decision

I've decided to have a hysterectomy.

when do you know?

I've been wondering--how do you know when it's time for a hysterectomy?  I've been seriously thinking about having one.  Over the past two years, I have read so much about the good reasons to keep a uterus.  I certainly don't want to have one if something else will work.  I've talked with women who have had hysterectomies, and many of the concerns I've had have not been problems for these women.

However--and there's always a "however," isn't there?--sometimes, it is the right choice.  I fully believe that the pain I've experienced is from my fibroid.  There are a couple much less invasive procedures that most likely would help.  Even with these procedures, though, I could either develop new fibroids or, at best, the one I have now would still be there.  It would lose some of its firmness (think about a Nerf ball as compared to an orange, but on a much smaller scale), but it would not shrink.   With my hypersensitive uterus, I might still have the pain.

Would it be so horrible if I decided to have a hysterectomy?  Would I feel like less of a woman?  Would I no longer feel like I could participate in conversations about women's stuff?  Would I be looked down on by friends for letting a doctor do what's easiest?

How do I know when it's time?

what to do?

Two years ago, I was having intense pelvic pain—during and after my period, during and after sex, resulting from an overly full bladder, etc.. Any stimulus would trigger several days of pain, ranging from vague cramping similar to early labor to pain so severe that I nearly passed out multiple times. Through a series of tests, my doctor discovered that I had a small fibroid tumor and an endometrial polyp. Although I had a weak afternoon when I begged for a hysterectomy, my gynecologist believed in saving the uterus whenever possible. In January 2007, I had a D&C, hysteroscopic resection of the fibroid, and an endometrial ablation.



Over the past 8 or 9 months, I’ve begun experiencing pain again, gradually increasing from discomfort to the same kinds of pain I had before. Although I haven’t resumed bleeding, there have been signs that the endometrial lining is beginning to build up again. In April, my gynecologist retired, so I made an appointment in June with one just down the hall. She commented that Dr. R. had written really long notes and asked me to tell her what had been going on rather than read it for herself. She recommended an ultrasound.


I put off the ultrasound for months, since the one I had in November 2006 (pre-ablation) was so extremely painful and I couldn’t stand the thought of having to drink all the water. Last week, I realized that I was having pain bad enough that I had to just suck it up and do it. So, Friday afternoon I had an ultrasound. This one was somehow more bearable than the one two years ago. The ultrasound technician said that she saw what looked like a 1-cm fibroid, which is what I’d had before and was no surprise. I was a bit relieved, in fact, to confirm that this was the cause of the pain.


Over the weekend, I began experiencing severe pain triggered by the ultrasound, just like I did during my periods pre-ablation. In fact, Sunday and Monday I was so light-headed and in so much pain that I considered going to the hospital. Instead, I was able to get a prescription that took the edge off the pain and let me sleep.


Today I called the doctor’s office to see if the ultrasound report had arrived. I had two separate conversations with the nurse, both of which I found upsetting.


Conversation 1: “The doctor says that your fibroid is stable and you don’t need to be seen unless there’s any change.” What??!!! I asked her what she meant by “stable,” and she said, “There’s been no change since your previous ultrasound in November 2006.” I asked how that could be the case, since the fibroid that showed up in November 2006 had been removed in January 2007. If there’s a fibroid in the same area, it’s not the same one that I had before. I realized that the doctor had simply read the report from the radiology department without even looking at my file. The nurse said she would share my comments with the doctor and that I would be contacted again.


Conversation 2: “The doctor thinks the fibroid is not causing your pain, that it’s a failed ablation and the endometrial lining is beginning to build back up. You’ll need to come in for an appointment and discuss your options. And don’t quote me on this, but that might mean a hysterectomy.” After thanking her (!) for getting back to me, I said that I would prefer not to go that route but that I looked forward to discussing all the alternatives with the doctor. Okay, I’m not a doctor, and I don’t know what actually causes pain. However, I would argue that while the rebuilding endometrium may be triggering episodes of pain, it is the fibroid that is the underlying cause. My previous doctor commented that the previous fibroid had been propping my uterus open just enough that my sensitive uterus was constantly on alert to contract. I am hoping this is just an instance of a nurse speaking out of turn, but I want to be prepared.


I have an appointment scheduled for Tuesday to discuss options. What are the right questions for me to ask? What are some of the benefits of retaining a uterus that aren’t related to childbirth? If I end up seeking a 2nd, 3rd, or 4th opinion, what are the relevant facts to include? What questions do I ask, and what answers do I want to hear? At what point do I decide that hysterectomy is an acceptable option?

ultrasound results

When I was pregnant with my babies, ultrasounds were full of excitement.  Sure, I hated having to drink and hold all that water for a couple hours, but I got to see my babies in real-time action.

Now that I'm past the baby-growing phase of life, ultrasounds aren't quite that exciting.  After putting it off for months, I finally got one scheduled for yesterday afternoon.  They've changed the amount of water you need to drink from 40 oz. to 32 oz.  That one less glass of water made a huge, huge difference.  I was uncomfortable from my full bladder, but not unbearably so.

I had a good ultrasound technician, who joked around with me about the magic wand (the ultrasound wand looks like a vibrator--and they cover it with something that looks like a condom) and told me about her new boyfriend (yes, these were related conversations).  Fortunately, she also told me what she was seeing on the test.  I was relieved to know that there was another fibroid.  I had started to worry that perhaps there was something else wrong, or that the pain was all in my head.

I'll call my doctor next week and figure out what my next step is.  But at least I got this one done!

if sarah palin were a man . . .

In the interest of fairness, I say that I am a political liberal, that I have rarely voted for a Republican candidate in an election, and that I am inspired by Barack Obama. Yet I look at the McCain-Palin ticket and find that I, well, I don't hate them.

Sarah Palin is someone with whom I disagree on issues that are extremely important to me. Yet she is my age and I admire how far she has come. She has a big family, and she has a special needs challenge. I have a great deal of respect for what I know of her personal choices, even though they may not be the same choices I would have made. She is coming under criticism for running for vice-president when she has five children, one with special needs and one a teenager with a baby on the way. "What kind of mother is she?" I've heard. I confess that it is difficult for me to understand why a mother with such a young child would want to be thrust into such a time-intensive job--but her current job as governor is probably just as time-intensive, so perhaps there won't be much change.

If Sarah Palin were a man, no one would be saying anything about it. How many men have run for vice-president and been criticized on the basis of how their campaign or possible seating in the position would affect their children or their parenting? If Sarah Palin were a man, her family's challenges would be a source of admiration for her wife.

This does not make me want to vote for McCain-Palin. However, it makes me nervous about listening to the Democratic challenges to her fitness to govern. If we attack her as a mother, then we cloud the issues that are significant to the nation.

if Sarah Palin were a man, this would be a non-issue.