WARNING: This post includes descriptions of medical interventions and a somewhat graphic photo. If this is not something you can stomach check out another post!
So the deed is done. As I’m reminded daily it’s a decision I can’t take back. With some effort, I’m spending time each day thanking my beautiful body for being so strong throughout this process, my uterus for growing my wonderful son and regulating my hormones for so many years. This sack of bones is one resilient body! I am truly grateful.
This surgery was a very difficult decision to make, not just because of the five-ring circus that is the Mexican health care system (just a different shade, as the US system has its own absurd rings), but because I truly don’t believe women’s health or bodies have ever been taken seriously, or studied sufficiently – ever. Cutting something out seems far easier than trying to understand its importance to a woman’s overall health and functioning.
For example, weeks before my surgery I was editing a friend’s audio interview with a researcher on Alzheimer’s out of Arizona University. I had asked her to insert a question about women’s prevalence of Alzheimer’s and hysterectomies. The reality is that women suffer Alzheimer’s at a rate six times higher than men, and a lot of that could have something to do with our shifting hormone levels. When asked specifically about the presence or not of a uterus, the researcher referred to a female colleague doing research on just that. “We used to think the uterus was just for carrying babies, but we’re seeing now that it plays a much bigger role in regulating hormones throughout the body.” So, its 2019 and we’re just realizing that a woman’s uterus might play a bigger part than carrying babies? Ugh. So I had some serious fears going into this surgery. However, despite a cancer marker that had finally gone down, I still feared its presence, and the decision I made was based on the fact that if I got cancer I might not have the time to suffer from Alzheimer’s down the road. There I was, between the devil and the deep blue sea.
Now that it’s done, it’s done. I embrace the decision as I’ve had to embrace every decision I’ve ever made whether I ultimately think it was for the best.
Much of my hesitation also came from the Mexican chorus of contradicting voices and opinions that followed me right up to my hospital stay. My surgery was initially scheduled to be at a new, fancy hospital in San Miguel recommended by my oncologist. I felt fine about it. However, as the date neared I ran it by a health advocate here in San Miguel. “Absolutely not. The post care is terrible. I’ve had people DIE there on my watch,” she said dramatically. Whaa??
So against the protestations of my oncologist who much preferred his hospital, we changed venues. Nothing like last minute major changes to put the mind at ease.
Hysterectomy, particularly laparoscopic, is said to be a fairly simple procedure, and one that more than 600,000 women have every year (all techniques). So I kept this in mind on the day of the procedure: I was joining approximately 20 million other American women who’ve gone through this.
I arrived at the hospital and was quickly wheeled into the surgery room with very little fan fare nor forewarning, not a hello from the surgeons nor a heads up that the surgery was about to start – like immediately. Ah, if only it was that easy. After a tortuous IV placement, I was completely sedated, where I would rest for TWO hours before the actual surgery began because this specific hospital did not happen to have the CO2 gas on hand necessary for laparoscopic surgeries! I learned later this gas was such a requisite aspect of surgical rooms, no one bothered to ask whether the hospital carried it. Two hours later the surgery finally began and three hours after that I was in a lovely recovery room with my friend Poppy trying to keep me from convulsing as the anesthesia wore off.
My days in the hospital were painful as can be unexpected but relatively uneventful. All staff spoke English and when they finally decided to allow me food and water again – 24 hours after the surgery — it was a putrid purple jello. My sisters were by my side day and night, taking shifts to make sure I wasn’t alone. In part, it’s a requirement in Mexico that a family member (or in my case, friend) be with you in the room particularly during the night in the event of “nurse shortages and to prevent falls”, one nurse told me.
Two days later I was released and, while sore and stiff, I was surprisingly energetic. I began my slow walking regimen right away, strolling around the beautiful garden in front of my house. At my one week check up I felt almost good as new. I had tons of energy, loved my pain meds and felt like recovery was going well. Perhaps I loved my pain meds a bit too much as the doc immediately told me I was taking too many and didn’t he say 1 every 8 hours??? “Your Liver, your kidney…” he cried. I reminded him that he specifically told me “as needed” and I needed a lot of them. He put his head in his hand, and said I was cut off.
In the end it wasn’t the pain from direct incisions that got to me, but the massive pains and cramping from gas. If anyone has ever had a hysterectomy or perhaps is considering one, let it be known the strange attack of gas – in your abdomen or chest – is so painful it starts impacting whether one can eat at all. Had I checked my hystersister site earlier, I would have read that women survive for weeks on gas X alone… But my doctor was flummoxed. So between a drop in energy from fear of eating and blood pressure that was running 60/40, I began to slide downhill. Then the internal bleeding began.
At my two-week check up, I was a different person. My doctor saw this immediately and after a spontaneous internal exam (OUCH) he told me I was being readmitted to the hospital right away and sent me on my way back to his suggested hospital (The main difference between this and my former hospital was that No nurse spoke a word of English. It was time to sharpen my medical terminology…). I didn’t learn until later that he thought we would be doing emergency surgery for internal bleeding. Instead, I was given rehydration fluids and scanned for the source of internal bleeding. Maybe it was from the staples used, one doctor said. Staples? What F-ing staples? Who in the hell uses staples in 2019?? Uh, my doctors…
The next day two more doctors did THREE more internal exams (OUCH again), deciding that internal bleeding was coming from some unknown place inside my abdomen, gathering in pools and causing a massive infection. Back to high doses of antibiotics. The next day it was decided that instead of surgery we would try a less invasive method: inserting a catheter into a blood mass that should take “15- 20 minutes”. This would drain the blood, take care of the infection, and get me on the road to recovery. What’s not to like?
Did I want the catheter inserted through my stomach or back, the doc asked? Since my stomach was already pockmarked with what looked like a shrapnel blast, I suggested the front. May as well add one more incision, and leave me the ability to sleep on my back. What I wasn’t told is that inserting a catheter through the abdomen was a more “complicated” procedure, which entailed sliding various “drill bits” for lack of a better term, past my organs – my ever-moving bladder and intestines – to then finally insert the catheter.
I was placed on a hard plastic surface inside a CT scan room that doubled as a meat locker. (CT scanners run hot so rooms always have meat locker temps). And so we began, sliding me back and forth into the machine as each millipart of an inch was monitored through the radiology of a CT scan. Because of the very tense, slow and fragile nature of the insertion I was told not to move at all. One drill bit was ever so slowly drilled in, then two and then finally a third, which was supposed to finally enlarge the hole enough for a catheter… Local anesthesia was added as needed. As usual, I needed a lot.
“Are we done yet?” Was my constant refrain. And wasn’t anyone concerned I might develop pneumonia from the temps I was breathing? And why are these medical “assistants” in plain clothes, wandering in and out of the CT room for various paper towels, plastic gauze and what not…? I felt like I was on display for the security detail of the radiology department, better than a Nat Geo special.
It was the longest 20 minutes of my life, mostly because it actually lasted 2.5 hours! By the time he was done, my legs and backside were screaming with cramps from the cold plastic table, I was holding off massive body shakes from the cold, and it was all I could do to keep from sobbing.
When they finally lifted me up and sat me in the wheelchair for my ride back to the hospital room, I broke into a million pieces. I was completely and entirely traumatized. I couldn’t even speak. To this day, it pains me to relive the experience, and I vowed never to do it again. In fact, no more hospitals. Ever. Not quite a promise I’m able to keep until this episode is over, but it will be my clarion call moving forward.
During the next week, I had various infections from IVs, blood loss to the point of near blood transfusion, and more drugs, nausea, and pain then I’d like to admit. My antibiotics were extra strong bringing on odd little hallucinations. When I asked for a different antibiotic the doc said it was the strongest they had. Cipro, for example, had ceased to be effective in Mexico. I’d have to stay on this. Plus, there were no indications of hallucinations in Mexico. “I’m an indication!” I yelled at my doctor. Stop saying there aren’t any when I have all indications you’ve never heard of!!” We were starting to get comfortable, my doctor and me.
My vocabulary word of that week became Iatrogenic: relating to illness caused by medical treatment or examination. Of course nothing is intentional, I reminded the doctor when he bristled at my new favorite word. But it’s happening all the same. For example, my latest is a blood clot in my arm caused by a larger than usual IV gone wrong, one of so many that had to be replaced once swelling and possible infection started in. Still, they wanted me to take blood-clotting meds to stem my internal bleeding. Oh, to follow or not follow a doctor’s recommendations… it was a constant struggle.
In response to so many questions from friends north of the border, of course I still wonder at the quality of my care and if any of this would have happened if I’d had my surgery in the US. But I’ll never know. What I do know is that these stories occur everywhere all the time; in fact the last time I interviewed a surgeon at St Vincent’s hospital in my hometown of Santa Fe, I vowed I would never ever go there under any circumstance, the horror stories were simply too many. I also know that in Mexico, they really, really do not want their foreign patients to die or otherwise have medical complications. I felt confident throughout that all three doctors were truly invested in my getting better, even if they didn’t know how to make it happen. They each gave me their WhatsApp numbers and told me to call or send a message anytime I felt things were going wrong or if I just had questions. I’ve never had this experience in the US.
“How are you feeling today?” asked my oncologist in a short WhatsApp note. “These hospitals are going to kill me! Why am I taking blood clotting medicine when I have a clot in my arm?!”, I responded in Spanish.
“Please continue to take the blood clotting meds. The clot in your arm will pass in a few days with heat.” Whether or not he was right, I felt better. What else could I do? I already had a second and third opinion.
A few other notes:
The cost was $6000 USD for the surgery, $1000 more than initially quoted because I’d chosen the hospital that had no gas for surgery, and another $6000 or so for my hospital readmission and complications. $2000 was paid in cash while the remainder went on my credit card. I’m currently awaiting the reimbursement by the insurance agency. As a US company, I can only imagine what they’ll come up with…
As I write this I’m a month post op, still on bedrest and, while unsure what the next exams will bring, feeling like I’m finally almost home. Recovery IS happening.
So is it Mexico or is it simply the complications of western medicine? As I lay on the radiology table with two doctors looking at the black and white masses on the screen in front of them, I watched them searching for pools of blood and their possible sources. These were the two doctors who, almost a year ago had decided I had cysts on my ovary that were cause for concern. Along with the elevated CA-125 reading it was that scan that sent me into the spirals that formed my decision to undergo surgery at all. So there I was, reclined on the table, when the radiologist looked up and asked his colleague, “You kept both her ovaries? There’s a cyst on that ovary.” My gynecologist made a point not to look at me; all I could do is turn my head and look out the door.