semiotic_pirate (![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png)
semiotic_pirate) wrote2015-02-03 08:05 pm
semiotic_pirate) wrote2015-02-03 08:05 pm
The Journey Toward Being a Crone
Four weeks ago, I found a new GYN doc that turned out to be one hell of a great decision and choice. She believed me, she empowered me to make decisions about my body, she gave me hope that I could finally get out from under the crippling pain that I had been experiencing on a monthly basis for YEARS.
Two weeks ago, after getting results back from my initial exam and based on a previous GYN’s TVA that had never been followed up with (b/c previous practice was a “patient mill” just wanting to make money and not actually caring about said patients or their health), I went through a very thorough and uncomfortable TVA exam. Mass – likely a fibroid – confirmed to be located in my uterus and the likely culprit for the steadily increasing, recurring episodes of crippling pain.
Okay. For the record: I am not underreporting or overreporting my pain. There have been good months where I only have one day of pain so bad that it reaches from my shoulders to my knees and wraps fully around my torso, and there are months (like this one) where I’m in pain for three days straight. This is need a doctor’s note because you can’t focus enough to work from home, never mind go into the office and work level of pain.
Note that prior GYN was only willing to tell me to take Aleve. Never even suggested that maybe I should take an acid reducer pill along with the mega dose of Aleve so that the naproxen wouldn’t eat a bunch of holes in my stomach. I figured that out on my own after I started experiencing severe GERD symptoms, which were much worse when I needed to take Aleve – to the point where I stopped taking it b/c the pain from (likely) an emerging ulcer was getting worse than the cramps. And the Aleve is only good for about six hours for me, despite the claim on the bottle that it’s supposed to be good for twelve hours. Which means I wake up with my legs and arms curled in and flexing out, waking up in massive pain, by 2am and can’t get back to sleep b/c I have to sit up and wait for the pain meds to kick in again.
I didn’t end up with prior GYN by choice, per se, but by default. I was seeing this wonderful GYN at this practice and we were sympatico and she was very supportive and intelligent and empathetic. I was starting to go through peri-menopause at the time and hadn’t yet started with the severe pain. Overall though, I like the new GYN better than all my previous GYN experiences combined.
Anyway. Replacement GYN pretty much threw all of this woman’s notes out the window and said:
Because it was an intermittent occurrence, because I was majorly stressed out at work because of the workload inherent with too few staff and a volatile, downturned then struggling economy, because it is such a difficult process to find a new doctor… I believe it ended up taking nearly three years to get where I am now. Ugh. Moving on.
Back to today. Today, I stepped another step forward toward being a crone. Today was the next step – identifying the mass – which is suspected of being a fibroid. The biopsy was not fun at all, although it was not as painful as my typical cramping pain. When I mentioned this to the doc, she replied that she was not surprised at all. Just prior to the biopsy, I had asked her for a doctor’s note because I had just missed three days from work last week.
Between one major snow storm and the next I had a humdinger of a period. Full on lack of sleep and one of the worst experiences of pain yet. Best part? It was my second one in the month of January. HOW THE HELL DID I END UP WITH TWO PERIODS IN ONE MONTH?!
Yeah. Let’s get back to the biopsy. You start out with your usual paper blanket, keeping your shirt, sweater, scarf, leg warmers, and scarf on. Bottom layers prepped with a nice, heavy flow pad for when this is all over. However, the new element at this point is that, instead of the plain paper sheet on the exam couch, you are sitting on top of an absorbent pad (twelve by twelve inches) with a waterproof backing… Because this is a procedure that I looked up and identified as an endometrial biopsy. This means that you get the usual speculum, followed by a clamp that is used to hold one edge of the cervix so the doctor can better access the uterus. The clamp grabbing and setting is a sharp pain. Then, if you’re really lucky like me, they’ve got to do something to dilate you too, again to get access to the uterus. More pain will be experienced, quite a bit sharper than that from the clamp. The next step is when a flexible pipette type of thing is slid up past the clamp and into the uterus. That pipette is moved up and down while a miniature vacuum runs to suck out cells scraped off the edge of the uterus as a result of the movement. That’s even more painful that the clamp but not as painful as the dilating. After less than thirty seconds of that, you’re all done and everything starts getting removed in reverse order. Throughout the whole thing I was consciously trying not to tense up since, in my experience, tensing up results in more pain.
Okay. I noticed I did a bit of distancing from the actual experience by mixing up my perspectives up there. Not going to fix it as it speaks to how I reacted to the experience.
Afterwards, I was talking with the doc for a bit about what comes next. While doing that, I felt myself leaking onto that pad I mentioned earlier. Sure enough, after our talk, when I went to get up, there was a bit of a red puddle that had been soaked up. Damned glad that had a waterproof backing.
The talk with the GYN went well. We’d already touched base with the fact that this whole series of steps will likely end up with me getting some type of hysterectomy. Now that she’d had a chance to eyeball my uterus through the TVA images and the biopsy, she’s recommending a laparoscopic assisted vaginal hysterectomy and the removal of everything but the ovaries. She figured I likely have about five years before they completely shut down given the length of my peri-menopause to date.
The whole idea of a hysterectomy is just a little scary, but more of a feeling of relief than anything else. In the end, it’s about reducing pain and increasing quality of life. Being scared is that, realistically, sometimes things go wrong, and that this is considered major surgery with a 2- to 3-night hospital stay and a multi-stage recovery to consider.
The most important thing for me to keep track of right now though is how this is all getting paid for. I’ve got what’s called a “high deductible” health plan. I put in a little more per month than the PPO plan requires for payments and I’ve been on this plan for quite a few years and it has worked well for me. With my DH on the plan, the deductible is about $4,450. Yeowtch, right? Not really. Because once that is paid, the plan I’m on covers 100%. In the long-run, it is much more cost effective and a safer bet. I just have to convince the hospital to take about $1,000 up front and put the rest of whatever is left of the deductible at the time that they bill for the surgery on a automatic payment plan equal to 2/3 my bi-monthly HSA contribution. I don’t see them having a problem with this once I get a chance to talk to them – probably tomorrow because of the staffing issues and overwork brought on by the near back-to-back major snowstorms. That’ll be a source of stress until I get it settled.
Next steps include:
All of this is scheduled to be over and done with by the end of March, with the surgery occurring shortly before Saint Patrick’s Day. I consider this to be Significant and Apropos due to thinking that this life change will bring closure to a time in my life when a series of most tragic events occurred and I was given a large dose of pain. When my son (my one and only attempt to procreate, that ended in sadness and death) was born. This is the date that I refer to as the “Birth/Death Anniversary” because it was not only the date when my son was born, it was also the date that my first husband took his own life. The details of that series of events is something that I’m going to have to put down in writing, explore, and perhaps fully put to rest; however, it is a tale for another day.
Two weeks ago, after getting results back from my initial exam and based on a previous GYN’s TVA that had never been followed up with (b/c previous practice was a “patient mill” just wanting to make money and not actually caring about said patients or their health), I went through a very thorough and uncomfortable TVA exam. Mass – likely a fibroid – confirmed to be located in my uterus and the likely culprit for the steadily increasing, recurring episodes of crippling pain.
Okay. For the record: I am not underreporting or overreporting my pain. There have been good months where I only have one day of pain so bad that it reaches from my shoulders to my knees and wraps fully around my torso, and there are months (like this one) where I’m in pain for three days straight. This is need a doctor’s note because you can’t focus enough to work from home, never mind go into the office and work level of pain.
Note that prior GYN was only willing to tell me to take Aleve. Never even suggested that maybe I should take an acid reducer pill along with the mega dose of Aleve so that the naproxen wouldn’t eat a bunch of holes in my stomach. I figured that out on my own after I started experiencing severe GERD symptoms, which were much worse when I needed to take Aleve – to the point where I stopped taking it b/c the pain from (likely) an emerging ulcer was getting worse than the cramps. And the Aleve is only good for about six hours for me, despite the claim on the bottle that it’s supposed to be good for twelve hours. Which means I wake up with my legs and arms curled in and flexing out, waking up in massive pain, by 2am and can’t get back to sleep b/c I have to sit up and wait for the pain meds to kick in again.
I didn’t end up with prior GYN by choice, per se, but by default. I was seeing this wonderful GYN at this practice and we were sympatico and she was very supportive and intelligent and empathetic. I was starting to go through peri-menopause at the time and hadn’t yet started with the severe pain. Overall though, I like the new GYN better than all my previous GYN experiences combined.
Anyway. Replacement GYN pretty much threw all of this woman’s notes out the window and said:
“Nope, you’re not in peri-menopause, despite all the symptoms you are having which point to the fact that you are. Nope. Despite your prior history, I think you should only get pelvic exams every two to three years rather than annually. Nope. I don’t think that your reports of increasing pain are of any concern. Deal with it. I don’t have any ability to care about your “issues” now get the hell out of my office.”
Because it was an intermittent occurrence, because I was majorly stressed out at work because of the workload inherent with too few staff and a volatile, downturned then struggling economy, because it is such a difficult process to find a new doctor… I believe it ended up taking nearly three years to get where I am now. Ugh. Moving on.
Back to today. Today, I stepped another step forward toward being a crone. Today was the next step – identifying the mass – which is suspected of being a fibroid. The biopsy was not fun at all, although it was not as painful as my typical cramping pain. When I mentioned this to the doc, she replied that she was not surprised at all. Just prior to the biopsy, I had asked her for a doctor’s note because I had just missed three days from work last week.
Between one major snow storm and the next I had a humdinger of a period. Full on lack of sleep and one of the worst experiences of pain yet. Best part? It was my second one in the month of January. HOW THE HELL DID I END UP WITH TWO PERIODS IN ONE MONTH?!
Yeah. Let’s get back to the biopsy. You start out with your usual paper blanket, keeping your shirt, sweater, scarf, leg warmers, and scarf on. Bottom layers prepped with a nice, heavy flow pad for when this is all over. However, the new element at this point is that, instead of the plain paper sheet on the exam couch, you are sitting on top of an absorbent pad (twelve by twelve inches) with a waterproof backing… Because this is a procedure that I looked up and identified as an endometrial biopsy. This means that you get the usual speculum, followed by a clamp that is used to hold one edge of the cervix so the doctor can better access the uterus. The clamp grabbing and setting is a sharp pain. Then, if you’re really lucky like me, they’ve got to do something to dilate you too, again to get access to the uterus. More pain will be experienced, quite a bit sharper than that from the clamp. The next step is when a flexible pipette type of thing is slid up past the clamp and into the uterus. That pipette is moved up and down while a miniature vacuum runs to suck out cells scraped off the edge of the uterus as a result of the movement. That’s even more painful that the clamp but not as painful as the dilating. After less than thirty seconds of that, you’re all done and everything starts getting removed in reverse order. Throughout the whole thing I was consciously trying not to tense up since, in my experience, tensing up results in more pain.
Okay. I noticed I did a bit of distancing from the actual experience by mixing up my perspectives up there. Not going to fix it as it speaks to how I reacted to the experience.
Afterwards, I was talking with the doc for a bit about what comes next. While doing that, I felt myself leaking onto that pad I mentioned earlier. Sure enough, after our talk, when I went to get up, there was a bit of a red puddle that had been soaked up. Damned glad that had a waterproof backing.
The talk with the GYN went well. We’d already touched base with the fact that this whole series of steps will likely end up with me getting some type of hysterectomy. Now that she’d had a chance to eyeball my uterus through the TVA images and the biopsy, she’s recommending a laparoscopic assisted vaginal hysterectomy and the removal of everything but the ovaries. She figured I likely have about five years before they completely shut down given the length of my peri-menopause to date.
The whole idea of a hysterectomy is just a little scary, but more of a feeling of relief than anything else. In the end, it’s about reducing pain and increasing quality of life. Being scared is that, realistically, sometimes things go wrong, and that this is considered major surgery with a 2- to 3-night hospital stay and a multi-stage recovery to consider.
The most important thing for me to keep track of right now though is how this is all getting paid for. I’ve got what’s called a “high deductible” health plan. I put in a little more per month than the PPO plan requires for payments and I’ve been on this plan for quite a few years and it has worked well for me. With my DH on the plan, the deductible is about $4,450. Yeowtch, right? Not really. Because once that is paid, the plan I’m on covers 100%. In the long-run, it is much more cost effective and a safer bet. I just have to convince the hospital to take about $1,000 up front and put the rest of whatever is left of the deductible at the time that they bill for the surgery on a automatic payment plan equal to 2/3 my bi-monthly HSA contribution. I don’t see them having a problem with this once I get a chance to talk to them – probably tomorrow because of the staffing issues and overwork brought on by the near back-to-back major snowstorms. That’ll be a source of stress until I get it settled.
Next steps include:
- A pre-op exam to be conducted by my current Primary Care Physician’s office (another place that’s turned out to be a “patient mill,” which will be fired as soon as I can finish the paperwork to transfer to this great PCP doc in the area, who doesn’t allow a first appointment to be made until they receive said paperwork so that the doc can actually review it prior to said first appointment) to clear me for the surgery. An EKG is involved and other stuff they didn’t reveal to me when I made the appointment.
- A pre-op interview and discussion with the GYN about the procedure, to go over any questions, to go over the results of the biopsy if we haven’t already discussed this on the phone, and the results of the pre-op exam conducted by the PCP office.
- THE SURGERY
- A post-op interview and discussion
All of this is scheduled to be over and done with by the end of March, with the surgery occurring shortly before Saint Patrick’s Day. I consider this to be Significant and Apropos due to thinking that this life change will bring closure to a time in my life when a series of most tragic events occurred and I was given a large dose of pain. When my son (my one and only attempt to procreate, that ended in sadness and death) was born. This is the date that I refer to as the “Birth/Death Anniversary” because it was not only the date when my son was born, it was also the date that my first husband took his own life. The details of that series of events is something that I’m going to have to put down in writing, explore, and perhaps fully put to rest; however, it is a tale for another day.
no subject
Your doctor gave an estimate on how much longer before your ovaries are all shut down? That's great! I never could get that from anywhere, and wished Mother Nature would send me a nice gilt edged card "Bye, we're out of here!" I had painful cramps (ate lots of aspirin to numb myself) before having children, and unpleasant after that.
Spring is a rough time for me too, but not at the level you have had.
Sorry for the random response. Would be good to sit and drink coffee.tea/beer and discuss!
no subject
I had bad cramps when I was a teenager but then next to nothing for decades. I'm not sure if the massively bad cramps started with peri-meno symptoms... Seems more like they matched the very short time I had a copper IUD implanted. Gosh, that was AWFUL. I thought it felt like I was having near constant muscle contractions in order to push the damned thing out of me. I think I had a reaction to the copper. Periods all of a sudden were very heavy and very painful. The doc said that it was unlikely to have cause scarring or anything and it wasn't a known side effect.
Of course, the estimate is just that. My luck and they'll give me hot flashes and night sweats for another ten years. If I go the way my Mum did It'll be 10-15 years.
Someday I'll make it down your way or some other occurrence in life will make it possible to have that yet to be decided drink.