Close but No Cigar

[Part three. This one is more graphic, and probably less funny. Surgery isn't really funny, so I don't know what you expect from me. Also, I need to apologize to those of you who thought my surgery was today. It was last week, and I am recovering quite well. Thank you for your concern.]

I tried to be optimistic, really I did. I felt confident in my doctor’s ability. I had back up help with my daughters if needed. The laundry was washed and dried and folded. The fridge was stocked with all the necessities. I was prepared to have a day or two of down time. I was ready to go.

The night before my surgery, I shoved one pill in my vagina and a melatonin in my mouth and slept well. I woke up in the morning, had a lovely shower, gave my legs a courtesy shave, put on comfortable clothing, and made the morning routine as close to normal as possible for my girls. After making their breakfast, I made my own and took my other pill orally. I slipped my other prescriptions, my vaginal morphine suppository and my Xanax, into my purse. We all got in the car to take the girls to school before heading over to the doctor’s office.

By the time we got there, whatever that cervix relaxer was had kicked in pretty good. I can’t vouch for how relaxed my cervix was, but the rest of me couldn’t walk a straight line. My husband signed in for me and then the nurse called us back to a waiting room. She handed me a cup for a urine sample and then told me to insert my suppository anally after I peed. I must have given her a baroo, complete with head tilt, because she explained that she knew the prescription was written for a vaginal suppository, but it’s not supposed to be.

I stepped into the bathroom and stood there for a few minutes trying to figure out what to accomplish first, the peeing in the cup or the shoving a suppository up my butt. I went for the pee, getting some of it in the plastic cup, the rest all over my hand. I put the container in the little cabinet marked “urine samples,” then flushed and washed my hands.

Next, I attempted to open the bottle containing the suppository. The bottle said to squeeze the sides to open the top, but hell if I could figure it out. I stood there squeezing and pulling and tugging, but it wouldn’t open. I stuck everything else back in my purse and stepped out of the restroom. No nurses were loitering in the hallway, so I wandered a bit until I found the lab and asked the woman who may or may not have been my nurse to open the bottle for me. She smiled and took the bottle, popping it open expertly before handing it back to me. “It’s kind of tricky, I know,” she said without a hint of condescension. I went back into the restroom and inserted the little waxy bullet in my ass, marveling at how easily it just slipped right in. I was still marveling about it when I sat back in the waiting room, next to my husband.

“It’s in there,” I whispered loudly. “I can feel it. Am I supposed to be able to feel it?”

“It has to get to body temperature to melt,” he told me.

“Gross,” I whispered back. "I have a candle wax bullet melting in my ass."

A different nurse came and collected me, and we passed by my doctor on the way to another room. I gave her a friendly little wave. We sat down and the nurse asked me to take out my medications, then expressed surprise at not seeing any pain medicine. I told her I already had ibuprofen and the cervix one and the other thing in my ass. Then I apologized for saying ass. She handed me a cup of water and instructed me to swallow my Xanax, then led me to an exam room, where she gave me an injection of something in my left butt cheek. I curled up on the paper on the exam table to rest because I really needed to rest. The nurse came back a little later and I asked her if I could put on some socks that I had brought from home, but I needed help finding them in my purse and then getting them on the right feet. My nurse was very patient. I didn’t feel quite as sleepy anymore, so I read the book I brought with me, only it was more like I read just one word over and over.

The nurse then led me to the surgical room. I removed my skirt and panties as she instructed me, then got on the table with my feet in the stirrups. She covered me up with a paper tablecloth and left me to pretend to read a bit more. After a few more minutes, my gynecologist came in with the nurse. She settled herself between my legs, turned on the monitor and a bright light. I thought how nice it would be if it weren’t so bright, but then she might not be able to see, and it would definitely make reading trickier. Still, she could do the same with a head lamp, which comes in handy while spelunking.

My doctor inserted a speculum, and then began giving me a series of shots in my cervix. You know how you go to the dentist for a filling and you get those shots in your gums and they are supposed to feel like a pinch but really feel like a hornet attack? Yeah, it was that. A hornet attack inside my forbidden zone. Satisfied, she stepped back out of the room to check her Facebook or something while she waited for me to get numb.

She came back in after some time and settled back between my thighs. This is where shit got real.  My doctor stuck something in my cervix; I think it was a dilator, or a series of graduated dilators. Each one was more uncomfortable than the last. Seriously, messing with a cervix is guaranteed to make you see stars with just the gentlest of contact. Ramming it repeatedly with different surgical instruments was a level of pain I can’t find words to describe.

Okay, graphic time. With everything she put in me, something wet flowed, flooded, gushed, shot, squirted out of me. I'm pretty sure it was a large quantity of blood. I held my book up over my face so that I wasn’t tempted to see what was happening to the bottom half of my body, from which I was becoming increasingly detached. I couldn’t even look at the words, but only used my book as a shield.

“There’s the culprit,” My doctor said. “You have a polyp. Let’s just biopsy that first.” That biopsy was the best part. I couldn’t feel it at all.

Then it was time to put a camera up my cooch to see what was going on in the farthest, darkest regions of my uncooperative uterus. Of course she couldn’t see well, which meant she had to move it around a bunch. Every movement brought a new level of pain. She decided to try without the speculum.

“Is this because of my wonky uterus?” I asked.

“Yes, it’s not easy to get in there and see what’s going on.”

She tried next with a shorter speculum. She tried with a longer one. Finally, she stopped trying and called another doctor in to look with her. Someone kept moaning, and it was really annoying.

The nurse came over to me and held my hand. She was a good nurse. She knew this wasn’t fun or easy or normal.

The other doctor watched the monitor as my doctor manipulated the camera around and around and around. They might have talked to each other, but I could only hear my own breathing, my inability to control it, and that annoying moaning.

“Well,” she said, removing the camera and the speculum, “We can’t do this. I’m sorry, but it’s just not worth the risk. You have a lot of scar tissue in here from those C-sections. Looks like you’ll need a hysterectomy, but at least insurance won’t be a problem since we tried this first.”

“Can we talk about that later?” I mumbled.

“Someone go get her some ginger ale,” she said. “You were a champ. Sorry it didn’t work out. But you’ve had a D and C now, so that’s something.”

And with that, she left the surgical room.

I stayed there with a heating pad on my belly, sipping ginger ale through a straw from a cup another nurse held for me. I don’t know how long that went on. At some point I remember my couch at home. And pain. A lot of pain. My husband found some old oxycodone from my daughter’s wisdom tooth extraction, and I took one of those, which I threw up some time later. I slept. I woke up cramping. I slept some more. There might have been a slice of pizza consumed, followed by more sleep and more cramps. Later, I was pleased to see I was still alive.

My follow up is in a week, at which point I get to talk about the next step. I definitely don’t feel ready for anything that involves any more poking and prodding in my baby maker. I thought about this whole experience today, and I’m curious why general anesthesia wasn’t an option. I had five pills at home, a morphine suppository, a shot in my ass, multiple shots in my cervix, and another pill to help me relax. I probably didn’t feel everything, but I felt enough. You would think with all that, I wouldn’t feel anything. This seems to be one of those in office procedures that probably shouldn’t be, or perhaps it’s so fast when it goes according to plan that some level of pain is acceptable. My question is, acceptable to whom?

I’m healing, but I am certainly not back to my normal. I am having a period from hell, as my very angry uterus retaliates for all it’s been through. And lucky me, no tampons for a week.  At least, I assume none. My doctor told me to not put anything in my bottom for a week, but I am pretty sure that is polite Southern for pussy. So I’m using pads, and no swimming or baths or other activity down under, which is fine by me, because I am just as angry with my lady parts as they are with me. And I am disappointed, that it didn't work, that it wasn't easy, that I went though all that and didn't even have surgery. That too will get better with time.

I’m sorry I don’t have a happy ending to share, but what did you expect? Happy endings are only for movies anyway.

Mise en Place

[Part two. If you read the last disclaimer, it still kind of applies, only this one isn't as gross for you squeamish types.]

After a few weeks of not thinking about my surgery, I now had to face it. Today was my pre-op appointment for my surgery tomorrow, an endometrial ablation.

The procedure is about as much fun as it sounds; the doctor inserts a device into my uterus to ablate, to destroy, my endometrial lining and thus hopefully eliminate a monthly, or in my case, more frequent than monthly shedding of my unused potential. Sometimes this is accomplished through burning, sometimes through freezing. In my case, it is a newer method that uses a tool to take measurements of your uterus before shooting a mesh liner to cover the entire inside of the uterus to burn off the lining. Think of a picklepicker that has the web shooting capability of Spiderman. The entire thing takes about five minutes if all goes well, and it doesn’t require general anesthesia, which means less recovery time. Sounds like a piece of cake, a piece of disgusting, burned, ablated cake, doesn’t it?

I usually see my doctor at a satellite office, but the surgery was to be performed at the main office near the hospital. I thought my pre op appointment was going to be there too, so I left a good forty minutes early since I don’t exactly live close to the hospital. I made it there in plenty of time, found decent parking, and walked into the office with fifteen minutes to spare, just enough to deep breathe my way to a lower blood pressure.

Except I was wrong. My pre op appointment wasn’t there; it was at the satellite office. Which meant I had to get back in the car and drive another forty minutes to get to the correct office. I practiced relaxation breathing techniques as I rushed across town, arriving fifteen minutes late and more than an hour after I left my house. It was an inconvenient mistake at most, but there was no way my blood pressure was going to be normal.

I worry a lot about my blood pressure, which is, of course, the best way to make it high.

Luckily, the office staff knew to expect me to come flying in all crazed-like. A nurse took me to a little triage room and took my blood pressure, which I nailed, then started asking me a bunch of questions about what kind of pain medicine I liked.

I have had a few surgeries in the past, and what I have learned from them is this: pain medication is not my friend. I’ve tried most of them, and experience has shown that if I swallow it, nine times out of ten, it’s going to come back up. I envy Rush Limbaugh his ability to develop an unhealthy relationship with pain meds.

I explained my predicament to the nurse, who assured me I would be just fine with lots of ibuprofen. I looked over the paperwork she gave me which said I was supposed to start taking 800 milligrams of the stuff at least three times a day two days before the surgery. So much for that. She handed me one prescription for a vaginal suppository that I had to get from a compounding pharmacy, and then followed that up with a list of the only three pharmacies in town that might possibly have it. I looked at my watch, thought about how I had time to get that medicine and also pick up my children from school, and asked what would happen if I couldn’t get it. She assured me I would be just fine, it just helps with the pain. She handed me another prescription, this one for a medicine to help relax my cervix.  Lastly, she handed me a prescription for one lonely Xanax, which I could have taken right about then. After telling me, again, it was all going to be just fine, she led me to an exam room to wait for my gynecologist.

My doctor breezed into the room and started reviewing my stack of prescriptions at light speed. She is a very competent doctor, but I swear she was a tornado in a past life. She comes in all blustery and leaves before you know what hits you. She explained how to use all my medicines in rapid fire. One pill goes into my vagina at bedtime. I take the other of the same one with my breakfast. I bring a Xanax with me to take along with my vaginal suppository.  The bad part was every time she said the word "vagina," she spread her legs a little bit and pointed between them, as if I wasn't quite sure where my vagina was.

I asked her about the suppository, since I just didn’t see how I was supposed to get it before 8:30 the following morning. She told me it was morphine and belladonna, but it would be okay if I didn’t have it. But breakfast I had to have, so make it a good one. Why? Because that’s too much medicine on an empty stomach, she told me. She then stressed the importance of me taking ibuprofen before I get there in the morning. I was beginning to think that this allegedly five minute easy procedure was going to be five minutes of pure hell.

As she left the room, I asked her how often she performed ablations. She said all the time. In fact, they are so easy, she never got to do hysterectomies anymore. I almost felt reassured. I grabbed my stack of prescriptions and paperwork and scooted out to the car to call the short list of compounding pharmacies. Lucky for me, one of them was only a twenty minute drive away and, lucky for me, had my suppository in stock.

I walked into the pharmacy, and it was like walking into 1960, except there was no lunch counter. I am pretty sure the items on the shelves were older than me, as was the dust that covered them. I talked to the pharmacist, who was the nicest, calmest lady in the history of drug stores. She looked at my prescriptions and then asked me if I had started taking my ibuprofen yet. I told her I had just come from my pre-op appointment, so I didn’t know I needed to until about thirty minutes ago. She just opened her eyes real wide and didn’t say a word.

“This is going to hurt, isn’t it,” I asked her.

“It shouldn’t be that bad,” she said unconvincingly.

While I waited for my medications, a few other people came into the store, all regulars and known to the pharmacist by name. They too looked like they had been coming here since at least 1960. I snuck out to the car to pop four Motrin and get that in my system, then went back inside to clarify some questions with the pharmacy technician, mainly which pill went in which orifice at which time. I had pills for my mouth. Pills for my vagina. Pills for bedtime. Pills for breakfast. And pills to take to the doctor’s office. No wonder it only took five minutes or so for the surgery. All the prep work was done before, by me.

I left the pharmacy and drove another thirty minutes to get in the car pool line in time to get my daughters from school. I stopped along the way to get some fast food, which I abhor, since I didn’t have time for lunch. I sat in my car eating salty chicken tenders and wondering how bad tomorrow was going to hurt. The afternoon felt like “Planes, Trains, and Automobiles,” a movie I hate more than any other. There are two kinds of people: those who love that movie, and me.

My doctor really should have given me an extra Xanax.

An Insider's View

[Disclaimer: This blog post is the first in a series of three posts that are all about my lady parts and their malfunctioning. If you don't want to know that much about women in general, or me specifically, don't read it. And if you do, thank you for your support.]

I never wanted to be that kind of woman who lived according to her menstrual cycle. You know who I mean, the one who won’t go swimming because it’s that time of the month, the one who has to take a day off of work because her Aunt Flo is visiting, the one who stays in bed and feels generally cursed by Mother Nature. I wanted to be like the girls on the Tampax commercials, with their hair blowing in the breeze as they water ski across the river, the ones executing a perfect dive off a platform or racing a car faster than all of the men. No period was going to slow them down.

Unfortunately, I am not a BASE jumper while on the rag. I am, at forty four, finally having to accept the truth about my lady parts, that they are out to get me. Ever since that first time, thirty two years ago, when my panties blossomed red, I have had a less than happy relationship with my uterus. From cramps in  junior and high school that were strong enough to make sitting in a desk impossible, to the horrible head-crushing migraines that plagued my twenties, to my less than ideal emergency C-sections in my thirties, to now, my reproductive system has had it out for me. And finally, after many years of my putting up a good fight, it’s winning.

Over the past few years, my menstrual cycle, which could never in good faith be described as normal, has taken the unusual and extreme to some new limits. I decided to mention how much worse the frequency and length of my periods is to my gynecologist at my last annual exam. She told me that the next time my periods came closer together than twenty days,  I would need to call the office for an ultrasound appointment. Sure, she tested my hormone levels and all that stuff, to see if I am going through “the change,” but honestly, everything else seemed to be okay, except for the part when I never know when my period is going to show up or how long it will last. My period is the worst house guest ever.

I downloaded this lovely app during the summer which keeps track of your periods for you, the greatest app ever created. Men, I am sure, don’t have to keep track of anything when they go to see a doctor, which is as often as never anyway. Women, on the other hand, are lucky to not be asked the date of their last period when checking out at the grocery store. You always know you need to know, and somehow you never do, which is why I still think my second daughter’s due date was more than a few weeks off. Anyway, with this app, I now know just how irregular my periods are. Sometimes, it’s every twenty five days. And sometimes, it’s fifteen days after the last. Considering it lasts over a week, that means some months I only get a week off. Government employees get more vacation time in a year than I spend not bleeding.

So I made my ultra sound appointment. I went to the doctor and sat in an crowded waiting room filled with everyone from young beautiful first time moms to way older women fighting their aging in a very ungraceful fashion. I just sat there, waiting for my turn, trying to avoid staring at the other patients, convinced that I had uterine fibroids and would need surgery, much like my mother and grandmothers had. What do I know about menopause? No one in my family’s history made it that far with a uterus.

The ultra sound technician called me back to the exam room after a bit of a wait that I didn't mind because of the awesome people watching. She was a very friendly woman, and I was nervous, not so much for the test itself as for what it might show, which meant that I was incapable of using what little filter I had and would tell this woman everything. She told me to step into the adjacent restroom to remove my jeans and underwear and to empty my bladder, after which I was to return to the room and settle myself on the exam table with my feet in the stirrups.

I walked back in the room after the peeing and disrobing part and said, “It’s just like at home.” She gave me a look that said odd, so I had to explain that I meant walking around without pants, you know, when you go home and take your pants and bra off, except that I generally keep my panties on at home, so really, it was nothing like that. I couldn't stop words from spilling out of my mouth.

She laughed politely and dimmed the lights. “Ah, creating the mood,” I said. She put a protective latex cover on the transvaginal ultrasound wand and then lubricated it before inserting it into my vagina. Let me translate that. She put a rubber on that thing, lubed it up real good, and tried to stab my cervix. It was all I could do not to ask her to turn on the vibrator so at least one of us might enjoy it, but was it really necessary for me to transfer my discomfort to this woman who was just doing her job?

She moved the wand around a bit, not unlike you would do with a stick inside a hula hoop, before saying to me, “Have you had an ultrasound here before?”

“Why yes, I am a member of your frequent flyer program,” I said.

“Did we put an IUD in you or something recently?”

“Yeah, about a year ago. It wasn’t all that easy.” Which was an understatement. It took two doctors over four attempts and one hour to do what was supposed to be a simple ten minute IUD insertion. Afterwards, it took two nurses to clean up me and the floor. After six unpleasant months, getting that IUD out was also an ordeal. No wonder she remembered me. I was the one who fainted on the table. Fuck waterboarding. If you want to torture someone, have trouble inserting an IUD.

“I knew your uterus looked familiar!” she said all excitedly.

“No one has ever said that to me before,” I told her.

“I don’t know faces,” she said, “but I never forget a uterus.”

She took all the measurements of my lady parts, data that meant something to her and my doctor, I am sure, before checking all around. She located one ovary, but then said,” I can’t seem to get a good picture of the other one.”

“Oh, that one likes to play hide and seek. No one can find it,” I told her. I actually had a theory that I expelled it several years ago, which is why I only get ovulation pain on the right side every other month.

“No, it’s there; it’s just hiding behind a gas bubble in your intestine. See?” She indicated what looked like a tube sausage on the monitor, which turned out, in fact, to be my bulging intestine. She pressed on it a bit more with the transvaginal wand to make certain I knew what she meant, down to the very core of my being.

“Oh, excuse me,” I said. “I’m gassy, and you can see it. How embarrassing.” I was desperately trying to keep it all in. Talk about control. Thank you, Joseph Pilates.

She removed her wand from my love canal and said,” I don’t see anything to be concerned about. No fibroids or anything. You look good to go. Go tidy up and get your pants back on, and then you can wait for the doctor down the hall.”

My gynecologist reviewed my chart, my ultrasound, and my history with me as well as could be accomplished in under two minutes. “An endometrial ablation is the next step. It’s simple, just five minutes in the office, not even general anesthesia. Most women don’t even get periods anymore after they have it done. And it’s perfect for someone like you, who just bleeds too much and doesn’t want any more children but isn’t really going through menopause yet.”

And so, I agreed. I fought the good fight, but I am ready to not have to spend so much of my time planning around my period anymore. No matter what I try to tell my daughters about how periods are a normal part of life, I accept that I am lying. Periods do suck. And I am ready to not have one anymore, especially if it means I can still have my own natural hormones. Sign me up!

Are We There Yet?

My baby went out of town last week for the first time without me, and you better believe I was upset and worried. It doesn’t matter that my baby is fourteen and needs to learn how to take care of herself. It also doesn’t matter that in four ridiculously short years, she will be going away to college, and I better get used it. Right now, she is fourteen, and she is my baby, and she has not spent more than a night or two away from home, and any of those few and far between nights away from home were always less than a two hour drive. This time, she went to the mecca of children the whole world over, Disney World, and she did it via chartered bus, and each way of the drive was a good eight to ten hours. There was no hopping in the car to come to her rescue, had it come to that.

My baby does have a good head on her shoulders, but no matter how good that head is, it is still fourteen and doesn’t fire from all cylinders. Logic is not a big part of the fourteen year old’s decision making process, but mood and feeling is. And if all moods and feelings are influenced by budding ovaries more so than rational brain function, well, I think you see what I am getting at here. This is a child who can’t be counted on to pack what the majority of us would call a lunch, let alone select an appropriate outfit or remember that shoes are required when going to a place of business.

Allow me to illustrate:

Last weekend before her trip, she decided she wanted to do her homework outside on a blanket and enjoy the lovely spring day. Not five minutes later, she stripped down to her bra and underwear in the back yard, because she decided she would work on her tan at the same time she studied. Never mind that a bra and undies are not the same as a bathing suit, nor that she would never let any of us see her in said bra and panties if she were inside the house, nor that it is the back yard for Christ’s sake, nor the fact that in my family, we do not “work on tans,” seeing as my father died from skin cancer when I was just a few years older than she is now.

I worry because I see how her decision making skills are sort of off-kilter during this adolescent time. My husband, who is a man and therefore doesn’t usually understand the point of worrying, actually agreed with me and got in the on the parenting act as well. Before she left, we took turns reminding her of stranger danger and discussing the value of a dollar before handing her a little less than two hundred dollars.

Whoever planned this school trip neglected to include the cost of meals, but it seems a little irresponsible to me to expect teenagers to manage money for four days. I don’t know what you people with teenaged boys would do in a similar situation, but I guess you would probably worry that you didn’t give your son enough money, seeing as how they can eat their own weight in food every day. Teenage girls, on the other hand, don’t like for anyone to know they have body functions, especially eating. My husband and I both worried that our child would not eat, and therefore not poop, for the four days she was away from our vigilant care.

So we had the “talk.” About how much food costs at Disney. About how three meals and two snacks are not unheard of. About how drinking water is essential in Florida, especially if you ever want to crap again. For her part, our teen did a fair amount of eye rolling and complaining and insisting that we gave her too much money. We explained to her that she has no idea how much food costs since she never pays for her own meals. Also, she doesn’t have a credit card to fall back on. What was in her hand had to last for the whole trip, but that didn’t mean not to eat for fear of running out of money. Seriously, these were our main points. It’s kind of hard to have a rational conversation with someone who thought fifty bucks would be plenty. I bet we both sounded like every adult in a Charlie Brown show to her. Wah wah wah wah wah.

She left on a Wednesday night, midnight to be exact, for an all-night bus ride, to arrive in the morning at Epcot, where they would brush teeth and change clothes in a rest stop. In my yoga class, around the same time she was eating a Nutrigrain bar and wondering where she put her retainer, I cried because the teacher played two of my daughter’s favorite songs in a row. The next day, while volunteering, I received a text, a picture of a chicken and waffle sandwich from the Magic Kingdom. I silently was thankful she ate. By the following day, she was solidly in a routine, and I only heard from her when she was clearly devoid of all food based energy and thus bitching wildly about anything and everything. That’s how I knew she was okay.

She got home last Sunday night. Her hair was lighter from all that Florida sunshine. She  hugged me and handed my husband a wad of cash. We gave her one hundred and sixty dollars for food for four days. She came home with ninety-five. She spent sixty five dollars. Then she showed us the shirt she bought herself at the mall when they stopped for lunch on the way home. It was thirty bucks.

 At least she ate a sandwich one day. The rest of the time she survived off frozen lemonade. She wouldn’t even eat the free breakfast at the hotel because it was too nasty. This child of mine isn’t spoiled at all.

For four days, I got used to not having her around, and she got a taste of freedom that was enough for her to hold my hand for a good hour after she got home. We both know she isn’t ready to be on her own, no matter how cool it sounds to grow up and move out. I also understand what it’s going to be like when she does come back to me. I will have to learn to be happy to see her and hold my anger and judgment at whatever choices she makes with which I don’t agree, especially if I want her to come back.

Parenthood is always a dance, and you are the last one to learn the steps. Also, one can’t survive on less than ten dollars a day at Disney. I don’t care what she says.