Maybe I should have thought more

I'm all about being an informed patient.  In fact that was negative feedback I got sometimes, that I explained too much, when I was working.  I also had to watch because the patients that were hardest were the ones who repeatedly "forgot" what I told them but continued to ask and then not listen to why we were doing whatever.

However, I maybe know more than I wanted to about hysterectomies.  I anticipate that I may get an appointment with little time to prepare (wait list type thing).  And because tricky decisions have to be made I need to know about several variations.  The trick is this:  Nobody wants to give me a general anesthetic again.  However only one type of hysterectomy can be done without and it is not done with a spinal all that often.  That way is vaginal.  The other thing about vaginal hysterectomies is that they are typically done on women who have had a vaginal birth.  That, clearly, is not me.  So when I saw Dr. Sweetheart she was speculating that she may be able to work around that to allow me to have a spinal.  I have a deep terror of these. Like terror that says "I will never do that", except that I need to protect my remaining brain cells.  I think it is a leftover from childhood when someone sneaking up behind me was bad.  I can tell one story that alone probably explains this.  We had a canoe (I don't know why exactly) and would go to the back-up reservoir that was a few miles from my house and canoe.  The rules there were that it was to be used for small boats and fishing only, no swimming.  Well, my father believed rules didn't apply.  He enjoyed shaking the canoe to pitch us out, or when we stopped for a break he would throw us in.  One day he hadn't thrown me in and I thought I was free and clear when he managed to sneak up behind me and throw me down in shallow water where I landed on a sharp rock.  It was one of several times people didn't get stitches put in because there was no good explanation.  I am sure I have a decent sized scar back there but can't see it.  So that's what someone coming up behind me is like.  (Incidentally I got so good at not being tipped from the canoe that years later as a camp counselor I took a boy who had cerebral palsy out on the fishing pond in the canoe.  We did fine until he lost he balance and slid off the seat, landing with his feet in the air.  I decided trying to paddle back in with him like that risked tipping with him landing face down in really gross water, so I walked to the front, picked him up and back on the seat and then went back in.  The other counselor was sitting in his canoe, ready for a rescue.  He just said "HOW did you DO that?" and I smiled.  I like-liked this guy and I figured mystery was a good thing.)
 
Anyway I am also worried about the vaginal approach causing PTSD as vaginal pain is not something  I handle well.  And then I read about how there can be a lot of repositioning to open things up as much as possible so that the procedure is essentially done in the giving birth position.  That would be increased for me since I haven't given birth.  And while Dr. Brain promises I will be aware of nothing this sounds tough, as does having vaginal packing.

I also kind of would like them to be able to look around thoroughly since I am keeping my ovaries and have pain there which probably stems from my uterus but mig ht not.  The procedure that is being considered is the only one that doesn't let them look around.

Now, there is no certainty that this will be the procedure.  It depends on whether there is space with the tighter ligaments I have from not having babies and the size of my uterus.  If given 2 choices I'm likely to choose the other unless it is open incision versus this and then I have no idea.  I am hoping that this way doesn't work but I also don't want the whole big incision thing.  Laparascopic would be wonderful but not sure if it's an option for me.

All that I know comes from a brief conversation, not really planning anything.  But I want to be able to ask questions so I've done some reading.  I still am very nervous about that spinal though.  Even though in ways it has advantages, like I would not have pain for some time post op.

I have trouble thinking of any of this as different from the last year's laparoscopy.  But it is different no matter how it is done.  Things are cut and sewn, blood vessels are removed and cauterized, it sounds like in my case my cervix will be cut out and replaced with an ending formed from ligaments or something.  There will be more pain.  I don't know how long I'll stay in the hospital; most go home after a day or so but I had an extra stay for the last surgery and this time we have to be even more careful in the monitoring to prevent anything like that.  So I may be in the hospital a few days.

In some ways I always want to just say "just do the fastest procedure" which is an abdominal incision.  I can deal with the recovery and less anesthesia is best.  The simply truth is that they could give me something to keep me out of it during the procedure and it would be one of the same drugs as last time.

There's also the small issue of whether I can even have a spinal.  (I kind of hope not).  I'll be on the special anesthesia protocol but MAOIs and spinals aren't good friends.

I just now have too many images in my head.  And so, probably do you!


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