Thursday, February 2, 2012

83 Days

Today is February 2nd, Groundhog Day. For most people, it's a day when a grumpy woodchuck is hauled out of a fake burrow into a carnival-like atmosphere and "decides" whether or not we will have six more weeks of winter.

Newsflash, people: we will always have six more weeks of winter after Groundhog Day. The spring equinox isn't until March 20.

Leaving aside the absurdity of trusting a large rodent to predict the weather, Groundhog Day means something else to me. On February 2, 2007, I underwent a total hysterectomy. On February 2, 2007—five years ago today—I got my life back.

I've alluded to the operation before in passing on el bloggo before. I specifically addressed it in one of the first posts I ever made, but I have never discussed what happened to me in the years leading up to my surgery and why I decided on, as my surgeon put it, "definitive management" at the age of 33.

I had a lengthy post partially written about all the trials and tribulations I endured, starting at the very beginning, but I have decided instead to let the 83 days (for perspective, that's 11 weeks and 6 days—almost three months) leading up to my surgery speak for themselves. I wrote these words down elsewhere long ago so I would never forget how horrible those days were. 


A slight bit of background: in the spring of 2005 I began to suspect something was wrong with me, and in October 2005 I went to the first of many doctor's appointments. By November 2006, I had been poked, prodded, procedured, and pill-popped to the extreme, with no relief or explanation. I was having periods that lasted two, three, or four weeks with mere days between bleeding episodes.  I was an emotional wreck from the hormone war inside me (I was on estrogen, progesterone, levornogestrel...). My whole life revolved around what was going on in my nether regions. Everything I did—from what I wore each day (the darker the better) to how long it took me to towel off after a shower to the sheets I chose to put on the bed (never the white ones)—depended on the state of affairs downstairs. My uterus had made my life miserable for a year and a half, and in November 2006 it launched its final assault.

Warning: everything from this point forward may be Too Much Information for some to handle. Proceed at your own risk.

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Day 1 (aka D-Day): November 12 (2006). I run the Ann Arbor Turkey Trot 5K that morning, come home, take a long hot shower, and find the first trace of Aunt Flo. "I've been expecting you," I murmur. What is her visit this time going to be like?

Day 16, November 27. Things have taken a turn for the worse after two weeks of mostly clear sailing. All of a sudden I am a fountain of blood. It's an unstoppable river. Clots galore. It's ugly.

Day 19, November 30. I wake up that morning in a fog, head spinning, so weak and dizzy I can barely stand up. I throw up. I call in sick to work. Go to the doctor. Get some estrogen pills. Am told to take TWO iron supplements per day to offset all the blood I am losing.

Day 20, December 1. A peanut-sized piece of my uterine wall falls out of me today. It is horrible. That is all I wish to say about that episode. (a quick note: The sight of that pinkish-gray blob stuck to the end of my tampon twisted my brain. I could not comprehend what I was seeing. It was like a horror movie. I thought: "My insides are falling apart." I broke down and cried. It would not be the only time I cried in the bathroom at work.)

Day 36, December 17. The estrogen FINALLY seems to be working. The open faucet has slowed to a steady trickle.

Day 37, December 18. I meet with the wonderful Dr. G at the East Ann Arbor Clinic today. I tell her I have been bleeding nonstop for 37 days. I tell her I want a hysterectomy. SHE AGREES. I get an appointment to see a surgeon at the University of Michigan hospital in a month.

Day 55, January 5 (2007). I have another pelvic ultrasound. I am bleeding like a stuck pig. I make a mess all over their sheets. I stand up and blood droplets splash on the floor, my leg, the sheet I have wrapped around me. I am so embarrassed. I say, "I'm sorry, I'm sorry." I want to die.

Day 58, January 8. Morning: The fresh Super Plus tampon I put in a mere hour ago is saturated. The next one is saturated within an hour and a half. And the next one after that lasts two. I go through five Super Plus tampons in one work day. I am exhausted by the end of the day from blood loss. The entire week is very, very bad. I estimate I lose at least 1/8 to 1/4 cup of blood per day. I give up on tampons and just let blood run freely into the toilet. I watch it. I picture my measuring spoons and cups, blood spilling everywhere, clots, running red, toilet bowl water like some operating room basin, a slaughterhouse.

Day 60, January 10. I realize I have been bleeding for sixty days. I start to wonder just how long it can go on. Now it's a game. A terrible, ghastly game. A game for which I cannot see an end.

Day 61, January 11. I have to get up three times in the middle of the night to change tampons. They are each saturated, rendered useless, in two hours or less. Only the pads I wear at the same time keep my clothing and sheets from being fouled. This goes on for days.

Day 66, January 16. I meet with the even more wonderful Dr. S. at the U of M. I beg her to make it stop. Just make it stop. Give me relief. Give me a hysterectomy. Take it all away. SHE AGREES. I have a surgery date of February 2. (Dr. S. is my hero. I truly believe she saved my life.)

Day 80, January 30. Eighty days. I have now been bleeding for eighty days. How is that even possible? I think back to November 12. If someone had told me on that day that I would still be bleeding at the end of January I would have laughed and told them they were insane, because periods don't last that long. How could a person bleed for 80 days and still function properly?

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Three days later, I had my operation. I will never forget the sensation of returning to consciousness in the recovery room. It was as if someone were slowly turning up the volume on the real world. I heard soft noises gradually getting louder, felt a soothing massaging sensation on my lower legs (anti-embolism cuffs), realized I was warm and comfortable...and...and...then, one thought, crystal clear, pushing all other thoughts aside: It's over. IT'S OVER. I WILL NEVER BLEED AGAIN. The joy and relief I felt at that moment were overwhelming; If I had had the wherewithal to scream, I would have: "IT'S OVER! IT'S OVERRRRRRRRRR!"

I'm sure the nurses would have loved that.

I wrote this a few days after surgery:
Surgery was Friday the 2nd (Groundhog Day...no word on whether or not my uterus saw its shadow upon exiting my body) and took about three hours. I came to in the recovery room at 3:00 and rested there for the next 6 hours as they tried to find me a room upstairs. I was finally moved into a room at 9:00. I had a mostly uneventful night, tried to get some sleep, used my morphine drip button as often as possible, and was woken up every hour for a vital signs check. The next morning my surgeon came around to see me and when she asked me how I was doing I said I was, above all, "relieved." She looked quizzical and I said, "It's over. Eighty-three days of bleeding and it's over forever. I'm just so happy." As I had predicted on the day I had my pre-op appointment with her (January 16) I was indeed still bleeding the day of surgery. 83 days straight. But it's OVER!

She told me that I had two pedunculated fibroids growing outside my uterus that were about three inches in diameter-- about the size of a tangerine. She showed me with her hands. Then she showed me how big my uterus was. The two fibroids combined were larger than my uterus. Ugh. I am so glad they are gone. I exclaimed, "Well that explains some of the odd sensations I had been experiencing for the past few months!"

I'm just so darn happy that it's over and I can start living normally again. When I took a shower the other day, it was so strange to be able to leisurely towel off instead of madly scrambling to pull on a pair of undies with a pad or shove a tampon into place before I started dripping blood on the floor. I am just not used to NOT having to wear feminine products 24/7. I have to keep reminding myself, "I have no uterus!" It's a wonderful thought. 
The transition to life After Hysterectomy was a wondrous journey. My first post-op shower (mentioned above) was the first in a series of rediscoveries of a life I had all but forgotten, a life that for almost two years had been drowning in a lake of blood.
I am now at day 12 post-hysterectomy and the novelty has not yet worn off. I'll turn over in bed, feel some muscles tense and then relax, and I think, Oh...I better make sure I just didn't have breakthrough bleeding...WAIT A MINUTE. When I used the bathroom in the time B.H. (Before Hysterectomy) it became second nature to perform a quick undie-check to make sure I hadn't fouled up my clothes. I still do it, and each time I give myself a little mental shakedown to remind myself I don't need to do that anymore! That will be a hard habit to break. Everything is so wonderfully NORMAL that I'm still getting used to it.
It took a long time for my sense of discovery and wonder to wear off. Each day in those early A.H. weeks was a revelation, but gradually I grew accustomed to my new life. One of the biggest triumphs I experienced was starting to run again six weeks post-op. Whereas before I had been severely hindered by fatigue from anemia (the 5K I ran on D-Day, November 12, was the limit of my endurance at the time), in the spring of 2007 I began to stretch my legs, so to speak, running farther and eventually faster than I ever expected. In May of 2007 I registered on a whim for the Detroit Half Marathon, and the rest is history.

If you've made it this far (and congratulations on that!) your reward is my discussion of the nuts and bolts of the how, what, and why of my surgery and the conditions that caused it to happen.

I had a laparoscopically-assisted vaginal hysterectomy (LAVH), which means the fabulous Dr. S. made three 1 cm incisions on my lower abdomen, delved into my innards with laparoscopes, and pulled my uterus and its appendages (fallopian tubes and cervix) out through my vajayjay. Having an LAVH meant I did not have to have my stomach sliced open from side to side: the peduncular fibroids clinging to my uterus were not prohibitively large for passage through my vagina. Once all the goods were removed, what was left of the ol' vajayjay was closed into a blunt end. I imagine it as a test tube and affectionately refer to it as "the vadge to nowhere." My ovaries were left behind; there was nothing wrong with them (small miracle!) and Dr. S. made it clear she didn't want me going into menopause at the age of 33. 

I was suffering from a condition called menometrorraghia, which is fancy-speak for "crazy-ass periods with no discernable pattern AND bonus fun awesomeness of massive blood loss!" The menometrorraghia was itself caused by adenomyosis (abnormal thickening of the endometrium) and a nasty little bugger of a submucosal fibroid a mere 1 cm in diameter that was camped out inside the uterine wall. The two pedunculated fibroids hanging off the exterior of my uterus were just there for show.

You've got the how, you've got the what...but what about the why? Why did my uterus sprout benign growths? Why did the interior thicken and grow in weird ways? Why did it happen? I still don't know. The best I can come up with is "it just did," and because I'm a scientist, that really irks me. I want evidence and explanations, and not knowing why my uterus decided to revolt after 30-ish years of peacefully residing inside my body bugs the crap out of me!

Some questions will be left unanswered.

Two more thoughts.

First: When I went to see Dr. S. six weeks after surgery, I thanked her profusely for changing my life for the better. I wish I could say I hugged her, but I honestly can't remember. I do remember, however, when she said:

"When you came here that day [January 16, the day I met her] you knew exactly what you wanted, didn't you?"

I sure as shit knew what I wanted. I wanted to be FREE. She gave that to me, and I will remember what she did for me for the rest of my life.

Finally: I consider February 2 my "second birthday." It is as important a day in my personal history as my real birthday or the day I got married.

Today is February 2. Happy fifth birthday to me!