Sterile

   If you're keeping up, you'll remember my fight to get the Paragard IUD last summer. When they warn that it could make your periods heavier and your cramps worse, they really aren't kidding. My periods were already heavy and crampy (but surprisingly regular), but the IUD took them to a whole new level. I had to upgrade some equipment just to handle the amounts of fluid exiting my body every month. I already have a history with anemia, so this was bad. My oncologist even suggested I add iron to my daily multivitamin. 
   But once all of that was under control, I still had to deal with the pain. I'd get random stabbing pains throughout the month just as a reminder that I had something foreign in my uterus, but then when my period started, my uterus made it clear that it wanted everything OUT. If I didn't have a stockpile of Vicodin from previous surgeries, I probably would've ended up in the emergency room. I used to be able to pop a few Pamprin (Midol never worked) or a few ibuprofen, but Vicodin and 800 mg of ibuprofen were the only thing that helped the Paragard cramps. It got to the point where I'd be driving (no Vicodin!) and get a wave of pain so intense, I realized I definitely shouldn't be driving in that condition. 

   I figured I had to give it enough time to settle down. But six months later, I still felt like I was dying every month. And then I realized, wait, why am I even putting up with all this? So everyone else feels comfortable knowing that I'm still fertile in case I "change my mind" about wanting kids? I realized this was a waste of my time, especially if the cancer comes back or I get hit by a bus (or black out while driving and crash the car). I don't want kids. Sorry to everyone who is offended by that, but then again I'm not actually sorry. My mom was a little upset, but then I pointed out a pregnancy would probably kill me, and she quickly changed her mind. 

   So I did some research, and decided to get the Essure procedure done, because I've had enough surgeries. They just go in the normal way, shove some coils in your fallopian tubes, and wait for the scar tissue to build up, finally rendering you sterile. 

   I asked my breast surgeon for the referral simply because she was the soonest doctor I had an appointment with, and if you remember how the clinic is, it would've taken me four weeks to get in, only to be told I can't get what I need anyway. She asked me if she should write "Consultation for sterilization" on it, and I said NO! Everyone freaks out about that word. In fact, the last time I used that word at the clinic, all of a sudden they found a doctor who would give me an IUD, even after being denied twice.

   So I found myself a gynecologist who's certified to do the procedure. The appointment was only for a consultation, and I'd had an IUD for 6 months, but her office still made me pee in a cup for a pregnancy test (and then charged my insurance $15 for it). The doctor was nice enough and agreed to do the procedure after I agreed to her condition. She then went on to explain how the procedure worked and any possible complications, which freaked me out. She said it doesn't always work and then you could end up needing surgery anyway. This convinced me to go ahead and get a traditional tubal ligation. I just wanted to get it done and over with. She even yanked my IUD out for me right there (as in she literally yanked it out with some extra long tweezers). That half-second pinch was nothing compared to the past six months of cramps. 

The only thing that will ever come out of my uterus.

   And the fact that she was sparing me from future misery helped me forgive her a little tiny bit for making me write a letter to prove I wanted to be sterilized. Yes, she wanted a handwritten letter to make sure I realized what "permanent" means and that I trust myself enough to make decisions for my body and my future. I can't really blame her for that, since a lot of women regret that decision, but it still pisses me off. As a cancer patient, I probably could've said "Hey, I want a baby right now" and halted all my treatment with no questions asked to work around a pregnancy. Because a baby that doesn't even exist will always have priority, even if I'm not alive to raise it. No one would've judged me for wanting a child, but when I don't want one and have a million good reasons not to have one, my uterus becomes everyone else's business. 

   But she agreed to sterilize me as long as I wrote her a letter. Unfortunately for her, I like to write, and I like to write a lot, so I asked if she wanted bullet-points or essay-format. It ended up being 1600 words. (And she probably didn't even read it.)

   The doctor called me a few weeks later asking about my BRCA genetic test results because that would affect the way she did the surgery. Yea, I had no idea what she meant, but apparently simply altering the fallopian tubes reduces your risk for ovarian cancer, which is believed to start in the tubes. But removing them completely reduces that risk even more. Plus, it's less likely something crazy will happen, like the ends magically reattaching to each other. (My genetic test results were negative for any known mutations, but it's still possible I have a mutation they haven't discovered yet.) The term for removing fallopian tubes is "salpingectomy" and I was planning a laparoscopic surgery anyway, so there was no extra work required. And I'm all for reducing cancer risks. I just wish more women knew about this.

   My surgery was scheduled for March 15 at that fancy curved hospital up in Princeton. We came prepared this time and I had "NO BP/LYMPHEDEMA" written down my right arm. I think I even got bumped up, so we only spent 15-30 minutes waiting. There was a large TV screen in the operating room since it was laparoscopic. (They knocked me out completely for this.) She made three incisions, two on my abdomen and one in my belly button, pumped up my abdomen with some kind of gas and then shoved a camera and some tools in there to get everything done. (I have the pictures!)

   I wasn't in too much pain when I first woke up in recovery. They said they try to get most of the gas out and then the rest comes out the usual gas exit. I would've preferred some excessive farting instead of the pain that escalated very quickly within the next hour. My shoulders started to hurt in that strange way right before I get a bout of costochondritis. So they gave me more pain medication and then let us check out.
   I was feeling okay at that point, but Kyle and I were both hungry and I needed to stop at a CVS anyway. Kyle decided he wanted Arby's (I didn't) and found one "nearby" using his phone, but I made him find a CVS first. We drove around for 20 minutes and he somehow managed to find the busiest CVS possible in the middle of the Princeton University campus. The pain in my chest and shoulders had reached a new level and I was trying VERY hard not to puke in an empty "Patient Belongings" bag. We finally found the CVS and I told him I needed ibuprofen, might as well get a big bottle. He was in there forever and I'm just sitting in the car crying and dry heaving in the middle of a crowded college campus on a Friday afternoon. He came back out saying it was a 45 minute wait for the prescription (screw that) and hands me a one-pounder THOUSAND-count bottle of ibuprofen. I did apologize right after I started screaming at him for being an idiot. When I said a "big bottle" I meant a 100-count bottle versus a 20-count bottle. He totally made up for this by driving around some residential backroads for another 20 minutes looking for an Arby's that obviously wasn't there. We never found the Arby's, but he made it home alive.  

   I spent the new few days camped out on the couch (my favorite spot). My abdomen barely hurt unless I bent over too fast, and the shoulder/chest pain was manageable with lots of ibuprofen. I came home with Bandaids on the incisions. Compared to my other scars, these are awesome. And we have that added perk of never having to worry about birth control ever again. 

(Just to clear things up, a lot of people assume getting your tubes taken out stops your periods. I really wish it did! You have to remove the uterus and/or the ovaries for that kind of freedom, but those procedures come with other side effects that I don't want to deal with right now.)