Saturday, May 30, 2015

The Tubal Ligation Experience of my Dreams

Yesterday, I finally achieved something that I've wanted for a long time: sterilization. If you remember, in August, I attempted to have the Essure procedure done, and we had to abort it because my fallopian tube was spasaming and my doctor couldn't get a good implant of the coil. I left feeling heartbroken and dismayed, and with a lot to think about. I had chosen Essure because it was non-invasive and performed outpatient. I had chosen it because I was afraid of anesthesia, so when my only remaining options were to go under anesthesia, I really had to think about it.

Why am I afraid of anesthesia? Quite honestly, I watch too many medical dramas. Anyone remember that episode of Nip/Tuck where the patient wakes up? Yeah. I didn't want that to be me. I'm a rational person, though, so I did a lot of research ahead of time. I also had the support of friends and family who had themselves been under anesthesia, who were able to share their own experiences and allay my fears.

Of course, I got a lot of "why would you do that?" and ""what if you change your mind?" from coworkers. Others were surprised my doctor agreed to do it without me having any kids already. Ladies: if your doctor won't consent to you having a tubal without having a real conversation with you about your body and what you want, you need to find another doctor. My primary care provider has known I don't want children since I started seeing her in 2007-2008, and when I started making noise around 2010 about wanting to be sterilized, she said "you're 30, I think you know what you want by now." She referred me to the office that attempted my Essure procedure, and even there, I wasn't assaulted by a barrage of guilt-questions. In fact, the doctor only asked one: "what will you do if you and your partner change your minds?" to which I bluntly said "adopt, because 'get more cats' probably isn't socially acceptable."

I have to say, as nervous as I was about having an invasive procedure, I made sure I researched how a laparoscopic bilateral tubal ligation was performed so that I would be well informed on the day of surgery. As well-informed as I try to be, I have to give credit to the amazing staff at Maine General. I was brought to a room where my vitals were taken by my nurse, Linda, who reminded both John and I of the actress Francis Conroy and told us about the best Goth clubs (the best happens to be called The Castle, and is in Tampa, Florida, if you were curious). She put me a lot at ease and at one point, got into a debate with us about how many times Rutger Hauer has played a vampire in movies and demanded John look it up in IMDB. She was compassionate and personable and took great care of me. That's what a nurse should be. She was also the first of many of the staff to compliment me on my nails.

I had the lower left option
I met my anesthesiologist, Dr. Brackett, who was amazing. She listened to my concern about intubation (mainly, I wanted to avoid the discomfort of being intubated, not that I had a real medical concern) and she was all for not intubating me, citing studies she had read, however, her vote was outweighed by the rest of the staff and I was to be intubated anyway, which was fine. She also asked me about my teeth, and showed concern that my one front tooth is mostly dental composite (remember, I had an emergency root canal done a couple months ago). She and her anesthesiology team made sure I had a mouth guard in case I clamped down after the tube was taken out, which I never even would have considered a risk. I actually had a team of three anesthesiologists: Dr. Brackett, an attending, and a student. They were all awesome (and all loved my nails). They wheeled me into the operating room which was really cold, but wrapped me up in warmed blankets, so I was very comfortable. The put the mask on my face and didn't even make me count backwards, just a few deep breaths and then I woke up in recovery. According to John, I was only surgery for about 40 minutes before I was taken to recovery, and I was there for an hour and a half, coming out of anesthesia and receiving pain management (fentanyl, which I surprised my recovery nurse by knowing that it's often delivered in a trans-dermal patch).

From recovery, I was brought back to my room where my wonderful nurse Linda checked my pain, took my vitals (I remember the blood pressure cuff would automatically inflate periodically, which was cool). The most painful part, honestly, and I say this from the couch the following day, was the CO2 gas that they inflated my abdomen with. It actually felt like the worst period cramps ever, including the back pain (I told them it would probably go to my back and not my shoulder). I slept a lot yesterday, and John was wonderful, setting alarms and getting up with me so I could take my pain meds throughout the night in order to keep them constant in my system.

Now it's just recovery time, and a followup appointment in two weeks. I'm so happy that this was so easy, and so happy that, after this pack, I can go off of hormonal birth control forever. I'm happy that I have health care providers that listened to me, as a woman, about what I wanted to do with my body, and that political agendas weren't thrown around to suppress that. I can only hope other women have such a positive experience making similar decisions for their bodies.

Thursday, April 2, 2015

Why do we Make Medical Procedures Scary? Or, I had a Root Canal Today

After a night of excruciating pain, I called my dentist and they were able to get me in (for which I am very fortunate). A few months ago, I had had a similar pain in my front tooth, and it was caused by clenching and grinding. The tooth was slightly longer than the other, so it hit on my bottom teeth first and with more force, causing the ligaments attached to the tooth to become inflamed. I figured I had the same problem again, and thought "this will be a quick fix; he'll just drill down the tooth a little more again."

After x-rays, however, my hygienist (who has the most ridiculously long lashes but I'm too shy to ask if they're real or extensions) showed me on the film that I had an abscess. My mom used to get them when I was a kid, and I knew they were painful and dangerous if left untreated. Then I was told my two options: pull the tooth or root canal. Both options put me in a panic. I live in fear of having "Mainer teeth," meaning not all of them, and obvious gaps. I could not have a missing front tooth. I know, it sounds terribly classist to say, but image is important to me. The other option was root canal, which I had only ever heard horror stories about. I opted for the root canal. I knew what to expect from past research (WebMD is only a click away!) so the little informative video my hygienist showed me was nothing new.

I got a shot of Novocaine and then two shots of something stronger. I was so tense it was visible and my dentist had to tell me to relax. Now, it wasn't a painful procedure, by any means, since I was numbed up, but it was still very uncomfortable. Apparently, my tooth  was badly infected, as they needed to use surgical suction, which felt awful. A root canal, however, removes the nerve, so the tooth itself doesn't hurt. I could do it again, if need be (not by choice!). The relief was almost immediate. I'm still tender and afraid to eat (I'm in the "draining" process. The canals get filled next week) but compared to this time last night, I'm so much better.

We all experience things differently, but we need to talk in a more positive way about medical procedures. Root canals aren't fun, but it wasn't the absolute horror show everyone always makes it out to be. Kind of like having a pap smear, I worked myself into an anxiety over something that was just not that bad. Had I ignored the pain (ha!) the abscess could have gotten much worse, eaten through the bone of my jaw, and even caused sepsis as it seeped into my bloodstream (I actually have another abscess in a wisdom tooth that I need to get pulled because that's what it's doing, draining into my bloodstream). I'm starting to wonder what other "awful" procedures are just not that bad.

Thursday, January 15, 2015

We Are Not Our Diagnosis

I originally started this blog back in 2012 as a way to process and cope with my diagnosis of Bipolar Disorder I. I felt the need to be candid, as at the time, I couldn't really find people talking openly about their disease. I explored my struggles with being unemployed, tracked mood swings, sometimes talked about what I was reading or watching. The blog, in turn, became a reflection of my day-to-day life. I haven't kept up with it as well as I would like in the past couple of years. I wanted to write last night, but I was too emotional and hadn't had the time to process my feelings or form coherent thoughts on the matter.

Recently, a man was shot by a (relatively new) police officer at the outpatient offices of the state psychiatric hospital. A few days later, he was identified as someone I had worked with, who I had recently trained at work. The article listed off all of his mental health disorders, which left a sick feeling in my stomach; I couldn't help but feel his privacy was being violated. I felt incredibly heavy and sad as I read the dossier and the laundry list of suicide attempts. Why was that necessary to publish? He will be in the hospital for a while recovering from the use of deadly force (why was that necessary? Why? And why was a rookie cop sent alone to deal with an escalated situation like that?) but I couldn't help but wonder how he would be treated if he returned to work.

I know, deep down, how he would be treated: people will ostracize him, fear him, avoid him, and be cruel to him. I already know people are gossiping; I have made it a point to avoid interacting with anyone that worked around him and am focusing on the class I have. I really don't want to hear malicious gossip about it, hear people say "he sat right next to me! He could have snapped any time!" Stop. This isn't about you.

The person I know was enthusiastic and eager to learn in class. Even after graduating class, he would get excited about his sales and share them with me. The person I know laughs at his own horrible pun jokes. He will openly bum a Pepsi from you on Wednesday and buy you a replacement on Friday. He enjoys walking in crisp weather while listening to heavy metal. He is friendly and loquacious. He is not Coworker With Schizophrenia. He is not his diagnosis, no more than I am Melissa with Bipolar I.

Behind the gossip and whispered "OMG I worked with him," and the "did you hear?" we must realize that he is still a person, a person with real feelings, with a name. He is not his diagnosis. He is a man who met a breaking point in life, but also a man who realized he had an illness and was voluntarily seeking help.

So please, if my coworkers read this, I don't want to talk about this, not at work, not outside. I don't have time for the gossip. My mind is preoccupied with concern for his well-being, that he heals well and without complications. He was not my friend, per se, but he was my student, and good person.

And he is not his diagnosis.

Tuesday, December 9, 2014

Good King Wenceslas

While I have other things on my mind currently, I wanted to take a moment to talk about something else I've been thinking about. Since Thanksgiving, I've had a CD of Christmas music on repeat in my car (yes, I'm one of those people). On that CD is a rather nice rendition of Good King Wenceslas, which has long been a favorite of mine (and easy to sing). Whether you hold with academics that argue it's foolish to be a Christmas song when the original tune was a Spring song or not, it still has an important message that I feel many people in the commercialization of Christmas ignore: taking care of others. Let's take a moment to look at the lyrics:

Good King Wenceslas looked out
on the feast of Stephen,
when the snow lay round about,
deep and crisp and even.
Brightly shone the moon that night,
though the frost was cruel,
when a poor man came in sight,
gathering winter fuel.
Hither, page, and stand by me.
If thou know it telling:
yonder peasant, who is he?
Where and what his dwelling?
Sire, he lives a good league hence,
underneath the mountain,
right against the forest fence
by Saint Agnes fountain.
Bring me flesh, and bring me wine.
Bring me pine logs hither.
Thou and I will see him dine
when we bear the thither.
Page and monarch, forth they went,
forth they went together
through the rude wind's wild lament
and the bitter weather.
Sire, the night is darker now,
and the wind blows stronger.
Fails my heart, I know not how.
I can go no longer.
Mark my footsteps good my page,
tread thou in them boldly:
Thou shalt find the winter's rage
freeze thy blood less coldly.
In his master's step he trod,
where the snow lay dented.
Heat was in the very sod
which the saint had printed.
Therefore, Christian men, be sure,
wealth or rank possessing,
ye who now will bless the poor
shall yourselves find blessing
In this holiday season, remember to take care of others, even if they aren't family. You don't have to be Christian to do this (I'm certainly not) or rich. Sometimes you can do something simple to help others out. Are you crafty? Can you knit or crochet? Children's homes and homeless shelters are always accepting of gloves, scarves, hats, etc.. If you don't have the funds or the skill, volunteer work is always appreciated by nonprofits that work hard to help people in the winter months. My friend Veronica made a rather thorough list if you want to donate money but aren't sure what charities are actually helpful and not exclusionary (Salvation Army is widely known for it's homophobic discriminatory practices). Here is her (unedited, for your pleasure) post on charitable giving:

So it's that time of year again where the bell-ringers are out guilt tripping people, and just like I did last year, I want to point out that the Salvation Army is incredibly homophobic and transphobic, PETA is a bag full of diseased dicks, FCK H8 is basically just a money-making fraud, and Autism Speaks has been denounced by the autistic community. I listed some breast cancer charities a while ago that are worth donating to, but I also would like you to consider donating to these other charities if you feel like donating this holiday season: the ACLU, Doctors Without Borders/ Médecins Sans Frontières (MSF), Goodwill Industries (SA's non-asshole counterpart), Oxfam International, The SEED Foundation, Planned Parenthood, Toys for Tots, or the ASPCA. Also consider giving to no-kill animal shelters or donating clothing to trans exchanges. Remember also that the things people most need in homeless shelters are things people usually don't think of, like toiletries, feminine hygiene products, and first aid things like cortisone cream or Neosporin. If you're doing "care baskets" for homeless people on the street, remember not to add food, but rather money (or the items I mentioned above), since homeless people have allergies too and they don't have access to medical services like we do. Okay, I'm done. Give wisely, my friends. 

Friday, August 22, 2014

A Roadblock

Today I experienced a disappointing setback in my reproductive health.

I got a call from the office that was going to perform my Essure procedure yesterday morning, letting me know that the appointment I had set with them two months ago couldn't be kept. They gave me the option of having it done today or on September 3rd. Since the later date would be impossible with my schedule, I chose today's date, for 10. I scrambled to prepare (without a functioning car at the moment, it was difficult, but John was incredible). I picked up a prescription for misoprostol and Vicodin at the pharmacy after work, packed a bag for the weekend, and headed back to John's for my appointment. This morning, the office called me stating they could get me in an hour earlier than anticipated. Hell yes, let's do this! I popped the Vicodin and we headed out.

By the time we got to the hospital, climbed the stair and got to the office, I could feel the effects of the Vicodin. They had me do a urine test, get a shot of Tramadol in each buttock,  and strip from the waist down. While I waited for my doctor to come in, I got dizzier and hot from the Vicodin. I wondered how on earth anyone could enjoy taking it recreationally. It just made me feel awful. Up to that moment, I was prepared, but I started to get nervous, so when the doctor asked me if I wanted anyone with me, I asked for John. I'm so glad I did.

click for larger image
I'm not the kind of person that sugar coats anything, and I won't here. It hurt. I didn't think it would hurt as much as it did, with the Vicodin and shots. The initial opening of my cervix was so uncomfortable, the camera going in hurt. It was like my worst menstrual cramps, multiplied by ten. She started on my left side. I tried to focus on my breathing and squeezing John's hand. We made small talk with the doctor. Things seemed to be going good as she got a visual on my fallopian tube, but when it came time to insert the Essure coil, it was clear there was some difficulty. She told me my tube was spasaming so it was difficult to place. She tried one more tool to facilitate placement: a spreader for my tube. It hurt. A lot. A sharp stabbing pain and that's when the first tears came. It was the last attempt and I was starting to feel a little despair too. She withdrew the instruments and talked to me about different options. Essure under anesthesia, or a laproscopic procedure with clamping the tubes. I hadn't wanted to be that invasive, which is why I chose Essure to begin with. I left kind of an emotional mess. Where some women leave a gynecologist's office upset because they can't have children, I was distraught because after wanting sterilization for so long and having an amazingly supportive primary care physician and a good doctor to perform the procedure, I was still intact and able to get pregnant, which is the last thing I want in life.

This is not to scare people from Essure. People tried to scare me from it. It's not a bad procedure, but it didn't work with my body, and it does hurt. My cramping has subsided but I am bleeding some, which is to be expected. I'm just filled with an incredible disappointment. I was really looking forward to a new chapter in my reproductive health, being able to get off of hormonal birth control and not having to worry about an unwanted pregnancy. I was looking forward to, in three months when the dye tests would have confirmed occlusion, of having an anti-baby shower with friends and lots of drinks. Now I feel like I'm in a holding pattern again, having to delve back into looking at my options and researching what might be the best course to go with.

But first, I need to process the emotions. I'm going to lay low for the weekend with John and relax. Then I can think again.

Thursday, August 14, 2014

It's Important to Talk About Depression

If you've been reading my blog from the beginning, or even just found it and are exploring older posts, I started writing this as a way to work through my own depression and diagnosis of Bipolar Disorder. People who have talked to me are often surprised that I'm so candid about my mental illness. I feel it's important to talk about mental illness instead of hiding it away like a dirty secret.

Shortly after Robin Williams' death was announced, my nephew's friend committed suicide. I've held off a few days writing about this because it is a triggering subject, and I wanted to give it some space. However, from what my sister told me in our conversations, this teenager was the "funny" kid, a good kid that no one suspected was harboring any sort of suicidal tendencies (kind of like Robin Williams). You will never truly know what's going on inside the mind of someone suffering from depression. Often, you don't even know they're suffering. There is such a  terrible stigma surrounding mental illness, and it needs to stop. It's absolute bullshit.

It's important to create open, honest dialogue, and create safe spaces where people can talk about depression and other issues. Victim blaming, telling someone to "get over it," or otherwise getting angry at the person is counterproductive and harmful. Last night I read an amazing article in response to the "people who commit suicide are selfish" trope that people like to trot out during a tragedy like this.

I am very candid about my struggles, but I also had the wherewithal to get help. For some people, they're too scared. I always hoped that if my blog, my honesty about my disease helped just one person, I was doing good. I've worked hard to be a functioning adult and to not let my diagnosis define me. Not everyone is me. If you think someone close to you is struggling, the best thing you can do is offer your support, and if you suspect someone is suicidal, make sure they have the Suicide Prevention Hotline, or the number to a local crisis center. Sometimes, just talking to a person helps. I know. I've had to talk two people out of suicide in the past, and they are both still alive today.

In closing, though, can we stop sharing this stupid meme? As a person with Bipolar I that has severe depressive episodes and the occasional panic attack, I find it offensive. My disease is due to a chemical imbalance, not some bullshit "trying to remain strong for so long" crap. Don't trivialize a real disease. Plus, it smacks of ineffective slactivism. Support people, don't just post a meme.

Tuesday, August 12, 2014

Race and Media

As horrible things happen in this world, I try to process them and my feelings about them, lest I get bogged down in the sorrow and hopelessness that I feel often for society. Originally, I was going to write about depression and suicide, but I'm going to save that. I've been stewing on something for a while that's been bugging me, and some articles I read on my lunch break made me think more on it.

If you haven't heard about the recent shooting of unarmed teen Michael Brown, it's another instance of police violence against a young African-American. While this violence is disturbing, that's not my focus here. It's how things are going down in the media. In this article, we look at how he was portrayed by the media, throwing a peace sign that's depicted by the press as a gang sign. Racial profile much? It's spurred an interesting movement in social media with the hashtag "#IfTheyGunnedMeDown," encouraging young people of color to post two photos to guess which one the media would show in a similar circumstance. It's a fascinating project, and reminds me how quickly the media is to sensationalize things. This bright young man was gunned down just before his first day as a college student, yet he, the victim is being depicted as a thug. What the actual fuck, media?

It made me think about the recent death of a local teen here in Maine. Immediately, the headlines struck a sour note with me: "Winthrop girl with 'everything going for her' dies suddenly." She wasn't gunned down-- it was a result of a pulmonary embolism which is horrible enough-- but as I looked at her blonde hair, light eyes, and white skin, I wondered "why is this a top news story when people--even children--  die every day?" I'm not speaking poorly of the dead; I didn't know this girl or her family and to lose a loved one, regardless of circumstances, is terrible. But it still made me think.

If she had been a black girl under the same circumstances, would it be news?

Maine is a pretty whitewashed state, racially. We have a pocket population of ethnic Somalis in the Lewiston area, but aside from that, where I live in Central Maine, the population is pretty damn white. There were two African American kids in my school growing up, and one died my junior year in a car accident. So if the young lady who met her end to soon was African American (or a darker Hispanic, or Asian, or Middle Eastern, etc.), would there have been as much press? Would there have been immediate movement for fund raisers to help the family? Would traffic have backed up on major roads outside of the funeral? I seriously doubt it.

Issues of race are still prevalent in the United States in 2014, and it's terribly depressing.