The Peri-Menopause Diaries II – Does this bulky uterus make me look fat?

Beat up uterus

Previously on I Hate My Uterus, Why Is It Doing This To Me…

From the number of private messages and emails I received after my last peri-menopause post, it looks like I am not alone in the struggle. Some folks shared their personal experiences and others thanked me for tackling such a personal topic and asked me to keep sharing. So, here I go again, with the usual caveat, of course, that this post will contain graphic women-stuff and if you’re squicked out by that then the time to turn back is now.

Still here? Good. Let’s talk about my lady parts! Yay!

When I last left you, I had come to the end of my peri-menopausal rope and had decided it was time to go to the doctor and seek a solution. And guess what? The doc agreed that I was not just being a hysterical female or that I was a hypochondriac (this is an actual problem with women and health care). He gave me a referral to the local gynecologist and off I went.

But before I tell you about my gyno visit, I want to stop a moment and talk about that whole “hypochondriac” thing because it’s important. If you are female, and you experience pain or fatigue, especially menstrual pain there is a much higher likelihood that your symptoms will be minimized or dismissed by your medical practioners. I’ve read horror stories of women whose genuine problems were dismissed as a case of over exaggeration only to discover much later that they were dealing with cancer or any number of life threatening illnesses. There’s a reason so many women are turning to unproven and sometimes ridiculous or dangerous alternative cures and “wellness” techniques (please don’t put jade eggs up your vagina, no matter what Gwyenth Paltrow tells you), it’s because we’re not taken seriously.

I’m here to tell all the women reading this that if you have a medical problem, if you are experiencing severe pain, fatigue or depression, you deserve real medical solutions. Please don’t let anyone brush off your concerns for your health. Keep demanding answers until you get them, even if you have to keep changing doctors. And where menopause and peri-menopause is concerned, yes, it’s natural but that doesn’t mean you have to suffer needlessly. Leprosy is “natural” but your doctor wouldn’t simply pat you on the head and say, “Some people just lose body parts, it’s part of the natural cycle” if you had it.

/rant

Back to the gyno doc.

Dr. A has a shabby little office in the heart of the city. I can’t say I was feeling overly confident as I sat in the waiting room, flipping through Facebook on my phone to distract from the cries of pain and distress in the next room. Eventually I was led in and Dr. A and I had a long discussion about the state of my health. He read off a list of symptoms and I answered yes to almost all of them (no hot flashes…yet). Then, inevitably, he wanted to examine me and take a biopsy of the offending sexual organs, so off went the pants and on went the flimsy piece of modesty paper.

The exam revealed that I probably had at least one fibroid (common) and that I had adenomyosis aka “bulky uterus” (also common). Chances were that both the fibroid and my endometriosis were behind the excessive, Niagra Falls, bleeding.  Dr. A gave me two options: an endometrial ablation or a hormone-releasing IUD (Mirena Coil), but recommended the former. He discussed the pros and cons of each and sent me home with an armload of pamphlets and a prescription for Fibristal, which would stop the bleeding NOW and also shrink any fibroids that might be lurking in there. He also sent me for blood tests and an ultrasound to rule out cancer.

I headed home, excited about the possibility of regaining control over my rebellious uterus, and hit the Google to research which of these two options I should choose.

Ladies, if you feel like you need a heavy dose of frustration and fear, I highly recommend reading through any women’s health forum about gynecological devices and procedures. Over and over again I read that the Mirena was the best/worst thing that had ever happened to these women, ditto for the ablation. There was no shortage of horror stories, either, about all that had gone wrong. Talking to real women I know didn’t help either—some had great success with the IUD/ablation, others had more of those horror stories.

In the end, I decided on the ablation because I know that hormones have a way of messing me up physically and emotionally (birth control pills were awful) and I’ve had a standard IUD and though it did its job it also caused severe cramping during my period.

So what is an endometrial ablation, you ask?

Quick women’s physiology refresher:

Every month, a woman’s body gets ready to have a future college-tuition-needing human. To prepare for that possible human, the uterus lines itself with a soft, comfy, squishy layer of tissue, known as the endometrium. Meanwhile, the ovaries are busy growing an egg. When it’s ready, the egg hops into the uterus and nestles in to the endometrium to wait for her gentleman callers. When said egg discovers that no one has swiped right on her Tinder profile, she declares, “Egg out!”, drops a tiny mic, and heads out of the uterus, taking the endometrium with her in true diva fashion.* This is a period or menstrual cycle (for those of you who don’t know or who are lucky enough to not have one).

Is that too much science for you?

Sometimes things go awry with the endometrium. Sometimes the tissue that is supposed to line your uterus instead grows in other weird places. This is endometriosis and it is super, super, duper painful. It is also one of the causes of the aforementioned “bulky uterus”, when endometrial tissue grows into the muscle of the uterus.

Anyhoo, there are other causes of bulky uteri, but that’s a common one. An endometrial ablation is when a doctor goes in and burns off the endometrial lining. As the lining heals, it scars, which means no egg attachment, and no (or significantly diminished) blood build up, which means very small or no periods.  A kind of female scorched earth policy, if you will.

There are different ways to burn off the lining, in my case, a type of balloon would be inserted into the uterus and pumped full of water hot enough to do the job. Naturally, this is done under general anesthetic, but it’s a quick procedure and a simple day surgery.

I’ll spare you the details of my ultrasound, which involved me trying desperately not to wet myself as the tech pushed the little ultrasound torture wand on my bladder over and over again. I’ll just say that it confirmed I had a fibroid but its size and location did not preclude the ablation. And my blood tests came back clear, except for my iron levels which had been dropping faster than Trump’s approval rating.

While I waited for my surgery date to arrive, I enjoyed being period free thanks to the Fibristal. This proved less joyous when my two weeks of free samples ran out and I discovered my extended medical insurance doesn’t cover that drug…which is $200 for a two week supply! Thanks, Obama.

On June 28th, I checked in at the local hospital for the ablation. And here I should mention that I am a huge chicken when it comes to getting my blood taken (it doesn’t help that my low iron levels make me feel like fainting when any kind of blood is removed from my body) and a massive, nuclear chicken when it comes to getting IV’s put in. Dr. A made a note that I could have some Ativan to calm me down and I asked the nurse if they had some freezing gel that I could put on my hand.  They did! I apologized for being such a wuss and she assured me that they would far prefer I tell them and take the appropriate measures rather than have me freaking out when the time for the hand-stabbing arrived.

And here let me take another quick moment to talk about self-care. No one likes to feel weak or wussy. Society drills into us that if we ask for any kind of special considerations at any time then we are special snowflakes and whiners. You know what? Fuck that. I suffered through stressful airplane travel for well over a decade because of this logic—Fred can attest to all the times he held my sweaty hands on take-off, landing, and through turbulence. My fear stemmed from a traumatic experience and there was simply no wishing it away. Now? I pop an Ativan and enjoy the ride. In fact, the ride has been so stress free that I find I can now often fly drug-free.

So when I get my blood taken, I ask to lie down. Awesome. No stress, no fear. When I have to get an IV I ask for Ativan and freezing gel. Awesome. No stress, no fear. Don’t let people make you feel small or weak for taking steps to minimize fear and anxiety. Be your own advocate. You are worth it!

/rant #2

The ablation went smoothly. The whole thing takes about 15-20 minutes, though I did not come fully out of the anesthetic for several hours. This always happens to me. I think partly because I’m really susceptible to general anesthetic and partly because I will always take advantage of a guilt-free nap under heated blankets.

That was a week ago. I am still recovering and will be for at least another week. But I am mobile and able to do most daily stuff except vacuuming, heavy lifting and stretching, and sex. As you can imagine, Fred is really bummed out that the house isn’t getting vacuumed.

I was warned to be prepared for heavy cramping and bleeding at first—“the worst period ever” according to the anesthesiologist—but so far I’ve only experience mild spotting and a few medium-painful days.

Will it work? I don’t know. But, even if the ablation buys me a year or two of small or no periods then it will be worth it. I will still have to deal with the wild hormone swings, I assume, and there’s still the matter of the low sex drive to address, but at least if I’m no longer merely a blood factory I can get back to my fitness routine and get out of that rut where I am so frustrated and sad that I want to punch sea otters in the face.

As always, I find myself learning valuable lessons late in the game. I should have sought help a long time ago. No one is ever going to care about my physical and mental well-being as much as me, so it’s my job to demand proper care. I also think that going in for surgery made my husband realize that this was a real medical issue and not some flaky “woman thing”. I’m not sure he’ll ever really “get” it, our bodies are just that different, but me taking action and seeking help went a long way to demonstrating the seriousness of my situation. There’s a wide gulf between “I feel crappy and you should understand!” and “I feel crappy and I am going to find out why and see if there is a solution”. As women, we owe it to ourselves and the people who love us to take that step and to search for solutions.

I waited too long to ask for the help I needed. I hope you won’t.

I will probably share another update down the road. Until then, me and my new, svelte uterus will be doing our best to make things work between us. Because there is no me in uterus.

Sorry, couldn’t resist.

*The egg actually breaks apart but I write fiction and, thus, took a little creative license.

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