I don’t only write about depression and therapy. Some of you dear readers may recall that I sometimes discuss the fact that I’m suffering from pelvic floor prolapse. Essentially, the walls of my vagina are caving in, and I need surgery to fix it so my uterus doesn’t fall right out of me. (I know, yuck, right?)
Originally I was going to have this surgery back in December, but I postponed it after a preparatory test triggered me. I realized that I needed more time to understand exactly what I was getting into, and to ensure that I would be both physically and emotionally prepared to cope with everything.
When I finally talked to the urogynecologist about this, she suggested I schedule an appointment with her to talk about the details, as well as a separate one with her nurse, who use to work on the floor with patients after surgery and who would understand better what it would be like beyond the recovery room.
I had that meeting with K., the nurse, last week. She is in her mid-thirties, tall, strong, fit. It’s very clear that she doesn’t know much about sexual abuse. She wanted to be supportive but was uncomfortable and awkward in our conversation. She was good at describing exactly what incisions I would have (5-7 of under an inch each, assuming nothing unexpected comes up),what things the floor nurses would be checking for, and what would be likely to be painful. But she could not say the words “sexual abuse” and only once said “history.” She told me that I would be the one who could best advocate for myself about what I needed, and that if I didn’t get it, I could talk to the floor nurse, and if I still didn’t get it, I could talk to the house supervisor. Her examples were all about advocating for the pain relief I might need. In my head, I translated that into advocating for the respect and dignity I need to have from anyone touching my reproductive organs.
K’s assuming, of course, that it is easy for me to advocate for myself in my daily life. Never mind that I may be groggy and/or in pain, and that the floor nurses may or may not be sensitive to survivors of sexual abuse.
I think that I will write a note ahead of time saying something like, “I do not want anyone to touch me to check on anything without first telling me exactly what they are going to do.” I’ll deliver that, but then I will ask my husband to be my champion and repeat that message if I’m not in good shape to do so. I just can’t stand the idea of nurses or CNAs poking around to see if I’m bleeding or how my incisions look or checking my catheter (ick) unless I’m prepared for it.
I’m scheduled later for a similar meeting with the doctor as well. And then I’ll probably have the surgery in April sometime, after I finish a big project at work. I can tell the internal situation is getting worse, so to my surprise I’m actually becoming eager to have my insides cut up and reconstructed (sans uterus, in the end). I would love to get it fixed before I’m at work one day and suddenly find myself in the uncomfortable and embarrassing position of trying to shove my uterus back inside myself before anyone notices that it’s fallen out. That would be quite the predicament.
After my meeting with K., I looked around online and found an article from the American College of Obstetricians and Gynecologists about working with adult survivors of childhood sexual abuse. So it’s not as though no one has ever thought of this before. But events seem to have put me in the position of educating my doctor and her nurse. Perhaps it’s karma, the universe giving me an opportunity to speak up.
I’m even thinking I might write a piece like, “10 Things Survivors of Childhood Sexual Abuse Want Their Gynecologists To Know.” I’d love to include ideas and suggestions from those of you with opinions on this topic. What do you think?
P.S. Why do literally ALL the images I found online related to this condition and the surgery only portray white women, generally young, thin white women? That’s another thing I think gynecologists should be attending to–making sure that women of all races, shapes and ages can see themselves getting the medical care they all deserve.