Today more than ever, it seems that women’s reproductive health is coming under attack. As if being a woman and dealing with all of the jokes that our reproductive organs play on us for most of our lives isn’t bad enough, the government wants to drive a stake through our soft tissue and lay claim to something they know little to nothing about. The more the POTUS and his cronies have been chipping away at affordable healthcare, the more grateful I am to have always lived in states where birth control is covered by insurance, where I have a right to end an unwanted or troubled pregnancy, where my insurance does not dictate how I care for my body. I was able to choose to use an IUD for birth control, and to choose less than a week later to have that IUD removed because I didn’t like the way it made my body or mind feel, even as my midwife reminded me I was “throwing away a $900 piece of perfectly good birth control.” I have access to quality healthcare, doctors whom I trust are making decisions that are in my best interests, and insurance that will cover the medical attention I need. I have always made a point to use my healthcare coverage to the fullest extent possible, even as it has started to cost me more and more money out of pocket. I see an allergist, a chiropractor, and a naturopath; I maintain my teeth, my skin, my body and my mental health. If I need medicine, I get it. If I need a therapist, I go. I listened to my body, and I thought I had gotten pretty good at giving it what it needs.
As I do every year, I followed up my annual physical exam with a full panel of blood tests to ensure my cholesterol was low, my thyroid was normal, and my other organs functioning properly. My midwife, who I had continued to see after my childbearing years for all gynecological care, recommended a uterine ultrasound after I reported for the second year that my cycles were out of whack and my periods were frighteningly heavy. I had tried everything to staunch the maddening flow of blood, believing at first that tampons had changed and materials were no longer as effective. I switched to a menstrual cup, then tried period-proof underwear from Thinx. I discovered Ultra sized tampons (as if Super Plus wasn’t big enough). I wore overnight pads during the day. No matter what I tried, I was miserable for 2-3 days out of every cycle. And with cycles repeating every 21-24 days, that meant that this was happening 15-17 times a year. I would have given anything to go through menopause and be done with the whole thing. It’ll probably be another eight or nine years of this, my midwife said with chagrin.
Still, when she called with the results of the ultrasound, I was not expecting her to tell me she had already referred me to a gynecological oncologist for a consultation. When I showed up, alone, at the surgeon’s office three days later, I was not expecting her to tell me there was a problem with one of my ovaries. When she drew the familiar diagram of my reproductive organs, she drew my right ovary three times bigger than the rest of the organs. Is that drawing to scale? I wondered to myself. How could an ovary be as big as a uterus? I asked her. Hard to tell until we go in and remove it, she answered. As we talked a bit more about my history of cervical dysplasia, biopsies, and menorhaggia, she strongly recommended a total hysterectomy. How long does recovery take? I asked her. You’ll be fine in a couple of weeks, she promised me. Can we wait until next summer? I wondered, not wanting to disrupt my classes and lose momentum with my students. She shook her head. How about in two weeks? she countered. I had not been prepared to sign pre-op consent forms that day, forms that would give the surgeon permission her to take as little as one ovary and as much as my entire reproductive system, depending on what she found once she went in laparoscopically through five incisions in my abdomen and started looking around.
But sign on the dotted line I did, and I tried to stay focused on the positives: no more bleeding, no more tampons, no more running to the bathroom to catch leakage before it became wreckage. The last time I got more than a day off work (not including summers) was after I had both of my babies–and the surgeon kept telling me this was really “no big deal”–so maybe I’d feel fine after surgery and get to revel in the time off. I thought about all the books I would finally read, the essays I would write. I thought maybe I’d look into NanoWrimo finally, and bang out the rest of the book I’d started writing five years ago. What I wasn’t thinking about is what if the surgeon found something she wasn’t expecting once she went in to remove the ovary?
My surgery should have taken under two hours, so when they wheeled me into the operating room at 10 a.m., I fully expected to get lunch in New Haven and be on my way home before the kids got out of school that day. I had planned on getting back to work in 3-4 weeks. Instead, I woke up at 4 p.m. to the surgeon telling me she had booked a quiet corner room for me and wanted me to stay overnight. But I thought I was going home? I said groggily. It’s better that you stay, she encouraged me.
Once I was lucid, my sister filled me in on what had happened. She led with what seemed to be the most important information: the ovarian cyst wasn’t malignant. But then, she told me the cyst wasn’t actually a cyst at all–the mass was endometrial tissue. I had been under for over five hours while the surgeon removed not only the ovary, but masses of endometrial tissue from my bladder, bowel, and other tissue. My surgeon, who has performed over 20,000 of these surgeries, told her I had one of the worst cases of endometriosis she had ever seen. My surgery, which started as a routine ambulatory procedure, had become much more involved from the moment they turned the laparoscopic cameras on.
Yet the surgeon continued to assure me that I’d be just fine. And even though I was more than a little aware that “fine” in medical language was a lot different than “fine” in layperson’s language (my midwife had told me my son would be “fine” even though he was born six weeks early–and though he was, eventually, I didn’t equate “fine” with a two-week stay in the neo-natal intensive care unit), I was still hopeful. I went home, rested, let others pick heavy things up and put them down again, and binge-watched more tv series and movies than I ever thought possible.
Though the surgeon only sent me home with a few days’ worth of painkillers, I was in serious pain for more than a week. Sheepishly, I called the clinic not once, but twice to refill my prescription. Because of the narcotics epidemic, this meant someone had to drive back to Yale each time to pick up more pills. Because everyone acted as though I shouldn’t be in as much pain as I was, I felt like a drug-seeking addict. Luckily, I had a close cousin who had gone through a similar surgery, and has supported her father through multiple surgeries in the last ten years. She sent me messages and called every day for the first two weeks with updates on how I should be feeling, so when I felt better for a day and then worse for two, at least I had validation that this was normal. Nothing felt normal, though. I didn’t want to read, I couldn’t write, and weeks went by without much change in how I felt. My 3-4 week leave turned into a 6 week leave, by the end of which I’d only read one book.
Having been given the all-clear at my follow-up appointment, I returned to work. I was excited to see my students, and we fell back into our routine without missing a beat. I got back to the yoga studio as well, and resumed all “normal activities,” as the doctor assured me there was nothing more to worry about. I felt good, if a bit manic. Being out of commission for so long made me want to do everything and all at once.
Three weeks later, I was back in the surgeon’s office, bloated and in pain. The vaginal cuff has ruptured, she told me after a quick examination. The what? I asked, though I was pretty sure I knew what she meant. The leakage is interstitial fluid, she said. Basically, my insides were making their way to my outsides. The tissue hadn’t healed, and all of the yoga and sex and lifting heavy things and putting them back down again had pushed things to the limit, causing vaginal cuff dehiscence, a rare but serious and potentially morbid complication of my surgery. After determining I wouldn’t need to be admitted immediately for emergency surgery, the surgeon told me she would call me the following day to let me know whether she would schedule surgery for Christmas Eve, which was a week later, or if she could get me in sooner.
Luckily, it was sooner. After only three weeks back in the classroom, I was back on leave and facing another 6 weeks at home. What was Christmas going to look like? There goes our New Year’s Eve party. Out of more than 20,000 of these surgeries, this had only happened to three of my surgeon’s patients. And nobody knows why. At my four-week follow up, the surgeon took a quick look to see how things were healing this time around. Hmmm, she said. Things look great, she said. But the stitches are all still there, she said. Apparently, this wasn’t supposed to happen either. Even though she still didn’t know why I hadn’t healed from the first surgery, at least she now knew why I’d needed a second surgery. She put me on her schedule for follow-ups every two weeks for the next six weeks, determined to keep a closer eye on things until they looked perfectly healed.
To make a long story even longer, it looks like I’ll be out of work for another four weeks, turning a brief FMLA leave into an even-longer-than-maternity leave. The surgeon has told me to continue restricting activities–no lifting, jumping, running, sex, swimming, squatting, yoga, or anything else that will put too much pressure on the pelvic floor. I won’t be skiing with the kids this winter as I’d hoped to do. I won’t be starting kickboxing or crossfit as I’d wanted to. The only thing I’ll be doing until the end of February is stewing in a million questions about how I could have missed so many messages my body had been sending me for the last six years. How could I be taking such good care of myself and not known there was something so wrong?
As it turns out, my body hadn’t betrayed me after all–I had betrayed my body. I hadn’t listened carefully enough–I hadn’t given enough credit to the connection between inflammation and food, between migraine and allergy, between my body and my mind. My inability to reduce stress–physically, emotionally, spiritually, meant my body didn’t have the resources it needed to heal. Instead of wasting the rest of my time off, I’ll be listening to my body, for sure. But I’ll also be listening to my whole self. Maybe this time, I’ll get the message.
(mostly) full disclosure 