Sunday, December 6, 2015

Light gives light

Mr. PNU turns 48 this week. On Tuesday.

We lit menorah this evening for the first time, commemorating a year of wonder, and hardship, and the room both make for miracles. 

Tomorrow we meet with our second surgeon for a cholecystectomy pre-op. Our neurologist insisted we have the procedure done in town where my husband's neuro team is located, which required that we switch surgeons. She's also insisted that we see a hematologist before she'll give clearance. As of this evening that means we have to push the operation back into January since the hematologist had no openings prior to the middle of next month. I'm trying to stay cool about the implications of dealing with surgery at the same time I'm beginning a new semester. Of course I'll hit the phone first thing in the morning to try and keep our December 14th operation date, but I'm just one woman and the team of doctors I must coordinate to pull the procedure off at a convenient date is a half dozen. 

Our latest development is in my husband's endocrine system. 

After his grand mal seizure, the neurologist noticed nodules on Mr. PNU's thyroid and ordered an ultrasound to confirm. There are four, just large enough that she said she'd like to keep an eye on them and repeat imaging in six months. That was early in October. We put the matter aside until a couple of weeks ago when my husband's urologist called. He discovered elevated prolactin levels in Mr. PNU's blood and zero sperm in his semen analysis. We were referred to an endocrinologist, who followed up with another set of blood tests to evaluate for a pituitary tumor called prolactinoma, and urged us to piggyback a biopsy of the thyroid nodules with Mr. PNU's cholecystectomy. For reasons mentioned, that biopsy may happen later than we'd like. But in the meantime, our urologist laid out the possible causes for both the elevated prolactin levels and the lack of sperm, or azoospermia. There are three possible explanations. 

(1) The seizure prompted a release of prolactin, as epileptic seizures do.
(2) A prolactinoma is causing high levels of prolactin production that is inhibiting sperm production.
(3) My husband is in early stages of premature testicular failure.

Neither of these options precludes either of the other possibilities. And so we could be looking at a whole mess of further issues. Number one does not solve the problem of the nodules. Number two is treatable, but no one wants cancer. Number three is something we'd just have to accept as the end of our hope of having children together. Bottom line, my husband is in the middle of a physical mess and the end is nowhere in sight. But he is going to make it to his 48th birthday, which is a miracle unto itself. Otherwise, this love of living in the tension has its limits, and I'm struggling for surrender, but mostly I'm just tired. 

Birthday wishes are welcome. We need a few more miracles. There are seven more candles to light.

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