The Major Surgery
June 2016
I had no recollection of ‘Recovery’ this time.
When I woke from my drug-induced daze I found that I was already in my room on the ward.
An irritating voice pierced through the solace of my sedation and with sleepy eyes I looked over at my neighbour, a pink-haired woman in her 50’s who had just had her boobs re-done. She had a double PCA (patient-controlled anesthesia) and was complaining loudly and dramatically about how bad her pain was. A young nurse stood there helplessly; there was nothing else she could give her at this time except for panadol (tylenol).
My neighbour begrudgingly agreed. When the nurse returned with the pills, the woman refused to take them.
Apparently, they were the “wrong” brand.
I grunted softly in perturbance and pressed the button of my Fentanyl PCA and drifted back off to sleep.
Throughout the night I continued to wake with a deep, radiating, almost unbearable ache throughout my abdomen. I would press the fentanyl button a few times to try to get control of my pain again. But the truth is, I was thrilled. This time I actually HAD pain relief.
Last time they gave me some ibuprofen and sent me on my way; last time I was tortured by the referred shoulder tip pain from the gas in my belly; last time I was bruised all over; last time I couldn’t swallow because of the rough intubation; last time they had ripped part of the skin off my lip due to bad taping around the endotracheal tube.
THIS TIME the new doctor removed most of the gas and filled my belly with a gel-like liquid to prevent adhesions and scarring while my abdomen healed from this major surgery.
This time I had NO shoulder tip pain.
I was ecstatic.
THIS TIME I had no bruising, I could swallow, my lip was intact and I actually had pain relief.
And I actually loved my TEDs (compression stockings) and the intermittent “massaging” of my legs with the SCDs (sequential compression devices – a long piece of white material that wraps around your legs and thighs that intermittently fills up with air, squeezing tightly in order to promote good blood flow and venus return while you lie flat and are unable to move). Their purpose blood clot prevention.
The first day was a sleepy blur.
My only interruptions were waves of pain or the shrill, irritating and constant complaints of my neighbour. I felt sorry for the nurses.
In the early hours of my second morning post-op I was awakened by a nursing student who was asking permission to take my catheter out. I, of course, obliged. I know what it’s like to be a student. Once my catheter was out I slowly swung my feet over the bed and, with correct physio-approved posturing, painstakingly pushed myself into a sitting position. I was looking forward to the “Power of a Shower”, as I say to my patients.
I must have been lying a little to one side because the fluid in my belly had obeyed gravity and shifted to my right side. I looked lopsided. My vagina was swollen to double its size and my pubic bone had also become unevenly edematous with fluid. I attempted a little laugh at my ridiculous appearance, but the pain stopped me mid-giggle.
The “Power of a Shower” was NOT over-rated.
Soon after the doctor came to visit me. He was cheerful and positive. He “casually” explained the surgery to me.
“It was really severe,” he informed me, ” but we got almost all of it.”
“You had some endometriosis in your diaphragm, and I took out what I could, but there was one spot high up on the left side where your diaphragm was too thin so I didn’t want to touch it.” He began to show me some pictures. There was also a spot deep in my vaginal wall, but he didn’t want to start chopping through muscle, so he left that lesion alone.
I was shocked.
“I also cut out some endometriosis from your bowel,” he said casually, again, “but don’t worry, the ends are connected back together and should be working fine. Let us know as soon as you open your bowels.”
At my pre-op appointment I had signed consent for a bowel resection if I needed it, though Dr. M said he didn’t do them very often. He said he would only touch the bowel if the endometriosis was severe, but it was good to have consent signed just in case. I agreed.
I swallowed and nodded. The severity of my condition was sinking in.
“I removed all the rest of the endometriosis and scar tissue, down to the Pouch of Douglas,” he beamed, showing me a picture of my ‘pouch of douglas’ (the deepest part of the pelvis, and where ‘deep endometriosis’ resides). “Initially,” he continued, “we could hardly see anything in your abdomen.”
I looked at the picture and tears were welling up in my eyes. The ‘Pouch of Douglas’ was in full view, with no obstructions. Who knew that one could weep with joy at the sight of one’s innards?
“And then,” he continued non-chalantly, “I cut off your right ovary, removed the endometrioma, and then put your ovary back on.”
And that point I laughed in disbelief.
“You said that way too casually, ” I replied, acknowledging the incredible level of expertise needed to perform such a feat.
He laughed. ‘All in a days work’ for him.
He then showed me a picture of my right fallopian tube that stretched tightly over the huge ovarian cyst (endometrioma) that was bigger than my uterus. “We all thought you were going to lose your tube,” he reported, “but we saved it.” He shrugged casually, as though this accomplishment was commonplace.
He showed me a picture of the removed edometrioma. They had laid it out on the blue sterile drape and next to it was his outstretched hand in comparison; my cyst was BIGGER than his hand.
I was speechless. I thanked him profusely and tried not to cry.
He smiled gently and said “You’re welcome.” His eyes communicated deep sorrow for us women suffering from endometriosis and he shared that his mother, a midwife in New Zealand, frequently told him how proud she was of him. It melted my heart.
Many of my medical friends have assured me that had any other obstetrician performed my surgery, I would have lost my ovary and fallopian tube. Dr. M truly had the skills of a surgeon.
I spent the next few weeks in a Netflix coma as I recovered from surgery. It was slowly sinking in that ‘Severe Endometriosis’ was now my PAST history, not my PRESENT.
The doctor had warned me, and set a CLEAR and REALISTIC EXPECTATION, that only about 80% of my pain would improve. I still would need lots of physical therapy, diet change, exercise and brain/nerve re-programming in order to SLOWLY recover from 20 years of chronic pain.
He was spot-on.
But an 80% decrease in pain is LIFE-CHANGING.
I sit here in deep emotion as I reflect on the difference this surgery has made in my life. Writing each symptom systematically is but a report, but the truth is that it is actually esoteric; you would only understand if you’ve experience the depth of pain, emotion, discomfort and hopelessness that accompanies a condition such as this. The improvements are listed, but the emotion is indescribable.
I started getting regular periods for the first time in my life
My right hip pain, from the endometrioma, disappeared
I no longer woke at night with panic attacks
I no longer had to take pain pills EVERY day in order to function like a normal human being
My migraines improved (and I only got menstrual migraines)
My back pain was 80% less
My pelvic pain was still ongoing, but I could function most of the time without pain relief.
My IBS symptoms improved dramatically. I had regular bowel movements and didn’t fluctuate between severe constipation and diarrhea.
I could start exercising again since I no longer had a ‘frozen pelvis’
I slept through the night……EVERY night. I didn’t have to get up to pee anymore.
I cried the first time that I slept through the entire night.
I woke up my husband and with childish enthusiasm, and profound emotion, I said “Babe, I slept through the whole night. I didn’t have a panic attack! And I never had to pee!!!!!!!!” My husband held me tightly in relief and I began to cry.
And there was yet another astounding side-effect that I hadn’t even considered possible……
I had an orgasm WITHOUT a migraine (known as a post-coital headache, sex or orgasmic headache). This……made……..me…….weep. I had assumed I would be plagued with this for the rest of my life. I had no idea that surgery would absolve this torment entirely.
This surgery was by far the MOST profound, life-changing treatment of my life.
