Post Op - the home saga

THINGS THAT ARE HARD TO DO FOLLOWING ABDOMINAL SURGERY (once you start to become more active):

Bend over - which is directly related to your ability to:

Pick up and/or move heavy (most) things - once released from bedrest in hospital, I found myself starting to figure out the boundaries of what I could and couldn't do. Opening spring-loaded doors was the first hurdle and I managed it by bending my knees and bracing my body weight on the wall before pulling the door open, this set me up for all sorts of other doors such as the fridge and microwave.

Open drawers - my advice - either pull everything out you need before your op or stagger them and leave them open (only the above waist level ones of course).

Brush your teeth - bless the nurse who taught me this one. Having been a twice a day brusher, and even though I'd been on a liquid diet, after 2 days in bed, my teeth were feeling decidedly furry so when the nurse asked me if I wanted to brush my teeth and I hadn't as yet been released from my bed, I learned that you can use a small plastic takeaway box to spit into and that will save you leaning forward into the basin. This is what I did for the rest of my hospital stay (even when I was able to use the restroom) and the first few days of being at home. After a few days, the bent knees thing also works.

Cough/sneeze - this was one of the first questions I asked at my pre-op clinic. I was most concerned as to how I was going to manage given the "violence" each of these wreaks upon the lower third of your torso. The advice I was given was to support your wound and not to try to hold it in.

The best advice I can give is to try to avoid the need for any of this - try not to contract a cold (deep breathing into your lungs to keep oxygen circulating and staying away from people carrying germs), also moisturise your nasal passages with a nasal gel - I used Fess. Hospitals are air-conditioned so smearing a little of this in your nostrils not only helps to keep your nasal passages clear but helps wash away dust that is likely to cause you to sneeze.

If I felt a sneeze coming on sometimes, I'd massage the outside of my nose which helped stop the itch but either way, if I had time, I'd sit down so that my thighs were a natural added support to my one hand.

At the end of the day, if you have to, you have to and it will feel like a shock to the system but you do recover.

Blowing your nose one-handed (the other supporting your wound) is not as easy as it sounds.

Also - buy one of these (image courtesy of the net):

I used mine for everything from grabbing a magazine out of reach while I was resting in bed to drying my legs after a shower and helping to pull on my undies in my first days home.

Afterwards, it can be used to pick up things which have fallen behind heavy bits of furniture. Mine even had magnets on the end to help pick up metallic bits and pieces.

Be physically fit - no one is suggesting you join a gym days before going off to have major surgery. I was fortunate enough to have spent years climbing stairs and walking uphill so my thigh muscles were quite well developed.

If yours aren't, go through your routine from getting up in the morning to retiring at night and move anything you have to grab from below waist level to above waist level. If, like me, you like everything in its place, the resulting "mess" will drive you nuts but should you find yourself without immediate help in your first days home, this will give you a great feeling of independence.

If you have someone to cook and clean for you, then leave it up to them. Don't feel guilty, you are better off having a good (short in the scheme of things) recovery than doing yourself some lifelong damage. If you don't have someone who can stay home during the day, organise in advance to stock the fridge with small pots of yoghurt, fruit juice, the makings of a sandwich, and the sideboard or dining table with small (easy to open) tins of soup, salmon, tuna, baked beans or bean salad. I emphasize small so that you don't have to lift heavy things and you don't have to store leftovers. If you have a heavy kettle, get a small saucepan and boil water for tea or soup on the stovetop.

You will need someone to help you on and off with the anti-thombosis socks, there is no way around this.

Getting out of bed - use your side and arm muscles. While still on your back, bring your knees up to your hips and using both your arms for support, roll onto your side. The momentum should be enough to swing your feet over the edge then use whichever arm is closest to the bed to push yourself up.

Drink lots of water, rest when you feel the need and eat a slightly elevated than normal fibre diet - if you've had abdominal surgery, your bowel is going to come into contact with the internal wound at some point. You want to make your pooh as soft as possible so that it doesn't scrape the wall of the wound on its way around. You also don't want to strain early on as this uses your abdominal muscles. (Hence the beans in the menu!). After 5 days of hospital food (lovely as it was to be catered for), all I wanted was a burger and some fries - I pretty soon paid for it so eat healthily, at least to start with.

ONE STEP FORWARD, ONE LEAP BACK
I honestly thought I had prepared myself for everything. The surgery went through without complications, my bodily functions came back to normal and I went home after 5 days' hospital stay. I had followed advice to get home comfortably (pillow between the seat belt and me), I had no pain and it was nice to be back in my own bed.

Everything was going swimmingly when I got a call from my surgeon. I'd had a urine test taken just before being discharged. "I'm sorry to have to tell you," she said, "but you have a bladder infection, most likely from the catheter, so I have to prescribe a course of antibiotics. It's very rare but I had two patients on the same day."

I don't like antibiotics at the best of times.

They wreak havoc with my digestive system and make me feel nauseous. As they needed to be taken with food, every meal became intolerable because I knew that I had to swallow the (literally) bitter pill at the end of it. I was gagging before I even started eating. As a result I lost about 5 kilos. Good for my waistline but not for my emotional health.

Somehow, I made it through the course, 21 pills over 7 days, 3 pills a day. It was a relief to go to sleep at night knowing that there were no more pills for the day. I had to take a urine test once I'd finished to ensure that the infection had gone. It took 5 days to get the results. I was once again starting to enjoy food then the call came. "You still have the infection, I have to prescribe a second course of antibiotics." I nearly cried on the phone to my surgeon, I asked if there were any other way of ridding myself of this, I suggested the natural remedy, cranberry juice, and she agreed that I should take it in conjunction with the antibiotics. I had resisted taking it because I thought that it might dilute the action of the medication. Who knows if I could have kicked the infection the first round if only I had taken it but here I was again, another 21 pills.

As a latent agoraphobic who needed regular meals, exercise and an occupied mind to keep the demons at bay, the combination of enforced inactivity and lack of desire to consume a square meal made my life hell. In an effort to immobilise the lower half of my body, I had been using my upper body more than it was used to, straining the back and arm muscles. In response, they tensed and wouldn't relax. I remember waking up one morning with my arms numb and tingling in my fingers. I started to suffer panic attacks and anxiety. There was a day when I was in such anguish I felt that I would be happier if my life ended there and then.

A combination of reassurance from my GP, seated (rather than lying down) upper body massages at my local massage centre, a heavy wheat pack heated in the microwave and draped over my shoulders, sashimi salmon, baked beans and support from my work colleagues at crucial times (not all at the one time) helped to get me to the finish line. This time, my urine test was clear. I was so happy I celebrated with chocolate.

What I learned was that most people were completely sympathetic once you told them the type of surgery you'd had. My osteopath, whom I visited as I'd put my back out getting out of bed, prescribed a pregnancy pillow to help ease the pressure on my lower body as I had to lie on a bed to be treated. I wasn't allowed to lift or carry anything heavy (and believe me, when I tried to defy that rule, I suffered), laundry was no go to start with and was a marker to another milestone passed. (My first post-op ironing session had to be cut short due to exhaustion and picked up the next day.)

In the weeks which followed my official recovery period (6-8 weeks), I had various panics one of which was the arrival of my first post op "period". One of the reasons many women undertake this procedure is because they have suffered extremely heavy periods. I assumed once my uterus was gone (as I wrote in my pre-op blog) that my period would also disappear.

Already on the lookout for any post operative infection, the sudden appearance of blood can ironically be a bit of a shock; ironic because it's something you used to dread, you thought you'd no longer have it but when you realise that you still have it and in a much more manageable way, you celebrate that you haven't ticked over into that next category - menopause - just yet!

The swelling which follows traumatic surgery was a concern. My best friends were longline tops and Target ponti pants. Much like pregnancy pants, they had enough firmness to support the entire belly region but sufficient flexibility not to constrict the blood flow. I couldn't wait to get into "normal" pants but I have to admit that I might have become a lifetime fan.

I also experienced some anxiety over my bowels. Given my fibroids added up to the size of a 6 month foetus, the space they no longer took up was filled gradually by my upper and lower intestine which had hitherto been pushed aside. I couldn't get to sleep at night because all I could hear was the gurgling of my digestive system. I was also constantly getting up to pee as a result of the litres of water I was advised to drink throughout the day. I used to lie in bed at night visualising my intestines as if I was watching a scientific film. It took a mild sedative and the advice to not drink after 9.00 pm to get me back to some semblance of a good night's rest.

I ended up needing the full 8 weeks to get back to work but once I did, I moved ahead by leaps and bounds. Having a purpose to my day helped to take my focus off being indisposed and at first I went home exhausted so I slept better at night.

Ten months on and I am back to complete fitness, I have been dancing, have done exercises to regain my stomach muscles and, most importantly, I am loving eating again.

They say it takes 12 months to completely recover but the lack of limitations on my life now, limitations which were imposed initially by the fibroids and then the operation, give me an exhilaration on a day to day basis which I haven't experienced for a long time.

This is not by any means a recommendation to go and have this surgery but if you have just cause to do so, this is one instance of what can happen.

Now, on to other things!

Post Op - the hospital saga

BEFORE

Doctors give you instructions for a reason and mostly you find, if you follow them, you will benefit from the best outcome possible for your situation. My doctor calls it team work.

Right from the pre-op prep, the cleaning out of your digestive system, following a strict diet down to your last drink, rough as it may be at the time, ensured that I was able to go into surgery with no delays.

Keeping yourself busy during the lead up helps - I did it by having the hall carpet pulled up and laminate flooring installed - a few days of negotiation with a couple of companies followed by a couple of days of physically moving furniture around. In hindsight, I probably would recommend a less taxing form of keeping yourself busy but my sense of achievement and ease of rest the night before my operation spoke volumes.

The morning of the operation, I had to give myself an antiseptic scrub with a special sponge, including my hair, excluding my eyes, ears and face. This is harder than it seems but I managed. It was a little eerie waiting before sunrise for the car to arrive (I had to be in the admissions centre by 6.30 am) but at the same time, as it was out of the ordinary, it felt like more of an occasion.

I had been to a pre-op clinic the week before, when they had taken blood for testing and been counselled for pre-op procedures so all I had to do was turn up and hand over my slip of paper. (I actually remembered this just after being seated in the waiting area so went back to the front desk - no harm done!)

After a little while, my name was called and I went over to one of the booths. This is where they check your details and tag you with the first of your patient bracelets. Having been through surgery twice before, I was familiar with the constant asking of my name and birth date and what procedure I was in for. Laborious as this may sound to the uninitiated, it is a comforting thing to have confirmed when you're the one being sliced open. At this point, they checked that my account was paid (which it was) and sent me back to the waiting room. I have to compliment the hospital on their efficiency - I have heard of patients being called in the morning then waiting around for hours (starved of food and liquid) until their operation in the afternoon, allowing their natural anxiety to build to quite unbearable levels. To the contrary, I was called again within half an hour of the last process.

With the good fortune to be a private patient, I was led into a single room and asked to remove all clothing and put on a rear fastening gown. I was also given a robe in case I needed the lavatory and a sample bottle to fill if I could.

Shortly after lying down in the bed, a nice young lady with a clipboard came and checked all my details, measured me for and applied embolism stockings and mentioned that James would take me up to pre-op. There was no appearance of urgency, in fact, we spent quite a bit of time talking to each other and she had to rush a few things towards the end as they were calling for me in theatre.

I was wheeled by James into an open ward where a variety of patients waited. Here a nurse checked my details and applied a red cap to cover my hair. By just after 8 am she had parked me in a medical bay outside the doors of the theatre. When asked if I was comfortable, I mentioned that I was feeling a little cold and was rewarded with a heated blanket which was heaven.

In quick succession, I met my anaesthetist (with whom I discussed various intolerances and my concern over nausea and to whom I mentioned that I always felt very cold on waking from anaesthesia. This provided me with the benefit of waking up with about 5 blankets instead of the normal single one and a high degree of comfort in comparison to previous experiences.) and my surgeon.

By 8.30 am I was being wheeled into the theatre and felt the prick of the needle providing a sedative. I'd been told that they would put me out to install the canula as my veins were small (nice touch guys!). The last thing I remember was being asked what I did for work. I don't remember finishing the sentence.

AFTER

The next thing I remember is waking up in a very dark room although it most likely only felt dark because I could hardly get my eyes open. A nurse was making me comfortable and I could hear family asking after me but all I wanted to do was sleep.

I remember being told about my personal pain medicator and how my bed worked. I don't remember being woken for the 2 hourly blood pressure, temperature and oxygen level checks but assume they must have happened. Next thing I knew, it was 6.00 am and time for the first post-op day to get under way.

I was "woken" for breakfast - an apple juice, jelly and clear broth combo that was designed to be digestible and to gently re-introduce food to my digestive system. (More on food later)

Breakfast was followed by a bed bath, hot damp towels laid against my naked body and wiped by two nurses. Although I was still in a bit of a fog, I remember hearing one of them say "Dr C just loves bethadine, doesn't she?". I can just imagine that I must have looked like I'd been dunked in a vat of it. I still find it amazing that they manage to change my bed sheets and my gown by having me only roll from my left to my right side and back the other way.

Once this was out of the way, my doctor came to see me. She advised me that everything went well, that she had not had to remove anything other than the minimum. She also looked at the morphine I had been prescribed for the evening of my operation and mentioned that they were going to remove it by lunchtime so I should use it as much as I could! In truth I hadn't needed it. I either seem to have a really high pain threshhold or perhaps other people are a little more restless than I am post-op requiring continuous medication to cushion the effect. I certainly wasn't in agony at any time and anticipated the discomfort I was feeling. That said, I couldn't help but give myself a booster every hour or so until they finally took it away from me!

In the days which followed, I came to the conclusion that as well as the general, a fair amount of local anaesthesia may also have been employed as the area immediately adjacent to the incision began to "thaw", in the same way that a shot at the dentist does, the feeling gradually came back. Unfortuntely by then I was no longer connected to the instant pump - fortunately, in spite of this, I didn't really need it - the pain was no worse than being nipped on the skin.

The only time I was glad to have it was when they removed the catheter. While not excrutiating, it was a bit of a shock to the system and not something I would choose to repeat.

After my various attachments had all been removed, it was time to get out of bed. I don't remember feeling overly anxious as I'd been mentally well-prepared for it by others' invaluable experiences. Once I'd done it the first time, with a little help, I was hauling myself out of bed every time I needed a bathroom visit. I understood that getting my system working normally was the first step to getting better.


FOOD

When one thinks of fine dining experiences, no one puts a hospital at the top of their list. An institution like this has to minimise risk and ensure nutrition to enable their infirm inmates to heal.

I do get this but after 2 days of breakfast, lunch and dinners, I was reminded of Jamie Oliver's Food Revolution programme where he documents his attempts at improving nutrition in the US town of Huntington. We meet the administrator of the school programme who tells him that his menu doesn't include enough vegetables so (unhealthy) french fries have to go back on that day's meal offering, an argument which illustrates the idiocy bureaucracy can result in.

My own example of this came down to my advising certain food intolerances which meant that entire food groups were eliminated from my choices - an intolerance of heated milk had me taken off all dairy products; an intolerance of fermented soy products had me taken off all gluten products, I was unable to eat eggs or nuts so that left me with ... very little.

After the first two tri-liquid meals, I was surprised to find when my dinner arrived at the end of the day that it was reduced to just two - jelly and apple juice, even less than I had been ingesting the rest of the day. A nurse took pity on me and offered me some toast which I readily accepted.

Once I was peeing as much as I was drinking (one of the measures for establishing your return to normalcy) I was happily given the freedom to choose what I wanted to eat but even this didn't go as smoothly as you might have thought. I duly ticked away at the menus but nothing that I ticked eventuated. Day 2 post op, for example, I ordered chicken and was delivered beef. I ordered the chicken again on the morning of Day 3 and was delivered fish. I began to wonder if someone in the kitchen thought they knew better than I what I should be eating. This is fair enough as my health is in their hands but then why give me the option?

The only reprieve I had was a surprise visit from a family friend who happened to work in catering at the hospital. I explained my dilemma and she offered to cook me a special meal (of which she is in charge for a select number of patients) which she did and it was terrific. This connection itself was not without its quirks however.

As I do not see her on a daily basis, I am still obediently filling in and having my menus collected just in case she is not in that day and my lack of menu leaves me without food altogether. My hope is that she will recognise my room number and amend my diet accordingly. On one occasion, having partaken of each of the protein options and finding it overcooked to my liking and unappetising, I decide to nominate only vegetables - a combination of steamed potato, broccoli and sweet corn with gravy. Part of me assumes rather smugly that they couldn't get this wrong, surely.

When I removed the cloche, I had to laugh (as much as this hurt me at the time) as they had presented me with just the steamed potatoes and the broccoli; of the corn and gravy there was no sign. For the life of me I could not figure it out but I ate the meal which turned out to be one of the best I had. Before my meal tray was cleared away, an officious woman (whom I discover afterwards is the hospital's dietician) brought another meal tray into my room and apologised that a portion of my meal was missing. She has brought me an entire other serving of the whole meal. I protest that I have eaten and am quite full but she insisted on leaving the tray anyway.

Before I can lift the cloche, I hear a short confrontation outside my room after which my friend arrives with a third meal tray! Quite simply, my friend, in the interests of looking after my health, had removed the corn and gravy from my original meal because she thought (incorrectly of the corn, correctly of the gravy) that it contained gluten and that I was coeliac. What she had brought me, apart from the steamed potato, broccoli, corn & gravy also contained a crepe which I had to gently advise that I couldn't eat because of my egg allergy. Although I didn't need it, I felt guilty about having been the reason for the wasted food so I ate at least one portion of corn and some gravy. In hindsight, given a hospital's penchant for plain and really really well cooked food, I probably could have eaten everything from the general menu with the exception of eggs and nuts. Lesson for next time.

1 STEP FORWARD, 2 STEPS BACK

My only real set-back was my lack of bowel motion by Day 3. I was starting to feel the symptoms of toxic waste. My body felt sluggish and I woke feeling groggy. Throughout the day, my stomach bloated to vast proportions and I passed enough gas to power a motor vehicle for a week but nothing came of it.

The doctor ordered a double dose of coloxal senna (a laxative) and a suppository (which I elected to apply myself. The nurse wass pleasantly surprised as she had two others she had to administer.) When it finally happens, it was like water gushing back through a pipe that has been temporarily shut down - but what a relief!

With everything getting back to normal, I am regularly getting out of bed for a 5-10 minute walk around my room, I can look forward to going home.

Farewell to the Sisterhood!

"There are only two certainties in life", the saying goes - "death and taxes"! This morning, I added a third - my final period, ever!

Weird as it seems, I didn't think it would end like this. Before my diagnosis, I thought that I would go into that twilight zone known as "peri-menopause" where my hitherto regular-as-clockwork monthly visitor would start to become erratic, unpredictable and tiresome - rather like a small creature on steroids. I was almost hoping that, having resigned myself to the sub-total hysterectomy, my body would react by starting that process, thus suddenly shrinking the fibroid and negating the need for surgery.

No such luck, it feels like my hormones are fighting to the end - "we're not your problem and we're going to soldier on until the last!" they seem to be saying. There is a slim chance that removing my uterus will lead to an early menopause but with this fortitude, I'm feeling optimistic that this may not be the case.

Time to think about what I'm going to do with the extra storage space, in my cupboard, suitcase, handbag ...

An average day

7.00 am - alarm goes off and I don't have the energy to get up - forget all thoughts of trying to make it into the office

8.00 am - clock radio shuts off creating just enough difference in ambience to wake me up from the secondary snooze I've gone into. Pull on a short and long sleeved T-shirt to warm the clothes up so that I don't freeze when I finally get out from under my warm quilt.

8.15 am - Lever myself out of bed and put more layers on. Feel like I'm walking in wet cement. Go to the kitchen and take a probiotic then out to the balcony where I do approximately 60 (who can keep count?!) laps. I like the cold breeze on my face but each lap is a chore this morning. I usually complete 60 in 15-20 minutes. Today, it takes 30.

9.00 am - Back from cycling, ravenous, sit down and eat usual gluten-free cereal with oat milk, checking emails as I go.

9.30 am - Washing the breakfast dishes, I feel a tinge of nausea. This continues while I continue my morning routine, take a couple of phone calls and get dressed.

11.00 am - Pulling on a pair of size 10 stretchy pants (thank goodness for stretchy pants!) I feel rounder than yesterday. This is not unusual, I can go up and down like a yoyo and most likely will have done so by the end of the day. By the time I've added a goose down vest, I feel like getting back into bed. Around this time, I would most likely take a walk outside to get some exercise and fresh air but today is so cold, I wait until after lunch to see if it improves.

1.00 pm - After a couple of hours of additional online reading - if I wasn't obsessive before, I certainly am now - I chance across an(other) e-book which seems like a bargain at US27.00. (The first one I purchased echoed most of what I was able to read online but it was good to get confirmation.) According to those who have read this one, the strategies outlined enable you to have a "happy hysterectomy". Will get back to you on that one!

2.00 pm - Had lunch - leftover from last night - yum! Followed this up with a cup of green tea then a cup of echinnacea tea - concentrating on strengthening my immune system as much as possible before surgery.

3.00 pm - Had planned to go out for my daily walk but had a visitor which resulted in some online research then started reading the e-book and was so engrossed by all the stories that I have only moved from my chair at the dining table for toilet breaks.

5.30 pm - See what I mean? Had a fair amount of intestinal wind following lunch which, having read the aforesaid e-book, could have been resolved by walking. Lesson learned!

8.00 pm - Bolt down dinner as I'm usually starving then regret it as it then starts to push into my other organs and make itself known. Need to sit stretched out so that I can digest.

11.00 pm - Get to bed but abdomen feels like a freshly pumped beach ball with no obvious way to relieve it. To the rhythm of gurgling and shifting, I finally fall asleep.

3.00 am - Awake but bathroom visit yields no relief. Massage abdomen until 6.00 am when finally fall back asleep again. And so it goes ...

So how does it feel?

It depends on the day, but some days, it feels like I have what I imagine the much maligned chronic fatigue would feel like - a walk around the local supermarket and I have to sit down for a rest.

Other days, I can wake up feeling like it was all in my head and I have a normal few hours then the pressure starts to build in my abdomen causing a nuance of nausea and I recall why I need to take it easy. Coughing and sneezing make me apprehensive as the squeezing of the abdominal muscles is intense in both cases.

At times there is a stabbing pain, like when you're trying to pull a particularly well-stuck bandaid off a piece of loose skin. This can ease or grow depending on the amount of physical activity I've undertaken.

Most of the time, there is a "fullness", as though I've eaten too much after a big meal - small constant meals help. I don't know why I should be surprised as I have been told that I am carrying the equivalent of a 6-month foetus around inside me - I have a newfound respect for pregant women and their burdens.

All of these symptoms are usually eased by a bowel movement and thankfully I follow a diet which ensures that I'm reasonably regular! That said, some days the pressure in that area deadens the desire to go until I consciously think of it. This is one of the reasons that I feel I need to deal with this sooner rather than later.

So the paperwork's gone to the hospital, my blood test is booked and I've paid the gap in my hospital fee. The machine is in motion.

Decisions! Decisions!

After arming myself with lots of online reading (thanks google!), I rolled up for my appointment with the gynaecological and pelvic specialist (I'll refer to as Dr B) to whom my GP had referred me.

I turn up a few minutes earlier than my 3.45 pm appointment only to find that they'd deliberately allowed a 15 minute window for processing paperwork (which took only 5 minutes) so I was left waiting till 4.00 pm before the said specialist came out of his office to call my name.

I had taken the liberty of looking Dr B up on the net, finding only a profile on the website for the clinic and a photo of his face. At least there were no bad "reviews" and I also noted that he worked overseas in Italy. While none of this was terribly comforting, meeting him in person was possibly less so. There is no other way to put it other than he looked a little like Tweedle-dum, not in an unkind way, just that he was almost perfectly spherical and rather short.

Perhaps it was always part of the plan but after asking me a few questions about why I was there (even though my documents were handed over prior to my being called to his office) he suggested I should have a CT scan. I pointed him to the scans which were open on his desk and the findings letter which was sitting underneath the referral letter. He gave a perfunctory look at the scans and started talking about the need for surgery. While I was keeping an open mind, it was almost with relief that he told me that he wasn't able to operate at the moment due to having had a heart attack at the end of last year and he was going to refer me to his partner in the practice, Dr C. Almost as an afterthought reassurance that he wasn't handing me over to a complete novice, his next comment before picking up the phone to call her, was to mention that his actual specialty was fixing other surgeons' mistakes and that Dr C was an excellent specialist in this area of surgery.

When she came in, Dr C reminded me of a Christmas elf. She was small, delicate and friendly. Unlike Dr B, she offered me her hand to shake and I'm pleased to note, it was a firm shake - good start! Although we began our chat in Dr B's office, once I seemed to be warming to her, she invited me into her own office and we started the consultation all over again.

I have to say, having done all the reading I had, I was determined to ask all the questions I needed to satisfy myself that this person knew what s/he was doing. Her first order of business was to show me what I was dealing with. She opened up her computer and brought up some full colour shots of various fibroids she had removed recently. (She did apologise but she hadn't had time to upload her latest two as she'd been too busy. She reminded me a lot of myself at this point.) The first one was impressively almost twice the size of mine, there were ones with uterus attached and without, with & without ovaries and ones where they were embedded in the wall. I'm assuming at this stage that mine is also going to end up in this gallery and although I have seen enough, she insists on showing me one last one. I guess it's good to know that she is passionate about her work.

We are then into discussing my options and her recommendation then filling in medical history details and talking through the procedure (which I should mention now is called a "subtotal hysterectomy" which is removing the uterus but leaving the ovaries and cervix intact. It appears from the CT scan that this fibroid is attached to the wall of my uterus and as I am unlikely to want to retain this for child-bearing purposes, they are removing it as well.

Although it is a very standard procedure, she has to outline the risks: the possibility that they may damage my intestine and I could end up with a colostomy bag; the possibility of heavy bleeding so I have to sign a consent form for a blood transfusion should I need it; one last thing, if they find there is a problem with my ovaries or cervix when they get in there, then I have consented for them to take those out as well, better than going under again I guess...

I try to imagine being in recovery for such a long time following this procedure and I can't. I don't think I've even had a holiday this long before so it will be interesting - perhaps an opportunity to watch all of those 2000 DVDs in my library!

Keep you posted!

Medical Drama - Ground Zero

I have tried to live a healthy life, partially as a result of food intolerances, partially hoping that to do so is to ensure a graceful descent into my later years with as little medical intervention as possible but with all my faculties intact.

Until this year, it seemed to be working.

I won't say that I didn't see it coming (in hindsight, there were signals) but like any busy person I put fatigue down to a temporary virus or lack of sleep or eating the wrong foods. So when this symptom reared its ugly head approximately 8 weeks ago, I chose to ignore it. I was pre-menstrual so feeling bloated, I'd been eating all the wrong foods as a result of working late in the office and I thought I'd picked up gastroenteritus which accounted for the gurgling sounds and sensations which were emanating from my abdomen.

I remember that first time leaning up against the sink while washing the dishes or the basin while brushing my teeth and feeling a distinct solidity which didn't feel quite right. I put it down to eating too many carbs and resolved to eat better. This, as well as the fact that it disappeared when my period passed seemed to assuage my natural inclination to panic.

When it happened again, I was still in a state of denial. Every morning I woke up and couldn't feel the mass I put off making a doctor's appointment. What finally convinced me to see a doctor was simply the matter of whether I was going to purchase a weekly rail ticket or not.

As it was a Sunday, I went to a medical centre and saw the first doctor I could get an appointment with. He asked a few questions then had me lie down on his examination table. Instead of prodding at me, he gently pressed both hands from the outside of my abdomen inwards. He said he agreed that I had an unexplained mass, the examination was done and went back to his computer to type. The outcome was a referral to a local lab, initially for an ultrasound, then, should that prove inconclusive, a CT scan. I had to ask what he thought the mass might be and he said possibly a fibroid.

That put paid to my weekly ticket.

Monday morning, not knowing but also not wishing to delay by doing the wrong thing, I rang the lab first up and asked whether I had to fast for the ultrasound. They asked what kind of ultrasound I needed to have. I said abdomen and pelvis. They said you need to fast for one but not the other. So both of us confused, they asked whether I'd drunk anything, following a negative, they gave me an appointment at 9.00 am. I trotted off and into reception where I filled in a form and was asked whether I'd drunk my litre of water. I said that I'd been asked not to.

My ultrasound technician came to fetch me, learned I hadn't drunk any water but decided to take me in anyway. She applied the gel then started to roll the instrument over my now admittedly flattish abdomen. At one stage, she put her free hand on her chest and I wondered whether that was a reaction to what she was seeing on the screen. She said she couldn't see my ovaries but she would print the images and consult with a doctor as to whether I should go straight into a CT scan.

Following consultation with the in-house doctor, she said he thought it was most likely a very large fibroid but had recommended I get the CT scan. I then had to sit in reception, drink 4 cups of water out of the vending machine and wait to be called.

I'm not proud but while waiting and watching Mornings with Kerrie-Anne on the flat screen TV, I was taken by the description of an eco-mop which I was too embarrassed to phone and order immediately but did so once I was back at home eating lunch thus proving that it is possible to shop almost anywhere!

About half an hour later, I went into another part of the building and was shown into a curtained booth where I was asked to remove my clothing while leaving my underpants and socks on, then to put on the gown and tie it at the back. Once I'd done all this (shivering all the while, those gowns are not made for warmth!) I was led into another big room with something that looked vaguely reminiscent of the Stargate gateway, a futuristic giant ring that the bed slipped my body in and out of while it blasted rays of light at specific areas.

I was advised that I would have to hold my breath twice when asked - this always seems like such an easy thing to do until you have to do it. The actual instruction came from a pre-recorded, mechanical sounding voice and I felt like I'd fallen into the set of 2001: A Space Odyssey with my own female version of Dave.

The procedure didn't take long and soon I was resting while a doctor checked that they had everything they needed. A monitor to my left started flipping through images, being rotated and examined by someone I couldn't see. Once the technician confirmed they were done, I was free to get dressed and go back to reception. Here I paid for the service and was told the images would be ready in an hour.

Having skipped breakfast and the time being around 11.00 am, I said I'd come back and went home to eat. I was back at the reception desk a little over an hour later only to be told that while the images were ready, the report hadn't been typed up and "it's quite a long one", as if this was a terrible burden.

For the next two hours, I sat through Ellen and was just thinking about going and getting some lunch when my name was called and I was handed my envelope. Thinking that I just wanted this to be over, I headed straight back to my new GP's medical centre and demanded an appointment, even though the frazzled receptionist didn't want to give me one. Hooray for my new found assertiveness, it's amazing what fear will do to you.

The doctor examined my scans and wrote me a referral to a gynaecologist. He asked me if I had any preference and all I could say was "a good one". The last question I asked him was how urgently I should try to make an appointment and he said "within a week".

This having sent shivers down my spine, I spent a sleepless night and went back to work the next day to wrap up everything I could, resolving to spend time on myself until I had some answers.

The third day, I woke up almost symptomless (the mass had mysteriously moved from its prominent position) and I wondered whether I'd imagined it all. It was a relatively good day, I spent a great deal of it getting my accounts up to date for the end of the financial year.

I probably stayed up a little longer than I should have so by the time I went to have a shower, I was feeling quite exhausted.

All today I've felt slightly nauseous and the bloating has returned. I'm glad now that I wasn't at work today as it would have been really uncomfortable.

My appointment is on July 8th. So the countdown begins, one day at a time ...