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.