09 April, 2017

Shouldn't it be HERsterecrtomy

Sooo, last month, I was at my old stomping grounds, Sen Sok International University Hospital.  No, I didn’t try to recapture my youth again which brought me to this wonderful hospital a few years ago.  For those of you who would like to relive my pain, please click here  My leg, by the way,  has healed up nicely.

No, this time another issue arose…my uterus decided it had had enough of hanging out the vacancy sign for the last 30 years or so and it took matters into its own hands.  It gave away a free room to some smooth muscle cells and fibrous connective tissue that had been loitering around my womb.  Thus a tumor was conceived, awwww…  It hung around -literally, it hung much like this Cambodian JackFruit tree.  (Hint – the tree is my uterus and yep, my favorite  of all time fruits in this country is being represented as my tumor.)

I first noticed the intruder’s presence in July of 2016 when a morning jog had me doubled over with cramping.  I had just started a new exercise routine with undue enthusiasm, so figured I had over done it.  I was in pain for a couple of days and our wonderful staff and kids had a good time with how exercise was hurting mommy.  I laid-off the running for a while and the pain went away.  After that there were times I just felt uncomfortable, nothing to pinpoint, but knowing my body pretty well (we’ve been bestbuds for over 45 years!) I just felt something wasn’t quite right.

But you know how it is, life commences and a visit to the gynecologist was not a top priority -but seriously, is it ever?  It was relatively easy to keep putting off, first I had to find one, then find the time, then blah blah blah, put off easily, but then I started to have lower back pain on my left side.  Not a good thing when I have little ones using my body as a jungle gym.  Then there was my belly which was growing as if I was pregnant.  When the kids started patting my belly saying “mommy has a baby,” it was time to stop procrastinating, so a week before my 49th birthday I went to my appointment and found out about my non-human, free-loading bodily intruder. 


In my usual efficient way, I researched all about fibroid tumors and since mine was hanging off my uterus, it would be a simple in and out procedure laparoscopically.  A day in the hospital and back home, easy at that, right?  Made the appointment to have a second ultrasound (the first one was inconclusive as unbeknownst to me, I needed a full bladder) and figured I would have the surgery after the ultrasound.

Well, the 2nd ultrasound showed a much larger mass than previously thought and in a meeting with the doctors, it was determined that I should have a hysterectomy.  I just sat there dumbfounded.  During my 2 week mental preparation for the tumor removal, not once did I allow myself to consider that it would be more.  More invasive and much more expensive.  I questioned having the hysterectomy, as to why to just not remove the tumor and be able to keep my, ahem…female parts.  The reply was pretty much in-my-face “Why? You don’t need them.”  Ouch!  Well, no argument there, but I did insist on keeping my hormone producing ovaries.  I did not want to be dependent on hormone replacements.  The other issue is that it's not really known what causes tumors and if they only remove it, another will probably take it's place, and then another...that's what damn freeloaders do.

After talking out every angle, I was not prepared to have the surgery that day.  Not prepared physically  and certainly not mentally.  Luckily we had repeat volunteer, Jaime, coming to Opot that day so I was able to catch a ride back with him later that day.  I went into my favorite restaurant in the city and just chilled for 3 hours.  Researched a bit, but mostly just came to terms with how I felt about having my uterus and cervix removed.  I KNOW my female parts are not what make me who I am, but it was a little hard to accept that they would be removed, I had had them for years!  I thank you Jaime for listening to me the whole way back to Wat Opot that day...it couldn't have been comfortable to hear so much about the female reproductive system and the surgical process, but I needed to get it out!

A week later I was back and this time more prepared.  I wasn’t worried about the actual surgical procedure as the hospital and doctors are top notch, even with 3 native languages present (French, Khmer and Russian) with English as the common language.  I was taken to my room and left alone for awhile to get unpacked, which I realised after the fact that there really was no need for me to pack clothes since I wound up wearing the wonderful hospital gown the whole 5 days!  I also had my secret stash of an olive baguette, instant noodles and nuts.

Before I knew it, I was gowned up, procedure paid for in advance and headed to my reproductive parts doom.  After I paid for the surgery the nurse glanced at me putting my wallet back into my backpack and stated that it wasn't safe for me to leave my money in my room.  I kind of looked around and said, what do you want me to do with it and she said keep it with you.  I kind of chuckled since I was soon to be doped up on anesthesia and in no way would be able to protect my money in that state.  I went along with it though and once inside the operating room the doctor said, "Why do you have this?" pointing to the wallet beside me.

I pointed to the nurse and said "She told me to bring it."  There was a short Khmer conversation and then the doctor scratched his head and then took out a surgical glove and stretched it over the wallet, then took another glove and put it on the opposite way, then taped it up and wrote my name over the tape (so it would be evident if tampered with) and then proudly showed it to me turning it over like a magician proving that the prop for his next trick was legit.  I just nodded and willed the anesthesia to kick in.

The surgery was performed laparoscopically and I only had 4  small incisions in my belly.  They planned on removing my female junk through the hole in my belly button (they insert a 'bag' into the hole, load it up with all the stuff coming out and then they pull the bag out), but since the tutor was 8cm I 'birthed' it.

I awoke some time later in the recovery room and was pretty groggy and had a bladder pain really strong.  It felt like I needed to pee really really bad!  I was only half-way coherent so when one of the doctors came to me I was trying to tell her that I needed to pee, but since I couldn't really speak, the words came out of my mouth like I was in slow motion.  I was saying "khnoooooooooom throooooooooow caaaaaaaaaaaah chuuuuuuuuuuuw noooooooooooome, I kept trying to say it over and over and it just wouldn't come out right!  It never dawned on me that this was my Russian doctor  not my Cambodian one and she doesn't understand Khmer, and certainly not Khmer coming out of a drugged up american mouth.  After a bit of "What do you want?", "I don't understand." I spurted out "Neeeeeeeeeeeeed toooooooooo Peeeeeeeee."  All the while "speaking whale" like Dori in Finding Nemo.

She assured me that I had a catheter in and that I don't have to get up to go to the bathroom.  I dozed off then and when I awoke again, I still 'had to pee' so bad and since I didn't research the logistics of a catheter, I thought maybe I had to actually pee in the catheter, like it was a funnel or something.  So I commenced trying to 'pee' in my catheter.  Pushing so hard that I'm surprised that I didn't shoot the catheter out!  I thought that maybe I had a mental block as you normally just don't pee in your bed.  Mind over matter, I kept trying to pee!  I summoned the nurse numerous times and the poor guy just kept confirming to me that my catheter was working and he actually lifted it up so I could see the filled pee bag.  I was not convinced though and longingly starred through tear stained eyes at a door at the far end of the recovery room that I just knew led to a bathroom!  I was convinced that when the nurse (who was sleeping in the room) got up to use the toilet, I would get off the bed and squat down on the floor and finally pee!

I fell into a restless sleep hoping each time that I dozed off that my 'mental block' would release and I would 'pee the bed'.  The next morning, when the doctor came in, I clearly and articulately explained that I still needed to pee so bad.  Her explanation which fell on my deaf ears showed the frustration on her face.  Then like a lightbulb, she said, do you have pain pointing to my gut and I said "YES!"  She turned to the nurse and said something that sounded like "Hit her up!" and gloriously a pain killer was injected into my IV and my 'bladder' pain miraculously went away.

Grant it, I didn't remember any of the above until about day 3 in the hospital.  Then the memory came rushing back to me and I was so embarrassed when the nurse and doctor came into my room.  I wanted to apologise but didn't even know where to start, plus it wouldn't seem sincere since every time I thought of it, I would crack up laughing at myself.   I cannot imagine how on earth he and the doctor kept a straight face while I was going on and on that I couldn't pee in my catheter.  My nurse probably took a video and as I type it's going viral on some Cambodian video site!

On day two my appetite came back and the doctor came in saying it was okay for me to eat, but it can only be soup, nothing solid at all.  I said "can I have bread" and she said firmly, "No, nothing solid, only liquid!" I said, okay, I will order some soup...as I glanced down at my bed gown hoping there were no crumbs from the 1/4 olive baguette I had just consumed!  I opted against googling what happens when you eat bread the day after surgery...

My friend Helen graciously brought me enough broth to feed a village of post-op patients so I sipped on that for 2 days.  Then I was allowed some noodle soup, so I pulled out the package of my beloved spicy kimchee noodle and proudly handed it to the nurse.  She brought it back piping hot and I feverously ate it down.  Later that day, the doctor inquired about my food intake and I said, "Yes, I had some noodle soup" and "may I have some more, as I'm hungry again".  I handed her another package (I had brought 10!) and she declared, "oh you cannot have this, nothing spicy."  I hesitated about ratting out my morning nurse, but I wanted some more so bad that I did, stating "Well, they gave me some this morning and I am fine".  She glanced at me and excused herself and I thought "Well, shit!  The last thing I want to do is piss off my nurse when I am bedridden!"  The doctor came back in kind of smiling and said that actually, they replaced my spicy noodle that morning with a plain one as she handed me back my morning noodle package -unopened.

I didn't know whether to be pissed off for being deceived, thankful that the nurses knew what they were doing, or dumbfounded that I hadn't even realised the difference, so I said 'fine' and had some broth without any bread as I slowly sulked.  

The evening of the 4th night I was awoken with sharp pain in my arm where the IV was.  I thought I had just hurt it because I tried to go to the bathroom without the nurse.  The IV (for non-medical readers) is attached to the pump that is plugged into the wall, so I had to do a little thinking.  I had watched the nurses open the machine and take out the tubing from the pump to escort me to the toilet.  I sat looking at it and realised that I could not possibly take it out, hobble to the bathroom, do my business, then hobble back to the bed reattach the tubing into the pump and then feign ignorance when the nurse entered to investigate why the machine was beeping.

So I opted to pull the machine with me as far as the electrical cord would reach and then try to reach the bathroom as far as the tubing would reach.  This failed and in doing so, I probably pulled the needle out of my vein not realising it.  Defeated, I pulled everything back in order and rang the nurse so I could pee.  Later that evening, the nurse came in and put pain killers into the IV bag and I fell asleep and that's when I awoke to the pain in my arm.  I mentioned it to the late night nurse and she rubbed my arm and said it was okay and that I would go home tomorrow and no, she could not take it out.

I contemplated either pulling it out myself because it felt like molten lava was slowly dripping into my arm, but I just didn't have the energy and figured I had caused enough trouble for one patient and sucked it up.  The next morning the nurse came in and changed the IV with another full bag!  I said, look at my arm, which was red and swelling and she said the doctor will come in soon, I said, can you get her now please (with tears in my eyes for added affect).  About 10 minutes later, the doctor arrived all gleeful stating that I could go home as soon as the IV bag was empty.  I said, "But look at my arm!" and she glanced at it and then rushed around to the other side of the bed and said quite matter of factly, "You can be finished now." as she removed the IV from my arm.

With my stomach half the size from when I went in, I was verbally released.  I was given pain killers along with the antibiotic, but since I had not had any painkillers for about 12 hours when my IV somehow came out of my vein, I opted out of them.  I was then officially signed out, given a detailed bill of my stay and released uterus-less and cervix-less back into society. 

This blog post is overdue as tomorrow it will have been 4 weeks to the day from surgery.  I came back to Opot and obeyed the strict 'no lifting anything over 10 lbs' post-op instructions for a month. Although in typing this, I realised that it's only been 4 weeks, instead of five, soo...I obeyed the instruction for 3 weeks instead of four, oops.  I have felt great since coming home and had no problems or pain whatsoever.

The kids, staff and a few village women are/were infatuated with the holes in my stomach, though, as a couple showed me their C-section scars...I explained to the girls what the surgery consisted of and the why and how of it all.  A few of them explained to the others, to the best of their ability, as to what happened to me.  Probably translated to something like the home of the baby was torn down and removed...

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