Hymenectomy, D+C, fibroids -- your experiences?

[graziaplena.livejournal.com]

...and PCOS and weird spotting and cancer fears.  I have a lot to talk about!

The big thing, though, is that I'm scheduled to have a hymenectomy and a D+C on Wednesday, and I was wondering if any of you who have had these procedures could tell me about your experiences.

Some background:  I'm 32, have PCOS, and have had irregular periods (average of 3-4 a year) since I first started my period at age 13.  Normally, I have a period in, say, January, then another in April, then another in October, with absolutely nothing going on in the months in between.  This past year, though, for the first time in my life, I've had experiences of spotting for 2-3 weeks between my periods.  So, for example, I had a normal (for me) period in mid-November, I spotted from around December 6 to December 18, and then had a normal period the first week in January.  I had "spotting months" in May, September, and December. 

Back in May, I freaked out when I saw the spotting, because my mother has metastatic uterine cancer and her only symptom before she was diagnosed was spotting.  (However, she was post-menopausal, so her spotting was a Big Goddamn Deal, whereas for someone my age, there are many benign conditions that could cause spotting, so I know our contexts are very different.) 

I made an appointment in May with my then-PCP, had a (sort of) pelvic exam, pap smear, and tests for BV and yeast infections.  (I have an intact and thick hymen/vulvodynia, so penetration is extremely painful, and my pelvic exam was not at all thorough because my doctor couldn't open the speculum wide enough to see inside me.  So if I had a condition like cervical polyps which can cause spotting, my doctor was unable to see my cervix to confirm or rule them out.)  Anyway, all the tests we were able to do came back negative, so my doctor said the spotting could have been caused by hormonal fluctuations, which would be likely given my PCOS.

When I started spotting again in September, I had just moved to another state and didn't have a PCP or good insurance.  Luckily, when I started spotting again in December, I had a new job, new insurance, and a new doctor, so I made an appointment and got blood tests done and a referral to an OB/GYN.  Blood work showed normal hormone levels and no other issues (thyroid, etc.), and my new OB/GYN suggested I have a hymenectomy to deal with that painful problem (which I had already discussed with past doctors several times, but I've never had good insurance until now), and since I would be in the OR already, to have a D+C done to check the lining of my uterus and rule out uterine cancer, given my family history.

I should mention here:  Watching my mother go through chemo, radiation, more chemo, radiation on the cancer that has spread to her lungs, surgery on the tumors that have spread to her brain, more radiation, more chemo....cancer scares the shit out of me, y'all.  I know, as a 32-y-o, my chances of this spotting being a sign of cancer are very slim, but...still.   

(I kind of suspect I have fibroids -- just a vague intuition -- so if any of you have fibroids and wouldn't mind sharing your experiences/symptoms, that would be very welcome!  My only abnormal symptom is that 2-3 week spotting spree in the months that I don't have a period.  My periods themselves are the same as always -- they last less than a week, relatively heavy for the first 2-3 days then tapering off, minor cramping in the first 1-3 days then tapering off.  The spotting starts very very light for a week, then actual pink/light red blood for 1-2 weeks (heavy enough that pantyliners need to be changed several times a day, but light enough that one regular sanitary pad is good for all day), then one day the spotting is gone).  Does this sound like your experience?

EDIT:  I am also not on any form of HBC, not sexually active, no chance of being pregnant.  The blood work I had done on December 23 (less than a week after I had stopped spotting) indicated I was currently in mid-cycle and sure enough, I started my period about 2 weeks later. 

SO!  Thank you for reading this far. :)  Onto my questions!

I'm going to be given IV sedation (not general anesthesia), which I've never had before.  What is that like?  Will I fall asleep?  Will I be aware of my surroundings? 

Will I be able to return to work that day, or should I take the whole day off?

Should I buy a little doughnut pillow to sit on for the week after the procedure?  (I have a desk job and am seated all day.)

Will I have cramping after the D+C?

How soon do I have to wait before trying penetration with my fingers/objects?  

Is there anything else I should know about?  Anything you wish you had known before-hand?

Thank you!

Comments

[atalanta0jess.livejournal.com]

The times that I've had IV sedation, which I believe was the sort that they often describe as "twilight anesthesia" I haven't been at all aware of my surroundings. I might as well have been totally out. I think that's very much a YMMV kind of thing though, unfortunately.

[graziaplena.livejournal.com]

My mom has had "twilight" when she had a port-a-cath installed....I didn't know that was IV sedation. This actually makes me feel better about getting it, since her procedure would have been very painful otherwise, and she apparently didn't feel or remember a thing. Thank you!

[lovefast.livejournal.com]

I'd suggest taking the day off, I had IV sedation for my colonscopy and upper endoscopy and both times I was really sleepy after. I don't remember anything, only tiny bits and pieces but i don't remember feeling ANYTHING!

I had a microperforate hymen and had a hymenectomy but under general anesthesia. It wasn't bad for me at all, afterwards I was sore and bleeding and uncomfortable to sit a certain way and had to be careful when I peed (and do sitting baths/squirt water in my vagina after peeing) but it was fine! After a few days I felt great.

My gynecologist had me come in for a post-op appt 2-3 weeks after surgery (can't remember exactly) and she examined me whcih didn't really hurt too badly, and i was healing almost fully. I'd say maybe 4-6 weeks for objects? fingers may be okay. Definitely ask your doctor though!!

Good Luck! :)

[graziaplena.livejournal.com]

Thank you for the info! If you don't mind me asking, did the surgery allow you to have painless penetration afterward?

[thisbudgrlz4u08.livejournal.com]

Bless your heart girl I'm sorry you're going through all of that and about your mom too!

Anyway, I had a D+C a few years ago and had twilight anesthesia also. It put me in a dream-like state where I kind of knew where I was at and was talking to the nurse (although I doubt I made any sense) who was holding my hand. You may be able to fall asleep though, as everyone is different.

You should probably take the whole day off as it's unlikely they'll let you drive yourself home (did they tell you to bring an escort?) and you'll probably feel out of it and want to sleep it off.

You may feel pressure during the procedure (that was all I really felt) maybe some pain and possibly cramping for awhile after, especially after the anesthesia wears off. They will probably write you a prescription for pain medicine and tell you to use ibuprofen or another NSAID (though I am not positive).

After the procedure they usually recommend 6 weeks before engaging in sexual activity or using tampons, at least from what I remember. Every doctor is different though so I can't say for sure.

The pillow may be a good idea, I remember having to go back to my college classes and just feeling uncomfortable but as with the other stuff you may be completely different :)

Good luck darlin'. It's not fun but it's not a -major- procedure either (at least I didn't think so afterward, beforehand I had panic attacks for days thinking I was going to die because of bad information from a bad place). I hope I answered some of your questions and wish you the best!

[graziaplena.livejournal.com]

Thank you for all this information, and for the good wishes! Actually, what you say about being in a dream-like state is...kind of freaking me out! I've never had any kind of surgery before and the idea of being put under, or in this case, being awake but unaware of myself and my surroundings is pretty scary to me.

Luckily, my doctor said the whole procedure should only take about 20 minutes, so it will be over before I know it. Hopefully, I'll be one of the lucky ones who fall asleep under the sedation. :)

[thisbudgrlz4u08.livejournal.com]

You're very welcome, any time :)... and I totally know what you mean about the freaking out part, it was the first time I'd ever had any kind of anesthesia but it wasn't too bad. I felt high as a kite that's for sure lol. It was in '05 when I had it done but I do remember that I was aware of where I was but not in a bad way, which was good since the procedure can be traumatic for some people I'm sure. I think mine took about 15-20 minutes as well and then was in recovery for maybe 15? I may have fought sleep honestly so you may very well be able to relax and fall asleep, I'm bad about fighting sleep for some odd reason (and I'm on RX sleep meds lol). I've had one surgery since then (my wisdom teeth- it was awful!) that I was fully under for and even though I'm glad they put me totally under it was SO much worse when the anesthesia wore off :(. You'll do great though darlin', it may be hard to relax (they will prob give you Valium or Xanax too beforehand, I forgot to mention that part lol) but you'll make it through it just fine :D

[maradydd.livejournal.com]

Do you know what kind of IV sedation you'll have? If it's propofol, you likely won't remember a thing. My husband's had it for a colonoscopy, and he fell asleep while talking to the anesthesiologist, then woke back up after the procedure was done and tried to continue the conversation with a very confused nurse, as if he'd never been out at all.

You will, however, want to take the rest of the day off, and you'll want to have someone else drive you home.

[graziaplena.livejournal.com]

No, they haven't told me anything except that it's IV, not general anesthesia. My parents have had colonoscopies and they say they've fallen asleep and/or didn't feel and don't remember a thing. Hopefully, this will be my experience, too. :)

[princessselene.livejournal.com]

I had two D&Cs right after I gave birth to my daughter (who was diagnosed with myotonic dystrophy and passed away in December). They gave me an epidural for the first one and a spinal for the second. Granted, I went into the OR both times due to blood loss and very different circumstances, but I don't remember any pain after when everything wore off and I didn't need painkillers. Hope that helps.

[graziaplena.livejournal.com]

Gosh, I'm so sorry about your daughter and that you had to go through all that. Thanks for sharing your experience.

[archangelbeth]

When I had an IV sedation to have my wisdom teeth out -- which may or may not be similar to your procedure -- it was apparently a big painkiller and... short-term memory wrecker. They put the needle in, and very shortly, I was apparently totally zoned out. I have a really vague memory of feeling one of the teeth cracked in half, without any pain at all to the recollection. I vaguely remember an assistant getting me to follow her to the little lie-down nook they had set up. I remember blinking at the ceiling. I remember my spouse being there. (Apparently this was a 10-15 minute actual gap, or more, between me lying down and them fetching him.)

I remember following him to the desk, then to the car, and thinking, "Hey, I'm not really dizzy, I could totally have driven myself home." I remember getting in, putting on my seatbelt, he went out of the parking lot... and then we're doing a familiar turn and I realize I lost at least 5 minutes, maybe 10, of driving, and okay, good thing I'm not driving after all!

So if you respond to the anesthetic like I did and are getting an equivalent dose, you will not be aware of your surroundings, but will be at most... Ever been in a state where you're kind of vaguely awake but your whole body is heavy and your eyes are closed and frankly, you'd rather go back to sleep? Yeah, like that. Also, your short term memory will be patchy for some time after the procedure.

Take the whole day off, would be my advice.

I'd get a donut pillow on the grounds that if you have it and don't need it, that's fine. If you don't have it and need it, that's awful.

I don't know about the D&C or penetration stuff -- that would be something to ask the doctor about.

Luck!

[graziaplena.livejournal.com]

Ack! Like I said to thisbudgrlz4u08, the idea of being technically conscious but not aware of my surroundings or what I'm doing/saying is disturbing to me. I don't like not being in control of myself like that. But I guess I won't know how I'll react to the anesthesia until I'm under it, so there's no sense in getting anxious about it...

Definitely taking the whole day off!

Would you happen to know where I could get a donut pillow on short notice (i.e., not online)? I checked Target today, but I couldn't find one. Would a regular pharmacy carry them, do you know? Thanks!

[archangelbeth]

A regular pharmacy should carry one, yeah -- you might also improvise with those little horse-shoe neck pillows, too! Those, I think I've seen even in the grocery store.

Apparently when I was under I wasn't really talking -- when I went back to have my recovery checked, as I recall, the dental surgeon said that yes, they did have to cut one of the wisdom's in half to get it out (so that memory was accurate), and that he knew I was under when I was just doing an amiable lounge in the chair. (I refused the nitrous for personal reasons.) I gather that till they took the IV out, I was basically way too relaxed to do aaaaaanything. Maybe you could ask if you could bring a recorder of some kind, so you will have at least audio for what's going on?

Good luck!

[graziaplena.livejournal.com]

Thanks, Beth! I was able to find a donut pillow in my local CVS, and I'm so glad I got it. I'm sitting on it right now, in fact!

And fortunately my anesthesia experience was really great. I was told that I would first be given something to just calm me down, and then later on I would get the actual anesthesia. The anesthesiologist gave me the first drug and asked me to tell him when I was feeling relaxed. About 10 seconds later I told him I was feeling pretty sleepy....and the next thing I knew, I was waking up in the recovery room. I was completely out for the whole procedure, to my delight. :)

Now I just have to get over this soreness, and I'll be golden!

[archangelbeth]

Hooray, hooray, and crossing fingers for a quick recovery! If they gave you painkillers, I advise taking them on the schedule that should've been provided -- if pain breaks through the painkiller, from taking it late, it takes longer to put it back down. (See also the instructions when Beth Had Her Wisdom Teeth Out. O:>)

[helenkacan.livejournal.com]

My last eye surgeries were under a combo of midazolam (brand name Versed) and fentanyl. These two MUST always be used in combination; the first induces instant amnesia and the second is a pain killer. Though I was told I wouldn't be knocked out completely for the third operation (I'd been awake for the first two), I was more than pleasantly surprised (thrilled, in fact) to find I'd been out for the duration. The reason these two drugs together have become so popular is because they can be adminnistered for procedures around 20 minutes. Otherwise, you'd be recovering far longer if you'd had a more traditional general.

As for post-op care, I had a laser D&C hysteroscopy (through the cervix) 10 years ago. I was silly and told my partner we'd walk home (12 minutes) from the hospital after it.
o:o
Yeah, sure. /sarcasm.
What I hadn't expected is that my abdominal cavity had been pumped full of gas in order to separate the organs to make sure the laser didn't nick anything other than the fibroids it was supposed to be obliterating. ::imagines a light saber inside of me:: So my entire torso hurt!

However, after my procedure on a Thursday, a couple days in bed with Tylenol 3, I went for a brisk 4-mile walk with a friend on Monday. I felt just fine.

[graziaplena.livejournal.com]

Wow, maybe I'll be given those two drugs...especially since my doctor said the procedure should only take 20 minutes. :)


Did you have spotting with your fibroids, may I ask?

[helenkacan.livejournal.com]

Are you asking if I bled afterwards? Oh, my. We picked up Poise pads at the hospital pharmacy before going home. I bled a river the first day, but it settled down to just a slightly heavier period for the next 3-4. And, then, I went back to having normal periods.

If you're asking about BEFORE, I had the operation because I was getting TWO periods each month (one reason was a huge sucker of an embedded fibroid in the wall, as well as other smaller ones), so bleeding about 15 or more days in total. I was SO not a happy camper to be bleeding that much - and it wasn't just mere spotting, but actual continuous flow. Perhaps once or twice, I bled one day, then nothing, then bled again. But that was the exception, not the rule.

[graziaplena.livejournal.com]

I'm so glad you posted this! I had the procedure today, and it went well....but if I hadn't read your post, I wouldn't have known to expect that I would bleed so much afterwards. They let me use the bathroom after I woke up in Recovery, and I swear to God it was like someone had poured a whole transfusion bag of blood in the toilet. (Sorry to be graphic, but I'm serious!) I would have flipped OUT if I had seen that without preparation. So thank you!

(The bleeding seems to have lessened a lot already, so I'm feeling better. :) )

[helenkacan.livejournal.com]

::giggles ... or not::

Um ... cry me a river???

In my case, they actually forced me to go to the bathroom and wouldn't have released me if I hadn't been able to pee. And, yeah, the river of blood.

I'm glad you got through it and I'm sure you'll see the bleeding diminish substantially.

I hope your recovery goes as well and as quickly as mine did!