Sunday, January 29, 2012

How to Have a Hysterectomy

This is the story of my hysterectomy. As with most stories involving female anatomy, proceed with caution.

I've had symptomatic fibroids for years, and finally, I had had enough. Each symptom by itself was fairly minor: bad cramps and heavy bleeding; a giant hard mass in my gut; fatigue from chronic anemia; frequent urination because of the pressure on my bladder. But put them together, and they add up to more than just a minor inconvenience. I wanted the damn thing OUT.

"Is there a test you can do to determine how close I am to menopause?" I asked Dr. KriP, who happened to be young enough to be my daughter. I was hoping impending menopause would make the surgery conversation moot.

"Unfortunately, no," she told me. "You could be five months away from menopause, or five years. At 50, you are exactly in-between the two sides of an easy decision. If you were 55, I'd say wait. If you were 45, I'd say do the surgery." She was trying to be helpful.

Dr. KriP proposed a hysterectomy with a traditional midline incision--one that runs straight up the middle from the pubes to the belly button--to put it in strict medical lingo. I was not on board with this idea. The thought of having a belly-crack to match my butt-crack was evisceratingly horrible.  Not to mention the long recuperation and the excruciating pain. I needed nitrous just to consider that option.

"No, thanks," I said pleasantly. "How about a laparoscopic procedure?" I had done just enough research to make things difficult. She told me that she and her colleagues did not have the expertise to remove my super-sized fibroids and uterus laparascopically, and I appreciated her honesty.

Then, on a Saturday morning, Dr. KriP called. "I was thinking about you," she said. Really? I thought; on a Saturday? "I was thinking about your low pain tolerance and your need for a quicker recovery time. I think you should call Dr. Minimally Invasive for a consultation. He might be able to do your hysterectomy laparoscopically." So I did, and he could.

In the weeks leading up to surgery, I had several conversations with other women who had dealt with fibroids, and I began to realize that the business of uterine fibroids is extremely competitive. "I had to have two egg-sized fibroids removed," one competitor declared. She did not even make it to the quarter-finals.

"My fibroid weighed a whole pound," said another. "They have it on display at the hospital."

"The woman who had her surgery right before mine had 24 fibroids!" said a third, basking in reflected fibroid glory.

I didn't have the exact data yet, but I was confident I had these losers beat. Dr. MI even told me I was a fibroid machine, and I could palpate a kitten ball-sized solid mass in my abdomen.
"Feel this!" I'd say to Mr. Peevie, lying on my back and pressing above my belly-button. "Feel how huge this fibroid is!" 

He would look over at me, disgust registering in his eyes: "Um, no thanks."

I went in for surgery on a Friday morning at 8 a.m., and related my uterine history and allergies to various be-coated doctor types.

"I need data," I told Dr. KriP. "Make sure I get a count of the exact number of fibroids, and the exact weight. I wanna win this thing!" She looked at me like I was slightly insane, or feeling the effects of some good drugs. "You know," I said, "The crazy competitive world of Uterine Fibroid Epic-ness!"

The next thing I knew, Mr. Peevie was telling me it was four o'clock. I was out of surgery and in recovery. Mr. P told me later that when he first saw me, I looked like Death, pale and droopy-mouthed. Later, he told me what I really wanted to know.

"Congratulations!" he said. "The normal uterus weighs less than three ounces. Yours weighed more than three pounds!" I couldn't wait to see my trophy.

As the anesthesia wore off, my throat got more and more sore, my uvula swelled up, and my bladder refused to cooperate. 

"Gaaacchh, gack, gaaah," I said to the nurse. "My uvula has swollen gacchhh gaaahhh and it's gecchhh gahh gack starting to block my airway. Gack. Please tell the anesthesiologist that I gecchh gecchh need something to unswell it."

"He's in surgery," she said. "I can't call him."

"No, you don't understand," I said firmly, "Gaaacchh. You need to get him in here to look at my gack gack uvula. Look at it!" I opened my mouth and stuck out my tongue and gaacchhed at her.

Ten minutes later my adorable Irish anesthesiologist strolled up to my bedside. "Gaach," I said.

"Let me see," he said. I opened wide and he shined his tiny flashlight into my uvula-blockaded throat. "Wow," he said, "That thing is huge!"

"No gaach kidding," I said. "I need steroids to shrink it." He obliged, injecting miracle juice straight into my IV. It took ten days and two blister-packs of prednisone for my obstinate uvula to return to its normal size.

Meanwhile, my chest, ribs and shoulders started to ache from the CO2 gas dissipating after surgery. Did you know they inflate the abdomen during laparoscopic surgery to improve the surgeon's view of the operative field? Well, they do; and afterward, as it's making its way through your body, random body parts start to hurt, and you feel like you got run over by a tank. That's how I felt, and the only position that gave me a bit of relief was sitting up and leaning slightly forward.

After I tried to pee several times, unsuccessfully, the nurse came in carrying a suspicious paper package. "I'm going to have to put a catheter in to empty your bladder," she said matter-of-factly, unwrapping a large garden hose.

"No, no, no," I said matter-of-factly. "No catheters. I hate catheters. No." Mr. Peevie, standing next to my bed, looked at the nurse and raised his eyebrows sympathetically.

"Well, it has to be done," said Nurse Ratched. "Lie back." She came toward me, swinging the the hose like Indiana Jones and his whip.

"Shit!" I said loudly. "No. No. Absolutely not." Mr. Peevie looked at the floor. "Besides, I can't lie back. It hurts too much."

"Well, I've never put a catheter in while the patient was sitting up, but I'll try," she said brightly. I'll spare you the details, but she got that hose up in my down there parts while I was not only sitting up, but also yelling and crying. I'm sure she subsequently added this achievement to her resume.

My bladder drained, but the pressure from the garden hose still felt like an urgent need to pee--like when you're on the highway, and the next rest stop is 20 miles away, and you have to hold it because you're a girl and you can't just hop out and pee behind a tree. Boys are lucky.

By this time it was nigh on eight p.m., and they were anxious to get rid of me. Nurse Ratched told me that they would be sending me home with the catheter which I would have to keep in until Monday--three days hence. (Why am I suddenly talking like Tess of the D'Urbervilles?) This was not a tenable situation.

"No frickin' way," I told her. "No. Uh-uh. Not going to happen."

"Yes," she said, "The doctor said..."

"Then you get the doctor down here to talk to me, because I am not going home with a catheter in me for THREE DAYS," I insisted. "In fact, I cannot stand this catheter in me for one more MINUTE, and if you don't take it out, I will take it out myself." Meanwhile, the urge to pee was becoming more intense and painful, and my crabby meter was registering in the red zone.

Ratched left the room, and when she returned, she proposed a compromise. "The doctor said we could remove the catheter and send you home on one condition," she said. "You have to promise that if you don't urinate on your own in eight hours, you will come back to the ER and let them re-catheterize you." She ominously itemized all the horrible things that would happen if I didn't cooperate, like Exploding Bladder and Kidney Malfunction and Hair Cancer.

"No problem," I said, so relieved I practically burst into tears. "I am committed to peeing." Mr. Peevie promised to bring me back if my urinary tract did not cooperate in the allotted time frame.

I slept on couch, sitting up, because any other position increased my pain exponentially. Weirdly, I had very little discomfort from the abdominal incisions and the actual amputation of my giant uterus. I hobbled to the WC several times, but did not actually successfully urinate until about 3 a.m.--about a half hour shy of the deadline. Phew.

The CO2 pains lasted about a day and a half, and the sore throat from intubation lasted exactly one week. Other than these relatively minor post-operative challenges, this surgery was a breeze. 

I think I'lll have a hysterectomy every December just so I can have the time off. 

What? Uteruses can grow back, can't they?

Monday, January 2, 2012

Twenty Twelve

Don't you love the new year? I do. The bowl is empty and you get to start cooking up whatever delightful repast you choose.

In 2012, I choose Jesus and writing.

My Jesus project is called Living with Luke. I decided to choose one book of the Bible to live with this year: to read through multiple times, and to study bit by bit, and to memorize from. I chose a gospel because I have neglected my faith somewhat in recent years. You know, what with kids and work and broken bones and homework and Life. It's no excuse--this is exactly where faith is relevant and meaningful. But I've been spending more time with Heath Barkley and Detective Goren than with Jesus, and I feel the need to return to the basics, to the Teacher.

I'll keep you posted on this project, assuming that I am able to stick with it.

My writing project has two goals: first, to blog more regularly, because blogging is story-telling, and story-telling makes me happy. "More regularly" is loose enough to encompass a couple of times a week or a few times a month, so that's my goal. Tell your friends to check in at least once a week.

But I feel compelled to work on a bigger writing project, so I'm putting the Book back on the table. I have at least two book projects in seminal stages--and by "seminal stages" I mean somewhere between an idea in my head and a draft of a book proposal including three chapters. My progress on these projects in 2011 was limited to non-existent, and that needs to change.

Writing is hard work--most writers will tell you that. After dealing with an eight-hour work day as well as the daily responsibilities of a household with five people, what I want to do is relax with a glass of wine and Simon Baker or one of my other pretend boyfriends. But I'm thinking that my soul or my psyche or some force inside me demands that I use my love for writing for more than just writing grant proposals and case statements.  My goal is to make a little progress on a book project every week.

I've had three weeks off in December for surgery, and I am rested and happy and ready to have a great 2012. How about you? What are you cooking up in 2012?