Apatel Assingment 1

The first 24 hours were filled with searing pain.

I woke from the anesthesia and the attending nurse informed me that I as soon as I could dress myself, I could go home. She knew I wanted to leave, she knew I wanted to leave as soon as I arrived for surgery that morning. I was a reluctant patient. But she explained that the most efficient path out of the hospital was to prove that I was over the effects of the anesthesia. The easiest test of that was to have me dress myself. So without her assistance, I managed to get out of the hospital gown and into the clothes I had already put on once that day.

It was a challenge.

I was determined.

I bit my lip hard the entire time, to keep focused.

Satisfied, she sent someone to get my husband, so that I could be discharged. Then she answered the question I was afraid to ask: Yes, the surgeons had saved my cervix and my ovaries were untouched.

Four weeks prior, I would never have thought this these words could have any significance to me. 

From the time I first started menstruation at around thirteen or fourteen, I had issues with painful ovulation and severe cramping. After I had my son, I knew that I wanted a long break from having another child, so I opted for an IUD. Apart from serving its stated purpose, I no longer menstruated every month, although the physical discomfort happened like clockwork. I remained very aware of my ovulation cycle, but felt the freedom of forgetting what it meant to bleed. I continued to have annual exams. I first noticed something felt different in December. I felt a strange heaviness in my pelvis. I had an ultra sound and it was noted that there were a number of fibrous tumors starting to develop in or around my uterus. I was nothing to be concerned about, they were small.

Three weeks prior, I was bothered by some spotting but not overly concerned.

I hadn’t had a period for over four years. The life-span of the IUD was five years and the first months I had it were a time of adjustment for my body. After that though, no more tampons, pads, emergency trips to a drugstore for sanitary supplies, nothing. I was fertile but not manifesting it on a monthly basis. I knew that if I changed my mind about having a second child, the IUD could be removed within minutes and my body would immediately snap back.

Two weeks prior, my doctor and I discussed removing my IUD to help reduce the cramping. 

The five years with the IUD passed without incident. No scares, no periods, no inconveniences. It was wonderful. I raved about it and recommended it to anyone who was considering an extended time on birth control pills. In January, it had to be replaced. The procedure was simple, the string from inserted IUD was located and tugged on using a small clamp. The arms of the IUD would then fold up as it was pulled back through the cervix. The new IUD was immediately inserted by placing a small insertion tube in my cervix and pushing the IUD in place in my uterus. The entire process took a few minutes.

One week prior, we discussed alternative treatments to surgery. 

Two months after the IUD was replaced, I began spotting. It was maybe once a week or so initially. I was training for my first sprint triathlon, so I allowed myself to think it was related to how hard I was pushing my body. The spotting increased and was flanked by severe cramping. I had my doctor do a pelvic exam. She could feel the tumors. We talked about scraping my uterus, after my triathlon in May. We briefly discussed the possibility of a hysterectomy. That was the worst case scenario in my mind. As the days and weeks went by, my pain intensified and the spotting became a daily occurrence.

That Tuesday, my doctor told me that she had scheduled the procedure for later in the week, for Good Friday.

Monday night, I had my doctor paged. The blood flow was increasing and I could hardly stand. She was on call in the emergency room at Mt. Auburn and told me to come in. I didn’t want the hassle of the ER and instead told her I would come to her office when it opened the next morning. She officially recommended surgery. Whatever was happening was not taking care of itself. The next morning, we agreed to remove the IUD. My body had been cramping so much that the entirety of the IUD, string and all, had been pulled into my uterus. It took twenty minutes to extract.

I called her later that day and told her I wanted to schedule the surgery. She called me back and said that she had booked an operating room for Friday morning. It was then that I finally cried. As much as I didn’t want any part of me removed, it was clear something was wrong. I returned to her office to fill out paperwork. She told me that they may have to remove my ovaries, but wouldn’t know until they began the surgery. She asked for permission to remove my cervix. I told her no. I did not want to be able to feel the scar from within. She said she would do what she could.

So, this is why I the nurse’s statement about what had been left brought me to the brink of grateful tears. But I had no real grasp of what I lost until night came.  In the dark, a time when all murky things manage to grow, I became aware of an absence. I knew what was left, but that night I realized what had been taken, I felt a burning thread where my uterus had been attached. 

The three small incisions on my stomach hurt a little, but what blazed was the newly created seam inside me.  It could not have been more than four inches long.  It was uneven and jagged and rough, like a child’s first attempt at sewing two pieces of felt together with yarn.  Every part of me was focused on that one spot, inside my lower abdomen. The pain medication was ineffective and I was left warm and sweating as my body adjusted to what had changed.  I was certain I was being cauterized from within, and it a feeling so well defined that if I closed my eyes I could see the dull red glow.

Even the slightest adjustment hurt, so I could only lie there, unable to nurse the wound that had immobilized me.  I spent my time that night and the days that followed trying to decide if I had rejected a part of my body, or if a part of my body had rejected me.  Eventually, it was determined that my body had an unusual reaction to the hormone in the IUD, that after it was replaced tumors began to grow at an impressive rate. The most painful of which were on the underside of my uterus, near the pelvic bone.

In the end, it really didn’t matter what caused it, the outcome was the same: a principal organ my body was designed to support had been removed. 

Today, the three incisions are barely noticeable, but I feel the pit form when conversation turns to having children, and heat wells up from deep within when asked if my son will have a sibling.  The icy sounding “he won’t” I deliver back in response to that innocent, but intimate question is white hot.

The answer is fueled entirely by an incision that will never fully heal.