Page 148 of Salto

“Not necessarily. It could be PMOS. But it could also be endometriosis. I don’t know for sure unless you have a laparoscopy.”

“What’s that?” My heart was starting to sound like a drum in my ears. This was not at all what I was expecting to hear at this appointment.

“It's a minimally invasive surgery where a gynecologic surgeon makes a few very small incisions in your abdomen—usually one near your belly button and a couple lower down. Through one of those incisions, they insert a tiny camera called a laparoscope so they can look inside your pelvis.”

I couldn't speak for a moment.

Surgery?

"If they find endometriosis, they can often treat it during the same surgery by removing or destroying the endometrial implants and breaking up scar tissue. That can help reduce pain and may improve fertility, depending on the extent of the disease."

“Wait, hold on.” I shook my head, a lump forming in my throat. Why was I suddenly about to cry? This information was too much, coming at me too quickly, and I’d been completely unprepared. To say I felt blindsided was an understatement. “Fertility?”

"One of the reasons we take endometriosis seriously is because, over time, the inflammation can cause scar tissue to form inside the pelvis."

He pointed to the diagram of the organs again.

"That scar tissue can make organs stick together. If it involves the ovaries or fallopian tubes, it can make it more difficult for an egg to be released, picked up by the fallopian tube, or meet sperm."

"So... I would struggle to have kids?"

He shook his head immediately.

"No. That's not what I'm saying. Many women with endometriosis go on to have healthy pregnancies, and some never have fertility problems at all."

He paused.

"But untreated endometriosis can increase the risk of infertility, especially if the disease progresses or causes significant scarring. The earlier we recognize and manage it, the better our chances of protecting your future fertility."

“And what about gymnastics? Can I still do gymnastics?”

Dr. Morgan nodded. “Yes.”

I finally took a full breath. Since he'd said the word surgery, it felt like I hadn't taken a full breath.

“But not like this,” he tacked on.

The relief disappeared as quickly as it had come.

“If this is endometriosis, continuing to train through this level of pain isn't something I'd recommend. You're already telling me your symptoms are getting worse despite treatment.”

I looked down. My knuckles had turned white from clenching them together so tightly.

“With the right treatment, many athletes with endometriosis return to high-level competition. Some even compete at the Olympics.”

“Really?” I looked up.

“Really.” A small smile crossed his face. “Endometriosis doesn't automatically end an athletic career.” His smile faded ever so slightly when he continued. “But if you choose to have the laparoscopy, it'll put you back a minimum of six to eight weeks for recovery.”

My eyes widened. “Six to eight weeks?”

He sighed. “Scarlet, based on your history and your symptoms, endometriosis is high on my list of possibilities. But I can't tell you with certainty that you have it. The only way to make a definitive diagnosis is with a laparoscopy.”

“Nationals are this weekend,” I whispered.

“I know.”

There was a moment of silence. Like he was letting that sink in.