How I spent my winter “vacation”

This post may be TMI for some folks.  However its something I think alot of women and the guys they live with should be aware of.  It was written in pieces, so while I tried to go back through and make sure that the tenses and what not matched I’m sure I missed some things.

 

So, back on Oct 25 I had laparoscopic surgery to remove my fallopian tubes.  Or as the surgical listing put it “voluntary salpingectomy”.  There were a few reasons for doing so.

First and foremost, I don’t want kids.  Haven’t since I was old enough to get a clue about raising them.  And despite everyone’s insistence that I’d change my mind when I turned 25/turned 30/turned 35/met the right man/got married/and so on, all that has happened and I haven’t changed my mind.

And birth control is a pain in the you know what.  Oh it has its good points, everything from regulating the menstrual cycle to having no bleeding portion of the cycle at all, helping control cramping, and what not.  But all it takes is one little goof and you end up pregnant.  And the longer lasting (less easily goofed) forms like the Depo Provera shot come with an even longer list of side effects and larger risk of weight gain.  I’ve been on the Depo shot now for several years, I know of which I speak.  IUDs are even more goof proof, but when an IUD goes wrong it tends to go really wrong, which is a little off-putting.  Plus many doctors really don’t want to implant an IUD in a woman who’s never had kids.

Birth control is yet another thing for the body to cope with too.  I’m already taking prescription anti inflammatories daily, and have been for years.  Which isn’t something my doctors are happy with.  They’re already testing my kidney function yearly (so far so good!), so if I can reduce the number of meds I’m on by even one, well, that’s not a bad thing.

And when I’m on hormone based birth control I CAN NOT lose weight.  When I’m not on it I can get the weight to start to trickle off, not anything huge, but a pound here, and a pound there.  But then we’re back to pregnancy prevention.

Did you know that more and more research is showing that at least some ovarian cancers may actually start in the fallopian tubes?  I didn’t till I went looking at related research.  Turns out that if a woman, who is done with child bearing, is having other abdominal surgery, there is now a general recommendation to have her fallopian tubes removed at the same time.

Oh, I could have insisted that Husband have a vasectomy, but in the long term it may well have been a good thing I took the route I did.

Salpingectomy is done laparoscopically, it’s a “day surgery”.  I went in at 1pm, was pulled into the surgical suite just before 3pm, and left the building about 5:30pm.  All as expected.  What didn’t go as expected?  When the surgeon first goes in, the first thing they do is take a “look around” at the various organs and bits and pieces in the region and make sure everything looks ok.  Pretty much the first thing the surgeon saw is a giant massive thing where my left ovary should be.  My right ovary looked maybe a little enlarged, but the left…..I’d given her permission to remove “things” if they looked bad, but this was WAY too big to be removed via a 1″ incision.  And since there was a chance it was a fluid filled mass she didn’t want to try to get a piece for biopsy for risk of puncturing it and potentially spilling fluid into the abdominal cavity.  She snapped a couple pictures via the camera used to guide the tools, backed out and stitched me up.  She didn’t see the point in making me go through the extra healing this time when there was definitely going to be a larger and more invasive surgery to heal from anyways.

A week later I was back into her office for the surgical followup, and to do an sonogram to take a look at my ovaries.  Good news: my right ovary is within normal parameters, which is 3 to 5 cm in diameter.  Bad news: my left ovary was approximately 12 cm in diameter.  That’s bigger than a softball.  They had trouble getting the whole thing onto the sonogram screen in order to measure it.  And it is indeed fluid filled.  Fluid filled isn’t necessarily a bad thing mind, a normal ovary shows up as mostly fluid on the sonogram screen, but it means that she did the right thing by not grabbing a bit to biopsy.  So then we did blood work, specifically looking for CA-125.  It’s not 100% foolproof, but a higher CA-125 number generally means a higher likelihood of ovarian cancer.  Good news, my numbers are completely normal.

Most likely this was a cyst of some kind, and most likely it’s been a fairly slow growing one, which is likely why I’ve had essentially no symptoms.  However we probably found the cause of the screwed up UTI symptoms and kidney pain I had back at the beginning of Sept.

A note for sleeping after surgery like this.  While I really wasn’t in much pain, trying to sleep on my side was extremely uncomfortable.  At least partially because I’m overweight, so the incisions on my belly got pulled around with my belly shifting over.  I ended up buying a “pregnancy wedge pillow” to help support my stomach.  It helped a lot!  I was kinda wishing I’d thought to pick up that pillow when I had the broken arm.

Two weeks after the laparoscopic surgery and I was back on my feet and feeling normal, though I was being a bit careful still about how much weight I lift.  Back to work, and otherwise normal.

Surgery to remove my enlarged left ovary (and both fallopian tubes) was scheduled for mid-January.  I kinda got the impression that the surgeon wanted to do it sooner, but I wasn’t thrilled with the idea of having major surgery right before Christmas.  And since it wasn’t actually causing me problems, and it probably wasn’t cancer, she agreed.

When you have surgery you have to stop taking all anti-inflammatories upwards of two weeks before surgery.  That wasn’t pleasant back in Oct, but it really sucked in January.

Removing an enlarged ovary that is that big is a much more major surgery.  Think c-section type surgery.  At least one overnight in the hospital, possibly two.  I had to be there at 11am, for a 1pm surgery.  The surgery before me ran late, so they didn’t actually pull me into the operating room till almost 2, but otherwise everything went smoothly.  Enlarged ovary and both tubes out.  My right ovary looked completely  normal on visual inspection.  Official terminology: left side oophorectomy, bilateral salpingectomy.

The rest of that day is a blur, which isn’t a bad thing.  But I was glad to be allowed to be on my feet the next morning.  In order to leave the hospital after a surgery like this they need a few things.  You have to be able to manage your pain with pills (vs IV meds).  You have to be able to walk on your own with a minimum of help.  You have to be able to eat and drink and keep it down (with the help of anti  nausea drugs if necessary).  And you have to be able to pee and pass gas.  By that afternoon I’d made several laps of the floor on my own unassisted, I’d used the bathroom and passed gas.  I’d been using pills to manage my pain since the middle of the night before (IV morphine is not my drug of choice).  And although I didn’t have a large appetite I’d eaten enough to keep everyone happy and had no nausea.  And so by 5pm the day after surgery they agreed with me that I could go home (note, if I’d said I prefered to stay another night they’d not have argued, but I wanted to go home and sleep in my own bed TYVM).

I’ve had surgery before, but this was my first experience with surgical staples.  Surgical staples suck.  I realize it’s not really my choice, but if it ever is I don’t ever want them again.  It turned out that a huge portion of the discomfort I was in after surgery was the staples.  Partially the staples themselves and partially the fact that I may have had a minor allergic reaction to them.  All I know is that when they were removed a week after surgery I left the doctors office feeling SO MUCH better.

Sleeping after this surgery wasn’t fun either.  My little wedge pillow helped, but without the pain meds I’d have still had some very unpleasant nights.   On my back, with my knees elevated was perfectly comfortable, but I find it almost impossible to sleep like that unless I’m very well drugged.  The addition of a belly compression band helped enough, with the pillow, to make sleeping more comfortable.

The only nausea was some mild motion sickness on the drive home from the hospital.

During the follow up to check the incision and to remove the staples the doctor noticed the start of what might have been a skin infection around several of the staple holes.  She prescribed an antibiotic and neither of us thought twice about it.

Till I took my first dose.

Now I almost never react to antibiotics.  I can’t take Levaquin because it screws with my joints.  But the only time I’ve ever had nausea from one was the one time they gave me a massively strong one to combat a bout of bronchitis that wouldn’t go away.   And even then I don’t think I actually puked.

An hour after taking my first dose of Keflex I lost my dinner, and couldn’t even keep down water.  I thought accidently trying to clear my throat with a 7+inch long bikini incision sucked.  Puking when you have that kind of incision is highly unpleasant.  If I hadn’t been, yah know, puking, I’d have been swearing.  Took us a bit to realize it was probably the antibiotic that set me off.  I finally took a dose of chewable Bonine and was able to move away from the toilet without feeling like I was going to need to run back, and was able to keep down a sip of water, took a pain pill, and went to bed.  A phone call to the doctor first the in the morning and she sent in an anti-nausea prescription for me.  A week on the antibiotic and the infection is gone.

The biopsy on the enlarged ovary came back as a benign dermoid cyst.  Ever seen one of those articles freaking out cause some woman had a huge mass removed from her abdomen and “it contained BODY PARTS!!!!1111!!!!”?  Thats an ovarian dermoid cyst.  They aren’t usually that huge, but they do tend to contain things like hair and teeth.  Occasionally other things.  Don’t look up the other things unless you don’t mind looking at gross pictures.  However if you’re not easily grossed out it can make for interesting reading.

Most women find out about them long before I did.  By all rights I should have been miserable.  It’ll be interesting to see what changes in the next several months.  Of course the screwed up UTI was probably the result of the cyst.  And in retrospect, the previous time I had a UTI (3 or 4 years ago) I also had kidney pain (and although I’m not positive I’m pretty sure it was also on my left side), and that was the first time I’d ever had kidney pain with an UTI, so I’m wondering if its related.

I’ve already noticed one change though.

I’ve had “diabetic nerve pain” (actually numbness and  lack of feeling in an area just above my left knee) in my left thigh since early 2010.  Three different doctors insisted on bloodwork to confirm that I wasn’t diabetic.  And I’m not.  I’m not even borderline.  The final decision was that it must be caused by a side effect of the lateral release surgery I had on that knee (actually just above that knee, basically right where the numbness is).  Two doctors offered surgery to correct the offending tendon, I told them it didn’t bother me that much.

Barely two weeks after the removal of the enlarged ovary and the numbness has almost completely disappeared.  It’s not totally gone, but its way less than it was 3 weeks ago.  Thigh pain or numbness can be a symptom of an enlarged ovary, I’d read that, but I didn’t expect it to make that much of a difference that quickly.

Because we were able to leave my right ovary in place I shouldn’t need to worry about my hormones or the like, which is one less thing to worry about.

I’m healing well, almost completely off prescription pain meds, just an occasional one at night if I push to hard during the day.  It’ll be a few weeks before I’m back to normal with lifting things though!

The almost complete lack of symptoms is what gets me the most.  How many other women out there are walking around with major cysts and they have no idea because it’s caused so few real problems for them?  Or it has caused problems, but they were shrugged off as something else?  In talking with two women I know who’ve had the same surgery for the same problem both stated that they’d been extremely uncomfortable for months (in one case) or years (in the other) prior to the discovery of the enlarged ovary, and that in both cases it took going through several doctors to find one who’d actually listen to the symptoms and try to find the cause rather than shrug it off as something “obvious”.  It may be something that more women need to think about.

 

Edit:

When I first started researching this surgery I found a remarkable lack of information.  Most of the information I have is based off of information provided to women who had c-sections or hysterectomies.  So some additional thoughts as I continue to heal.

I stopped needing both the wedge pillow AND the compression band by about 2.5 weeks, but I still needed one or the other till just about week 4 on the nose.

While I felt pretty good by week 2, I had no stamina at all.  Doing anything more than puttering around the house and taking the dogs out to the fenced run left me in desperate need of a nap.  By 3.5 weeks this was starting to annoy me to no end.  So I hopped on the elliptical machine.  No incline, slow walking speed.  The first day I lasted barely 4 minutes, and my belly was sore that night.  2nd day was the same.  Third day I made it 6 minutes, and I wasn’t sore afterwards.  At 4.5 weeks I’m up to 20 minutes twice a day, and while I’m tired afterwards I’m not in desperate need of a nap, nor am I sore at all.  I also managed to make a complete grocery run by myself.  MUCH improvement!

Because we were able to leave my right ovary I shouldn’t have any serious hormone issues.  However I can’t find anything official about whether the remaining ovary will kick in right away, or if it takes time.  In discussions with women who had one ovary removed with their hysterectomy it appears that it may vary.  Some reported no problems at all, while others stated that they had apparent hormone ups and downs for a couple months before things returned to normal, so I guess we’ll see.