Don’t I have a beautiful family?  As I contemplate the big step towards hysterectomy, I am so grateful that God gave me my husband and my daughter.  She is the best part of both of us…

This afternoon my sweet husband took me to my doctor’s visit to consult about hysterectomy. I think he was a bit anxious when the nurse took us into the examining room because she started fiddling with the robes as if she was about to ask me to undress!  Fortunately, it wasn’t THAT kind of appointment this time, and he was able to breathe a sigh of relief when the nurse ushered us in to meet the doctor in his office.

I had a long list of questions, and the doctor patiently answered each one.  If I had to describe in one word what we thought about Doctor C., we’d say: Competent.  I’d add another “C” word, too — Confident.

Here are the highlights:

Ablation.

I wanted to know how deep the adenomyosis went into my uterus because I had read that sometimes an ablation could remove the disease without having to remove the whole uterus.  I found out that in my case, the lesions penetrate at least halfway through my uterus.  If I were to have an ablation, my pain might actually increase each month since the ablation would seal off the lining and would cause blood to pool up in the muscle wall with nowhere to go.  At least now I know.  Ablation as an option is out.

To keep the ovaries, or not to keep them…that is the question.

The cause of endometriosis is a mystery, but doctors do know that a woman’s hormones play a key role.  Because my miserableness extends throughout the entire month and is cyclical in nature, the thought is it might be a good idea to remove the source of fluctuating hormones — the ovaries.  The down side of this choice is it would plunge my almost-40 body into menopause.  Hot flashes. Mood swings.  Hormone replacement therapy.  The good side of this choice is I would then be on a steady dose of hormones…no more roller coaster.  At least some of my digestive woes would be mitigated if I no longer had the hormonal surges that caused them.  In addition, we don’t know the condition of my ovaries.  If they are covered with lesions, then they are diseased and need to come out anyway.

What kind of surgery?

There are many different kinds of hysterectomy surgery.  Doctor C. recommends a LAVH, which stands for “Laparoscopic Assisted Vaginal Hysterectomy.”  This kind of surgery would allow him to use the scope to look around for and remove any stray endometriosis “invaders.”  After the research I’ve done on the (sometimes unreliable) internet, it does sound like LAVH is the way to go for me.  However, there is a small chance that my organs might be so diseased that they have adhered to each other.  For example, my uterus might have “grown into” my bladder due to endometrial tissue growth.  In that case, the doctor would need permission to go ahead and do an open incision in order to have more room to fix the damage.

What hospital?

Thankfully, Dr. C. prefers to perform surgeries at one of the newer hospitals in town.  Due to his office’s proximity to an older one with lackluster reviews, I dreaded the thought that that particular hospital would be my only option if I went with him.  I’ve had experience with sub-par care at a hospital and don’t want to go down that route again.

What to expect for recovery?

Dr. C. said that most of his patients have surgery on Wednesday afternoon and return home on Thursday afternoon.  The surgery itself is about an hour and a half.  Then I will need at least two weeks to be a lady of leisure.  (I like the sound of that!)  Although I’ll need to get up and walk around as I’m able, I have to take it easy.  No cooking.  No cleaning.  No laundry.  No driving. Just reading books and watching movies. Wow!  It’s a good thing my husband has the Papa John’s Pizza number memorized!  Seriously, though, I know I have an extended family of friends from my Classical Conversations community that would help…and I have not one mom but THREE (my mom, my husband’s mom, and my husband’s stepmom) who have all offered to come help.  I was thinking today how fortunate I am to have my husband walking with me through this decision and to have a family able and willing to lend a hand.  That’s more than some women have, I know.  So I am grateful.

Any Downsides?

Dr. C. seems to be highly competent and confident.  He’s performed probably a “thousand” of these kinds of hysterectomies.  He is very much a typical Western medicine doctor in that he considers natural hormone therapy “bogus” and pushes pharmaceutical answers.  I am not sure I want to take horse-urine-derived estrogen as replacement therapy when there are natural alternatives…if they work.  So even if I choose Dr. C. as my surgeon, I might want to find a different doctor who is open to natural therapies.  An interesting tidbit I learned today: the amount of estrogen in hormone replacement therapy is about a third the amount as is found in birth control pills..so perhaps I would not have the side effects  that I suffered years ago.  Also, the reason birth control pills contain both progesterone and estrogen is that straight estrogen can lead to uterine cancer.  But in patients who have no uterus…straight estrogen can be given.  At least according to Dr. C.

Anxiety?

Keep those prayers coming, because so far they are working.  Sort of.  It helps to know that it’s completely normal to feel anxiety about surgery. If I decide to go with Dr. C., then my surgery could be as early as next week. The sooner I get it scheduled, the less time I will have to talk myself out of it.

Next Step?

Tomorrow my husband will go with me see Dr. R.  Dr. R. was my ob/gyn when I first moved to North Texas.  I left his practice about two years ago after he suggested to me that I have a hysterectomy due to my increased pain and bleeding.  I was offended and set out to see FOUR more doctors for solutions…but now look where I am today, right where he suggested I be in the first place.  If I had listened to him, maybe my quality of life these past two years would have been different.  Maybe my anxiety level would be diminished to such an extent that I would have gone overseas with my family for vacation instead of staying home.  I’m still convinced that everything happens for a reason.  Two years ago I clearly wasn’t ready for the idea of a hysterectomy.  Now, after suffering for so long, I am just about ready to perform it on myself.

(Well, maybe not.  But you get my point!)