You don’t need those organs anyways…right?
I was always afraid to be an “organ donor” when I was younger. Afraid that if I got in a car accident or something, a doctor would be less inclined to try to save me when my organs could save so many other people.
Uterus and ovaries are not visualized.
I opened the CT scan results, not expecting to find anything worthwhile — just to check since I don’t remember combing through it as deeply as the blood test results at the time.
The exam date was April 14th, 2017, but the report didn’t hit my patient portal’s inbox till almost 3 months later.
I’d already been diagnosed with Celiac Disease. I don’t know what I was hoping to find as I examined the condensed print of the scanned-in results from my iPhone 7.
Probably just curiosity piquing, I think.
When I got the diagnosis, the second thought I had was that the hysterectomy was probably unnecessary — it was Celiac, all along. Heck, the hysterectomy made things worse, but that is opening a whole new can of rage I’d rather keep sealed for the time being.
Even the gastroenterologist asked if I saw the pathology report from the uterus, and I hadn’t… At least I don’t remember hearing or seeing anything about it.
Was I supposed to?
I couldn’t walk prior to the surgery. Something inside my body was pulling my insides “down”. I could stand for a few minutes at a time, but past about five, I was curling over in pain — stuck wherever I was standing unless someone helped me move to a resting position.
It was like some strong man had his hand inside my gut. When I stood for too long he’d clench his fist, squeezing all the organs within his grasp. If I pushed it for any longer than a minute or so more, he’d tighten his fist further, then pull down hard.
It was agony.
But, within six weeks post-hysterectomy, I found myself curled over again. It was a bit different this time.
Before it was constant discomfort and pain. Now there was pinching and stabbing that took my breath away and only eased with boatloads of pain killers and lying on my stomach for hours.
I’m thirty years old, twenty-nine at the time of the hysterectomy. I remember the doctor not wanting to take my uterus in the first place. She sent me to a specialist, her mentor, who asked a slew of questions then examined me.
Within ten minutes he confirmed that the pain is due to my uterus “flipping over” and pulling down on other surrounding organs, likely due to abdominal adhesions since I’ve had so many abdominal surgeries.
By that time, I’d made up my mind that a hysterectomy was necessary. I came to terms with it. I was ready to just move forward after four months of immobility.
I had three kids almost back-to-back — I was pretty sure I fucked up my reproductive organs enough to warrant some kind of issue. My only demand was that since there were no cysts or endometriosis or anything else major, I insisted on keeping my ovaries.
She agreed. She said she never planned to take them. I needed them to stave hormone therapy — to put early menopause off as long as possible.
Surgery day rolled around, and I was scared. I’ve had more operations than I can recount without thinking hard on it, but I don’t remember ever being scared. Typically I was in so much pain or discomfort, I couldn’t wait till I was out of surgery and everything that was causing me hell would be out and over with.
Sure, I was ready to feel better — to take control of my physical future. I was ready to lose all the weight I’d put on between the kids, the depression, the immobility.
I was ready to do more with my family — to be the wife and mom I wanted to be, more so now than ever before.
I didn’t know, then, that things were about to get a hell of a lot worse.
The first sign should’ve been when the nurse somehow gave me a mini-seizure trying to get the IV into the back of my right hand. When I came to, the look on my husband’s face — his eyes were glistening and his face was long and worried — it was painful to see.
“Are you OK, Babe?” His voice quivered.
“You passed out. You, you, had a seizure or something.”
The nurse, eyes wide and body tense, asked: “Has that ever happened before?”
“Never,” my husband said firmly.
The nurse left and rallied a phlebotomist from the floor.
(I was just annoyed that they woke me from the beginnings of a really good dream that apparently only lasted for a few seconds.)
Maybe that “sign” was a stretch, but receiving the wrong consent form from the woman who “never wanted to take my uterus in the first place” should’ve been sign number two.
“I can’t sign this one,” I said. “It says you’ll be removing everything — uterus, cervix, tubes and ovaries.”
She hastily responded: “Well, we will be doing a total hysterectomy. We’ll remove your uterus and cervix. Your ovaries aren’t being taken today.”
I turned the form toward her. “So what does this mean?”
She grabbed the piece of paper and traced her eyes down the page. “This is just saying that if we get in there and there’s a problem and we need to take your ovaries as well, you give us permission to do that.”
“It’s not phrased that way. The way this was written is telling the patient that this will be happening — it’s not in a ‘cover your ass’ kind of context.”
My husband straightened up in the corner and cleared his throat. I wanted to look over at him — usually if I’m getting too mouthy, he’ll touch my arm or something to signal that I’m going too far or that he disagrees, but he didn’t do it this time. I wanted so badly to look at him, though, to see if his face was saying something his mouth wasn’t.
“I didn’t write it…”
“I figured,” I interrupted. “But that’s not the point. The point is that there shouldn’t be a problem. If there was something in there that would cause us problems, it would’ve shown up in the ultrasounds, right?”
She hesitated, eyes intensely staring at me. “OK, I’m going to scratch this out,” she said and took the pen — like I was wasting her precious time. “There, there’s no confusion. I won’t be taking your ovaries, Mrs. Goff.” She forced an assuring smile.
I looked over the consent form once more. “Can you initial this, please?” I pointed to the ‘ovaries’ portion she scribbled out.
She looked at me, acute.
I held her gaze. Oh yes, I’m very serious, I thought as we stared at each other for a moment — what felt like an eternity.
“Yes, I can do that,” she said, inhaled noticeably, then initialed the page.
I don’t know if that meant anything. Maybe the form was like a check, you know, when you make a minor error and correct it, you initial it — proof that you, the account holder, in fact, agree that this is acceptable.
In this case it’d be proof that the doctor operating on me would not, under any circumstances, take my only remaining organs that would send my still young body into twenty-years-early hormone-shock.
After waking from the surgery, they wheeled me into a private room where my husband was waiting for me. His smile made everything better.
God I love that man.
“Everything went well, Mrs. Goff,” the doctor explained later that day. She revealed how she created a wall with sutures, separating my vaginal canal and rectum. Since there’s a large mesh in my abdomen, preventing laparoscopic assistance, they surgically removed my uterus, cervix, and fallopian tubes through the vagina, successfully.
The ovaries are still in place.
She handed me a photo of the inflated abdominal cavity, red and pink with two white, fluffy-looking golf balls, cozily resting at the base.
Was this before or after the surgery? What am I looking at?
She said it was before, then said, “No, wait, sorry. This is after the surgery.”
Which is it? Are you sure? You seem very unsure.
“What about my bladder?”
She smiled, amused. “Once your uterus was out it just popped right back up on it’s own.” She motioned “up” with her hand.
“Oh! So it didn’t need support or anything?”
“No,” she said. “It went right back up, healthy and youthful.”
Four weeks later, I sat in the small room, waiting for the post-op exam.
I was a good patient, I’d say. Didn’t have sex, like we were told not to. I didn’t stick anything up there, going against the obsessive need to thoroughly clean myself. I did shave for the occasion, though. I’m sure gynecologists notice that much — whether they care or not, that’s a whole different thing.
She said everything was looking great, healing well. It’d take another two to four weeks for the stitching at the top of the vagina to absorb, but I was cleared for sex.
I remember being giddy about that part.
She asked how I was feeling, and I said I was doing pretty well, “But I’m starting to get this ‘pinching’ feeling on the lower right side, in the front part.”
She sighed. “Well, you’re going to feel the sutures for a while — probably six more weeks or so. If you have any more problems after that, come back and see me.”
I thanked her and she left.
It was two more weeks before that pinching began to worsen. It was nearing the pre-surgery pain.
What’s happening to me? I don’t understand.
I Googled my symptoms and most of it pointed to post-surgical abdominal adhesions. I remembered the doctor pointing out my heavy collection of scar tissue spanning from the abdominal wall cut open to remove my seeping appendix back in 2002.
I went back to the doctor. She seemingly dismissed my research on abdominal adhesions. She then mentioned a sling for my bladder and asked if I was seeing a therapist.
What the fuck?
“Hold on, so there is a sling in there?”
She hesitated. “No, no…”
“Do you need to go check?”
“No,” she said in a huff. “There is no sling, Mrs. Goff.”
“Have you started hormone therapy yet?”
“Hormone therapy. Have you started it yet?”
“I didn’t think I needed to. I still have my ovaries, right?”
She hesitated. She wasn’t there anymore — her mind was combing through the patient file she never brought into the room with her.
Her practice could afford to custom build a mega-medical center, but a dozen tablets for the the physicians to bring along with them? Nope, that wasn’t in the budget.
Or maybe it’s a pride thing — maybe some doctors think they look like they’re hot shit if they don’t need to refer to anything. You know, like the restaurant server who never writes anything down. You’re wary that your order will be wrong, but he’s confident in his elephant-like brain in retaining everything your group orders.
Then when the food comes, someone’s missing their meal.
“Oh, yes, yes,” she said. “You still have your ovaries…”
“Do you need to check that?” I blurted, eyes wide and face getting hot.
She narrowed hers at me.
The distaste for one another seems to be mutual.
“Where is your pain?” She detoured.
“In the lower abdomen,” I said. “It starts in the front, on the lower right side and if I push things it rolls around the back and over to the left side.”
She had me get up on the exam table, and after two firm pushes into my lower back on each side, she said she needed to have me get tests done for my kidneys.
Weary, I said, “OK,” and left the building with a hand full of paperwork and orders for more tests, per usual.
As soon as I got home I took to Google, again.
Kidneys? I told her the pain is low and in the front.
Outside of the nausea, none of the other symptoms fit. I took it into my own hands and decided to forego the kidney tests and seek out another doctor.
The next gynecologist had no issue bringing in a small HP tablet with keyboard attachment to review my file right in front of me.
Fast-forward a year later, and a CT scan revealed that there was, in fact, a sling used to suspend the bladder.
Bladder is distended…
And the ovaries are nowhere to be found.
Prior surgical removal of the uterus and likely the ovaries.
The scan found a one-centimeter, “small midline hernia containing fat” with “fat planes well maintained” — whatever that means. OK, I’m fat and there’s fat that slipped into a hernia — surprise, surprise.
Even more of a surprise is how the fuck the CT scan could see a measly one-centimeter hernia, describing the fat within it, but my “ovaries are not visualized”.
Somebody explain that to me.