My paranoid thought for today …

Do not let THIS be your paranoid thought because it doesn’t feel very comforting.  I’ve been thinking about my expanding middle as of late.  Definitely not pregnant … if you’ve been paying attention at all this is a blog about cats my hysterectomy.  Obviously with no baby house I CANNOT be pregnant.  Very thankful about that actually. I decided to keep my tubes and ovaries because I didn’t want to go into dramatic and sudden menopause … and did discuss this issue with my GYN who agreed keeping my ovaries was definitely reasonable based on my health history and age.

Ovarian CA Facts

But I’m thinking that horrible thought about ovarian cancer!  I do have both my ovaries and well, one sign is swelling of the abdominal area.  However, I’m trying to rely on that saying, “When you hear hoofbeats, think of horses and not zebras.”

Horses not Zebras

I remember the first time I heard this saying.  I was working in an inner city ER as a nurse and having a conversation with one of the best ER physicians I have ever known, Dr. Byon Vaughn (RIP).  I was asking him how in the world could he make such accurate and discerning diagnoses and be sure it wasn’t a scarier, rarer diagnosis.  How did he know?  And that’s when he quoted that quote up there.  Me not being as bright as he, had to ask for clarification of this aphorism and it’s meaning has stuck with me to this day.

So, I’ve told myself that I don’t have a family history of ovarian (or any other kind of cancer) and that I’m not having any other signs of ovarian cancer … although ovarian cancer is quite evil and sneaky being often diagnosed late.  I’ve decided that the truth is that I’m eating too many sweets, enjoying wine and other alcoholic beverages and not exercising … so, this is the recipe for weight gain.

Ovarian cancer symptoms — 

The signs of ovarian cancer may be different for each woman and any one of these symptoms may be caused by noncancerous conditions. Because the ovaries are located near the bladder and the intestines, gastrointestinal symptoms often occur.

When present, common symptoms of ovarian cancer may include:

  • Persistent abdominal bloating, indigestion or nausea
  • Changes in appetite, often a loss of appetite or feeling full sooner
  • Feelings of pressure in the pelvis or lower back
  • Needing to urinate more frequently
  • Changes in bowel movements
  • Increased abdominal girth
  •  Feeling tired or low energy

Cancer Center Treatment Centers of America

Looking at the above list, I wouldn’t say I have bloating or indigestion or even nausea.  I would say I have a loss of a waistline with pudgy McPudge Pudge setting in.  My appetite seems to be just fine … perhaps too fine at times!  Candy bar(s) anyone?!  Cheetos now, later or both?  No, pelvic pressure but yep some low back pain, but for Pete’s sake I have a desk job!  I sit on my bony @ss ALL day!  DESK JOBS ARE BAD FOR YOU! Nope no change in the amount I pee — still the same as before the hysterectomy … just can’t pee as fast.  No change in bowel movements EXCEPT that since my hysterectomy I am not constipated all the time.  My BMs are more normal — aren’t you glad you know that about me?  Yes, I do feel tired lately … I think it’s because I’m simply out of shape preferring to exercise my mouth and chomping away instead of using my whole body by exercising.  I also have become a stress-eater.  I used to lose my appetite under stress and now all I want is to make poor food choices!  And sex is NOT painful — not one bit.

So, I’m either in the early stages of ovarian cancer or simply getting an apple figure.  Bleh.   I don’t want to be an apple!  And I certainly do not want ovarian cancer!  I had a beautiful Canadian friend die of ovarian cancer … she had pretty much all the listed symptoms. You can read about my lovely friend Andrea HERE.  It won’t take you long really … just go visit my dedication page.  You’ll be back in a jiffy to read more of my jabberwocky.

I’m going to try something new for a change.  I’m really, really, really going to try to eat better or at least avoid the “bad things” and I thought about doing this really crazy thing … like only drinking 1-2 drinks once a month on whatever special occasion happens (think anniversary, 4th of July, Labor Day, Birthday, etc.).  This is so hard because I like wine with my dinner many nights and I’m a sucker for beautiful concocted cocktails.  

The other problem I see coming down the pike is when there are two or more “special occasions” in a month!  Holy Moly, I guess I’ll just have to prioritize.  I don’t know if I can succeed at this or for how long.  Being that today is the 1st of May I thought I’d give it a go … always nice and orderly to start something on the first of something I think.  My BIG “have a drink day” this month will be my wedding anniversary!

Anniversary someecards

It’s going to be big anniversary number EIGHT!  Does that mean I can have eight drinks?  Just kidding.

I also thought less wine with dinner will be cheaper on the budget too.  Somehow drinking, and I don’t mean to excess by any means, simply one or two glasses every few nights really increases my appetite the next day.

Did you know?

Alcohol also acts as a potent appetizer. Ever heard of an aperitif? It’s an alcoholic drink taken before a meal to increase the appetite, and many restaurants realize this is a great way to get you to order more food! Several studies exist that show a sharp increase in caloric intake when an alcoholic drink is consumed before a meal (compared to a glass of water, or even a soda!).

SOURCE

Moreover, research shows that as few as two standard alcoholic drinks can slow down your body’s fat-burning process by a whopping 73%. (And that goes for any high-fat foods you eat while drinking and any fat you’ve been trying to get rid of before you took your first sip—even if you’ve eaten one of these fat-burning foods.)

SOURCE

I feel like the non-alcoholic alcoholic.  I don’t really need to drink … I simply like it.  I need to lose weight.  I look like a pudge in all my photos and some pants are starting not to fit.  I FEEL better when I weigh less.  I figure cutting back on alcohol is one great way to save on calories.

cat fat cat fat

If I were I cat I’d look something like this.

Please wish me luck in this endeavor.  Perhaps if I were French and walked everywhere I could drink more wine, but alas I’m an American who drives EVERYWHERE and usually don’t take the stairs up (only down).

Ciao for now! ❤

Hormonal sadness

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Going off hormones can be a bad idea.

Of course, if you have a breast cancer that’s estrogen receptive or positive, then of course you need to stop those hormones.  Duh.

I wish I hadn’t tried going off my Lo Loestrin for 8 weeks.  While I have restarted the hormone regimen again, my body is taking a while to catch up, especially emotionally lately.  Hormones aren’t like instantaneous pain pills — like take a pain pill and feel better in about an hour.  It doesn’t work that way and I’m sure you know that.

I simply didn’t realize how hard the emotional aspect would hit me after stopping the Lo Loestrin.  I can’t wait until things are back on track emotionally-speaking. I’m not sure how long that part of this hormonal process takes to stabilize.  I really have no idea.

let-shit-go

Easier said than done.

I don’t like feeling sad or crying easily — it reminds me of my teenage years and through the times when my hormones weren’t very balanced.  I hate being a sensitive person and having petty things upset me to a greater degree than they “should”.  I very much envy stoic people … not that I like to be around these unfeeling people much, but I do envy their lack of emotional responses and seemingly controlled cool-as-a cucumber outer appearance (perhaps facade).  And no, no, no I wouldn’t want to be an unfeeling psychopath by any means.

Why isn’t my skin thicker?  It’s a stupid unrewarding question only asked to torture oneself with no real logical conclusion that can only serve to spiral into more self-deprecating thought.  I can only think hormones, genes and past experiences combined play a part in this emotional downspin.

And I don’t want to become a man pumped full of testosterone with a sex change either simply to avoid female emotions.  I suppose the hormone balancing act is one that takes patience … and perhaps the tension of the Christmas season with all it’s various stressors don’t help either.

Where’s my cyber friend Wanda when I need her to tell me that depression is a lying asshole?  Wanda, Wanda, come out of the woodwork wherever you are. ❤ 

Anyway, physically my hormonal symptoms are greatly improving but this lack of estrogen and progesterone (whether synthetic or not) has me reeling into depths of being oversensitive and almost drowning in self-doubt.  It’s to the point that if you tell me I’m shit, I believe you without fight or question.

Sorry for the sad post folks … it’s usually not my style.

Then I feel guilty about being sad … like my sadness is stupid, selfish, a waste of time … I don’t have cancer, I’m not like the woman I saw in the grocery store today with only half an arm, my dad didn’t die, I didn’t lose a baby, I didn’t get fired … I feel like my sadness is all bullshit and trivial.  However, on the other hand I genuinely feel it … it’s not fake … the tears come, the lower lip and chin quiver, the thoughts grow, merge and a take on a life of their own.

No worries please, I know and hope too as the eternal optimist that I am that this too will pass.  It’s just so amazing how it feels like it won’t.  I’m nowhere needing the “suidcidal hotline”.  It’s simply sadness with undertones or rather overtones of unworthiness.

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I also know I need to get myself to yoga tomorrow … yoga does something very special to me … more than words can explain.

healing yoga

I got so excited and then …

… it all went away after a few minutes in.

screaming uterus

Since my hysterectomy I get especially excited to work with patients who are going to have a hysterectomy.  I’ve been there.  I’ve done that.  And while each hysterectomy and the person having the surgery is unique, there are still commonalities about the hysterectomy.

A few weeks ago … I’m still thinking about this patient and what happened … I got excited to call a patient who was to undergo a hysterectomy just like mine.  I got all excited to talk to her and then … all she wanted to talk about were her innumerable food, medicine allergies and sensitivities along with her severe Celiac Sprue disease. 

allergies jesus

This is all good and fine, but I couldn’t serve her in the best role I was meant for and set out to be.  I’m not a nutritionist nor an allergist nor would I be serving her any of her meals, because like I tell most of my patients, “You probably won’t see me … I’m simply that mysterious phone nurse.”  And LET ME MAKE THIS VERY CLEAR, yes, yes and some more yes, I do think knowing a patient’s allergies and sensitivties are VERY IMPORTANT.  There is no confusion here.  Or Confucius either.

cat confuciousI like listening to patients and I’m pretty good at reassuring anxious ones — in fact, it’s probably my secret hidden super power.  I call patients all day long spending about eight hours talking and listening, so much so that when I get home I don’t want to talk to my dear husband, ending up listening to him instead (or at least pretending).  He has a deficit of how many people he gets to be heard by and talk to in a day, so I’m the brunt of his verbal download.

This poor patient has unheard by previous medical people because I paid the price of her dissatisfaction with the healthcare profession.  I got to hear all about how she gets severe anxiety when nurses and doctors term her Celiac Sprue disease as only an allergywhich I never did once in the conversation.  She made it very clear that this disease is simply not an allergy and is an autoimmune disorder.  No argument from me there … I would have never oversimplified this disease, or what she has had to endure.

We spent a lot of time going over the Celiac Sprue.  I listened and listened and listened some more, taking her very seriously.  I really, really, really, really wanted to tell her about the pre-op hysterectomy process, the recovery room and what her stay in the hospital would be like.  I wanted to tell her about the surgery she was about to have.

WE NEVER EVER EVER WENT THERE.

She told me how we (people who work in hospitals) in my state kill people.  I had to do a double take on this statement.  I almost fell out of my chair.  Yes, she used the word kill.  Apparently she moved from another state and somehow got misinformation that my state, which will remain unnamed because that’s not the gist of this conversation — to defend my state — unplugs people at the drop of a hat and doesn’t save people when they are about to die.  I will, however, defend my profession and my experience.  I’ve been a nurse for two decades and I’ve never, ever experienced anything close to anyone not saving someone who looked like they were dying, getting ready to die or even dead — yes, we’ve even tried to save the dead in my E.R. experience!  I’ve worked in pediatrics, the ICU, ER and recovery room to name some critical places where patients are most likely to have life-threatening situations.  We go through a lot of training on how to save people and what codes mean and how to call them and what each person’s role in a code is.  We as nurses take your sickness, your signs of dying VERY, VERY, VERY seriously.  We are here to help you.  There is a reason why nurses are called angels!  And where I work is no exception — some of the most caring nurses I’ve ever met who will give each and every patient the best care humanly possible!

So … I had to spend some time gently educating her that the mission of my hospital and my profession was to save people at all costs UNLESS they specifically had the legal document of a DNR (do not resuscitate) with them or on their chart.

In that point in time, this is what she wanted and needed — she needed to talk about serious dietary concerns and what happens in dire life circumstances.  I couldn’t share my hysterectomy knowledge or experience with her.  I am saddened because I feel like my care wasn’t complete.  She was pretty much done with the conversation when I finished getting and giving the essential information like directions to the hospital, asking her what medications she was taking and instructing her on basic pre-op instruction like no eating and drinking after midnight.

This patient still sits in my mind today while I wonder if she’ll get the information she needs through her surgeon, the internet or whatever sources she may find.  She and I couldn’t get there — into hysterectomy world.

doubt and fear

I feel horrible that she has severe Celiac Sprue disease because it must be hell to manage a daily diet, let alone even begin to eat out at any restaurant or have dinner at someone’s house without constant worry and fear.  I am sorry that she wasn’t listened to by some other healthcare professionals (or felt like she wasn’t listened to) in the past and her disease wasn’t taken seriously.  AND I feel empathy for her in that she fears for her life thinking that healthcare professionals in my state won’t act to save her life if needed.

DISCLAIMER

This must be a terrible place to be in one’s mind.

bread cat

Time lost and time gained … and time lost thinking about time gained.

lost TIME

The other morning while I lay in bed I thought about all the days and weekends I missed due to my dysmenorrhea.  I thought about how I would retreat to my bed when I could, after taking my pain medication and sleep … simply trying to sleep the hours away until the pain was gone.

I thought about the ibuprofen and Tylenol #3 (acetaminophen with codeine) I would take while I waited for their effects to slowly chip away at the pain.  I would often, but not always have my heating pad at my back waiting for the pain to melt away.  Yes, that’s the feeling it was.  There was no high.  There was no euphoria.

All the pain medication did was bring me to a state of semi-normalacy … a pain state that was tolerable.  

There had to be a fine balance because too much Tylenol #3 — STILL within the prescribed dosing instructions — and I would become nauseous and later very constipated.  How anyone can become an addict is beyond me and something I never want to discover firsthand.  I HATE CONSTIPATION!

The only treasure in all that misery was some private time, some deep sleep … it was an exit to life of sorts.  I’m not up for exiting life, but with pain and fatigue that wracked my body the brief escape was welcomed.

The idea that retreating from life — a time period comprised of up to one-sixth of every month of my life for countless years is somewhat mind-boggling. Since my hysterectomy and after the four week healing post-op time frame, I feel like I’ve gained extra time.  That’s a gift really.  I used to count on at least, the very least, three days of every month being completely shot.  Worthless.  Kaput.

In a twisted way, I miss the retreat and melting away of pain … and I think this is because it was a way of life for quite some time.  Like a person enraptured by Stockholm syndrome I came to know my abuser (the pain, the dysmenorrhea) well and defending the abuse as my way of life … my way of being.  The pain became a part of me. Rewards came as respite and breaks from pain.  Although my life was never in true danger I sometimes felt like I could die.

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My idea of hysterectomy was at times once thought of as frightening because I didn’t know what to expect with the surgery and recovery with life afterward. The dysmenorrhea was predictable, routine and generally consistent.  Had the possibility of children not been on my radar I’m sure I would have had a hysterectomy sooner.

Psychologically it was challenging to live in the maybe-baby zone.  I think it’s much easier to fall on either side of the fence … not wanting children whatsoever or wanting them with fierce desperation.  It’s difficult to be in the middle.  Just ask that middle child, they’ll know all about that middle thing!  Most of the women and friends I’ve come across over the years wanted to have children.  There have only been a handful who didn’t.  There are even fewer women I’ve met who sit in an indecisive position like me.  There is nothing like longing to know you aren’t alone.middle path

I stayed in that grey zone and as such my monthly pain visited me without fail … choosing a definite direction either way I’m sure would have brought it’s own what ifs, possible regrets and other life-defining experiences.  I could only choose the middle path because that’s what felt right to me for as long as it did … until it didn’t.

Sometimes I think about all the time and other experiences I lost to being sick, being in bed, being tired, being in pain, being utterly fatigued, being comfortably medicated and wonder what I could have accomplished or simply not lost to time … and I also know my decision to have a hysterectomy came at a time I was both physically and emotionally ready.

And cats … well cats don’t care about time or choices.  Cats are in the moment choosing the choice in front of them without regret.  Cats don’t ever think all the things they could have done if they’d had more time … cats do have nine lives after all!

*DISCLAIMER

cats during emergencies

Post-op days 2 through 4

So, days two through four are basically a blur at this point.  I took my pain medication Percocet with three 200 mG ibuprofen about three times daily.  I needed it.  I slept A LOT.  I cannot even believe the amount I slept.  I slept in, I slept into the afternoon and I slept well when I went to bed around 10 pm at night.  I was hungry and ate well in-between all my sleeping.  I also downed A LOT of water.  In fact water was the only liquid I wanted to drink.

I really felt like I was becoming a cat!  Sleep, eat and go to the bathroom — that was my existence for about four days after surgery.  I only went one day without having a bowel movement and that was post-op day two.  Sorry if the rest is a little TMI … but I usually have a BM once daily … sometimes twice and severe constipation was my biggest worry with this surgery.  It wasn’t a problem.

The night before surgery I took two Senokot (senna) tablets the night before surgery and while I was hospitalized I got one Senokot-S tablet twice daily.  I think this was a huge help in preventing severe constipation.  They also gave me Gas-X (simethicone) three times daily in the hospital which I continued for the next 3-4 days at home for gas and bloating.  Constipation was no problem for me with this surgery.

I also PREPARED for constipation … I bought dates, prunes, fresh peaches, fresh plums, yogurt, cantaloupe, papaya and fiber crackers to nibble on in-between meals.  These were all great little helpers combined the above medications.

But I will say, unlike some other women’s stories I have read after my da Vinci hysterectomy I was not exactly up-and-at-em!  I didn’t feel like I had excruciatingly painful surgery, but I didn’t feel super spry either.  I mostly felt bloated, fat, full, sleepy and tired.  I kept my pain and constipation well-managed and I let myself sleep as much as my body dictated.  Luckily, my husband was very supportive of my sleeping.  He worked on projects around the house but was available at any time I needed him.

I would say this surgery was like a revved up version of the laparoscopy I had a few years ago … the bloating and fullness lasting much longer though with the da Vinci hysterectomy.

I finished my Percocet sadly in this time period and my doctor’s office called in for some hydrocodone (Vicodin) — which is not as strong as Percocet.  I have not needed the hydrocodone like I did the Percocet on those first few days though so that was truly a mental relief.

There is nothing like the fear of pain.

Agliophobia, or the fear of pain, is one of the phobias that has a rational basis. Everybody is afraid of doing things that they expect to be painful to some degree. Fear of pain is a perfectly natural response; for the most part, pain exists because it is a signal from our nervous system that will deter us from hurting ourselves, or cause us to take notice that something is wrong with our bodies.

Pain.com — agliophobia

Now, I don’t exactly think I have agliophobia, but I have been undertreated for pain in the past and I didn’t want this situation to be repeated.  However, two things happened: I got my prescription for hydrocodone and on post-op day five I felt almost normal physically — that was a big leap in the healing process.

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Keep calm and sleep!  What a great motto!  It worked for me!

The day BEFORE surgery

Working on the day before surgery is not a good idea in my opinion. I should have taken that day off and kept my mind busy doing other stuff. I was not the most productive me at work and being that I work at a hospital there were constant reminders of all things medical. I should have taken the day off, but I didn’t want to use up any more of my PTO (paid time off).

I found a few sites in my search for information on the da Vinci laparoscopic assisted hysterectomy. Most were helpful and one was downright scary.

HysterSisters provides a lot of information and personal stories. Then there was the HERS Foundation — a site that scared the bejeebers out of me! This is the WRONG site to read days to hours before one’s scheduled hysterectomy! From my understanding the founder of that HERS site had a total hysterectomy with ovaries removed as well and went into sudden menopause. Yeah, that would be a shock for sure. I have spoken with a lot of women over the years who’ve had a hysterectomy and I haven’t met one yet that has regretted her decision.  According to statistics (sorry no source) over 90% of women are happy they had their hysterectomy.

The site that really helped me was: Hysterectomy Tool Box — although a bit old from 2009 — I found most of the advice and the description of the experience helpful. Of course the da Vinci procedure wasn’t mentioned in 2009. There are probably some other great sites out there but these are the three I came across most recently.

I did have a mini-breakdown on the day before my surgery knowing that the surgery was permanent and making this decision didn’t give me any chance to turn back. I talked at length to a nurse friend who really helped calm my mind about this decision.  Nurses really can be great people to talk to about all kinds of things — not simply medical ones! She herself had a hysterectomy a few years ago and said it was one of the best decisions she had ever made.

She told me that orgasms were no different. She said I would be shorter. Silly me, I thought she meant my height would be shorter and told her that was a good thing because my husband wasn’t very tall and I hated being taller than him. She looked a me kind of funny and informed me it had nothing to do with my actual height, but that my vagina would be shorter. I laughed. She laughed. I’ll take a shorter vagina over monthly back, leg pain and debilitating fatigue for sure!

I told her I had sort of wished my pregnancy test had come out positive so that I could postpone the surgery. She then asked if I was truly ready for the surgery and reminded me I could cancel at any time. It’s not so much that I wanted the pregnancy and have a baby — I simply wanted to postpone this permanent decision a little longer, plus if I was pregnant I could be free of painful periods for NINE MONTHS!

But all my labs were absolutely normal, including a negative pregnancy blood test. This was a good start.  I’m not afraid of the surgery but am concerned with how my life will be after the hysterectomy (see choice #3 below).

tomophobia

What causes Tomophobia?

Tomophobia could be caused by a number of reasons. Some common examples could be:

  1. A bad situation or traumatic event occurred in the person’s life as a child involving a surgery;
  2. Some people are afraid of the risks a surgery could hold (i.e., death);
  3. Some are afraid of how their life will be after a surgery (i.e., diet, movement, sex, health, longevity);
  4. People are scared of catching other illnesses or getting sicker after a surgery;
  5. People are afraid of having major procedures performed (i.e., heart surgery);
  6. People are afraid of possible negative outcomes from surgeries (i.e., scars, bruising, or loss of mobility); and
  7. People just are afraid of painful things or events, such surgery. These are only a few possible causes. There are probably hundreds more causes.

source: Common Phobias.com