Saturday, January 31, 2009

Feeling Like Freddy

So back to the beginning...after Oliver was born, Joel and I made the decision that we were done having kids. This brought up the subject of birth control. Having been on the pill many years I really didn't want to go back to that but wasn't sure which route to go. Joel, the great guy that he is, suggested/offered to get a vasectomy so that is the route we went.

My menstrual cycles, after each birth, always went back to normal within 6-8 weeks. I always considered myself someone with a medium-heavy flow. On a scale of 1 to 10, 1 being the lightest flow I would rate myself a 6 or 7. After Oliver I returned to that pretty quickly, however, during the course of the next 2-3 years that changed drastically. I didn't notice it much at first and figured that my body was getting back to normal after having my second child and not going back on the pill. I had also heard from friends, websites and my doctor that getting back to normal usually took a bit longer after the second kid.

Okay, I have to stop for a second, I have found myself as I write this all out, loathing the word, normal. Normal is not normal, normal is different for each person, normal changes constantly. Normal schmoral people!

As time went on, I started to notice that I was inching my way up that 1 to 10 scale, a solid 7 maybe even inching towards an 8 pretty soon I was thinking that I might even be a 9. My cramping was also becoming more uncomfortable and at times, very painful. I had been on the pill for so long and that helped control the flow and cramping but now that I wasn't on it anymore I just figured that my body was figuring out what normal was. The problem is, it never stopped getting worse. My bleeding eventually became out of control and the cramping at times was horrible and what I would describe as violent. Violent may be a bit dramatic but in the midst of it, that is what came to mind. There were, typically, three days each cycle that I would be afraid to leave the house.

By this time the 1 to 10 scale, in my mind, did not have enough numbers. Why isn't there a 12 or 13, why stop at 10? I was passing clots the size of ping pong balls and flowing like a fountain. To give you an idea of how bad it was, I live less than a mile from Fred Meyers, there was more than one occasion that I would leave the house to go grab some groceries and by the time I got to the store, I would have bled through/filled my tampon or Diva cup, soaked and bled through my mattress sized pad, through my pants and onto the towel. A towel because I knew that it was a possibility so I always sat on a towel to avoid having to clean the seat of my car. I, more than once, never made it inside the store. Even if that didn't happen I was always afraid that it would so I would race through the store and race back home. My cramping associated with my cycle was also getting out of hand. I would cramp so bad that, at times, I couldn't stand up straight. Hard to explain to the sales associate at the store that your bent over the shopping cart and doing lamaze like breathing because of cramping and to please not worry because it will pass. They also didn't seem like normal cramps to me, more of a stabbing like pain which was different to the achy crampy like feeling that I was used to. Curling up on the couch in the fetal position for hours was not uncommon for me on those days.

After talking to my doctor about these symptoms and horror film like bleeding that could scare Freddy Krueger right off of Elm Street, she gave me a few options.

1) Do nothing and continue down this path. Not the optimal but still an option.

2) Try Advil, studies have shown that taking 4 Advil 3 times a day for the 3 or 4 days that I'm bleeding can decrease the amount of bleeding by as much as 10%. Doesn't sound like a enough of a decrease to me but might be what's needed to get me off the couch. Plus the extra amount of Advil may help take the edge off of the painful cramping. Have to be careful with this option though because Advil is tough on the liver. So mush so that she suggested that I take no other Advil for the rest of the month.

3) Ablation was her next suggestion. Taken from this website,
Endometrial
ablation is the removal or destruction of the endometrium (lining of the uterus). It does not require hospitalization, and most women return to normal activities in a day or two. Ablation is an alternative to hysterectomy for many women with heavy uterine bleeding who are wish to avoid major surgery. After a successful endometrial ablation, most women will have little or no menstrual bleeding. Patient selection and physician experience is essential to a good outcome.
This is an option that I really considered. Could I live with the prolapse and other symptoms if the bleeding was minimal? I'll let you know later why I didn't go this route. She also told me that in some cases the lining of the uterus would/could actually repair itself and the bleeding could possibly return after time.

4) Hysterectomy, hopefully you all know what a hysterectomy is. In case you don't though, it's where they remove your uterus, the ovaries may or may not come out with the uterus, that's another big decision. More on this later.

Another huge side effect of my bleeding was that I was becoming extremely anemic. I can't remember the numbers but A range is low, B range is normal (there's that word again) and C range is above normal. I was testing in the low end of the A range. This was killing my energy. Getting out of bed on the really bad days was a monumental task. I did because I had kiddos running around but without them I am sure that I would have been in bed for days at a time. I am taking double the recommended daily amount of iron to keep my levels in the low end of the B range.

Next post I will discuss the 5th option and what I am doing now as a temporary fix (although it really hasn't "fixed" anything) until my surgery.

Friday, January 30, 2009

You Are Doing What To My Insides?

As mentioned yesterday, I had an appointment with a prolapse specialist on the 27th. That was one of the most interesting appointments I've had in a while. Interesting is really not the right word but I am not really sure how to describe it otherwise. I've been to a few "lovely lady parts" doctor appointments in my time and with one miscarriage and two beautiful boys that number just shoots right up there but none have been quite like this one. So now that you have an idea of what a prolapse is and where I am at with mine this is kind of how the appointment went...

Visual exam at first, just trying to get an idea of what she's working with, an idea of how I'm laid out, where the episiotomies were cut, how long/deep they were and how well they were repaired, etc. Then she used the speculum to find my cervix, luckily she had read my chart well and listened to me when I told her what my doctor told me to tell people when trying to find my cervix and she found it quickly. She had me bare down, cough and pretend sneeze, etc. which, unfortunately, made me start to laugh. She was checking the strength of my vaginal walls and how everything moved during these activities. She then took the speculum apart, used one half of the duck bill looking part to help her take measurements. She took measurements while I was relaxed, while I was baring down, while I was coughing, etc. Rattling off numbers to her assistant and my nervous tic to laugh kicked in again. Not the appropriate time to laugh but I felt like I was at an auction or something. After all the measurements were taken, which let me say, was not that bad. No pain and she was extremely proficient. She is definitely the person to see. If you need the name of a good doctor, email me privately and I will pass on her information.

Side note: I decided not to name my doctors on the blog only because I have not asked them for their permission to do so. I have an amazing doctor and if you are in this area looking for a good doctor please call or email me.

Back to the exam, so by this time I've been in the stirrups longer than a normal exam, which I expected, but the not so fun part came next. I am assuming she used the piece of the speculum, but I can't confirm that for sure, along with her fingers to literally push my cervix and uterus back up to where it should be. This is when I decided that she was actually a professional at torturing people and the doctors office was just a ruse. Why do you ask did she do this? Well, what she was wanting to find out is if, when all is said and done, I would have bladder problems. Sometimes, the uterus, cervix and even the prolapse will hold the bladder in place. Once you remove said uterus and fix the prolapse this can, at times, create problems with the bladder. So, with my parts uncomfortably shoved back into place with whatever torture device she had, her fingers holding whatever they were holding, I had to then bare down, cough (hard!), and whatever else she made me do to see if I would leak urine. OKAY, to be fair, it never really hurt, it was definitely uncomfortable, not pleasant at all and extremely odd but it never hurt. So please don't let my experience scare you away from doing what you need to do!! Good news is that I never leaked urine no matter what she did or how she shifted and shoved my internal organs. Woohoo! My exam ended with a quick rectal exam to check the strength of those muscle and to make sure that everything in that area was working and where it should be. All good there too.

So in the end, my prolapse, according to her, can be easily repaired. They will leave ligaments that are already in my uterus/vaginal walls, pull things up and tight and connect those to my pelvic bones...or at least I think those were the bones that she said they would connect them to. Technically, my cervix will be gone but they still want to pull up the vaginal walls. My bladder looks to be in great shape and will need no additional surgery or help.The appointment, although not fun, was not that bad. I was a little crampy and achy for the rest of the day but a little bit of Advil helped with that. Unless you have some questions or think I left something out, I am done talking about my cervix and prolapse...high five!!

Thursday, January 29, 2009

Prolapse: The "Sag"a Continues

Prolapse: I found this website, and I think it does a great job of explaining in simple, straight to the point, terms what a prolapse is. Even though you can go there and read it if you want I will also do a quick recap here so you don't have to if you don't want to.

Your uterus is normally held in place inside your pelvis with various muscles, tissue and ligaments. Sometimes because of childbirth, difficult labor and delivery, these muscles can weaken. As we age, have kids, naturally lose the hormone estrogen the uterus can collapse into the vaginal canal, causing the condition known as a prolapsed uterus. There are different stages or degrees of prolapse...your uterus can simply just sag or your come completely out of your body.

First degree: The cervix droops into the vagina.
Second degree: The cervix sticks to the opening of the vagina.
Third degree: The cervix is outside of the vagina.
Fourth degree: The entire uterus is outside the vagina.

Now from there it can actually go onto other degrees or layers or conditions that are created by the prolapse. Think about it, your rectum, bladder and even intestines are all nicely tucked into that area and when things start moving they don't usually move alone. I won't go into all of that stuff because again, I am not a doctor, nor do I want this to be a medical website of sorts. Just know that with a quick search on the Internet you can find oodles of information.

At this point, I am, thankfully, only a first degree prolapse. When I bare down or lift heavy things, do any sort of exercise that contract my abdominal muscles (not many exercises that don't), etc. I become a temporary second degree prolapse. Because my uterus has started to collapse and my cervix is drooping into my vagina I constantly feel pressure of some kind. Again, I am lucky that I don't often have pain, but it is a major annoyance. It feels as though I constantly have a tampon in that is not in there correctly and moving around. It is very difficult to ignore. I'm under instructions, so the prolapse doesn't worsen, to do things like; avoid lifting anything over ten pounds, don't do anything that would create a baring down situation like crunches or weight lifting, don't cough too much, try not to avoid sneezing, eat lots of fiber to avoid constipation, etc. Do you know how many of things you do without even realizing it? I've lifted heavy bags of groceries out of the cart and into the car that cause things to move. To follow these instructions for me has been impossible.

I had an appointment with a prolapse specialist on the 27th and I will tell you all about that in my next post. After that, I will be moving onto the next symptom/issue that has led me down this path. Thanks again for sticking with me!

Wednesday, January 28, 2009

What Just Happened?

Unfortunately, for those of you that decided to read this blog of mine, we're not quite done with my cervix. But first, a confession, after my annual pap in April of 2006, I didn't go back to see my doctor until 2008. DO NOT DO THIS. I made sure that everyone else was taken care of, saw their doctors, dentists, etc. and just didn't do this for myself. Not that I was jumping up and down to go have my insides painfully manipulated but I still should have done it and so should you. My cervix never did go back to what was my normal after having Oliver, again this is supposedly normal after childbirth so although it concerned me I tried to not let it bother me. I was more self conscious about it though and found myself holding back or distracted by it during sex. I also noticed that exercise wasn't as comfortable and I was thinking way more about that area of my body than I should have been. (Now is the time to remember my disclaimer) I also noticed that I could feel the hard, feels like the end of your nose, tip of my cervix, with my finger inserted no farther than my first knuckle. Wow! It's never been that low before. I also noticed that my cycles were getting heavier and heavier over time (more on that in another post) and was having a hard time dealing with that. At one point I decided to try a Diva Cup.

Side note: Seriously, the Diva Cup is an awesome concept that worked somewhat for me and if you are one of the lucky ones with a normal cervix then please look into these. Here is the Diva cup website, http://www.divacup.com/, and here is a great website that talks about the differences between some of the feminine cups out there, http://community.livejournal.com/menstrual_cups. I know someone else that uses one of these and am pretty sure she would talk to you more about it if you want.

Anyway, The DivaCup is a non-absorbent menstrual cup that simply collects menstrual flow. It is inserted in the vagina and sits at the lower base of the vaginal canal. It is worn internally, yet because it is soft and smooth, it cannot be felt nor will it leak when inserted properly. Because my cervix sits so low, it would actually cup around quite a bit of it. When inserted correctly it creates a bit of a suction and when taking it out you break the suction by gently squeezing the cup. I did this but was having a hard time getting the suction to break...my cervix was in the way. When I gently pulled down a bit to break the suction, not only did the Diva Cup come out but so did my cervix! "HOLY SHIT, what just happened?!?!", was my first thought...sorry but it's true. I gently pushed my cervix back into place, came out and immediately told Joel that I was going to see my doctor on Monday morning and I did. I spent the rest of the weekend stressing out. I was also wondering why this was happening, I am one of those people that did and still does her kegels religiously. Aren't they supposed to help keep all this stuff from happening?

Kegel side note: I have found that triggers work really well for me when remembering to do kegel exercises. Each time I get stopped at a red light or a stop sign I do a set. Each time phone rings, I do a set. When I am changing the laundry from the washer to the drier, I do a set. I find myself doing them now without even thinking about it. Kind of like Pavlov's dog. =)

Anyway, I saw my doctor as soon as possible and I told her what happened and she checked me out. Everything looked okay but we talked a lot that day. Luckily, like I said, I have a great doctor and she spent more time with me that day than I am sure they had scheduled/planned for. I went loaded with questions and she answered each and every one. The one that concerned me the most that day was about prolapse...which I will talk about tomorrow.

Tuesday, January 27, 2009

Looking Back

Wow! I must say that I was hesitant to put this out there and share at first. However, I knew that I needed to do something and this is cheaper and in my opinion more fun than therapy. I can not express how much your kind notes and words have meant to me. It's amazing how much better I feel already. Thank you so much.

So I have found myself writing about one symptom at a time, although I don't know if symptom is the right word to use or not. At this point, I am going to discuss one of my symptoms and all the stuff related to that then go back to the beginning and start with the next symptom. There will be some crossover and a bit of back and forth but it seems to be the easiest way for me to write without getting confused.

I can't say for sure when it all started to head downhill, but I believe that having Oliver really brought things to the surface and got the ball rolling. After having him, I never ever really got back to feeling normal. I would say it took about 18 months after Noah to feel human again but to this day I still don't feel right and Oliver is 38 months old! My first clue should have been when Oliver stopped breast feeding at ten months old (his choice not mine) I continued to lactate WELL for at least two months and I could express milk for another four after that. Not a lot but I was still producing. I should have known at that point that my hormones were not working right. Seriously, who produces milk for six months after there is no demand for it? I also noticed, and pointed it out at my annual pap six months after Oliver was born, that things just didn't seem to be right down there. I couldn't wear tampons because they would hit my cervix, sex was only comfortable in certain positions and when I wiped it just didn't seem/feel right. Nothing really hurt per se but I always had this nagging feeling that it wasn't right. My doctor said it looked and felt normal and not to worry about it yet, to give myself a good year after birth before being concerned. Reminded me that I have had two kids with two episiotomies and things were going to be a little bit different. She is a good doctor though and said to keep an eye on it and come back and see her if things still didn't feel right in another six months. She did talk to me again about my uterus being tipped though. Most people 70% have what they call a "normal" uterus that tilts forward, 20% have one that sits more straight up and down and then 10% like me, have one that tilts backward. However, mine just doesn't tilt backwards, it darn near lays down flat and my cervix at times, according to my doctor, will actually rest on/hit my pelvic bone. A pap has always been difficult for me, the doctors have a hard time finding my elusive cervix and when they do they have to manipulate it quite a bit in order to get the scrapings that they need. Not a comfortable feeling at all and my poor doctor spends the entire time saying, "I'm sorry, I'm so sorry, I'm hurrying, sorry." My doctor has told me, more than once, that I need to put a note/letter in my wallet with my ID for the emergency room doctors to find. WHAT?, what do you mean? She says that my cervix is so difficult to find that in case of an emergency that may require a pelvic exam, I should have a note in my wallet telling the ER doctor where to find it. Nothing like a cervical treasure map in my wallet to make me feel more at ease! X marks the spot Mr. ER doctor!

Soooo anyway, to wrap this post up, when I look back and really think about it, I would have to say that within six months of Oliver being born I knew that something wasn't right. I just didn't know what or why, couldn't articulate it well, etc. Plus all of what I was feeling really could have been birth related. How was I supposed to know?

Monday, January 26, 2009

Ready, Set, Purge!

I'm starting this blog more as a way for me to talk about what's been going on for at least the past two years but probably more like three years now. It has affected my life more than most people know. I thought that by writing it down it would help me purge and maybe just maybe help someone else along the way. I have invited a few of you along for the ride and if you know of someone that may benefit from this then feel free to pass it along to them too.

DISCLAIMER: I am not going to leave much out. It will be graphic at times and brutally honest.

This blog will tell the story of my struggle over the past few years with my emotional, physical and mental health due to the physical and hormonal troubles surrounding my lovely lady parts. Menstrual cycle, prolapse, PMS, hormonal roller coaster rides, etc. I will break it up into easier to read parts so you aren't reading a 40 page single blog post but am not sure how I am going to tackle it exactly. I'll figure it out along the way. I hope to cover a lot of what I am dealing with, my doctor appointments, my pending surgery and then my recovery.

I did a post on my family blog asking my readers what their new years resolutions were. I never did post mine but it's simple, get this taken care of, feel healthy again and get back to being me. I have not felt like myself for a long time now hence the name of my blog...