Tag Archives: uterus

On the Outside Looking In – Hysterectomy

As I type this, a dear friend is undergoing a hysterectomy.

Painful periods and heavy flow prompted tests and the diagnosis of Endometriosis with adhesions was given.

My friend was thankful to finally find an end to her monthly pain, but also nervous about going under general anesthesia and the knife.

Because of the location of and amount of adhesions, she was not a candidate for laparoscopic surgery.  She would have abdominal surgery – in the same scar used for her C-sections.

She was concerned about pain and length of recovery.  I could only share of my own experience – which was far different than her own will be.

I did not have endo and adhesions were not a problem for me.  I had fibroids – some the size of grapefruits, some on stalks – and a uterus the size of a 6 month pregnancy.  Surprisingly, I WAS a candidate for a laparoscopic hysterectomy.

How my experience and that of my friend compare remain to be seen.

I hope all goes well and that she is up and around and back to some semblance of normal within a week or two. Full recover, no matter the surgery chosen, won’t occur for about a year.

As I type this, I am aware that my friend will never experience another period – ever.  I thought it ironic that my last period was due to begin same day as my surgery.

During her last period, I asked my friend to consider two things.

  1. Was there was anything she would like to experience during this last period? After surgery, there will not be another opportunity.
  2. Was there anything about her period that she would like to share with her young, teenage daughter?  After surgery, her daughter would be unable to experience or learn from her mother’s periods, or benefit from anything she might learn from them.

Do you know when your last period will be?

Most women don’t.

If, while reading this post, something came to mind that you need to address, don’t put it off.

  • If there’s a product you want to try, try it.
  • If there’s something you want to know, ask it.
  • If there’s something you need to learn, learn it.
  • If there’s something you want to experience, experience it.
  • If there’s something you want to share, share it.

Now.

Don’t wait until it’s too late.

Period regrets are such sad regrets.

Be period wise.

Keep Your Ovaries – Study Says

This is a matter dear to my heart – and one I argued with my own GYN about prior to and up to the moment of my own hysterectomy.

Me: “When you get in there, if my ovaries are not diseased or irreversibly damaged by the tumors, I insist that you save them!”

He countered with: chances are great that following hysterectomy your ovaries will cease functioning – at your age, menopause is just around the corner anyway. By removing them we remove any possibility of ovarian cancer down the road. You can always take the HRT route.

Me again: “I respect your thoughts and concern, but it’s my body and my decision.  I keep my ovaries if at all possible!”

For me, the period wise thing to do was to keep my ovaries.  And, I did. They continue to function. I still cycle. Not as regularly as I did when younger (peri-menopause does that, you know), but I do feel the affects of the hormones my ovaries continue to crank out. And, I know I made the right decision.

While surfing the web for ideas (actually, I was bored and was looking for something interesting to read) I stumbled upon a report on Fox News entitled “When Removing the Uterus, Leave the Ovaries”. The byline indicated it originated with Reuters so I headed there, searched “hysterectomy” and found the article by Kerry Grens – which directed me to Obstetrics & Gynecology.

Obstetrics & Gynecology, also known as The Green Journal, has been around 60 years and is the official publication of the American College of Obstetricians and Gynecologists. The goal of the journal “is to promote excellence in the clinical practice of obstetrics and gynecology and closely related fields.”

The April, 2013, issue of Obstetrics & Gynecology provides an interesting report about a study conducted to determine the effects of removing ovaries (oophorectomy) vs saving them (ovarian conservation) at the time of a hysterectomy for benign disease.

It’s noted that the participants of this study were nurses – 30,117 women – and the follow-up process was long-term: 28 years.

An excerpt follows.

Each year approximately 610,000 U.S. women undergo hysterectomy for benign disease and 23% of women aged 40–44 years and 45% of women aged 45–49 years have concomitant elective oophorectomy to prevent the subsequent development of ovarian cancer.1,2 Bilateral oophorectomy, when compared with ovarian conservation, is associated with a decreased risk of ovarian cancer but may increase risks of death from coronary heart disease (CHD) and all causes.3,4 Although some studies are not consistent with these findings, they include small numbers of women, have short-term or delayed onset of follow-up, or compared oophorectomy with natural menopause.5,6The Nurses’ Health Study is an ongoing prospective observational study of women and health outcomes. In a previous investigation over 24 years of follow-up, we found that bilateral oophorectomy, compared with ovarian conservation, at the time of hysterectomy was associated with a lower risk of incident ovarian and breast cancer but a higher risk of incident CHD, stroke, lung cancer and total cancers, and mortality from all causes.7…we found that at no age was there an overall survival benefit associated with bilateral oophorectomy compared with ovarian conservation at the time of hysterectomy for benign disease. Our analysis…found that at the time of hysterectomy, bilateral oophorectomy was associated with a marked reduction in mortality from ovarian cancer and a lower risk of mortality from breast cancer when oophorectomy was performed before age 47.5 years. Among the 30,117 study participants followed over 28 years, 44 women with ovarian conservation and four with oophorectomy died from ovarian cancer. However, these risks were overshadowed by the significantly increased risks of dying from other causes: a 23% increase in CHD mortality, a 29% increase in lung cancer mortality, a 49% increase in colorectal cancer mortality, and a 13% increase in all-cause mortality.

Additionally, it was found that

  • oophorectomy before age 50 years in women who never used estrogen therapy was associated with a 41% increased risk of all-cause mortality
  • lung cancer and cardiovascular disease mortality were also elevated only in the women who never used estrogen therapy
  • oophorectomy increased the risks of cardiovascular disease and all-cause mortality in low-risk women
  • oophorectomy may have a greater effect on otherwise healthy women
  • for women who never smoked and never used estrogen therapy, oophorectomy before age 50 years was associated with a 200% increase in mortality
  • oophorectomy may be associated with increased risk of colorectal cancer
  • oophorectomy may affect lung cancer risk
  • 80% of both cardiovascular disease deaths and all deaths occurred 15 or more years after hysterectomy

A reminder to women with a known genetic tendency toward ovarian and breast cancer was issued and a warning to women who undergo elective oophorectomy at the time of hysterectomy:

At the time of hysterectomy, women with known high-penetrance susceptibility genes for ovarian and breast cancer (BRCA, Lynch) should strongly consider oophorectomy because the lifetime risk of ovarian cancer is high.18 In contrast, approximately 300,000 U.S. women without these mutations, and many more worldwide, have bilateral oophorectomy at the time of hysterectomy for benign disease every year. Consequently, the association of oophorectomy with increased mortality in the overall population has substantial public health implications.

For more information on the study and its findings, please visit Obstetrics & Gynecology: April 2013 – Volume 121 – Issue 4 – p 709–716

Aching to Start

I crave chocolate.

Yes, I do. I could eat it by the pound right now, slowly savoring the taste, the texture…the feel of it on my tongue….

My breasts ache…no, make that HURT…my breasts hurt.  They passed “aching” hours ago.

And, my bottom feels heavy.

Fingers are so puffy that I can hardly type and my legs, well…they look like over-stuffed sausages.

My appetite?  Ha! Ravenous! Not only do I crave chocolate, I crave corn as well – cut or cobbed, creamed or chopped, Doritos or Fritos – I crave corn.  And, tomato.  Oh my…. You know…tomato as in pizza, spaghetti, ketchup….

I’ve eaten 4 Hershey Kisses since I began writing this post.  My corn allergy prohibits me from indulging in any corn products, so I’ll head back to my Kiss stash and partake of a few more….

A nap would feel so good right now. To just curl up and snooze for 15 minutes, or 30 or an hour…or two.

Hang on while I throw away my small pile of silver Kiss wrappers…get more…brb….

Back.

Ah…where was I?  Oh, yeah…hang on again while I open and pop another kiss into my mouth.

M-m-m-m-m-m…so-o-o-o-o g-o-o-o-od….

I have not yet begun the runs to the bathroom – they will come in waves as my bladder becomes sensitive and urination picks up as all this excess fluid leaves my body. And, of course, there will be the “check” trips because my vagina feels “leaky.”  Oh, and at some point, diarrhea will result…just too much fluid for my kidneys to deal with at one time, I guess.

Ouch my boobs hurt!

Perhaps removing my bra will help.  Ah…it helps somewhat.  Good thing I’m small breasted.  😉

My “seat” is aching like it’s been spanked.  Labia hurt, vagina hurts, everybody down there is cranky.

My mind is crazy today, for lack of a better word.  I type things I don’t intend to type.  Mispell simple words.  Change that to: Misspell simple words. My mind can’t get herself together no matter what I do.  5 cups of coffee by noon and still I’m fuzzy around the edges.

And, my bottom feels like it’s going to fall off of me.  ARGH.  This is getting on my nerves.  First the boobs and then the bottom.  It’s like they take turns calling my attention to them – boobs then bottom, boobs then bottom.

And, no…orgasm did not help. One did not.  Two did not. I’m certain three would not either.  If anything orgasm made matters worse.

What I would really like is to…ah…what time was it Hubby said he would get home?

I feel like my vagina is expanding within me…like everything is swollen…lush…ripe.

Usually, I’m able to control my cravings, but this weekend really did me in.  The family ate Kentucky Fried Chicken – a NO NO for me but I ate it anyway (sans skin and coating).  Saying “no” was just too difficult for some reason.  I wish now I had.  The swelling would be far less than it is if I’d stuck to my natural foods diet and the other issues would be nearly non existent as well.

Ah, well, it is what it is.  I gave her what she wanted and she’s doing a number on me now.  Ha ha!

You go, girl.  Enjoy every sensation.  Enjoy the cravings, the aches and pains, the fullness and bloating. One day all this will be a faint memory, if that.

Oh, I forgot about the bloating.  I’m in sweatpants today.  For the first time in ages my abdomen is bloated.

I’m miserable.

And, having light cramps, too.  They originate near my ovaries and extend down into my vagina.  Not really painful…but not all that comfortable either.  They end with a profound ache/tug at the top of my vagina.

My lower back aches.  A heating pad would feel nice against it but I’m too lazy and sluggish today to get up and get one.

Boo me.

I just want to go to bed and sleep…or eat.  Eating is good, but I’m tired of chocolate.  What else is there that I can nibble on?

No, no, no…I don’t want an apple….  I might make some fries….  Oh, or a chocolate shake…or fries AND a chocolate shake…OH!! I know…fries dipped in the chocolate shake….

And, a spoon of spaghetti sauce…I wonder if I have any in the cabinet….

I wish my period would start.  That would make my body so happy.

The chips…I found them hiding on the microwave.  Forget the fries…forget the shake.  I’ll go with greasy, salty crunchiness.

Several times I’ve headed to the bathroom to check and see – stopped myself because I knew flow had not started.  But, it felt like it had…such an odd sensation.

Crampiness is increasing.  CD 1 can’t be far off.

My breasts ache, upward into my armpits – I find myself with my hands cupping them, lifting and cradling them…attempting to ease their pain and find that I only add to it.

I’ve not checked my stash of menstrual products or cleaned my cup for use.  I’ll not place a pad, tampon or cup “just in case” I start. I won’t worry about bleeding on or staining anything I wear. And, I won’t insert my finger to check my cervix’ progress toward menstruation.

Why?

Because I no longer menstruate.  But, I do still cycle.

My cycles have become irregular in the past year and I thought I had reached menopause a couple of months ago as I experienced a cessation of symptoms associated with the various phases of my cycle.

It’s odd to experience everything up to the moment that flow should arrive – and for there to be no flow.  And, to experience everything during the period of time in which I should be flowing except for flow itself.

I lost my ability to menstruate when fibroid tumors enlarged my uterus to the size of a 26 week pregnancy and filled my abdomen and pelvis with softball sized tumors. Shortness of breath, intestinal worries and difficulty emptying my bladder signaled it was time to put my health ahead of menstruation. It was a sad day.

A very sad day.

My ovaries were uninvolved so I begged to keep them.  They have functioned well since surgery – at least up until late last year when I noticed changes in myself and in my cycle.

Each and every cycle, since the hysterectomy, has been a blessing. No, I don’t flow, and, yes – I miss it greatly.

It’s one thing to cycle through all the various frustrations and changes and arghs associated with the menstrual cycle and be rewarded by flow – and quite another to go through it all and not experience flow.

One day I will no longer cycle.  I’ll admit – I’ve wondered who I will be and what I’ll be like when I stop.  I can’t imagine living without the changes…without waiting for certain days in my cycle when I KNOW certain tasks will be easier to accomplish.

After all, I’ve cycled for 40 years.  That’s a long time.

But, that day has not arrived yet.  I am awaiting the start of my “period.”

No, I won’t bleed.  No, I won’t become menstrual in the truest sense of the word.  No, I don’t have a uterus to get grumpy and irritable – and crampy – as she goes about her business of expelling the old as she renews herself.  No, I won’t flow red.  But, I will flow.

Yes, I will flow. With all that’s in me, I will flow.

(This is the second in an occasional series that began with “Finding Normal.”)

This hurts! I Feel Like I’m in Labor, Ow!

Menstrual cramps are a monthly reality for many and for some they are disabling.

What advice would you give a young woman who expresses her menstrual pain as “I’m trying to walk, this really hurts. I feel like I’m in labor. This hurts! Contraction!”

If you think of the uterus as a muscle (which it is) and menstrual cramps as a “charlie horse” of the uterus (muscle contracts strongly/cramps up, cutting off blood flow to the muscle, causing pain, soreness, etc) then it makes sense to treat menstrual cramps as uterine charlie horses. Period cramps are just that – cramps.  And, cramps are exaggerated/strong contractions. One of the functions of the uterus is to expel by contracting (that’s how babies are born and it also aids in expulsion of menstrual fluid).

Take 47 seconds and view Alexis Chaffin’s “Cramp vlog” below. Then join me afterward and let’s provide a list of known helps for menstrual cramps.

http://www.youtube.com/watch?feature=player_detailpage&v=eUfx0Suz7bE

Tips for relieving menstrual cramps/uterine charlie horses:

  1. Massage (more information)
  2. Ibuprofen (take as soon as your period begins, or just prior to its start)
  3. Heat to lower abdomen or lower back
  4. Rest
  5. Gentle exercise (many find activity helps)
  6. Calcium/potassium (chocolate milk and a banana – which many crave during their period)
  7. (Please continue the list with your suggestion(s) in the comment section.)