Friday, December 13, 2013

Let's talk about my uterus

Hey, so I had an endometrial ablation back in October, and I mean to tell you all about it. This will be a pretty darn graphic post (I've decided to skip the photos, though -- YOU'RE WELCOME) with regard to my ladybits and what comes out of them on a monthly basis, so if you're not feeling up for that sort of thing, I invite you to seek your entertainment elsewhere this afternoon. For real, though. This is going to be kind of gross.

(If you just want to know whether I'm happy with the procedure without hearing all the gory details, then YES. I am VERY VERY happy with it. Have a nice day and enjoy your lunch.)

Okay, the rest of you, gather 'round. Here's the thing: I was diagnosed with menorrhagia about ten years ago. We are talking bleeding through an overnight pad in less than an hour on days 1 and 2 of my cycle. We're talking standing in the shower while blood clots the size of plums fall out of me one after another (I know, I'm sorry). We're talking an inability to leave the house and sometimes the bathroom for long stretches of time. Abnormally heavy bleeding: I had it.

When I was first diagnosed 10 years ago I had diagnostics done, ultrasounds and whatnot, to make sure there were no fibroids or cysts or polyps or tumors. There weren't. I was fine. I just bled a lot during my period. My doctor at the time offered some possible treatments, mostly involving either hormones or destroying the lining of my uterus. I don't do well with hormones at all, and destroying the lining of my uterus seemed ... a bit rash, maybe? Invasive? Overkill? I opted for my usual solution to most problems: ignore it and hope it will go away.

It didn't.

So fast-forward 10 years. Ten years of that absolute awfulness every month. Only now that I'm in my late 40s instead of my late 30s, I also get to experience the joy that is sometimes having two periods per month, or bleeding for 20 days with a week off and then another period. I ENJOY BEING A GIRL.

(I should explain that during those 10 years I did try stuff. Tampons: they do not work for me. My flow is thick and tissue-y and I bleed AROUND them instead of into them. Silicone menstrual cups: I LOVED my Diva Cup and thought I had finally found the solution ... until I started getting UTIs every time I used it. I was keeping it scrupulously clean so I assume it was some issue with my anatomy, that the way it was positioned in order not to leak meant it was putting pressure on my urethra somehow. Argh.)

So yeah. Enough of that. My doctor from 10 years ago had retired and my GP, who handles my ladybusiness now, isn't really equipped to deal with this sort of thing. She did send me for diagnostics, though -- very, very thorough diagnostics -- and they showed absolutely nothing wrong again, some more. Hormones or ablation. Argh.

So I went to a specialist, right? And she did even MORE very, very thorough diagnostics. Abdominal ultrasounds, transvaginal ultrasounds, saline-assisted ultrasounds, blood work, camera scopes and more camera scopes. Again, there is absolutely nothing wrong, and in addition to that I am fertile as a Duggar -- my ovaries are apparently so full of eggs at the ripe old age of 47 that I could be pumping out natural octuplets if P hadn't had his own little procedure performed at the urologist when H was a toddler. Which is not what you want to hear when you are kind of praying on a monthly basis for menopause to deliver sweet relief. In addition to hormones or ablation, this specialist offered me one additional possible solution: hysterectomy. Suddenly an ablation didn't sound quite so invasive. I made an appointment.

The procedure I had done was Novasure®. It was performed in the doctor's office under i.v. sedation (propofol). I had to fast for a few hours beforehand, then I showed up at the doctor's office, changed into a gown with fuzzy socks and no undies and a nice, warm blanket (beats a sheet any day), talked to the anesthesiologist, climbed up on a table, had an i.v. inserted, and went night-night.

The procedure itself only takes about five minutes. There are no incisions or sutures or anything like that (refer to the link above for more info on this specific procedure). My doctor took "before" photos of the lining of my uterus with a little camera scope, then did the procedure, then took "after" photos. (Again, YOU'RE WELCOME.) They shot some antibiotic into my i.v. and when I woke up it had already been removed. The doctor talked to me in recovery, let me know everything went fine, showed me the photos, and as soon as I was able to sit in a wheelchair without falling over, they wheeled me out to P's truck and I was done.

So, the recovery. Well. Immediately after the procedure I felt a little sore down there. For the first 12 hours or so there was moderate cramping and just a generally yucky feeling like I was having a bad period. I took Aleve and that helped a bit. I had the procedure at around 3:00 in the afternoon and when I woke up the next morning, the cramps were gone. For the next 3 days or so I'd feel mildly crampy if I stood a lot or was really physically active, but that was about it as far as discomfort went. In terms of pain or whatever, within a day or two it was like I'd never had anything done.

There was discharge, but it was mostly very light. Kind of yellowish for the first 24 hours, then I started passing little bits of dead tissue (WAY less gross than the giant clots I was used to). That went on for a day or two. I would say that in all I had light discharge for about three weeks after the procedure; however, the last week of that was likely a period according to the app I use to track my cycle. During that last week my discharge was a bit pinker than it had been, and I got mildly crampy again, but I never really BLED, you know? After the first 48 hours post-procedure I didn't need anything heavier than a pantiliner, and even at its heaviest the discharge wasn't even a FRACTION of what I'd have during a typical period. I was expecting something like post-birth lochia but it was nothing like that.

I figured the big test would come when my NEXT period was due, since that one wouldn't be overlapping with my recovery as much. So here's what happened: first of all, according to my app this period was four days late. Welcome to your late 40s. On the fourth day after it was due to start, I woke up feeling a bit crampy (not bad, just noticeable) and put on a pantiliner just in case. At around lunchtime I went to the bathroom and there was a little smear of fresh blood on the pantiliner so I put on a pad. After several hours there was NOTHING on the pad, though the toilet paper was a bit pink when I wiped. I switched back to pantiliners and over the course of the next 7 days I had a few instances where there was just a smudge of fresh blood on the liner, transitioning to older-looking blood as the week went on. My cramps were never bad at all and I never needed anything heavier than a pantiliner.

You guys? I would recommend this procedure in a heartbeat for anyone who is dealing with very heavy menstrual bleeding and does not want to have any more biological children. I really wish now that I had done it 10 years ago. I went into it thinking that even if we could cut my periods in half, flow-wise, that would be a huge victory. But to only need pantiliners for a few days out of every month? HELL YES. That is HUGE for me.

So yeah. I'm very happy. If you've got questions or need more details, put them in the comments or shoot me an email. Otherwise we need never speak of my ladyparts again. So let it be written, so let it be done.

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