This entry won’t be for everyone, but I want to preserve my observations and reactions to having surgery in a country where I am a resident but not a citizen. It centers around female problems so decide now if you want to read on.
During my annual exam with a gynecologist new to me, I had a transvaginal ultrasound, though I don’t know why she chose to do so; perhaps she was just being thorough as I was a new patient. She asked me if I had blood in my vagina; “No”. Well, she saw my uterus was full of blood. Yikes! That really scared me as my mother and her mother had both died from cancer, though not uterine. I was to return for a biopsy which was two weeks later.
Thirty minutes beforehand I took the prescribed painkillers. When she finally called me into her office two hours later she told me I needed to hold really still and that it was going to hurt A LOT. Ohhhh. It sure did, and that was before she even did anything! Being sixty-four, my cervix was closed tight as a drum. There was no way she was going to be able to execute the procedure.
Before she tried she had done another ultrasound and took more measurements. I had more fluid by then which increased the size of the uterus by about three mm. Scared me to death. She didn’t think it was cancer as my endometrium was only 1.5 mm more than it should be.
Another week later I was admitting myself to the hospital to be put under anesthesia so she could open my cervix and do the biopsy. Twenty minutes after I was registered, given a bill for the hospital expenses, and signed three copies of contract that I would not sue them if there was a problem, a nurse, who speaks English, came to take me upstairs to get ready. Dorita had me change into the gown and “boots” and lay down on the bed. She recorded some information, took the results of the EKG and hemogram I had to have done so she could make copies, and then inserted the IV. Interesting to me, she didn’t put it in the inside elbow but lower on my forearm. “You have thin veins,” she remarked. Hmmm. That was a new one. I’ve been told they were tough before; maybe it was a language thing. She also put on an oxygen monitor on a finger and placed electrodes on my chest. A phone call from the doctor’s assistant came through asking someone to come pay the bill.
I was left alone for forty-five minutes while saline slowly dripped. Bill went to pay the bill, about $1200, and move the car as the parking was going to close before I would be ready to leave.
Just before the appointed hour of 7 o’clock, Dorita returned to put me in a wheelchair and transported me to the OR. Bill had to wait outside on a sofa and went out to get some dinner as well. After transferring to a bed, I mentioned to a young man dressed in surgical gear that I was cold. He immediately covered me with another sheet and then rolled a heater to the foot of my bed. He took the long flexible tube, such as one might see on a dryer, and placed it between my legs and on top of my pelvis so it would blow warm air all over me. That was kind of nice! Never experienced that before!
As I waited I suddenly heard a baby cry…..a newborn. I’ve never witnessed the first cries of a baby before. Very healthy sounding!
My doctor appeared in the hallway across the room, smiled, and said we would be getting started soon. Another ten minutes I saw her again, on her phone, and she repeated we would get started soon. Maybe another ten minutes, making it forty minutes past the start time, I was taken into my operating room and prepped for my adventure.
I scooted over to a narrower bed, and then two men took hold of the sheet under me to hoist me further down towards those awful stirrups. The anesthesiologist introduced himself, asked me the same questions about having had previous surgery and for what, and then the assistants did something else new to me. The bed has boards that come out at arm level, perpendicular to the bed. They placed my arms on them making me feel as though I were being crucified. One was for the blood pressure monitor and the other for the IV, I think.
I remember feeling the room swim a bit and then I was gone. About ten-thirty Bill thinks, I was awakened to see the faces of the anesthesiologist and gynecologist looking down at me. The first thing I was told was they took out my uterus because she had made a hole in it. That was fine with me. The pain, though, the pain! I have never felt such pain. I had been given morphine about ten minutes before that and it would take another twenty for it to kick in. I told them morphine doesn’t do anything for me. In the ER for severe stomach pains in January 2013 I had to be given laudunum to be made comfortable. He didn’t seem to know what that was so they ended up giving me something else.
Meanwhile, they were concerned about my level of pain and were afraid I was bleeding somewhere. I was then taken down for an ultrasound with several people in attendance. She was concerned she couldn’t find my bladder but finally gave up saying it was just empty. No bleeding was evident so I was taken back to recovery where I was given something to make me sleep. I remember just before that a nurse, I’m not sure which one, told me I had a large fibroid on the outside of my uterus. I asked if it had hair and nails. She laughed and told me it wasn’t that kind. I remember my calves being wrapped in compression bandages and being told a catheter was being inserted to be sure my bladder wasn’t bleeding. Then I was off to sleep.
I woke up about 6:30 in the morning to sounds of laughter out at the nurses’ station. A nurse soon came in and provided me with a breakfast of rice milk, which was actually pretty good, apple juice, and chamomille tea. I skipped the juice as sometimes it gives me gas. Bill arrived while I was dosing, about 7:45. He had left after midnight and gotten about three hours sleep before Jack, our cat, woke him to be fed breakfast. Wanting to check on me he ate breakfast, dressed, and drove on over.
He filled me in on some more details. Dr. Gazel was looking around my very retroverted uterus and nicked it making a hole. To stop the bleeding she had to cut me open. Once things were under control she went to ask Bill if she should just go ahead and take everything out – uterus, cervix, and ovaries. He hemmed and hawed but since I didn’t need them any more and knowing I was terrified of cancer, he said to proceed. I’m so glad he did!! I think his concern about his decision propelled him to see me as soon as possible to explain everything. He told me Dr. Gazel hadn’t seen any signs of cancer and that the anesthesiologist explained the need for the ultrasound. Also, there was a very large fibroid tumor on the outside of my uterus, about the size of her fist or a tennis ball. It hadn’t shown up on the ultrasounds in her office.
Bill drank my juice and made my tea. It was tepid by then, but wet. I remember several times the night before asking for some ice chips or something as my mouth was incredibly dry. A cloth dipped in water was squeezed allowing drops of water to replenish the moisture in my dessicated mouth. It was enough to ease the discomfort.
After a while the nurse, Rosa, returned to help me wash. I didn’t feel dirty having taken a shower shortly before leaving the house the previous day, so she just removed my bandage and washed my incision. She also made me get out of bed so she could change the sheets which had some brownish blood stains. Oh, my, getting up the first time was not fun, which she told me it would be “fea”, or ugly. When she was done she and Bill helped me get back into bed. Rosa took my legs while Bill supported my back. I was given oral pain meds, another bag of painkiller through the IV and a shot in the arm to help move my bowels along. Apparently, anesthesia creates constipation. At some point I was also given my own bottle of morphine mix with a button to push whenever I felt a need for relief. I only used it twice that day.
Then the two of us dosed on and off for about three hours. I was visited by a nutritionist who gave me lunch choices. I opted for soup which turned out to be watery and lacking flavor. The zucchini and carrots seemed fresh with bites of chicken. I added salt which helped. There was also a bowl of dry rice and a bowl of banana slices.
At that point I needed to pee. Rosa was so happy as Dr. Gazel had already called twice to see if I had been able to urinate. She took me into the bathroom and helped set me on the toilet. She was right that the second time getting up was less “fea” than the first time, though not much.
At some point my friend Jeanne called to see how I was doing. So kind of her.
Then we dosed off again. Bill had a built-in bed which could accommodate two adults, for those people who wanted to spend the night.
Around three I was awakened by more talking and laughing. I thought I recognized my doctor’s voice. Yes, she came in shortly thereafter. She was so happy and relieved I was feeling so much better than the last time she saw me. She gave the run down of the OR experience, told me what I can’t do for sometime, and prescribed medications. I had to call her assistant to make an appointment for the following Tuesday so she could see how I was healing and give me the biopsy results.
She also gave me the choice of spending another night or going home. The cost would have been another $350, about a sixth of the average cost in the States! She was concerned about me riding in the car for a half hour or so but agreed to sign the release. We planned to leave about six, skipping dinner.
We asked about the additional cost as she performed considerably more than a biopsy. Since we don’t have private insurance, she said she wouldn’t increase her fees. Wow! That wouldn’t happen in the States! What should have taken just a few minutes took about three-and-a-half hours. Because the biopsy turned into major surgery, another gynecologist was called in to assist. That added another $600 t0 the bill.
I had to walk so Rosa and Bill escorted me around the second floor. Tentative but steady steps were taken so I was feeling pretty good about leaving. Rosa took out my IV’s and removed my personal bottle of painkillers. Later Bill took me for another walk around the floor and helped me get dressed.
Just before six a nurse came in with a wheelchair and away we went to check out. The bill was about ready, being requested some time before by Rosa. As we belong to a group of doctors who work with Hospital Metropolitano, we were given a 32% discount for the hospital services and materials. The anesthesiologist was separate and charged another $600. The total for everything – medicines, three doctors, materials, room, lab, etc. was just over $5000. Amazing!! That would likely have just been the c0-pay in the States!
I didn’t know how well I would wait for the week to pass to get the biopsy results. I was aftraid I had cancer as I had had spotting a few days before the and had cramps all weekend. Last night, three days after surgery, Dr. Gazel called me to say everything was fine!! I cried with relief! I had hyperplasia, an increase of cells of the endometrium. The treatment was to remove the uterus, but that had already been done. The fibroid was indeed just that, measuring 5.7 cm, which she said was quite large. No cancer!!!!!
Now I just need to keep walking gently, not lift anything heavier than a gallon of milk, and do only light housework. I have two narrow bandage strips over my incision, I have colorful bruises down there, and the discomfort is not bad on meds. I have learned how to get up and down with assistance, though letting myself relax to the point of being a rag doll took some effort. Now I can even get up and down by myself, including getting into bed. Every once in a while I get a tickle on the right side of my throat. Coughing is ghastly as it hurts my bruises so much. I try to be gentle and sip some water.