Thursday, November 6, 2014

I Broke My Therapist and Got a New Diagnosis

Warning:  This post contains possible triggers for self-harm.  If you are not safe, please don't continue.

The new diagnosis is Bipolar II and doesn't really have anything to do with me breaking my therapist.  It's something that's been tossed around as a possibility a couple of times in the past.  I think we're calling it semi-definite now.  Enough that I'm trying a new medication for it.  We'll see if that does anything to change my life.

But the real reason for this post is the whole breaking-my-therapist thing.

Let me start off by saying how much I adore my therapist, Dan.  A lot.  He's amazing and has helped me so much over the years.  He's seen me through some very difficult stuff and walked me through the dark corners of my life that I didn't want to go into.  I would recommend him to anyone.  Well, almost anyone.  Anyone who needs help but doesn't have a problem with self-harm.

You see, along with being a hero, my therapist is a person.  Just a regular human being.  With issues.  I know.  Therapists aren't supposed to have issues, huh?  But they do.  And he does.  And self-harm is the one I triggered.

For anyone who doesn't know me well or hasn't read my blog much, self-harm and I are old friends.  She's helped me get through some really heavy times.  (Not sure why I called self-harm female, but let's just run with it.)  Generally I'm a scratcher.  I use a broken plastic spoon to scratch myself (usually my arms) until I get through several layers of skin and it welts up and bleeds and stings really good.  I say good because to me, in those moments, it feels good.  Don't ask me why.  It doesn't make sense in my logical brain.  It just does.

I'm not good at knowing what will set it off.  It just happens.  I go months without doing it and then WHAM!  Out of nowhere I'm slicing my arms open.

Only this time I maybe should have seen it coming.  I've been fighting a nasty depression (with a couple days of hypomania thrown in, just for fun).  I went quite dark a few days.  Started isolating myself.  Quit getting dressed or leaving the house.  Stopped communicating with people.  Not a happy place.

I don't know what the straw was -- you know, the one that broke the camel's back.  But something happened and I knew I was going to hurt myself.  And being in that dark place when it started coming on, the idea of asking for help didn't occur to me.

But this time I didn't need to scratch.  I needed to burn.  See, it's like getting an itch.  And it's a peculiar itch.  An itch that will only be well scratched with the proper technique.  Sometimes that's the spoon.  Once in a while it calls for the curling iron.

Almost before I knew it I had a nice, big, second-degree burn on my arm.  Ugh.  I'd gone so long without doing it.  I'd been able to wear short sleeves without worrying about traumatizing my kids or others.  And then BAM!  All down the toilet.  Dang it!

Yes, it felt better in the moment.  Yes, it took away the itch.  Was it worth it?  I don't know the answer to that yet.

But then I had a therapy session.  Therapy only works if I'm honest with my therapist.  So I told him and showed him.  He wasn't happy, but we were functioning.  We were even making some progress.  Until near the end of the session.  When I, in the interest of honesty and knowing it was something I should tell him, told him I was thinking of using a blade.

And it triggered him.  And he lost his therapist brain for a bit.  And he called me a coward.

I completely shut down therapeutically.  I refused to look at him.  I started crying a lot.  I told him I was done and wanted to leave.

He could tell things had gone off the rails and tried to fix them a little, but it wasn't going to happen.  He asked when my next appointment was (because now he was very worried about me; it's never a good sign when you leave a therapy appointment in a more fragile state than when you entered).  When I told him it was in two weeks he said that was too long.  He looked at his schedule for the next week to see where he could squeeze me in.  It was packed full.  But he had an opening for the next day.  Would I take that one?  Whatever, just get me out of here.

I called my husband and told him what had happened.  He could hear how bad I was.  He tried to talk me through it.  I said I was safe (therapy code word for not-going-to-hurt-myself).  I said I was just going to go home and go to bed.  Maybe watch some Angel or Buffy the Vampire Slayer.  He offered to come home.  I said he didn't need to. 

Apparently he didn't believe me, because he showed up a couple hours later (he has a two hour commute).  I needed him more than I thought and spent the rest of the night next to him.  Then he took the next day off work so he could come to my therapy session with me.

I don't often want outside help.  My husband is many things, but my strength is not usually one of them.  This time it was.  I needed him to be my buffer with my therapist.  Also not a good sign.

Usually when I take my husband to therapy with me it's because he's having a problem (we see the same therapist) or we're having a marital problem (which still usually means he's having a problem).  So as we sat down in the therapist's office he asked if there was a marital problem.  I said that we were fine.  He asked if Bill was there as support.  I said yes.  Then I looked him in the eye for the first time since he'd called me a coward and through my tears said, "I don't feel emotionally safe with you."

I chokingly explained what had happened the day before, thinking that maybe he didn't understand what he'd said or didn't mean it that way.  He said, "Yep.  I did."  Then he went on to defend it with the idea of challenging a patient.  Using the relationship between patient and therapist to push the patient into something healthier.  He said self-harm was a deal breaker for him.  It was his Achilles heal.  He said sometimes people forget that therapists are people, too, and have their own issues.  This was his.  If I couldn't commit to not do it anymore maybe it would be a good idea for him to refer me to someone else.

I've been seeing him off and on for over eight years.  The idea of starting over, of having to explain everything - my whole life story - again to someone new, was not appealing.  Was exhausting to just think about.  But I was pretty sure I couldn't work with a therapist that I knew saw me as a coward.  Someone I wouldn't feel comfortable telling when I self-harmed.  And I knew I couldn't say I was done.

I told him I needed to think about it and let my husband spend the next forty minutes asking about Bipolar II (really, just to get our money's worth; I had made the decision).  Then my husband ran out of questions.  It was time.

My therapist apologized for using such a "harsh" word.  I looked him in the eye again and said, "It wasn't harsh.  It was demeaning."  He just nodded.

We all sat in silence for a minute or two.

Then I looked him in the eye and told him I needed him to refer me to someone else.  I told him I've never not seen him as a person.  I never thought he didn't have issues.  But I have my own issues and I can't carry his, too.  I have to carry the issues of too many people in my life.  I can't carry his.

So he said he would refer me out.  He said his feelings weren't hurt.  He said I could come back if I ever needed to.  I understood completely why he reacted the way he did (I know what it's like to be triggered).  We patched things up amazingly well and respectfully.  I left with a recommendation from him (Jason) and a promise from me that I would get medication for Bipolar II ASAP.  And with a heart that was breaking, because even though I knew it was the right decision I was so sad about leaving him.

My husband and I left his office and I immediately set appointments with the new guy.

Lest I leave you with a bad feeling about my therapist, there is more.

He called me later that night to check on me and make sure I was okay.  I was.  I was actually doing great.  Much better than I'd been in days.  Because I'd done something very brave and very hard to stay true to my own needs.  I was riding a bit of a high from that.  He also said that what I'd said, about not carrying his issues, had stuck with him.  He'd been thinking about that a lot and would continue to do so.

Then he called me a few days later to apologize.  He said not only had he handled the first appointment horribly, inappropriately, but he'd botched the second one, too.  He said it's never okay to call someone names.  He acknowledged that he'd not been in his therapist mind at the time.  He said he'd spoken to some colleagues about it and understood a bit better.  He said to force me to transition to a new therapist while in the midst of a deep depression was completely wrong of him.  He said he knew that he'd shut me down when I needed to be heard.  And he was so sorry about that.

Then he said he'd also talked to his colleagues about his issue.  He said he understood self-harm better and how to see it as a symptom and to treat it as such.  He said he thought we'd done great work together over the years and still could.  He said he thought he could work with me, that he liked working with me, and wondered if there was any way we could repair the relationship.  Would I be interested in coming back?  Seeing him again?

I thought about it for a few seconds, but the decision was easy.  Because just moments before he'd called me I'd gotten out of a session with my new therapist.

I thanked him for his apology and gladly accepted it.  I told him we had done lots of good work together.  And then I told him I'd just met with Jason and wanted to try that course for a while.

He said he understood and that I would always be welcome back.  I told him it was nice to know I had a parachute, should I need one.

Will I go back?  Honestly, I think eventually I probably will.  I want to see what this new therapist has to offer.  Maybe he can help me kick the self-harm thing for good.  Maybe he can help me want to.  He thinks he can.

But I don't imagine he can possibly solve all the problems that keep me crazy.  My life is not simple and shows no signs of letting up any time soon.  I imagine I will work with him, get better for a while, leave therapy and try to make it on my own, and eventually crash and burn again (I mean that like a plane going down not depression and self-harm).  And when I do I will look for that comfortable place.  That worn pair of pants.  Because Dan and I still fit.

Friday, October 17, 2014

Have to Write

Have to write.
Can't.
Stuck.
Hurts.
Wound so tight.
Things a blur.
Unsure.
Lost.
Choking on thoughts.
Flailing.
Drowning.
Pinned at the bottom of the sea.
Looking up.
Wishing.
Waiting.
Believing.

Tuesday, August 12, 2014

What Depression Looks Like

Earlier this year a friend of mine asked if she could take my picture.  She's spending the year focusing on the importance of the people in her life, A Year of Faces.  I was one of many she'd asked and declined at first.  It was a very dark time in my life.  Not a time I would look my best.  I explained to her where I was emotionally and asked if I could participate later, when I felt better.

She said she understood and, of course, we could wait if I wanted to.  But if I was willing, she'd like to capture where I was right then.  The darkness.

And I knew it was right.  I needed this to happen.  Even though it wouldn't be pretty and even though it was difficult, it was also so important.  I agreed to do it.

She sent me some pictures she'd found on the internet of depression.  Some were very stylized, very artsy.  Some were blank stares.  Some were silhouettes.  I understood why people associated these with depression.  And these might represent depression for some people, or even me at some times.

But not this time.  None of these came close this time.

This was my darkest time, at least the darkest I can remember.  This was the most painful depression I've ever had.  And the most unrelenting.  Months and months of pain and numbness and isolation and fear and loneliness and sadness and confusion and anxiety and guilt and exhaustion.

The day she came I was wearing the same pajamas I'd been wearing for three or four days straight.  My hair was dirty because I just didn't have the energy or will to shower.  She was the first person I'd invited into my home in weeks.

She asked me to tell her about my current struggle as she took photos.  She was gentle and kind.  She listened and asked questions.  It was an important moment.

She used one photo for her project.  I've been saving the others for the right time.  Today is the right time.

These photos are difficult for me to look at.  They hurt.  But people need to understand what depression is and I believe these will help.

Thank you, Karen, for capturing a hidden moment that needs to be seen.

My fingertips are pressing on the spot where I've had a headache for nine years.  When I cry, I tend to furrow my brow; this makes my head hurt worse.  I press on that spot to try to get the muscles to release and relieve the pain.  It helps a little.
Depression makes me feel incredibly vulnerable.  I have no emotional energy to protect myself.  That's part of why I isolate.  So often, when I am with other people, I feel the need to defend or explain myself.  When I am in a depression I just have nothing in me to do that.  I have no strength or will to draw boundaries and defend them.  It's easier to just be alone than to feel like a rag doll at the whim of those around me.  I often find myself in the fetal position in an attempt to seal myself off from the world and keep myself safe.
Sometimes my depressions are emotionless.  I feel nothing.  Most of the time it was like that.  Dull.  Blank.  Empty.  Nothing.  Other moments were like this.  Gut-wrenching.  Crying from the deepest parts of myself.  Falling to the ground sobbing.  Unable to stop shaking from the shredding of my soul. 
And this is how I felt so much of the time.  For months and months and months.  Like an empty shell.  Depleted.  Like everything that made me who I was had been taken away.  Worthless.  Like I had nothing to offer the world.  Without hope.  Without purpose.  Gone.  Lost.  Alone.
This is what depression looks like.  It's not a bad day.  It's not when things go wrong.  It's when the world is pulled out from under me and I am plunging to my death and I just don't even care.

Thursday, July 24, 2014

My Facebook Fast

A week ago tomorrow I was done.  Absolutely finished.  I couldn't stand one more minute on Facebook.  So I decided to take a break.

I didn't start out planning to be off for a week.  Just a few days to cleanse my system.  It was making me anxious.  I was feeling social pressure (that probably wasn't even there but was just in my own head).  I felt compelled to like this or comment on that to make sure she knew I was reading her stuff or he knew I still paid attention to his life or she felt like I liked her.  Seriously, it was ridiculous.

I was not feeling peace.  I wasn't acting; I was reacting.  I wasn't being true to myself.  And I am not okay with that.

So I announced my departure and went away.

And very soon I was anxious about being away.  I missed it terribly.  And I started to wonder why.  I started to examine my feelings and their causes.  Why was I uncomfortable being away?  What was it that Facebook was fulfilling in me that pulled me back even though it had been causing me negative feelings?

So I spent the next few days watching my own behavior and paying attention to the pull.

This is what I learned.

The thing I missed most was knowing what was going on in my friends' lives, especially within my own neighborhood.  I missed knowing when a friend was having a bad day or hurting.  I missed knowing who was having a birthday that day.  I missed knowing when someone in my neighborhood needed help.  Facebook has opened up communication in a way that just wasn't there before.  People share more.  I can get the info immediately or whenever it's convenient for me.  We can have a communal conversation over several days.  It's awesome like that.

But the flip side of it is over sharing or people sharing things I just don't want in my life.  Political/religious disagreements.  Posts with the F word.  Griping/whining in a victim-y way, with the same complaints over and over with no intention to try to make their own world better.  Pity parties.  Sexual images and/or status updates.  Non-stop selfies.  Contentious behavior of all kinds.  And certain people who just rub me the wrong way no matter what whom I hid from my feed but then they show up anyway because one of our friends in common likes or comments on their post.  I didn't miss those things.

Of secondary importance, I felt like I lost my voice.  My ability to communicate with the world was severely diminished.  Many times a day I wanted to share something and didn't.  I think this was the most important area for me to evaluate and an area I still need to work on.

I've always been curious.  I find many things interesting and always have.  Growing up I used to talk all the time -- ALL THE TIME!  I made people crazy.  I could sometimes sense it but didn't understand why.  The things I was saying were so interesting (I thought).  I don't remember how old I was when I finally understood (but it was probably much older than I should have been).  I don't remember what happened to precipitate it, but I remember distinctly realizing that I didn't need to share every thought that popped into my head.  In fact, it made people crazy that I did that.  It was truly an awakening moment for me.  It's taken years for me to learn to be quiet, because my brain never shuts up.  (It was many more years after that before I learned that other people want to share, too, and it's so important to listen.)

Facebook has been this lesson all over again.  I find so many things interesting in a day.  I have so many thoughts that I think are incredibly clever.  So many observations I find fascinating.  So many news stories I think are noteworthy and/or important.  I want to share them all.  And some days I know I'm sharing more on Facebook than others want to read/know, but I just can't stop myself.  I can hear people rolling their eyes at me when I post the third news article in a 15 minute time span.  To all of you who are my Facebook friends, please know I do try and I do censor and you aren't getting half the things I want to share.  You're welcome.

And it would be bad enough if that were my only sharing problem, but it isn't.  I started paying attention to the status updates I wanted to post.  So often this last week I found myself wanting to post snotty or complaining status updates.  The kind of communication that has become so much a part of our society.  The kind of communication that takes place on so many of today's TV shows that it's just become how we communicate with each other.  The kind of communication that's flippant and sarcastic, that we've all come to accept as appropriate humor.  The kind of communication that isn't Christlike or kind or sincere.

I don't want that to be my communication style.

Facebook is just too easy and quick and removed.  I don't have to think through, censor, or see the reaction to my thoughts the way I should.

I also missed seeing the updates from my daughter who is on a mission and knowing she's still okay.  That was hard on my heart.

There are lots of other things I missed and lots of other things I didn't miss at all.

So am I ready to get back on?  Kind of.

I still don't feel sure of my ability to regulate my behavior in a way that will bring me peace.  So I'm going to ease into it.  Tomorrow I will begin reading Facebook again.  I will communicate through the private message system about important things.  I will like my missionary daughter's posts so she knows I'm seeing them.  But I will not "like" any other posts.  I will not comment on any other posts.  I will strive to be an observer for a while as I continue to examine my thoughts and feelings.

When I feel like I can be true to myself and behave in a way that brings peace to my heart, I will participate fully again.  Until then, I'm going to practice observing and listening.

Saturday, July 12, 2014

My Hysterectomy

I will be using proper names for female body parts and bodily functions in this post.  There will also be pictures of my belly after surgery.  It's going to be long because I want to get the whole story out in one post.  If any of these bother you, please skip this post.

**********

So, twelve days ago I had my surgery (to read why, go here).  A total hysterectomy and oophorectomy.  He removed my uterus, cervix, ovaries, and fallopian tubes.  He cut the parts away laparoscopically using a DaVinci robot and delivered them vaginally.  He then sewed up the top of my vagina to keep everything inside from falling out.  I think that's the gist of it.

This is a picture from the internet of the DaVinci robot:
DaVinci Robot - cool looking, huh?
And this is what it looks like in action:
DaVinci robot in actual surgery, but not my surgery
The surgeon is that guy over on the left with his head in a box who looks like a ref watching instant replays in a football game (I'm pretty sure that's not what he's really doing).  That piece is separate from the robot.  Some of the internet pictures have it up close to the robot, some have it across the room.  No idea how close it was during my surgery, obviously.  The surgeon uses controls to maneuver the robot and do the laparoscopic part of the surgery (kind of like the crane game).  The advantage to using the robot instead of traditional laparoscopic surgery (according to my surgeon) is that with the robot he has full 360 degree rotation and with traditional he only has 180 degree rotation.  My feeling was this -- if he's the one doing the surgery I'd like him to use the method he is most comfortable with and has the most faith in.  I trust that he knows better than I do.

And this is how it all went down.

I went in the Friday before my surgery for a blood and urine test.  They look for anything that could be a reason not to do surgery or a situation to monitor.  They do a pregnancy test -- because, duh, taking my uterus.  At this time a nurse also reviewed my health and medication history.  I signed several forms, including one that said I understood that after my surgery I wouldn't be able to give birth anymore.  Apparently, some women haven't understood this in the past.  Oops.

I got a call later that night telling me there was a questionable result on my urine test.  It was possible that I had an infection, but not definite.  The nurse asked if I had any of the symptoms of a urinary tract infection, as she named them.  I didn't.  She said they were incubating a sample and would let me know if there was a problem, but it was probably just a contaminated sample.  Like maybe I touched something I shouldn't have in the collection process.  Anyway, I never got a call back on that so I guess it turned out okay.

My surgery was on Monday, June 30.  I was to be at the hospital at 11:00am to begin the whole process.  Shortly after we arrived (my husband and I) they took us back to pre-op.  The nurse came in and went over the flow of the process with us.  Pre-op, holding, operating room, post-op, room.  They had a board with the estimated time of things and I was instructed to let them know if the time passed and things hadn't happened as she explained them.  I think that was an important thing for me.  I tend to be extra patient and would probably just wait.  The surgery did start later than expected, but she had come in and told us it would and gave us a revised time, which was accurate.

She then reviewed the pain scale.  It looked something like this:
Pain Scale
She asked me where on this pain scale I would normally take something for the pain.  I said probably around a 6 or 7.  She said that wouldn't work in the hospital.  They want to know when my pain is about a 4 or 5.  I'm pretty sure I looked quite incredulous.  I said I would do my best to pay close attention and tell them at that point, but I sometimes don't notice it at that level (due to my chronic pain, I've had to learn to ignore most pain).  They took more blood and urine to test.  She hooked up my IV.  She hung an antibiotic on the IV post and said they would start that when they started my surgery.  And we waited.  How long did we wait?  I'm not sure.  We got there at eleven.  My surgery was scheduled to start at twelve thirty.  It was pushed back to one forty-five because the one before me went a little long.  I don't know how long the nurse's stuff took.  They took me back to holding at about twenty after one (if I'm remembering correctly, which no one should really count on).  My husband gave me a kiss and we went our separate ways.

In holding it was just a nurse working at a computer and me.  The room looked like it could hold several beds, I'm guessing six or so, but there weren't any others in there for most of the time.  This is where my surgeon and anesthesiologist met with me prior to surgery.  It's also where I presented this picture to my surgeon, who left it with my chart so the anesthesiologist and nurses could see it:
The creature
I explained to my doctor that I was pretty sure this was the creature that was chewing and clawing it's way from my body.  I wanted to make sure he recognized it when he found it.  He, the anesthesiologist, and the nurse each got a chuckle out of it.

Both doctors explained (in their separate visits) what they were going to be doing.  They asked if I had any questions.  They were both very kind.  They both seemed sincere in their concern for me.  My heart felt calm in their presence.  I felt safe in their hands, which was very important to me.

I spent about fifteen minutes in holding, give or take a few minutes (there were clocks visible everywhere so I could keep track).  Then they wheeled me to the operating room.

I don't remember a ton about the operating room.  I remember thinking it had a lot of equipment in it.  It also seemed like there were a lot of people in there.  They put my bed up next to a narrower bed and had me skootch (totally a real word) over to the smaller one.  There were no rails on this one like there had been on the other one.  I had a slight feeling that I could fall off.  But not for long because then they put a strap over my hips and secured me to the table.  The anesthesiologist told me he was giving me something in my IV to relax me (although I was amazingly calm, much more so than I expected to be).  Then someone, I'm guessing it was the anesthesiologist, told me they were going to give me oxygen and put a mask on me.

The next thing I was aware of was a man trying to wake me up in post-op.  I was very nauseous and worried that I would throw up, which was a concern I had prior to surgery.  I told whoever the man was waking me up that I felt like I was going to throw up and could he give me something.  He told me he'd already given me three things for nausea (if I remember correctly) but would give me something else.  He also handed me a cool blue bag with a round plastic neck in case I did throw up.  I kept this bag with me throughout that first day.

Through my still sedated haze I could see that there was a clock on the wall.  I fought through the medication to clear my vision enough to read it.  My daughter is on a mission and only gets to communicate home through email once a week.  I knew she would be doing so some time between 4:00pm and 5:00pm.  My other daughter was supposed to email her info on how the surgery went as soon as my husband got word and called her.  I wanted to make sure we hit that window.  I knew the surgery was supposed to take a couple hours so we might be cutting it close.

When my vision cleared enough to see the clock I saw that is was about four fifteen.  I asked the man if my husband had been given an update and explained to him why it mattered how quickly it was done.  He said my husband had been told and he would go find him to see if my missionary daughter had been told.  He came back shortly to report that communication had gone back and forth with my missionary daughter and she had the info.  Then I relaxed a bit.

I was moved to my room shortly after that.  We passed my husband in the hall, who joined us.  I think he waited in the hallway while they got me situated in my room.

He stayed with me until about eight that night, when I sent him home to sleep.  I wanted him to be rested when he took me home the next day.  My three younger kids (15, 17, 19) and a friend who's like our kid visited.  My parents visited (after receiving permission).  They can sometimes be stressful for me, but I understood that they needed to see that I was doing okay.  Their visit was short and nice.  And I was doing fabulously!  Every nurse commented that they just don't usually have people who are that happy on their floor.  I guess I threw off the anesthesia quicker than most.  And because all the anxiety I'd had before surgery was gone, I was very happy.  I had pain, but that I can handle.

I pretty much asked for the meds on schedule.  They gave me morphine to begin with.  I think that was every two hours.  Then they added something else; I want to say Tramadol, but I'm not sure.  Whatever that second one was, it was longer between doses.  Six hours maybe.  I was on a clear liquids diet, which was fine because I was still nauseous.  I got strawberry jello and a couple things of grape juice.  And water.  The nurse warned me to sip, no matter how hungry/thirsty I was.  Good advice!  I didn't want anything coming back up.

After my husband left I played hand solitaire and tried to find something to watch on TV.  I don't generally watch commercial TV, so it was tough.  I found a channel with old shows and watched some Murder She Wrote and later watched O, Brother, Where Art Thou?  I also went for four laps around the nurses station.  The nurse walked next to me, but I was stable enough on my feet to do fine just holding the IV stand.  The nurse was thrilled with my efforts; she said usually she can't convince people to even get out of bed and try walking.

I barely slept, which I knew would happen.  I listened to an audio book of Harry Potter on my mp3 player (I always listen to Harry Potter when I sleep because I am such a light sleeper; it's my white noise).  The nurses did their best to keep the interruptions to a minimum and keep the lights off to help me sleep.  It just wasn't happening.  When the phlebotomist came in at 3:00am to draw my blood I was awake.  (I guess my hematocrit had been low prior to surgery and they wanted to check that).

I had a little trouble with my catheter.  I still felt like I needed to go to the bathroom, which is a sign that it's not in right or is kinked or something.  And there wasn't as much output as would be expected from what I was drinking.  The nurse worked with it a couple of times.  It worked okay for a bit and then struggled again.  The other nurse had told me that since I was doing so well she would take the catheter out at six if I wanted her to.  Otherwise, they'd wait until I woke up.  I said six would be great.  It ended up that the nurse was in my room around five for something else, medication or IV or something.  I asked when she could take the catheter out.  She thought for a second and then said she could do it right then if I wanted.  I definitely wanted!  So she took it out and told me I had seven hours to pee on my own.  If I couldn't by then they would do a scan and see if they could figure out what was wrong.

On the information board in the room they write what the goals are for the patient.  The main goal was pain management.  Then she added "urinate by noon."  I can honestly say I don't think I've ever had peeing as a goal.  I had no problem meeting that goal.  I was able to pee all by myself within an hour or so of her removing the catheter. 

She switched me to a soft solids diet some time during the night.  After the catheter was removed I was finally able to get a few hours of sleep.  When I woke up I ordered breakfast.  I was so excited to be on a soft solids diet because it meant I could have milk!  Milk is what I usually use to soothe my nausea at home, so I was glad to have it.  I had pancakes, hashbrowns, two cartons of milk, and some tapioca pudding.  I wasn't a fan of the tapioca, but I ate everything because it had been so long since I'd had real food (fasting for surgery, of course).  I showered and put on a clean gown and underthings.  I went for another walk, without an escort.  Five laps this time.  I also asked for something other than morphine, since it was making me itch.  They added Percocet in its place (every four hours).  And the nurse applied an estrogen patch to my abdomen, to wear for seven days before switching to pills.

My husband and oldest daughter (23) came over around nine.  My 19-year old daughter is a nanny and brought the kids she cares for to visit. 

My doctor had told me I would get to go home after one night in the hospital.  Since I've taken care of many family members and a few friends while they were in the hospital I knew it wouldn't be until after the doctor made his rounds, which are usually done in the morning.  We hadn't heard anything by about noon so we asked our nurse to check on it.  He said he'd seen my doctor on the floor so he didn't know why he hadn't come to see me.  My nurse came back shortly and said the doctor had started his rounds but was interrupted by an emergency.  He would return when that was taken care of.

He came around one.  As he washed his hands I asked, "Did you get him?" (meaning the creature).  After only a slight pause he said, "Yeah, I ran him out of there."  He said he'd been getting a report from the nurse and been told I was hopping all over the place.  A wonderful report.  He asked how I was doing (fabulous!) and gave me instructions.  He asked if I had any questions.  I had typed my questions into a text message to myself in my phone so I wouldn't forget.

I asked how much it mattered if the pain meds made me itch (Percocet does a little).  He said as long as I could breathe okay, he wasn't worried about it.  And he said I could take Meclizine (which I had at home) with the Percocet for the itching if I wanted to.

I asked about yoga.  I have been wanting to start, but was waiting until after my surgery because I'd been hurting so much.  He said he didn't want me doing anything straining.  Yoga is out for a while.

Then I told him I have a high tolerance for pain and since I have chronic pain I just usually ignore it.  I asked him how much I needed to respect this pain.  He said my toughest struggle would probably be wanting to do more than I should because I felt so good.  We agreed that I would take the pain meds on schedule for 72 hours rather than according to my pain.  I agreed to not do dishes or laundry for two weeks.  I agreed to not lift anything over 15 pounds or spend too much time on my feet.

The nurse asked the doctor if he could take my IV out then, if he was done with it.  The doctor said yes.  But I'd been watching the clock and I know how things go as someone leaves the hospital.  It was almost time for my next dose of IV pain meds.  I asked if we could wait fifteen minutes and give me that last dose before removing it.  The doctor said that would be a good idea.

He left.  I got packed up.  The nurse gave me my last dose and removed the IV.  I got dressed.  The nurse came back with discharge papers.  He said someone had to accompany me out but I didn't have to ride in the wheelchair if I didn't want to.  That made me very happy.  I hate being pushed in a wheelchair, especially when I feel fine.  I signed all the papers and got the ones he was sending home with me.  The nurse shook my hand and thanked me for making his day fun.

Soon a lady came with a wheelchair.  I told her the nurse had said I didn't have to ride in one.  She said I could just put my stuff in it then, which is what I did.  As we walked to the elevator she asked what I'd had done.  I said, kind of embarrassed because of how well I was doing, that I'd had a hysterectomy the day before.  She said, "Wow.  You're doing great!"

The valet brought us our car and we were on our way.

I had amazing nurses the whole time.  In fact, everyone I interacted with was awesome, right from the first phone call.  Seriously, I couldn't have asked for kinder people.

I was sent home with a prescription for Percocet, prescription Ibuprofen, estrogen pills, and a stool softener (which was actually over the counter).  I took them on schedule for three days.  I took my last Percocet Friday morning, four days after my surgery.  I took the Ibuprofen (one at night and one in the morning) through Sunday. 

Monday afternoon I got a call from the surgeon's office checking on me.  How are you doing?  Great!  Any trouble urinating?  Nope.  Doing great.  Any trouble with bowel movements?  Nope.  You're able to go okay and without straining?  Yep.  We don't want any straining because you could pull your stitches.  Nope, no problem.  And how's your pain management?  Great.  What are you taking for the pain?  Nothing.  Really?!  You're not taking anything?  Nope.  And you're great?  Yep.  Well, okay.  I see you're already scheduled for your follow up and you say you're great so I guess we're done.

I've really been so much better than I expected to be.  My friends and family have been amazed at how well I am.  One friend said I seem so much better, they must have gotten something that was making me sick.

And I do feel so much better than I did before surgery.  Did it cure the problem?  It's hard to know for sure because there is still some pain in the same area that was hurting before because that's where they cut parts of my body out.  But I think so.

And this is what it looks like after:
July 2, two days after surgery
They make four incisions for the robot, including one in my belly button.  The incisions have surgical glue on them.  I think the doctor said the glue was over stitches, but I could be wrong.  It might have been in place of stitches entirely.  I never saw any stitches.  That white thing on the lower right is the estrogen patch.  To do the laparoscopic surgery they inflate your abdomen so they can see everything and maneuver.  I have no idea how long it takes for all of that air to leave, but my belly definitely still felt swollen for several days.

July 3, three days after surgery
That bruise on my belly button got bigger and darker for a few days.  The surgical glue started pulling up around the edges by this time.

July 9, nine days after surgery
The bruises are mostly gone by this point.  I took the estrogen patch off that morning, but the skin there was a little sensitive so I decided not to worry about the glue left behind from the patch until the skin there healed a bit.  The surgical glue is gone from everywhere except my navel.  It didn't rub enough to loosen it and that area was a bit tender so I left it alone.  You probably can't tell, but the incision on the left isn't healing quite as quickly as the two on the right.  It's possible that I might have encouraged that glue off a little sooner than it was ready.  Don't do that!  If you do, it's possible that the wound will weep a little and glue itself to your clothes and then when you move quickly you will tear off the scab and start bleeding and it will hurt.  Don't ask me how I know this is a possibility.

July 11, eleven days after surgery
Bruises almost completely gone.  Surgical glue gone.  Skin under patch healed enough to scrub clean.

Oh!  I forgot to mention vaginal bleeding.  I expected to bleed more.  I wore a pad for a few days (no tampons allowed because of the danger of infection).  The day of surgery I had some bleeding.  Not much though, like a light to moderate day of period bleeding.  The second day it was less.  By the third day I wasn't really bleeding anymore, just had some pink when wiping.  By the fourth day I was done.  It's kind of crazy that there wasn't more blood.  I bled a lot after having babies; I kind of thought it would be like that as things healed.  I guess it makes sense that things would heal much faster when they do it surgically and sew things up and cauterize them.

I am still on the same restrictions I was given when I left the hospital.  I see my surgeon Monday for my two week follow up.  At this visit he will check my abdomen to make sure that's all healing well.  We will also discuss which restrictions I still need to live by and which can be lifted.  I see him again around six weeks post-op.  At this visit he will do a vaginal exam to make sure everything is healing properly there, that I haven't pulled any stitches, and that nothing is falling out.  He expects that all restrictions will be lifted at this appointment except for one.  No vaginal penetration until eight weeks post-op.

I'm really feeling great.  I'm so glad to have it over with.  Everyone who took care of me was fabulous.  I even received a thank you card from the nurses who took care of me thanking me for letting them care for me and wishing me swift healing.

I can't imagine anything in the whole process going any better.  And I'm so grateful!

Thursday, June 26, 2014

I'm Sorry to Have Taken Your Time

I haven't written much the last few months.  There's a very good reason why.  Since my diagnosis of uterine prolapse and then my decision to have a total hysterectomy and oophorectomy I really can't think of much else.  I've written a few posts about it but not a lot.

And here's why - I'm pretty sure everyone in my life is sick of hearing about it.

So how am I supposed to write if all I can think about is something others are bored with?

As I pondered this question I realized two things.  First, it's my blog and I can write about whatever I want.  I'm always saying my blog is more for me than for anyone else.  So why am I holding back this time?  Which leads me to the second realization.  I am holding back because again I feel like I am inflicting myself on others and it's my job to protect them from having to experience my life.

That last part is an ongoing issue for me.  It has been for as long as I can remember.  I often feel guilty when I take others' time.  There are many people I would like to be closer to.  There are many people I'd like to visit.  There are many people I'd like to spend time with.  But I don't initiate these encounters because their time is limited and they shouldn't have to spend it with me.

Even when people have loosely invited me to do so.

"Let me know when we can get together for lunch."  "Stop by again some time."  "Come see me."  But because there's no scheduled time I am sure I'll pick the wrong time and they will let me stay to be polite, but they will be counting the minutes until I leave because they've got things to do.  More important things to do.  More important than me.

It sounds stupid when I say it; but it's how I feel.

Why do I feel this way?  I'm pretty sure it's because my parents always made me feel like I was a burden.  So now I feel like a burden to everyone.  (Which is also why it's so difficult for me to ask for help - even when I really need it.)

And because I am such a burden, I want to protect people from me.  I don't want to be the albatross around their neck.

It's dumb.  And I'm working on it.  And now that I've realized it about this situation I'm going to stop it.

This is my blog.  And I want to write about my pain and upcoming surgery.  And if you don't want to read about it, you're a big girl (or boy) and can take care of yourself.  Click away and go somewhere else.  You are responsible for your choices and feelings and I am responsible for mine.

I'm hurting.  A lot!  I feel like there is an alien inside my uterus eating me alive as it chews and claws its way out.  My ovaries feel like they are tied in knots (okay, maybe that's my fallopian tubes).  Sharp, shooting pain that radiates down my leg making it difficult to walk.  Sometimes I can't stand up straight because it hurts so bad.  There is no position that makes it better and no pain killer seems to help.

I have so much I still want to do to get my home and life ready for my recuperation time.  It's four days away now so I'm running out of time.  It's a bad time to be hurting so much because I can't do anything.  It is making me prioritize though, decide what's the most important to get done.  It's also reminding me I'm making the right decision about having surgery.

You see, I'm terrified of the surgery.  But more terrified about life after surgery.

I don't want to be anesthetized. I don't want to be cut open.  I don't want parts of my body removed.  I don't want those first moments coming out of anesthesia, being disoriented, nauseous, and helpless.

I don't want to be the patient.  I don't want to be the center of attention.  I don't want to need help.  I don't want to be weak.

I don't want to hurt.  I don't want to be on narcotics.  I don't want the rebound headache that's going to follow.  I don't want the potential depression that could come from sedative use.  I don't want the hormonal hurricane that will follow and the emotional trauma I could experience and/or cause.

I don't want my family to worry about me, especially my children.

I don't want to be an inconvenience to anyone.  I don't want to take their time and emotional energy.

And we're right back where this post started.  I don't want to be a burden or a bother.

The decision is right.  I am sure of this in my heart.  And mind.  And body.  I just wish it didn't come with so much other junk.

Tuesday, June 10, 2014

How My Prolapsed Uterus is Like a Pregnancy

I counted the other day and it turns out I will be having my hysterectomy and oophorectomy (removal of the ovaries) about nine months after I first started really hurting and knew I needed to go to the doctor.  This got me thinking about the other ways this whole thing has been like a pregnancy.

The biggest similarity is the nesting.  Okay, I'm not getting my house ready for a new baby, but I have been deep cleaning and getting my house ready for my down time and possibly visitors.  I don't generally receive visitors in my bedroom, but that will be a possibility for a few days after surgery.  So I wanted it to be presentable.  All those things I've wanted to do for a long time to make it the way I wanted it to be are finally getting done now.  I've been deep cleaning and purging so I can recuperate in peace without being anxious about things that need to be done.  Other than maintenance (which includes getting my family to actually clean up after themselves), my house is ready!

Discomfort.  Ugh.  Being pregnant brings about all kinds of weird and unexpected changes to your body.  And you spend so much time worrying if this is normal or something to worry about.  Should I call the doctor?  Do I need to go to the hospital?  Twinges.  Pain.  Swelling.   Cramping.  The one thing that's been nearly constant these last nine months is a cramping uterus - very like contractions only less come-and-go and more constant, like a Charlie horse.  It feels like I have a giant rock in my lower abdomen, very much like when I was about two months pregnant.  Uncomfortable to me, but not noticeable to anyone else.

And, because of my uterus being displaced, a more frequent need to pee.

An ultrasound as part of the diagnostic process.

Way too many pelvic exams.

Way more doctors visits than I'd like.

Deciding when and how to tell people.

Lots of people asking when my date is (surgery date as opposed to due date).

And when it's time I will go to the hospital and have a delivery of sorts and spend a night in the hospital while they monitor my bleeding and recovery.

I won't be bringing home a bundle of joy (but I also won't be gaining another lifelong responsibility).  There will be no naming of anything under any circumstances.

But hopefully, when all is said and done, I will experience the same joy and freedom and relief that comes after pregnancy when I feel like I finally have my body back the way it should be.  Fingers crossed!