Thursday, November 29, 2012

The Day After

I woke up on Friday, August 17, 2012 feeling wonderful. I joined my mom downstairs and she said, "How do you feel? You look great." I told I felt really good. We had breakfast, everyone got dressed, and talked about what to do with the day.

There's this little produce place that I had joined a few months earlier and wanted to take my mom. It's only open two, sometimes 3, days each week and one never knows exactly what they'll have. For a small monthly fee I have privilege of shopping there and my family has enjoyed eating more fresh and organic produce because the prices are so low. Mom wanted to go, my kids were along for the ride, and we arrived shortly after they opened at 11:30 am.

I don't know what we bought, but I know I was feeling good when we left and headed to another store that mom doesn't have access to in her state. It was just a short drive away and we headed there.

By the time we arrived around 12:30 at that store, I was feeling tired, but OK. We walked through the store. Found some good deals, but within 30 minutes, I looked at my mom and said, "I think I need that wheel- chair from the front of the store. Can you go get it for me, please?"  She walked to the front of store and returned with it.

My mom and my two kids wheeled me through the rest of the store. I assured them that I was OK and just feeling tired. When we left at 1:15, I was weak and totally exhausted. We drove straight home, where I landed myself on the couch- too tired to walk the steps to my bedroom on the second floor.

Around 3 pm I checked my temperature. It was 99.8 degrees. I was sick. My normal body temperature is a cool 96.6 and when I hit 99.0, I'm sick. Like, laying on the couch bundled up and not moving sick.

At 4:00 Mom stuck the thermometer in my mouth. It read 101.4. I called the OB/GYN office. Of course, it was a Friday afternoon and they'd already closed up shop for the weekend. I followed the instructions to get a call back from the doctor on call. He called me right back. He asked for details like when I started feeling bad. He assured me that I hadn't "over done it" shopping. He was concerned about the late onset of the fever. He said, "If this was Thursday night, I might have you just wait and come in tomorrow, but it's Friday and the office won't be open until Monday. You shouldn't have spiked a fever this afternoon. I think you should come in to the emergency room. I'm already here waiting for an expectant mom to deliver. Please, tell the E.R. staff that I'm here already and told you to come in." By 4:15 pm I was off the phone and calling a close friend, asking her if I could drop my kids off- I was going to ER. Mom called my husband and my dad. They were out working on our "dream home (which, truthfully warrants a blog dedicated that particular adventure)," and it would take them 35 minutes to drive home and a bit longer to get cleaned up for the hospital. She said she'd call them when we knew something, but don't worry about hurrying in.

At 4:30 we dropped my kids off with my friend. They were excited to spend time with her two children, and I told them I loved them and would see them later in the evening. We pulled out and headed to the hospital. I sipped on a Crystal Lite "mocktail" on the way. I felt awful. I was thirsty. I was so very cold.

4:45 pm, August 18, 2012: My mom pulled up to the ER entrance at the hospital, got a wheelchair for me, wheeled me in, and went to park the car. I signed-in, shivering in the wheelchair. Within 5 minutes my name was called. I told the staff that I was just 36 hours post-op after an endometrial ablation and was running a fever. I anticipated waiting for an eternity before being seen. Instead, I was wheeled right over to be officially signed-in. I had my insurance card scanned, answered questions about my health, blood pressure checked, and my temperature checked in at a cool 100 point something. Apparently drinking that cold drink wasn't the   smartest thing I could have done. My mom came in and I was relieved. I seriously could not answer any more questions.

To my surprise, 5 pm found me in ER room 7.

Wednesday, November 14, 2012

Burning Pain... And I Volunteered For It.

Thursday, August 16, 2012 was a day that I had looked forward to for three weeks. It was the day that was going to change my life forever. It was going to put an end to me missing life because of my period. Instead, it nearly put an end to my life.

My appointment was at 10 am. I was instructed to arrive an hour early, bring my prescriptions, and have someone waiting to drive me home. My mom was visiting from out-of-state and drove my kiddos and I to the office. I kissed everyone and was taken right back to a prep room. The nurse gave me a cup of water and tipped out a Percocet and a Valium. "Take these. They'll help you relax for the procedure. We're cleaning up the room now and will take you back shortly. Do you have any questions?" No, I did not have any questions, I was just ready to get it done and head home to nap.

I had my iPod and played a rousing game of Mahjong while the medications had a chance to work their way through my bloodstream. Within 15 minutes the nurse was leading me down the short hallway to the surgery room.

Directly in front of the door was the exam table... Stirrups out. The NovaSure instrument was to the left. It had a screen and some warning stickers on it such as "machine will only run for 90 seconds and then will require x amount of time before reuse." There was a chair between the machine and the table along the back wall. I went over and had a seat. Another nurse came in and asked what medications I'd taken and when did I take them (Percocet, Valium in the other room). "Do you have a prescription for ibuprofen?" "Yes," I replied. "May I have it? You'll need to take one of those now." "Yes, here it is." Water, swallow horse-pill sized ibuprofen. The next item on the agenda was a shot in the rear. For the life of me, nearly 3 months later, I think it was a muscle relaxant, but I'm not entirely sure.

Dr. W. came in wearing scrubs, greeted me, and said I needed to strip from the waist down, hop up on the table, and cover with the paper sheet. You know, the typical drill in an OB/GYN exam room. She came right back in, followed by two nurses. I noticed that the room was equipped for IV lines and briefly wondered if they were ever used during this procedure. Again, no one asked me about my history of Group B Strep.

I was swabbed with some sort of cleansing agent and the NovaSure machine was turned-on to get ready. It was not a quiet machine. Dr. W. told me she was going to dilate the cervix and insert the wand. There was a camera on it. "Look at that screen, see all those blood vessels in your uterus. That's a lot. This machine is going to cauterize them all using radio waves. If it's successful, you should have a whole year of absolutely no periods." My response, was something along the lines of "that will be great, those are all blood vessels?"

Before actually turning on the machine, I was reminded that it was going feel like a really bad cramp and it was going to last for a full 90 seconds. "OK. I'm ready."

Ninety seconds can feel like an eternity. I delivered baby #2 without drugs and will readily admit that childbirth is a painful experience. I will also admit that after one scream the doctor looked at me and said, "Screaming will not help you. You need to focus on pushing. Don't scream." I didn't scream again. I just pushed. The NovaSure procedure was a bit like childbirth. It hurt. It really hurt. The nurses asked how I was doing and I barely got out "OK" through my gritted teeth. My eyes watered with the pain (yes, I cried, but I tried no to) of having my uterus burned to a crisp. I wondered what in the world I had gotten myself into. And then, it was over. Unlike childbirth, I did not have anything to show for my efforts or pain. I had a mess. The doctor and nurses cleaned up what I imagine looked a lot like a disemboweling, turned off the light, and let me doze before coming back in a few minutes later.

They came in, sat me up, and told me to sit tight for a bit longer- they'd kept my mom and kids updated in the waiting room. When I felt ready, I could get dressed. They left a heavy duty post-partum type maxi pad for me. Standing up I wobbled on my feet. I managed to get my shorts back on (why, oh why had they not recommended yoga pants for this?), cleaned up a bit more of the gore on the table (I did what I could and figured it just wasn't my job) and opened the door. A nurse walked me out. I scheduled the two week, no, three week follow-up. Dr. W. was booked and couldn't get me in until the three week, nearly four week mark. I was reminded to not swim, take a bath, or have sex for 2 weeks.

The rest of that day is a bit of a blur to me. I napped most of the afternoon. I took a Percocet at the recommended time and then a 600mg ibuprofen before bed. I'm not big on drugs and my mom is a nurse who believes that if you can handle the pain, you should. I could handle it, so I did.

I went to bed early and woke-up feeling great the next day.

Sunday, November 11, 2012

An ultrasound & a Biopsy

So, an ultrasound is no big deal. It really isn't. I don't mind having ultrasounds done. This one was no different. The technician was personable. The room was actually warm (versus the usual cold of every doctor's office). Truthfully, there are no details from that event worth sharing. The results, however, might be.

My patience thus far was rewarded with the results of the ultrasound being phoned to me within 72 hours. The nurse that called told me "you have a large uterus and the endometrial lining is thicker than normal." Ah, this would explain my "problems." I finally felt like I wasn't nuts for feeling like my period was abnormally heavy. I mean, who actually talks about how heavy their periods are? I have a couple of very close friends, and while we do talk about personal things, we don't generally go into gory details.

With the results of the ultrasound in, it appeared that I was a good candidate for NovaSure. The next step was an appointment with good ol' Dr. W. for an edometrial biopsy.  Before going in and totally burning the uterus, the doctor wants to be sure there isn't cancer hiding and causing the menstrual problems.

Have you ever had one of those biopsies done? It's not something you'll soon forget. First, you assume the position (heels in the stirrups, bum nearly hanging off the exam table, knees spread). Then, the doctor dilates the cervix. OUCH! Dr. W. told me that if I "did OK with the pain, we could do the NovaSure procedure in-office. Otherwise, we'd have to do it in the hospital under full anesthesia." She also warned me that it would feel like a bad cramp. Honestly, it felt like a bad cramp. It was the gathering of the samples for the biopsy that about did me in. There are no words to describe what it feels like to have a part of one's uterus picked-off to be sent to a lab, so I'm not even going to try. Let me just say that I handled it well enough to be told to make an appointment for the procedure on the way out. I was also handed prescriptions for ibuprofen, an anti-anxiety drug, a narcotic, and told to fill them and bring them with me to the appointment.  

May I make a note here? Oh, that's right, I'm the one writing this blog. I'd like to point out that at no time has any one asked me whether or not I'd ever tested positive for Group B Strep. It never came up. If it had, I would have told them that, yes, as a matter of fact, I did test positive with both of my pregnancies. This is important because Group B Strep (GBS) is a bacteria that, if you test positive for it, requires that you are hooked up to an I.V. of antibiotics before the doctors will allow you to deliver your baby. The antibiotics are to protect the baby during travel through the birth canal. They are also to protect mom from having that bacteria enter the blood stream during delivery. My doctors never told me that last part. They only said it was to protect baby. Given that GBS lives in the vagina and vaginal births generally end with tearing at best and episiotomy at worst, it's the perfect chance for that bacteria to get into the blood stream. So, one would think that since NovaSure involves taking an instrument up through the vagina (possibly picking up GBS), beyond the cervix, and into the uterus, testing for GBS would make sense. Again, the bacteria lives happily in the vagina, but is not supposed to get past that cervix. The cervix is, ideally, an exit only from the uterus.

Back to the story. On my way out from the biopsy, I stopped and made the appointment. Thursday, August 16, 2012 was the day appointed for my NovaSure procedure.

Tuesday, November 6, 2012

I Waited Six Weeks for This?

I'll never forget meeting her. She walked into the exam room, introduced herself, and shook my hand. "Hi. I'm Dr. W."  She was a very pretty blond. I couldn't help but hope she'd take me seriously. We talked. She asked about me and what brought me in to see her. I told her I was a homeschool mom. I was only really feeling "normal" one week of every month. My periods made my life difficult. I felt bad that my kids and husband had to deal with me. I tried to put on a happy face and just deal with it, but it's kind of hard when the only thing that helped was a good nap. Not very practical for a homeschool mom.  

After that "introduction to my life," the visit went something like this after a "why are you here, seeing an OB/GYN" question:

Me: "Well, I certainly wasn't going back to the practice I went to when I had my babies. Dr. G.                          recommended you."

Dr. W: "Oh, I see. What can I do for you?"

Me: "I'd like to have an endometrial ablation done."

Dr. W: "Hmmm. Heavy periods, low energy, no interest in sex, mood swings... Are you sure you're not dealing with depression?"

Me: "I've dealt with depression. This is something else entirely. I think, if my periods were just normal my life would improve."

Dr. W: "You're 34. This is totally normal. Are you sure you don't want to try an antidepressant? I could also put you on birth control pills to regulate your cycle. That might help."

Me: "I'm not interested in going on any drugs. I've heard wonderful things about the ablation. I'd like to have that done."

Dr. W: "OK. Well, you can't swim or have sex for two weeks after the procedure. This is summertime, so I recommend waiting until the fall to have the procedure done; after school has started back up and there's no chance of you needing to go swimming with your children. Most of the moms that have NovaSure done go on birth control for the summer, just until their procedure."

Me: "I'm not going on birth control. Swimming is not an issue. I want to have everything done as quickly as possible."

Dr. W: "I'll need you to schedule an ultrasound so we can make sure that you're a good candidate for this. Make sure everything is normal with your uterus and ovaries. If that turns out normal, then you'll come back for a pelvic exam and I'll take a sample of the endometrium to check for cancer. Your cervix will need to be dilated. That's pretty painful, but if you do OK, it will mean we can do the procedure in the office. If not, we'll do it in the hospital with general anesthesia."

Me: "That's fine. I'm OK with all that."

The whole appointment took all of 15 minutes. She gave me two brochures about endometrial ablation, one provided by NovaSure, one with general information. She never asked about the deliveries of my babies. Never really went over the possible risks- she'd done around 600 and never had anything bad happen. Never inquired if I'd ever tested positive for Group B Strep. Didn't ask if I had family close to help me out after the procedure. Really, she didn't press the issue. Just looked at and said, "Sure, if that's what you want, we'll do it. You're so lucky you have this as an option. It used to be that women with heavy periods had to have a hysterectomy."

I made the appointment for the ultrasound.

It was only a 3 week wait to get in for that.

 


Monday, November 5, 2012

You Mean I Have to Visit My Doctor?

March 2012 I found myself hurting and wondering what in the world was wrong with me. My joints ached. My cycle was a crazy mess. I was fighting depression and thinking that maybe, just maybe, losing so much blood every single month had something to do with it. (Which, by the way, I'm convinced it did. Doctors, however, disagreed with me.) I called my doc and got in before the end of the month.

Before I go further, I should disclose that I have a general distrust of the medical/pharmaceutical/government  powerhouse that is our current system. I believe that we truly are what we consume. I believe that the body is designed to do certain things (the uterus is for child-bearing, breasts are for making milk for babies, brains are for learning and thinking) and when we don't allow those cells to do what they are designed for, we're more likely to experience diseases specific to those areas. Those are my personal thoughts that I've developed after reading lots of books and looking at statistics. I'm not interested in debating that in this venue. I grew up only visiting the doctor for annual check-ups and if a sore throat was looking like it could be a strep infection. I'm raising my children the same way... Sort of.

Why is this distrust relevant? I want my readers to understand that I do not run to the doctor for a fever, a sniffle, or even a cough that lasts for a month. Doctors are for life and death situations in my book. I can look at my children month after month and see that they do not need a well-child visit. They are well. They are growing, learning, and advancing as they ought. I treat myself the same way. I need to lose weight? I exercise and say no to the sweets that every single tooth in my mouth craves. Or, I bite the proverbial bullet and buy bigger jeans.

So, I went to my general practitioner knowing that a) he was going to say, "It's been FOUR YEARS! YOU ARE OVER-DUE FOR A PAP!" and b) he was going to take me seriously and let me talk about why I was there, because it had been 4 years. He was concerned about my joint pain, not concerned about my diet or weight (yes, I've gained weight, but I'm 34, have 2 children, and don't eat processed food unless necessary), and didn't have much to say about my period complaints. He ordered fasting blood work and said, "We'll talk after that."

Blood work came back all within normal ranges, although my thyroid levels were at the upper end of the newer standards, which my doctor wasn't using. Nothing out of the ordinary. So, he told me to see an OB/GYN about the period thing. I asked for referrals. I hadn't been to the group that delivered my babies since my 6 week post-birth check-up 8 years earlier. I looked the doctors up online. One was in the group that I used for both babies (no thanks, and he was a male). The second was another male. Nope. I was ready to see a lady doctor. The third was a female and looked to be about my age. I called and made an appointment. There was a six week wait.

Sunday, November 4, 2012

It all began...

I first heard about endometrial ablation as a 28 year old. An acquaintance had one done after her second child. I didn't think about it again for 5 years. Another acquaintance sat down next to me at an after church fellowship and said, "Let me tell you about God's gift to women." I was thinking more along the lines of a new dark chocolate, Spanx(R), or even menopause. No, she launched into singing the praises of endometrial ablation, specifically, NovaSure(R).

My interested was piqued. She told me her story of being a woman in her late 40's and dealing with ridiculously heavy periods. Periods that arrived whenever they wanted. Periods that left her in situations requiring friends to purchase pants for her while dining out. Really, what are you going to do? Walk out of a nice restaurant a bloody mess? Periods that lasted longer than 7 days and required the world's largest tampons and pads. Periods that left her exhausted. But, she no longer had to deal with periods. NovaSure took care of that. She had energy. She was able to exercise again. She got my attention. I'd switched from O.B.(R) Ultra Tampons to the Diva Cup (R) and was aware of exactly how much I was bleeding. At 33 years of age I was exhausted. I gave up my gym membership because I was just too tired. I mentioned that and she said, "You can only have the procedure done if you're done having kids. You're still pretty young..." I replied that while I was young enough to have more babies, our family was complete with two children. "Oh! You should definitely have NovaSure done! It's so great!"

That was in the Fall of 2011. I thought back to that conversation repeatedly over the following months. Every time my monthly came early... or late... or twice in one month I thought, "Maybe I should see my doctor and ask him about NovaSure."

Fast forward to March 2012. I was sick of feeling tired. Sick of bleeding that was so heavy that I hesitated to leave the house. Sick of not being able to be the mother that I wanted to be to my children.  Sick of losing the better part of 3 weeks of every month to my period. One week of PMS. One week of bleeding. One week just trying to get back to whatever "normal" was. Maybe my math is off, but, the way I figured it, I only had one "good" week a month. Looking at over a year: 3 months of PMS, 3 months bleeding, 3 months recovering, 3 months of "normal." When I talked to my husband in those terms, he jumped right on board and encouraged me to call my doctor.

To be continued...