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The Best Time I Got an Endometrial Ablation
Now that was a good time. Last November I had the endometrial lining of my uterus basically razed to the ground, and it only took like 20 minutes. Pizza delivery takes longer, and you don’t even get anesthesia.
Endometrial ablations (removing the lining of the uterus) are generally performed on super-heavy bleeders, to help reduce the flow. Various methods are used, some of which sound more frightening than others: lasers (!), microwaves, radio waves, extreme cold, or extreme heat. My doctor uses the mesh method, brand name: Novasure, which you’d best believe is a registered trademark. This mesh is somehow positioned along the uterine wall (by a certified mesh-positioner, I am guessing?) and then — check this out — ELECTRIFIED. Burns that endometrial lining right off, and the resulting scar tissue makes it much harder for any more lining to attach (and then be ejected) in the future.
I may have exaggerated tales of my flow to get this procedure. Any flow is too damn much, I tell you. I’m quite done with babies, but too young for menopause; I just didn’t want a period anymore.
The first two days of my cycle were always marked by bone-deep fatigue. Like, fall asleep if I sit down fatigue. I missed work every month because I couldn’t stay awake that day or two. It made me go into “junkie mom” mode, too — Mama’s gonna be face down on the couch for a while, so go have some cereal for dinner. I do quite a few athletic events each year; nothing is more maddening than training for three to six months for an event only to have race day tanked by getting my period. And then if race day was a Red Flag day, I could get through it with adrenaline propping me up, but it was no damn fun. And all those 6 a.m. Saturday training runs were for nothing!
I first heard about this procedure at a triathlon expo seminar titled “Managing Your Cycle during Training,” presented by a gynecologist with the delightful nom de practice of OBJen.
OBJen proposed a handful of methods, some of which I’d already tried: skip-the-placebo-week birth control pill, hormone-fortified IUD, progestin implant, and then endometrial ablation. I’d tried the first option for about six weeks, gifting me with six straight weeks of PMS, so I wasn’t cool with hormonal intervention. I already had a non-hormonal IUD in place, which was not helping matters any. An endometrial ablation is no guarantee of total period stoppage (only about half the women who have it done stop cycling entirely), but I was desperate for any help in this area. A 50% chance? I’d take those odds.
One downside is that I would still have to use birth control, because if an errant egg does find purchase in my womb without that lining, it’s apparently a very nasty business for all involved: there are higher rates of miscarriage, tubal pregnancies, and all sorts of pregnancy complications. On the upside, I’m not getting laid any time soon anyway, so that was not a big issue. Okay, maybe that’s kind of a sad upside. Still, I could take the money I was spending on those pricey OB tampons and buy Qream instead.
A few months after the expo, I had my annual gyno exam. “I’m not coming back to the office ’til I get the go-ahead for my endometrial ablation!” I told my co-worker. “Oh. Kay,” she said. “Good luck with that.” Most of my friends had the same reaction of confused, slightly concerned wonderment when I told them I was getting this procedure. Like me, no one had ever heard of it before. But my mom had! An old hand with surgical matters as an OR nurse and boss lady, she responded the way she does to news of most procedures we might tell her about. “Oh, we’ve been doing that since ’98. It’s no big deal. Go for it.”
Turns out I had to persevere over the next six months or so after the exam where I first asked for an ablation, as the doctor told me to first schedule an IUD removal and wait to see how that helped. Removing the IUD did decrease the flow somewhat, but did nothing about the face-melting fatigue.
I impatiently waited a few months, then went back for another consultation to move the process along. Having ruled out the IUD effect, my doctor was quite open to the ablation option. She scheduled me for an ultrasound and an endometrial biopsy to check for any funny business. (Fun fact: the day these procedures were performed, my daughter started her period: CIRCLE OF LIFE.) The sonogram showed a wee burst of something off one of the ovaries, which my doc said is normal and probably indicated a recent ovulation — but I still had to wait another six weeks and get another sonogram before we could schedule an ablation. Ponying up a $35 co-pay each time I went near this doctor’s office was getting me mighty irritated with this stop-and-go process, but six weeks later, the second sonogram was all good and I was scheduled for the next month.
On the morning of, the prep for the procedure took about an hour. I had to go sit in an exam room to get robed and IVed up, sign waivers, meet the disconcertingly attractive anesthesiologist, and so forth. Then I went into another room for the procedure. The room was full of people, but a lovely twilight sleep quickly knocked me out and then left me clearheaded afterward to stare at the clock in wonderment. Finally, off to another room to sit in an armchair for about 30 minutes before I was cleared to go home.
This lack of pain or bleeding made me suspicious, as I had only been under for about 20 minutes. My mom, the day’s designated driver, had been hanging out in the waiting room, so I asked her if maybe the surgical team had put me under and then just snuck out for a smoke break. “They didn’t walk past me,” she said, and I believed her because she too is a medical professional, she was sitting near the door, and the office has no second exit.
Really, the whole thing was a bit anticlimactic, because the result was essentially nothing. I had no pain, no bleeding, no cramping, and after one more super-light period, no more periods either. And no more life-destroying fatigue, most importantly. There was, as prophesied, a slightly singed smell issuing from my nethers and some clear discharge for about six weeks. The discharge is supposed to stop after two or three weeks, but I never bothered to go to my post-op appointment to ask about it (don’t do this! Go to your post-op appointments, everyone!). During the pre-op appointment, my doctor issued me a hefty prescription for Percodan, so I assumed I’d be in pain afterwards. I took half a Percodan when I got home, just in case, but really I was just sleepy that afternoon. The rest of the Percodan languishes in my medicine cabinet, awaiting its day on Craigslist (KIDDING).
Obviously, this process probably won’t be such a breeze for everyone. I’m guessing the gals who get cramps on the regular (I rarely did) would be more likely to have them after this procedure. Also, some people’s anesthesiologists won’t be dreamy and their periods won’t come to a screeching halt, but we have to do the best we can with what we’ve been given.
Maureen Kelly lives in Austin with a variety of mammals and rides her bike a lot.