Getting A (Standing) Ablation

Yes, I know the title is spelled oddly. I'm not talking about getting applause; I'm talking about matters to do with my lady parts, so if you are squeamish, or don't want to read about my body's natural functions, this is your opportunity to step off the bus.

Okay, now that it's just down to those who want to read this, let me give you some backstory...

I first got my period at 10 years old. I'm pretty sure it was earlier than most of my peers, but I don't know, because I didn't have a lot of friends in Grade Five, and we didn't really talk about stuff like that. And I certainly wasn't going to tell my bullies (all but one of the other girls in my class), giving them fodder for further opportunities to ridicule and humiliate me. Thankfully, my Mumzy understood, as she had started getting her cycles early, too. So, I at least knew what it was and what to do about it before it ever happened.

Fast forward 7 years. I'm in Grade 12, and sitting in the exam room of my family doctor with Mumzy, asking him what I can do about these painful periods. I mean, I was losing 2 days of school per cycle. In my grad year, that was disastrous for my grades, so I wanted to do something to better manage the pain. My old-school Scots doctor puffed on his stogie (yes, this was back in the day when doctors smoked in their offices, and patients didn't ask them to put the disgusting, smelly things out) and told me I had three options: live with it, get pregnant, or go on the Pill. I was actually hoping for better pain management, but given those options, and considering that I was a virgin, going on the Pill was the best of the options offered. The Pill did provide me with some measure of relief; I went from 9 days of bleeding to four, and instead of missing two days of school writhing in pain at home, I used acetaminophen and ibuprofen to manage the slightly less intense cramping, and was able to be at school. And I knew when it was coming.

When that wasn't enough, I got a prescription for pain - Ponstan, I think it was called? Remember, I'm thinking back over 30 years, here, and my brain power ain't what it used to be.

That helped for a number of years, as did switching to a lower estrogen brand of Pill. I was taking oral contraceptive pretty solidly from 17 until 29, when BioDad and I decided to try starting our family. That first month off the Pill, I got pregnant. And then I miscarried. 55 days of waiting, and then the biggest, longest period I can recall. The large clots were the telltale sign that I had lost a baby I didn't even know I was carrying. The day it began, my family was watching a documentary on embryonic development, and I couldn't stay in the room. I locked myself in the bathroom upstairs and cried. I knew Mumzy would understand, but for some reason, I said nothing at the time. In retrospect, I was worried that the others would just say that maybe I was mistaken, that I couldn't have gotten pregnant so quickly, that it was no big deal if it happened, that it was an early loss, etc. I just didn't want to hear the well-meant but ultimately empty placating of people who really didn't have the first clue about what I was experiencing.

My cycle after that was 35 days long, and it took almost a year to get pregnant. I had a wonderful, garden-variety pregnancy, a relatively easy delivery (if you call almost 36 hours of active labour easy), and was delivered of an 8lb 5oz baby boy on his due date - which was also his father's birthday. Primus was very conscientious! Once things got back to normal, I went on Depo-Provera, as my doctor and I (new doctor by this time) agreed that me remembering to take a pill every day with a baby in the house might not work so well. I got the basic info on frequency of shots and efficacy, but it was not communicated to me that I might experience weight gain with each shot ( I gained 8lb each shot, on average; I'd struggle to lose 5lbs, only to have another shot and the associated weight gain), that my periods might stop altogether, and that I would feel my least beautiful or feminine while being on it. BioDad and I had agreed to have two children (I had initially wanted four to his zero, so this was the compromise), and we wanted them to be about three years apart. In August of 2003, I stopped the Depo shots. In February of 2004, I spoke to my doctor about my concern that my cycle hadn't started again. He sat back and said he didn't worry about that until it had been at least a year, and shouldn't I be glad that I don't have to worry about it? I replied that I, the patient, was worried, and I wasn't going to sit idly by for another six months before he deigned to show interest in my reproductive health. I asked for - and got - a referral to the gynecologist.

My appointment with the gyno was strange at best. I was ushered into his exam room to wait. He swept in, shook my hand, asked a handful of questions, then handed me a drape and excused himself while I stripped waist-down for a man I had met not three minutes before. Now, I realize that he does this hundreds, if not thousands of times in his career, but THIS WAS MY FIRST TIME. I did as requested, and this person I hardly knew lubed his hand up to "just check things out". To be fair, he was utterly professional, he asked if I'd like his nurse in the room, and was as gentle as one can expect with a tipped uterus and high cervix. I got the good news that everything felt like it was in good working order, and that my periods should really resume any day now. I left that appointment feeling disjointed and not really in my own body. I also felt like nothing had really been done.

I got my period the very next day. So there's that, at least.

From that point, I had a 30 day cycle, so precise I could pin down when in the day it would start. With the goalie pulled and a puck on the ice, it only took until June to get pregnant. Another garden-variety pregnancy, and another easy delivery - 9 hours and 14 minutes was MUCH better - and for BioDad and I, our family was complete with Secunda. I had another early miscarriage after Secunda, which was not as difficult to bear, but still made me sad, as I really did want more kids.

When my first marriage ended, I felt it was prudent to go back on the Pill. Yes, I wanted more children, I always had. But I wanted them to be born into a marriage. I'm old-fashioned that way. This Pill was another low estrogen type, and it was also supposed to help with the horrible, painful acne I suddenly developed at 34. Cycles were 31 days.

Five months later, I was introduced to Hubby. We knew we wanted children, and having them soon after our wedding was part of the plan. I mean, we had two young kids already, so having them spaced as seamlessly as possible appealed to us. I stopped taking the Pill in April in anticipation of that, and it took a whopping 6 weeks after our wedding to find that we were expecting! In pretty quick succession, we had Tertius, and 16 months later, Quarta
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I found that after having Quarta, my cycles started getting heavier, and more painful. Not every month, mind, but every three to four months. By the time Quarta was 2, it was every other month, and by Christmas 2015, it was a heavy, painful, go-through-three-changes-of-clothes-a-day proposition.

I had friends who had undergone uterine ablation, with much success, so in March 2016, I went and spoke to the gynecologist again - I didn't even have to take my pants off! He heard what I had to say, was confident that we were actually finished having children, was satisfied when I told him that Hubby was going to a specialist of his own to ensure that, and we scheduled the surgery for the end of April.

So, what is uterine ablation? I'm so glad you asked! It's where they knock you unconscious, and cauterize your uterus in an attempt to relieve the heavy bleeding, or even stop it altogether. The gynecologist explained that in about 20% of cases, nothing appreciable happens, in 40-60% of cases, you notice improvement, and in about 20% of cases, the cycle stops completely. He said I could expect to be pretty tender and tired for a couple of days.

I admit, I was nervous about the procedure. Hubby was awesome, taking the day off work to take me to the hospital, and to spend the next two days taking care of me and getting all the kids to and from school, as well as do their paper routes with them. Oh, and cook. Yeah, I got a great guy :) The procedure itself was pretty quick, and I remember coming to in the recovery room as they jabbed a needle in my hip. I asked the nurse what it was they'd given me, and she explained that it was a shot of Depo-Provera, given as a matter of course. HOLD THE FREAKING PHONE. I had not seen anything about Depo on my paperwork, nor had I signed off on its use. I asked to speak to the doctor about it, and he showed up a few minutes later. I asked where I had signed consent for that, and he reiterated that it was a matter of course to do it. I reminded him of the patients right to give informed consent, and cautioned him to ensure patients' rights were observed in the future. He apologised, and in my anaesthetic-induced, haze, I felt that I had sufficiently stood up for my rights and expressed myself succinctly. Now, I understand why they do the shot of Depo; ablation makes the uterus a most inhospitable place for an embryo to grow. They want to avoid the possibility of implantation and miscarriage; but they really need to be better about allowing patients to give informed consent.

So I'm dealing with the usual weight gain I associate with Depo, but I haven't had a cycle since the procedure. Now, some of that could be because of the Depo, but I'm hopeful that the procedure put me in that 20% of women who don't have to worry about the murder scene in their pants anymore. If you like, I'll keep you posted!