one child to have to care for. Even then, the little man would be in daycare, or could go stay with grandparents. I don't have to worry about time off as my company has an unlimited PTO policy. However, I would have to worry about getting my synthetic hormones right while pregnant. Too much  or too little thyroid hormone could harm baby, and it could be harder to gauge how much I need while pregnant.

 If I wait, I will have to care for 2 children. One of which being a very newborn. I had planned to take the little man (mostly) out of daycare while I was on maternity leave to save money and spend time with both of my babies and let them bond with each other. I wouldn't be able to do this if I had surgery. I would need someone to come stay with me as I wouldn't want to send the little man  away as soon as I have a baby or he could think it was BECAUSE of baby, and it wouldn't solve the problem with the new baby either. And having someone here to help, doesn't free me from having children who want me. I also don't know if trying to get my new meds right after having just had a baby and trying to nurse, would be any easier. Which also brings up the point of nursing. Having to stay in the hospital and recover from surgery, could hinder my ability to nurse. Those first few weeks are critical to establish nursing. I likely wouldn't have enough stored yet, and would likely have to supplement with formula, which I would really like to avoid.

Then I consider money. 

With baby due at the VERY beginning of January, there is a good chance I will have a December baby. Between appts, ER visits, and now my thyroid stuff, we are going to be close to hitting our out of pocket maximum this year even if both baby and surgery happen in January. But then we are looking at hitting our out of pocket max 2 years in a row. If I do the surgery during pregnancy, and baby happens to come in December, then everything is in 2015 saving us several thousand dollars. Even if baby comes in January, it would likely save us a couple grand.

Then I consider timing and convenience.  

We are trying to pack up, sell, and buy a house all before baby arrives. My big annual conference and big tradeshow for work both fall at very inopportune times for the timing of second trimester surgery, whereas I am already planning to be off in January. I want time to process surgery and research doctors and get second opinions.

So there are several pros and cons to each, but when I consider all of this, I am leaning toward having the surgery during the second trimester. And just when I think I have made a decision,  the doubt and questions come. I feel like I am risking my baby's entire life for POSSIBLE less invasive treatment for myself and a better recovery. I feel like am putting my health before my baby's and that makes me a bad mom. I can say I am thinking of how recovery would be better for him/her, as well as the entire family, but if something happens to them during surgery, it doesn't matter. Will I be able to forgive myself for making the choice I made? And how can I even bring money into this equation at all? How shallow am I?

And the list goes on and the rabbit hole gets deeper. And I just want to crawl into a hole and ignore it. I try to not think about it and tell myself  there is a possibility I will not even have to make the choice. But if I do... I have to have thought it through, made sure I have thought and considered, and weighed all of my options. Because I know I won't be able to forgive myself if everything doesn't go perfectly and I feel I didn't consider it enough.  This just sucks....

I will have my next midwife appt on July 15th, so I will be able to talk to her and ask her opinion before I have my biopsy. 

So I will wrap this depressing mental purge up with an adorable belly shot of baby Palmer at 13.5 weeks.