The Uterus Chronicles, Episode the Last

Welcome to the last installment of The Uterus Chronicles! If you  need to get caught up, here’s Episode 1 and Episode 2.

As mentioned at the end of Episode 2, I had found the right doctor for me (who ended up being a surgeon), and had scheduled my hysterectomy for August 7th 2012, a week and a day ago.

(There are other places to go for in-depth information on hysterectomies, alternatives, risks and whatnot – one of the best places being the HysterSisters, celebrating their 14th anniversary this month. I learned a lot at their site, though I wasn’t a frequent contributor. )

So, last week I had my hysterectomy. I actually walked into the operating room – wow, what an experience! I tried to catalog as much as I could with my writer’s brain. It’s true, operating rooms are very white, very bright (even without those huge lights over the bed turned on). Two nurses were counting surgical instruments (of which there were LOTS – like, way too many to be used on my body); the Chief of Anesthesia was there doing his thing prior to giving me an epidural; a couple other nurses were busy doing something (but they were behind me, so I couldn’t see what they were doing).

As soon as I felt the numbing go down to my toes, I swung up my legs and settled on the operating table before the epidural settled into my butt. And that’s pretty much the last thing I remember before waking up in recovery.

Soon, I was happy to get settled in my own room. The doc took pictures of my incised uterus (which I am NOT sharing here – you’re welcome!) and showed the hubs before I got to see them – and I must say, the photos were impressive. As reported elsewhere, the typical female uterus is 6-8 cm. Mine was 22 cm. I liken it to the size of a little kid’s soccer ball (for four-year-olds). Plus, my uterus held over 40 fibroids of all sizes and calcifications, the largest of which was 8cm. Apparently, my OR team was impressed (and I ended up being the talk of the doc’s office staff, as well, lol). All in all, it needed to come out. I’d made the right decision.

After some hemoglobin issues during recovery (my body recalibrating itself), and some pain med issues (they bumped me up to percocet), I finally came home Thursday evening. Grateful to be here, despite the heat.

One of the takeaways from this experience for me is, surprisingly, the pain management. I had a low, bikini-cut incision that was carefully stitched internally and seamed with glue on the outside (kinda neat, I think). I can tell when I’m in pain (besides, you know, the pain) – the area around the incision gets hot. It never got hot in the hospital, nor did it when I was on the percocet. (I switched over to the vicodin when it became apparent that I’d never eat solid foods again while on perc.)

“Staying on top of the pain” is more than mere med-speak. It’s real, it’s vital, and it’s damned hard to do. Do I sleep, or set my alarm to take my meds at the right time? I’ve gotten all discombobulated the past three days, which has made the pain management difficult. The boys are working with me, and I’ve got a whiteboard telling me what to take when, but still getting the right pills inside me at the right time has been interesting, frustrating, and an intellectual exercise (how in the hell do soldiers, who live by “toughing it out”, deal with pain meds?).

Other writers may write really well on drugs – I, however, am not one of them. It’s too hard for me to keep my story in mind as I write, so until the pain meds get tapered to just ibuprofen, I’m sticking to reading and blog post writing (because that’s about my attention span, lol).

As my doctor said, the body heals slower when in pain (which is why he advocates an epidural during surgery – keeps a lot of the pain at bay those first 12 – 24 hours). Staying pain-free is imperative to healing, at this stage. I’m also learning that just because I might not be in immediate pain (when the vicodin has kicked in and I’m floating) doesn’t mean it’s okay to haul around  cast iron pans, or gallons of milk, or that I should bend over to feed the cat. My old nemesis  friend, patience, keeps patting my hand and telling me to relax and about an hour after the meds kick in, I do relax. But I’m looking forward to this part of the journey being over.

The big takeaway for me, however, is to encourage everyone to pay attention to your body. When I was in my twenties, I kept a couple pages in my day planner to detail my monthly cycle. Days I started, how heavy the flow, etc. I only wish, now, that I had kept it up through the years. If I had, I might have caught that my periods were getting heavier; that I was gaining weight without changing my eating habits; that my stomach seemed hard, and bulgy (because, you know, it wasn’t my stomach).

I wish I had mentioned the heavy periods to my doctor; that I’d complained more about the little things that could have led them to a diagnosis of fibroids sooner.  More than anything, I wish our culture wasn’t so afraid to talk about uterus issues. I wish I had had a community of women to turn to when things started to change (the curse of being in a small nuclear family without an extended family).

I have that community now. Women I’ve been friends with have opened up to me and shared their experiences. They’ve taken me under their wing and assured me all will be well and I believe them, completely. But not having that community is why I posted such a deeply personal topic on this blog in the first place. I didn’t know where else to go, didn’t want to whisper about it, and saw no reason to hide an issue that may face every woman (or her friend) at some point or another.

Speak up. For yourself to a doctor. To a friend in need. Reach out and help where you can, and ask for help when you need it. Women’s health, while it has come a long way, is still in many ways a shadowy part of medicine (in the fact that uterus issues aren’t openly talked about) and it doesn’t have to be that way. It SHOULDN’T be that way.

Plus, we’re all getting older. PAY ATTENTION to your body. Make notes of how you feel, maybe once a month. I’m not advocating being paranoid; I’m advocating being aware. Its so easy to ignore stuff that may be bothersome; but if you can catch a health issue before it becomes an emergency, you and your loved ones will be far better off.

Okay my chicks, lecture over! Back to our regularly-scheduled Wine Fridays…thanks for listening.

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This concludes Christine’s two years of health issues. She will be back to her regularly healthy self very soon, and appreciates your patience with her. She has renewed her warranty for the next 50 years, to her hubby’s satisfaction.

 

The Uterus Chronicles, Episode 2

If you’re just joining the conversation, Episode 1 is here – “Does My Uterus Make Me Look Fat?”

Episode 2: Help! I Need a Good Doctor!

So, I really liked the OB/GYN I had gone to. I felt cared for, and listened to, and the next day I even wrote her a thank you note. I felt like I’d found my medical home, female-wise at any rate. The biopsy came back about a week later and it was negative for cancer, always good news. My new doctor and I talked for about twenty minutes about my options -one of which included Uterine Artery Embolization. She gave me the name of a place near her office that does this type of work, and suggested I talk to an Interventional Radiologist before I make a final decision. And, whatever I do, if I could let her know she’d really appreciate it.

I made the call. I got transferred to three different people before the office manager came on the line to tell me that, no, not only do they not do UAEs, but they have NEVER done UAEs. So I call the doctor’s office back, get the office manager, and she tells me that well, maybe this other place has one, and UCLA has one. But she’s not giving me any kind of referral (the bane of having a PPO instead of an HMO. I guess the Motion Picture HMO spoiled me, sigh).

So I back away from the phone and think some more. People make mistakes, I’m aware of that. But this mistake is kind of a big one. And do I want a doctor that makes mistakes because they didn’t do their homework? What if they make a mistake while in surgery? Or while prescribing hormones or something for me?

I’m not in any kind of an emergency situation, so time passes as I dither think about my options, and suddenly it’s time to see my GI doc.

This is the same doctor that did my colonoscopy two years ago – and when he comes into the patient room, I remember that I really like him. He’s got a big smile and a hearty handshake, and he listens to my entire tale before telling me not to worry. That the bleeding in my stool is most likely from the hemerroids (sp) caused by the fibroids (the trigger that started this whole drama). Unless things change down the road, he doesn’t want to see me for another three years and I’m happy to oblige, lol. He also told me to take a fiber supplement -one dose a day for the rest of my life. He says its like a miracle drug for all Gastro-Intestinal docs, and he’s been doing it for 20 years. So I’m now taking the generic equivalent of Benefiber each day.

So then, I started poking around on the internet. Found a highly respected doctor, fairly local (but then, anything within 50 miles is local in the Los Angeles area), with major expertise in removing fibroids without removing the uterus. Even big fibroids. Bingo! I checked him out thoroughly and made the call to get a consultation.

The pleasant person who answered the call barely heard me describe my symptoms before she told me, in a firm voice, that the doctor doesn’t take any insurance and it’s $250 to $450 to walk in his office door and talk to him. (After checking the website again, I see that you have to put up 20% of the cost of surgery prior to having it.) I put the phone down, once again confounded by doctors.

I wasted time did some more careful thinking about my options. I still hate the way I look and feel. More friends talked to me about how great they felt after their hysterectomy (after they healed, that is).

Finally I hit up the internet one more time, searched out several doctors, and found one closer than the other one. I filled out an online “consultation form”; and two days later, at ten o’clock on a Friday night, that surgeon emailed me back. He assured me that his office takes my insurance, and encouraged me to set up an appointment, which I did.

I took my husband to this appointment, and I’m really glad I did. This doctor specializes in minimally-invasive gynecology surgery as well as urinary tract surgery. He doesn’t deliver babies or see women on a yearly basis, and he’s done thousands of these surgeries. He talked a bit to both of us about options, and did an exam, and told me my uterus is 18cm and the fibroids are calcified, which means they can’t come out laparoscopically – as a calcified fibroid is basically rock-like, and they can actually break blades. (I know. Weird, huh?)

He also said they didn’t calcify overnight – I’ve probably had fibroids for years (most women do), they grew slowly, and over the past five years or so calcified. He couldn’t give me a reason why other doctors missed it so I’m doing my best to let that part of this whole thing go. (Change happens, and we’re not always aware of it. Got it.)

He drew pictures, gave me and my husband a straightforward view of how it all happens, as well as possible complications. He was warm, intelligent, caring, and spent quite a long time with us going over other options but in the end, I chose to have a TAH – Total Abdominal Hysterectomy – leaving in the ovaries.

This is a man I trust. This is a man who cares, who answers email from a stranger at ten pm on a Friday night, who spent time talking to my husband as well as to me.

On a high note, when I asked my nurse neighbors about this doctor, they both gave him a two-thumbs up (they work at my local hospital, and this doctor sometimes does surgeries there as well). Gee…I really should have asked them for doctor referrals earlier in my doctor search, but I didn’t think of it. Who better than nurses to give referrals to doctors?

Surgery is scheduled for August 7, 2012. I want to be as healthy as possible going into surgery, so I’m walking, eating healthy, and giving myself ballet classes (well I was until I sprained my ankle); I’m taking iron supplements (patients tend to lose 2 points in iron during abdominal surgery – I’m at an 11, over 12 is normal, he wants me at a 13); I’m also taking calcium and fish oil, but I have to stop the fish oil ten days prior to surgery (it’s a blood thinner, did you know?). 

So that’s the story. The takeaways? 1. ALWAYS see the proper doctor for the proper thing. 2. DO YOUR HOMEWORK when searching for doctors – ask friends, neighbors, nurses for referrals. 3. TAKE YOUR TIME if you can before deciding on any procedures. and 4. TAKE A FRIEND/LOVER with you to any important doctor appointments. They will often be thinking clearer than you and will both ask important questions, and remember the answers afterwards.

My next book, DEMON HUNT, comes out either July 15 or August 1st, so I have promo to do for that.

I’ll also be hitting up RWA’s Annual Conference in Anaheim at the end of July, then back to work for a week of getting Important Stuff Done; then I’ll go out on disability and have surgery. During recovery, I’m going to be a writing fiend, as I won’t really feel like moving much. Middle of September? Back to work. Middle of October? Start giving myself ballet classes again to get into shape. A busy summer/fall!

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Thanks so much for stopping by! There’s a Midsummer Blog Hop tomorrow, and on Friday I return with a Wine Blog – sorry about the absence of that feature! Cheers all, and remember to Drink Responsibly!