Q

And What, Pray Tell, Is Happening With That Uterus?

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?)

pelvic-prolapse

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.

 

 

 

 

33 comments

  1. So many good things in here! Three in particular: representation in the literature, your potential “10 Things” piece, and your idea for a note requiring informed consent before you are touched (and having your partner back you up on that when you’re vulnerable).

    It sucks that you have to do the educating. In this day and age, and all that.

    Liked by 1 person

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    • Thank you! I am a bit surprised that I have to do the educating. I’m going to write more about that probably this weekend, because now I met with the doctor too, and I just don’t understand why it’s so difficult.

      Liked by 1 person

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      • And how is it that medical “professionals” can ignore something affecting so many people?!? I really do want to to write/speak up about this, though I don’t know yet how or when.

        Liked by 1 person

      • Well, statistically speaking, at least some of the (both female and male) health care professionals dealing with you have also survived sexual abuse. So this blank wall of incomprehension and awkwardness you’re facing is especially odd. Although denial is a powerful thing.

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  2. While I was reading this, I was taken back to something I saw earlier today. Something that might be helpful for you. I saw a sheet of paper divided into post card sized pieces. Each post card said the same thing. It was for parents of special needs children. Each post card gave a quick description of their child’s differences…whether it be looks or behavior and why, or what to expect. It was for parents to hand to people who stared or made inappropriate comments because they were unaware of the child’s needs/differences. It can be easier than trying to have an emotional charged conversation with someone who doesn’t understand and somehow written words are more of a statement then a request.

    I think it could be really helpful for you to keep a stack of these cards with you in your room and one attached to your chart, especially considering you may not be able to communicate your needs if medicated.

    Perhaps it’s something simple like titled “Abuse Survivor – please see special instructions below for handling this patient” Then a list of what to do or what not to do.

    It also might be something that you can share with other survivors in similar situations to give them a voice when they are unable to advocate for themselves.

    Liked by 3 people

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    • I definitely do think that written communication will be helpful. I feel weird, though, handing out something that says ‘Abuse Survivor’ because I worry that will become my identify as far as they are concerned. I am still figuring out in my head what my letter might look like…a

      Liked by 1 person

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  3. I love this idea of having something to hand out to everybody about your needs. My biggest thing for that 10 Things is that I may appear fine, but I may be partially or totally dissociated when you are touching my private parts, and while you can’t see this, it is still traumatic for you to touch me in anyway that feels out of my control.

    Liked by 1 person

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    • Thanks, Patty, I think you are right. One thing they need to know is that they may not be able to see it when we are very upset about what is going on. That was definitely the case back when I had the bladder study back in November. On the outside, they couldn’t see anything, but on the inside, there was a lot going on.

      Liked by 1 person

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  4. Can’t even begin to tell you how amazed I am by your courage. I don’t know that I could go thru that surgery.

    Certainly one thing you MUST include in your 10 Things write up: If a patient is crying uncontrollably, don’t say things like ‘it’ll all be over soon’ and continue to shove instruments and your hands up inside of her. Stop what you’re doing. Completely. I had a doctor do that to me, and I STILL don’t trust any of them. Can’t do a pelvic exam at all.

    Liked by 2 people

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    • That makes me furious a doctor would do that to you – it is both harmful in the moment and very long term, because now you are not comfortable going for pelvic exams, which are supposed to be a routine part of preventative health care.

      Liked by 2 people

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      • My current doctor is quite concerned about it. I tried a pelvic exam with her; different place, different doctor. I was completely hysterical.

        My original story gets worse; at one point the doctor walked out of the room and left the door wide open while my feet were up in the stirrups. Just thinking about it…*shiver* I probably should have sued, should have stood up for myself. All I wanted to do was get out of there.

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      • That is shockingly unprofessional! How can any doctor think that is okay?

        Maybe in time you will be able to figure out a way that you get the medical care you need but also stay emotionally safe. My therapist always emphasizes that both matter a lot.

        Liked by 2 people

      • Please don’t worry about following the instructions, this was just a way for me to say I admire you! You are brave and you have had a rough go of life. Just based on the fact that you’ve come this far, I have confidence you will find your place of peace.

        Liked by 1 person

  7. For the top 10, how about something like “if you have feelings about my history, please take care of yourself and talk to someone, but not me.” I guess my point is that I had a (female) gyno once who was doing a cervix biopsy. She did the biopsy part (where she took a small piece of my cervix) without telling me, and I had a complete panic attack/reaction that ended with blood all over the room and me totally traumatized. And she was pissed at me! She acted really angry that I told her to stop the procedure and her feelings were not helpful. I would have rather her consulted with someone else or hold it in and debrief after. She seemed annoyed and put off. It was very unprofessional.
    On your end -well done. And your title made me smile 🙂

    Liked by 1 person

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  9. It’s been almost a year to the day since I’ve been back to the ObGyn. The last time I went I was bleeding and I never bleed. I was visibly upset and anxious and she wanted to call my T. The ObGyn wanted to prescribe me Xanax. Maybe if she had known what was really going on or I don’t know if that would even help. Some doctors are just more in tune than others. My chart should just be noted-emotionally sensitive!

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      • And she never followed up with you to talk about it or see if you were ok? That’s what I hate, I think doctors shouldn’t be so afraid of women’ emotional reactions.

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      • Of course not. She followed it up with a vaginal ultrasound and a regular ultrasound to ensure I wasn’t pregnant. Also got a pregnancy test and the nurse called the next day to assure me I wasn’t pregnant. Which of course I wasn’t. My T attended to me that day and was very helpful and understood exactly what was going on.

        Liked by 1 person

  10. I have to say that the condition of a prolapsed uterus, really scares the SH#T out of me!!! Actually, a prolapsed anything frightens the hell out of me. You should definitely write that blog post regarding survivors of sexual abuse. Ideally, they need a nurse trained in this area who can advocate for them. Xx

    Liked by 1 person

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