Post-op

I had my post op appointment yesterday. I think I left my book in one of the waiting rooms. My gynecologist's office has two waiting rooms. One is the main outer reception area room. This is the standard waiting room featuring a TV, a somewhat surly receptionist sitting behind the sliding glass window which is typically slid shut, and many many parenting magazines. I consider the parenting magazines to be truly cruel, as this gynecologist is not a typical OB-GYN doctor but a specialist in "reproductive endocrinology". In normal person terms, this means he's the guy you go to see if you can't make, carry, or have babies.

Thus, a waiting room which is practically plastered with magazines featuring glossy images of smiling children and parents, while potentially quite relevant to many of the patients sitting there, seems like it might be a source of anxiety or possibly sadness.

Consider if you were going in because that last set of tests came back and you've got a feeling the news isn't good. I think I'd probably be sobbing. If I wanted kids that is. It does bug me that my female specific health issues are important to address only if they are couched or approached in the context of my reproductive abilities. But that's how it is. And the reality is that most of this guy's patients desperately want to conceive and give birth to a child.

This potentially insensitive magazine selection extends into the inner waiting room. The inner waiting room has an old research poster up on the wall showing the percent mean changes (and standard deviations) in lipid panel levels for women receiving various forms of hormone therapy. It is an old poster, printed out on multiple piece of 8 1/2 x 11 sheets of paper (landscape formatting) rather than the more modern and highly popular posters which I have come to think of as "wall sized". Something about the old fashioned poster comforts me. It feels more humble and therefore somehow more reliable than the wall sized posters which preesnt both impressive and non-impressive research endeavors with equal overwhelming grandure.

Apparently it comforted me right into leaving my Joyce Carol Oates book on one of the happy child and parent strewn tables. I felt stupid last night when I realized I may have left the libaray book there. I hadn't even really liked it very much, I was having a hard time connecting with the characters, the subtexts, or even just the scenery. I brought it just to have some distraction since I found the baby/parenting magazines insipid in the extreme. It did occur to me this morning though that the book might have been a source of even momentary salvation for some woman pondering an outcome which would make looking at glossy smiling baby faces unbearably difficult for a long time.

Given how the visit went, I think it was understandable, possibly even likely, that I would leave a piece of me behind when I left. I was in a total of two waiting rooms three times, thus the book was in and out of my bag repeatedly. I sat in the inner waiting room once when I was first called back, then again after the exam but before the "wrap up". The second wait was longer than the first. The first, I think I had barely taken the book out before my fella and I were summoned by the resident who was working with my doctor that day.

The resident struck me as a bit tight lipped, nervous and hiding it reasonably well, although not as well as she thought. She wore open sandals like flip flops but in nicer materials. I strongly disapprove of open shoes in a hospital, and the doctor's office is IN a hospital - you go down the hall and turn left and you can easily access two different inpatient units. Christ, you can see straight into a patient's room from one side of the bank of elevators you have to take up to get the office. The idea of wearing anything other than a full coverage shoe in this environment was shocking to me. I wonder when I see them, do the people who chose such footwear walk in some kind of bubble which preserves them from encountering spilled sharps containers, bodily fluids, and the more than occasional poorly driven stretcher or wheelchair? I cannot imagine sacrificing so much necessary practicality and utility for fashion unless one was completely unaware of the sacrifice.

The resident was not very good with the exam. She was sporadic on her warnings for touches, and gave none when she inserted the speculum. I should say "tried to insert" because whatever she did with the first attempt to get it in failed. I heard it clatter out of control for a second, pinching bits of me in it. I shrugged my left foot over, stopping just short of kicking her in the shoulder and glared down over the sheet for a second. She looked up after a moment and said "sorry..." Despite her leisurely tone, I wanted to believe that she was very very sorry, not because I was feeling filled up with human kindness milk or honey or whatever fluid it is that human kindness comes in these days, but because I had to believe she was sorry or I might get pissed off enough to kick her and you don't kick someone who has metal instruments in you.

After sucessfully inserting another speculum, she began poking about for the strings which were supposed to be the visible evidence of my IUD.

"Can you find them?" my gynecologist asked. He leaned over her left shoulder since my foot was close to her right.
"Uh...I think..." came her voice from behind the sheet. "Oh yeah, there, I think there they are" she said finally.

I released the breath I hadn't been conscious of holding.

"They're really..." she said and I felt the sensation of internal digging about "short. They keep slipping," she said with something between slight alarm and frustration.
"uh..." I said, foot poised. My other foot was thudding against the stirrup in the uneasy rhythm I maintain when something uncomfortable is happening to or in me. It's more than discomfort, it's not emotional but it's not totally physical. It's that "ishk" feeling which moves from your gut to your head and makes your hands tingle. It's a little hard to describe because the triggers are different for everyone, and I suspect the manifestation varies a bit too.

Consider the things that make you sort of shudder. How it feels when you think of being catheterized, for example. Or someone digging about in your arm to find a good vein. Or what happens after you put you hand down on a sewing needle, what happens aside from the pain of course. Or the feeling you get when steeling yourself to pull a splinter out of a toe. Or maybe to insert something into your eye. We all have different boundaries of that feeling, some of us being able to tolerate even a painful experience with no such sensation only to find ourselves close to swooning over something only mildly painful but UNcomfortable in that way.

Her digging was UNcomfortable like that. She stopped for a moment, I think I had begun humming tunelessly and rolling my head about a bit. My doctor handed her an instrument. "It's easier if you use a forcep sometimes," he said, and quickly added "gently" as she inserted it, again with more clattering.

But once she gained her comfort with weilding the forceps, she seemed to locate the string relatively quickly. "Don't pull hard," my doctor told her when she annouced in a victorious voice "I got 'em!"

Then it was time for the ultrasound. He let her start. "Slowwwly..." he said and I watched a blur of ghost insides images on the monitor, resolution swaying in and out uncontrollably.
"More slowly," he said to her and it sounded like he was laughing a little. I didn't mind since the ultrasound is truly not painful unless someone chooses to grind down on a tender spot with the probe.

Finally my doctor took over the exam. He moved the probe around in slight angles making crisp, meaningul images clearly and easily on the screen and taking a few stills here and there. We had the usual "your left ovary has a cyst" "My left ovary ALWAYS has a cyst" conversation.
"That's good!" my doctor said happily. "It means it is ready and working to make a baby." He didn't say this with condescention but I heard it and bristled nonetheless. I tried to remind myself that most of this guy's patient population would give their right ovary to hear someone say "your left ovary has a cyst" and this helped me feel less cranky.

There was some fluid (which you know, to me seems like it might have some relevance when taken in conjunction with that constant left ovary thing but what do I know, I'm just the patient). Mostly what he was interested in was making sure it didn't look like his serious cutting and sewing had come undone and in making sure the IUD hadn't worked its way up to my esophagus or something. All was good, and I am happy for that.

The pain, he said, was from the cutting and sewing and also from the IUD. The IUD was to be checked again in 3 months, according to the manufacturer. I had intented to make the appointment when I was leaving but the surly secretary was at lunch.

Making the appointment for the 3 month checkup is like a promise, or a hope. Hopefulness that it won't need to come out before then. That I will tolerate it, that my body will learn to tolerate it and stop trying to expell it. I don't know that I do believe this, but I am practical and I know if I don't make that three month appointment soon, I will forget. I mean to call today, to make the appointment and ask about my book.

If I consider it too long, the thought of the IUD inside me, strings hanging too short to grasp even with me cranked open wide, is a little creepy. I know it would disturb me less if it were less trouble, less painful. I talked with my doctor about the pain. "It's going to take a little while, but it really should get better in a couple of weeks," he assured me.

My god I hope so. Last night was HORRIBLE. Fresh blood instead of old, but not much and that is a good thing. But the pain, god almighty it was bad. I took 400 mg of celebrex (do NOT try this at home) and I was still having these waves of profoundly painful cramping - worse than any menstrual cramps, and I get bad menstrual cramps. Fortunately the wave pattern of the pain meant I had some in between times when I could carry on half conversations with my fella or pat my cat or read. For this I was relieved and thankful, not thankful to anyone in particular, just feeling a sense of staggering and nonspecific gratitude.

I took another pill before bed, took a hit of benadryl to put me out (again, don't try at home - my family history as medical professionals makes me probably a bit stupidly fearless with mixing meds - I do check for interactions and contraindications before I do this but it is not a practice I advocate at all).

I woke up without pain today. Nevertheless, I'm planning on staying totally drugged for at least the next week. No, these are not the fun drugs. The fun drugs fuck up my intestine, that touchy fucking tube of hell. The only side effects of my current pain med is a risk for kidney failure and ulcers, and an increased risk of having a cardiovascular "event". Nothing even remotely cool, oh yeah, except for the coolness of not literally grinding my head into the floor, my nails into my head, and frantically pounding on things with my fist while muttering "fuckfuckfuckfuckfuck" like a mantra while it feels like something with dull, wide teeth is chewing its way through the deeper parts of my pelvis.

It's after four, I just now realized on my most recent trip back from the bathroom. I also realized I haven't called yet. I will call when I am done with this post. After this next cigarette. No more pain pills until 10:00 tonight, and although I remember looking at the pill bottle this morning at 10:00 AM, the twinges of pain I felt just now make me wonder if I did in fact take the 10:00 AM pill. This poses a conundrum. Which do I believe? Do I trust my memory and, by extension, my sense of reliability? I explicitly recall holding the pill bottle this morning, but I don't have an explicit memory of taking a pill. But why else would I have been holding it if I hadn't taken a pill? I'd like to believe I am not so flakey that I'd pick it up, look at it, and then put it back without taking the med. But flakey is alluring because I don't want to believe what my body is starting to whisper, that I hurt even though I have 6 more hours to go until I'm supposed to take another pill. I want to think that I must not have taken the pill this morning since it shouldn't have worn off so fast.

It occurs to me as I sit here typing and not calling for my routine 3 month appointment and not knowing where my book is that the question might not be so much "what do I believe" as "what do I believe in?"