Time


It’s been almost a year since my last post here.  It feels like incredibly too long.  However, while I am a bit disappointed in myself for not keeping up with something that was very important to me not so long ago, I am okay with letting this blog fall into decline.  The reason?  I’ve been okay.  Except I am starting to realize that I really haven’t.  Sure, I haven’t been obviously episodic, but I’ve become a hermit.  That’s not exactly true, of course, but close enough.  I don’t really have any meaningful interaction with real people except my husband and daughter.  I’ve taken to referring to myself as a shut-in, but that isn’t entirely accurate either.  I still leave the house.  I still run errands and chat up the grocery store clerk.  I go to counseling (almost) every week.  That’s really it, though.

I’m happy.  And that makes me feel incredibly pathetic.  I’m happy because I am hiding from the world.  My “human” interaction consists of debating with people on the internet.  My life has been reduced to what forum topics are happening that day and whether or not it’s something I can discuss with my husband.  I do have to say that I am better informed now than probably any point in my life about what’s going on in the world, specifically regarding America’s political climate.

About a year ago I decided I wanted to have another child after over 8 years of insisting that the one kid was quite enough, thank you.  But I had this yearning.  My husband agreed that we could see how things went and that I could talk to my psychiatrist about going off of my medications.  So, as of December 29, 2011 I am psychotropic medication free.  When I talked to my pdoc about going off meds I had it in my mind that I would start trying for a baby right away as soon as enough time had passed for the meds to be out of my system.  Then David said he wanted to wait and see how I did off my medications to see if I could handle being off of them long enough to gestate a baby.  I didn’t understand the reasoning since bipolar episodes don’t work on a timeline.  I can go months and not have an episode and then just wake up one day and have it be like someone flipped the bipolar switch to “on”.  However, we agreed to wait six months.

Part of waiting was that I was supposed to have my SSDI review after 24 months from my approval (36 months from when I applied) and that fell in April 2012.  We decided to wait until after that on the off chance that I didn’t get re-approved and had to return to work (and thus would not be planning a baby at all).  So, we agreed on June to start trying.  Then in February David started bringing up the fact that if I was re-approved (and still disabled, which we both believe I am at least when it come to working outside the home) would I even be able to handle pregnancy, let alone raising another baby and resulting child on top of our existing “special needs” child while dealing with my own mental health issues?  Because my first pregnancy was hard, and that was way before my bipolar diagnosis (although looking at my history I believe I’ve had the bipolar since 16 or 17), but still had a lot of emotional issues, and more so than “normal” pregnancy hormone related emotional issues.  I also dealt with post partum depression and anxiety and very obviously my mental health hasn’t improved since then, quite the opposite.  He was concerned about me, and he was concerned about how it all would effect our existing child as well.

This was an ongoing discussion and rationally I knew he was right, but there was the biological clock of mine ticking away the minutes and years.  Eventually I started to tune out the clock’s ticking and realized that while I still *wanted* another baby, I wanted just that – a baby.  I didn’t want to raise another child, especially not if that child ended up with the health issues that my existing child has.  Don’t get me wrong, I LOVE my daughter and would not change a thing about her, but it’s scary watching your child struggle to deal with health issues, behavioral issues, and just being so irritated about all of it while at the same time feeling so incredibly guilty that you’ve passed these issues on to said child.  In case this is the only post you’ve read of mine: My daughter is 9 years old and she has eczema, asthma, allergies (some of which cause anaphylactic reactions) in addition to attention deficit hyperactivity disorder combined with oppositional defiant disorder.  She is also intellectually gifted.  She is more than a handful, and my having bipolar disorder makes dealing with her issues sometimes just too much to bear.

So, I finally conceded that we would not try for another child.  My husband said that maybe we could try some other time in the future, but I insisted that it was now or never for me.  Chances of my bipolar getting better in the next year were not high, and I didn’t want more than a 10 year age gap between kids as I felt that would negate the whole sibling-sibling relationship that was part of wanting to have another child.

Well, the summer came and I felt a bit melancholy over the time coming that we had agreed to try, but knowing that we had agreed not to try after all.  We had plans to go to Florida the second week in August because David’s baby sister was getting married.  Well, my period came the first week of July and I realized it was likely I would be dealing with that the week we were in Florida.  I haven’t really written much about my menstrual issues on this blog, but I will briefly say that I had been dealing with menorrhagia for most of my adult life and had tried taking hormonal birth control to fix it, to no avail. (You can read more about my issues here. TMI warning!)

I’m going to pause here a moment and add a TMI warning.  The next several paragraphs are very much me over-sharing about my gynecological bleeding issues.  If you are queasy or just really don’t care to read about that then please check out some of my other posts on RainyDayRamblings if you haven’t already.  I am planning on this being the only post on this blog from this point forward that goes into gross detail about my lady parts issues.  And, with that, onward…

So, when my August period started a few days early I was relieved that I would be able to go on our trip after all as by the time we traveled I would be on my ‘lighter’ days, which for most women would still be considered heavy.  Anyway, when I woke up on August 1st to Aunt Flo visiting I decided that I was done dealing with all these issues, especially now that preserving my ability to have children was no longer a consideration.  My gynecologist happened to have an opening that afternoon and I went in and spoke with him about having an endometrial ablation done.  I had been doing some research on the procedure prior to going in to see him, but the possibility of my period keeping me from being able to attend my sister-in-law’s wedding just kicked my butt in gear to do something about it.  He agreed that it was a good option for me and said that we could do it in two weeks if I was ready, since he liked to perform the procedure about mid-cycle.  Because of us going on vacation we decided to wait until September to do the procedure, however. (You can read about that a little more here.)

Well, as usual, things didn’t go as planned.  I was started on progesterone Sept 1 to thin out my uterine lining.  I was supposed to start it the second day of my period (which I did) and take it up until my procedure.  It was supposed to stop my period for that month.  Instead I bled lightly from the 1st through the 13th or so and then started bleeding more heavily like my regular period three days before I was supposed to have the procedure done.  When I got to the surgery center the day of my procedure my hemoglobin was 8.5.  Normal is 12-15.  Below 8 is when my dr considers a blood transfusion because the count is too low for undergoing a surgical procedure.

Anyway, we talked about him not being able to do the Essure because of scarring in my tubes that I was diagnosed with 10 years ago (a month before I got pregnant with my now 9 yr old).  We had a backup plan for that, we never discussed him not being able to do the ablation.  So, imagine my surprise when I wake up in recovery and am told that he couldn’t do the ablation but the Essure went fine.  I bawled.  Agreeing to be sterilized was only because it wasn’t safe to NOT be with the ablation.  I never would have gotten sterilized if it weren’t for that.  I was so upset for about a day, then realized I was being irrational because it isn’t like I was planning on changing my mind about having babies anyway, and if I had gotten the ablation I would still be sterilized.

Turns out he wasn’t able to do the ablation because my uterus was enlarged and the balloon that is used in the procedure only fills to a certain diameter and no larger.  If it can’t place constant pressure on all sides against the inside of the uterus it won’t fill at all with the hot water that burns the endometrium.  He said that he didn’t see any on the inside of my uterus but he suspected fibroids, which cause uterine enlargement and are also one of the most common causes of menorrhagia.  My dr did a D&C in prep for the ablation so I did end up with that regardless and it is considered a treatment for menorrhagia, although usually a temporary fix and not a permanent one.  I wasn’t supposed to have any bleeding after the procedure, and my dr was especially concerned about it because of my low hemoglobin level.  Well, I had the procedure on Monday afternoon and woke up Wednesday with the tell tale gush of blood.  I called the office, as instructed, since it wasn’t heavy bleeding, but it was more than just spotting.  I went in to see the dr that afternoon and they checked my hemoglobin – it had actually gone up to 9.3 which was good.  He sent me home and said to just keep an eye on it and if it became heavy to call him.  We discussed possibly putting in an IUD to help with my monthly bleeding since the ablation was off the table.  He told me that the D&C does help some women for awhile as it kind of “resets” things and we agreed that we would wait and see what my period was like when I got it again.  After 2 or 3 days it went back to just a bit of spotting, and by the following Tuesday was practically non-existent.

That Tuesday night (8 days after the procedure) I decided to venture out to the grocery store with Angelina and while shopping felt a large clot trying to pass.  I hurried to the restroom and sure enough I passed a tangerine sized clot.  There didn’t seem to be a lot of bleeding so I decided to finish my grocery shopping and see how things went.  I ended up making it through the checkout before I had to use the restroom again and had a repeat performance.  As Ang and I were heading out to the car I got a bit lightheaded and decided it was time to go home and call my dr.  I passed two more similar clots when I got home.  I called my dr’s cell and told him about what was going on.  He told me to take two of the progesterone pills I had taken prior to the procedure and if the bleeding lessened and I didn’t pass anymore clots I should come to the office the next afternoon, but if I continued bleeding or passing clots I should go to the ER.  This was all particularly concerning because my hemoglobin was so low to begin with, and also because I just had a procedure 8 days before the “cleaned” everything out of there which meant that I was bleeding pretty badly inside my uterus to have formed that many of those large size of clots in that short amount of time.

The progesterone calmed things down and the bleeding had practically stopped within a couple of hours.  I went into the office the next day and my hemoglobin was again at 9.3 (so it had probably gone up a bit the few days before that, then back down when I had the bleeding).  We discussed where to go from there since the D&C didn’t seem to have worked as he’d hoped.  He said the IUD was still technically an option, but that it could either help or make the bleeding worse and because of all the bleeding I was already having I would probably be one of the people who ended up with worse bleeding from the IUD.  And then we discussed a hysterectomy.  I left the office that day with the agreement that he would submit the request to my insurance (HMO) so that if when I came back in 2 weeks (hopefully not sooner) for my ACTUAL follow-up and decided I wanted to hyst that we didn’t have to wonder whether it would be approved or not.  And if it wasn’t approved we could discuss my options from there.

I didn’t have any more heavy bleeding after that and actually made it the two weeks to my next appointment.  David and I discussed the hysterectomy and agreed that it was probably my best option.  Since I had already been sterilized there really wasn’t much reason to hang on to my uterus and the hysterectomy was the only guaranteed fix for my bleeding issues.  So on October 10th when I saw my GYN again I told him I was ready to schedule my hysterectomy.  We scheduled for November 2nd since I had promised my daughter I would take her trick-or-treating on Halloween.

I actually felt mostly at peace with my decision but I was really concerned about having a bipolar episode after the procedure just from really facing the fact that there was no going back from having a hysterectomy.  Not to mention that even though I kept my ovaries there was the possibility that they would go into shock from the trauma of surgery that jostled everything in there around and I could experience menopausal symptoms.  After learning that I started second guessing myself and telling myself that my periods weren’t really THAT bad and I had been dealing with them for so many years anyway.  Then I got my period on October 20th.  It was the first “real” period I had after having the D&C and it was terrible.  Even worse than the couple periods I had prior to the procedure.  It cemented in my mind that I was making the right decision.

I ended up being very fortunate.  I have had hardly any “side effects” from the hyst, barely any spotting and the emotional issues I’ve had seem to be related to my normal cycle.  This past week I have been weepy and the other day I caught myself thinking “Maybe my ovaries are wonky”  and then I looked at a calendar and realized that if I hadn’t had the hyst my period would have started on Tuesday and I’m probably just having my normal PMS symptoms.  That in itself is a bit weird and will probably continue to be.  I still have a cycle, hormone wise, but no bleeding to tell me that’s what’s causing my emotional lability.

Anyway, I am at 3 weeks and 2 days post-op and slowly but surely recovering.  I should be “fully” recovered by the 6 week mark, December 14.  I ended up with a total vaginal hysterectomy which means the only incision I have is in my vagina, which greatly reduces recovery time.  I had my dr take a picture of my uterus after he removed it, and any doubt that I had about this being the right choice was wiped away when I saw that picture.  He ended up having to cut it into about 4 pieces to be able to make it fit through my vagina.  It was completely covered in fibroids and weighed four times the “normal” amount it should have weighed.

If you’ve made it this far, all of this contributes to that “happy” feeling I mentioned way at the beginning of this post.  I am so incredibly relieved by all of this.  There’s a part of me that is sad that I will never again grow a human being, but I think it’s just my sentimental side.  Because my logical side says “WOO HOO! I was never really going to have another child anyway!  Now I can feel better physically.  I can also feel better mentally because I don’t have to freak out if my period doesn’t show when I’m expecting it to, because I won’t have one anymore!”

My hemoglobin was 8.5 the day of my surgery (again), but up to 9.5 at my 2 week post op visit (which was actually at 12 days post-op).  My dr said he expects it to be up to 10 or 11 something when I see him again at 6 weeks post op.  Which also means that I could be back up to a normal level by the middle of January.  My hemoglobin hasn’t been high enough to be “normal” in almost 3 years, that I know of.

Now that I have purged the huge events of 2012 here, I must go to bed.  It somehow got to be 5:30am and my family has been asleep for awhile.

I’m not making any promises, but I am going to try to get on here and write more often.  Hopefully those updates will be a few paragraphs instead of half a book in length.

And with that, I leave you this:

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