Sunday, November 07, 2010

OK.  I think I need to write this out and get it off my chest.  I wasn't going to because it's pretty personal, but it goes a long way to explain why I've been silent for so long.  It was life-controlling, and I had no room for anything that wasn't absolutely necessary.

This is probably going to be more than the world needs to know, but I need to say it, and who knows, someone else in a similar situation may read it and be helped.

WARNING! TMI ALERT! This post may contain Too Much Information!

As I mentioned a couple days ago, I recently had surgery. I actually had two procedures: endometrial ablation and tubal ligation. Having this done was a strangely difficult decision for me, and I'm not really sure why.

The backstory is that I have been dealing with menstrual irregularities for several years, in which I would bleed heavily for weeks or sometimes months at a time. Especially this year, it got much worse and I bled continuously and very heavily from the end of May to the end of October. Thank goodness for my DivaCup.  Often I would lose 3-4 ounces of blood per day, which is more than is lost in an entire "normal" period.  I estimated that I lost roughly three gallons of blood in five months.  I felt like I couldn't go anywhere or do anything because of the bleeding. Of course I did do things, but the bleeding and how I was going to cope with it was always right up there at the front of my mind, the first consideration.   Obviously, this is not a happy situation, either from a physical or mental health standpoint.

The excessive blood loss meant that I developed severe anemia, though I didn't know it at the time. Let me tell you, anemia is not fun. I was tired to the point of exhaustion ALL THE TIME, and felt like I had no reserves at all.  Absolutely none.  At one point in August, I was mowing the lawn and had to stop three times to sit down, catch my breath, let my heart rate return to normal, and stop feeling like I was going to pass out. Our lawn is not that big.

Looking back, I think I've been anemic to one degree or another since I was a teenager, except when I was taking birth control pills. When I was on the Pill, my cycles were clockwork regular, not heavy, and normal-length. If not on the Pill, my cycles were all over the place; irregular and heavy.  On the Pill=not tired. Coincidence? I think not.  I was found to be mildly anemic when I was pregnant, and took iron supplements. But for most of my life, the doctors just told me that in order to fix my tiredness, I should get more sleep and eat more red meat. Multiple doctors told me this.  They just shrugged and told me that heavy bleeding and irregular cycles were just something that some women had to deal with. So I did.

When finally, out of desperation, I went to the doctor again in September, my hemoglobin levels were so low that if they had been half a point lower it would have been considered life threatening. When the doctor called with the blood test results, she told me to get to the grocery store now and buy iron pills and orange juice. Don't wait until tomorrow. That was a little scary.

At my followup appointment, we discussed options. She said that hormonal imbalances were the cause of the excessive bleeding and irregularity, and the most obvious course of action would be to go back on birth control pills. I am not willing to do this, because every brand of pill I've ever tried does bad things to me. Been there, done that. Yes, the regularity is nice, but it comes with grouchiness, depression, weight gain, and generally feeling horrible about myself as a person. So that was not an option.

The second option she offered was to have a full or partial hysterectomy. That seemed a little extreme. I have no desire to go into immediate menopause, or risk the rest of the known side effects like cardiovascular disease and osteoporosis. So that was not an option either, not if there was anything else that I could do.

Her third option was the endometrial ablation. This procedure surgically removes and scars the lining of the uterus to reduce or eliminate bleeding. Since it's obviously not a good idea to become pregnant if you have no uterine lining (it would result in an ectopic pregnancy), sterilization is indicated. She suggested tubal ligation.

So why did I have such a hard time coming to terms with having this done? I'm not really sure. Part of it, certainly, is the finality of it. I can never have another baby. Never mind that I have a beautiful daughter, am turning 40 in three months, and Shaun and I don't plan to have any more kids, of course, but still. I destroyed a part of my body, the part that nurtured Emma for nine months. I will never get that back. That part of my life is over.

Then one night, I had a thought. If I had appendicitis, I wouldn't hesitate at all to have an appendectomy. It wouldn't even be an issue. Just do it, fix it. I don't plan on having more children, so what's the problem? My uterus is a part of my body that is not functioning properly, which I am not currently using and do not plan to use in the future.  So I went ahead with the surgery.

Now I've never had surgery before. To say that I was nervous would be an understatement. I was terrified. I had my wisdom teeth out in college, but in the dentist's office. The only other time I've been in the hospital was during childbirth, and that's not quite the same thing. That was a happy occasion, a generative occasion, and I was not losing a part of myself. I was scared, but I was not unconscious and for the most part I felt in control of what was happening to me. In a very real sense, I was doing it to myself.

With this surgery, the doctors were doing it to me. I felt vulnerable. They were going to be rummaging around inside my body and I wouldn't even be aware of it. I will say this, though- deep slow breathing works as well for controlling pre-op hysteria as it does for getting through labor contractions. Seriously, I was nearly in tears when the anesthesiologist came in to talk to me beforehand. I was briefly in tears when they left me alone for 5 minutes before wheeling me down the hall to the operating room. Breathing helped and somehow I managed to hold it together. Then they make you scoot off the gurney onto the operating table, by yourself. It's like going to your own doom. Giant lights. Many trays and carts. Lots of monitors. Nurses tossing around phrases like "Foley catheter" and "intubation".  I'm a biologist, I know what those words mean.  Next time: sedative, earlier, please.

I've never had general anesthesia before, and it's weird. They started a saline IV in the pre-op room, then when I got to the operating room the anesthesiologist added something to make me feel "floaty," then I think he put a mask over my face, and then I woke up two hours later. The anesthesiologist asked me how I felt, and I remember answering "Sleepy." I think I also might have said "leave me alone", but I really hope I didn't say that out loud, because the anesthesiologist was nice.

Once it was over, I was fine. Not too much pain, and I went home 3 1/2 hours after waking up. Which is ridiculous when you stop to think about it. They knocked me out, cut me open, did a bunch of stuff, and then just sent me home. They did make sure that I could keep down liquids and also pee before they would let me go, though. Ah, healthcare.

I slept most of the first day. Surprisingly, I didn't have that much pain, as long as I didn't move around too much. I didn't need the Percocet, or even Advil. I didn't take any pain medication at all after leaving the hospital.  I was crampy from the ablation and the laproscopy incisions (two, from the ligation) hurt if I bumped them or contracted my abs, but otherwise it was fine. I mostly stayed in bed the rest of the day Tuesday and Wednesday. Thursday was better, and I even did some laundry and the pile of dishes in the sink. By Friday I was up all day, and feeling mostly back to normal.  My belly was still a bit sore, but I could get up out of bed or a chair and bend over with no pain.  Today I'm feeling a bit bruised, but otherwise fine.

The ligation was much more invasive than the ablation, and had a longer recovery time.  Which is ironic, because it was the ablation that was the primary objective; the ligation was just an "extra" to make sure I won't get pregnant.  If I hadn't had the ligation, I wouldn't have needed general anesthesia, and I would have been back to normal in a day.  Anyway, it's done, and I'm fine.

The anticipation was definitely worse than the surgery itself.  Much, much worse.  Here's hoping the ablation will be effective.  Supposedly almost 50% of patients don't bleed at all anymore, which would be nice, but I'll settle for normal length periods, even if they're irregular.  It doesn't solve the underlying hormonal imbalance, but at least I won't bleed to death.


Anne said...

Sue, so glad you made it through and recovering quickly! I've had a lot of surgery, none quite that invasive, and it is never fun. I agree, the anticipation is always the worst part! I hope it solves the problem, I can't imagine living with that for as long as you have. I'm guessing your body is going to be happier now! Hope to see you Monday evening. Let me know if you are not up to the 'White House'.

PJ said...

Oh, man...that really is something! Well wishes to you. back almost a year ago I had a surgery to cut my rectal muscle...totally eased an extremely painful, life absorbing thing I took too long to correct. although surgery took a few days longer than I expected in recovery it was well worth it. I truly hope this will be for you!

Liz said...

wow, Sue. what an ordeal! I really hope the ablation works for you... I've considered it from time to time, but my periods aren't nearly as extreme as what you were dealing with.
Glad you're on the mend now.

Cathy said...

Good for you to think it through and do what you needed to do. I'd like to read an update in a year.

Leigh said...

Sue, no wonder you haven't been blogging. That's a lot to go through. I had an ovary removed many, many years ago and had the hardest time shaking the feeling of being deformed afterwards. Weird, I know, but there's an emotional element to surgery thats hard to explain unless you've been there.

I have hormonal imbalance too. The best book I ever read on that subject is Dr. John R. Lee's What Your Doctor May Not Tell You About Menopause. The title is unfortunate because if I had read it when I entered puberty, I would have saved myself decades of heavy, irregular, painful periods and probably wouldn't have had so much trouble conceiving. It's well written and definitely worth a peek. Your library may actually have a copy.

cyndy said...

Very glad to hear that you are doing well after your surgery...and even though the "healthcare" part of things seems screwy, ya gotta marvel at modern medicine. I certainly hope this takes care of things for you.

Question: you mentioned dishes and laundry...but did you have anything on the needles or spindle? did yu have a "go to" project, and if so, was it mindless to keep your hands busy, or complicated to keep your mind busy....just wondering?

ps..I'm with you on the sedative...earlier.

Yoko said...

Best wishes to you post-surgery. I had anesthesia for the first time about 2 years ago, and I couldn't get over how the time just disappeared-- one minute, I was awake, the next, I woke up with my tonsils gone.