Tubal Ligation Play-by-Play (Follow-up to yesterday's post)

For anyone that hadn't seen my previous post, I'm going in for a tubal ligation tomorrow, and I'm going to do a post about the process and procedure for those interested in hearing a first-hand account of what all is involved. Now, this is just my personal experience. I'm sure this process is not the same for everyone, but if knowing how things can go from someone experiencing it can help anyone make a decision to have this done (or not), or answer any questions, I'm all for doing what I can.

Quick Background:

I have never wanted children. My husband does not want children. I also have a pretty serious pregnancy phobia that makes even the thought of becoming pregnant thoroughly make me uncomfortable, to say the least. I had wanted to do this for years, and now have the opportunity to have it done. I decided to go this route, as opposed to my husband getting a vasectomy, because I want to have control over my BC. If my husband were to get snipped, and then we were either to separate, or something out of our control were to happen to end our relationship, I would again need to find BC. It also wouldn't protect me in the case of a sexual assault. Now, sometime down the road, my husband may very well get a vasectomy, too, so we can be extra safe. It is something we have discussed.

Getting Started:

I had initially begun looking at permanent BC almost 7 years ago. Unfortunately, I didn't have steady health insurance, and procedures like tubal ligation were usually not covered to any real extent by plans available at the time, at least for cases like mine. At that time, I was also under 30 and had heard numerous stories of women being denied or talked out of getting permanent BC by Dr.'s. (I had first hand experience of this during a routine GYN checkup about 5 years ago. When taking my patient history, I stated very emphatically to the nurse that I did not have, and did not ever want children. The look of disgusted disbelief she gave me said it all. This was followed by the Dr. telling me that I'd "change my mind, the biological clock is a powerful thing" and not to rush into any big decisions. And these were both females, in a Family Planning Clinic, no less.) So I put it off for a bit longer, waiting until I was 30. I had just begun seriously looking into the Essure procedure and looking for a Dr. in my area that could preform it, when I lost my insurance for nearly a year after being laid off from my job due to budget cuts. So things got pushed off even more. I signed up for insurance through the ACA during open enrollment last year. In early November, I called the nearest clinic that did Essure (a 45 minute drive over a mountain pass away. Hooray Wyoming) and after talking to a very helpful nurse about the different procedures available, I scheduled a consult for early January, after my new coverage went into effect. I sensed no judgement or weirdness from the woman I talked to, which was great.

Consult/Initial Appointment:

I arrived at the OB-GYN clinic and filled out all the needed paperwork. I had specifically requested a female Dr., and had my laundry list of reasons I wanted to get this done rolling through my head, ready to fight for what I wanted if necessary. After speaking with a (much friendlier and understanding) nurse, I met with Dr. F. While she was very intent at first on telling me about all the other non-permanent BC options available (IUD's, implants, etc.) once I was able to explain to her all the reasons I didn't want those other options (I had researched all of them, and ya know, really don't want kids) she spent a bit of time making sure I was totally sure. She made sure to let me know that she wasn't asking these questions to be patronizing or patriarchal, she had just been in the practice for long enough to have seen several cases of women expressing regret at having the procedure done. We then went over the consent form, she told me about all of the rare, but possible things that could go wrong, and had me sign the form. I then had to have a basic pelvic exam to essentially make sure everything was were it should be, and she couldn't feel any tumors or growths that may cause problems. Once I was decent again, we discussed the time frame I was looking for, she said the surgery center would contact me in a week to confirm a date, and I was on my way.

Insurance: I have a silver level plan through the ACA, with Blue Cross Blue Shield. Because BCBS follows the birth control mandates set forth in the ACA, this entire procedure will cost me absolutely nothing. I still can't wrap my head around it, but it's amazing. And I know that not all insurers are this in compliance with the rules on BC. All I have to say is this, and please forgive this brief foray into politics - While the ACA isn't perfect, overall it has helped millions of people across the country in numerous ways. The birth control mandates set forth under the law are a fantastic thing for women, and the more plans that are required to include all BC options, the better. However, the new administration and GOP lawmakers want to repeal the law, with no replacement even close to being offered, and the few ideas that have been floated around have been pretty much panned as much worse across the board. They also have shown repeated interest in limiting, if not fully abolishing, women's reproductive rights. Please, contact your legislators to let them know how important this coverage is, and that they should be working to make the law better and more helpful for more people, instead of dismantling it out of spite. And let them know that women's health, safety, and ability to make their own decisions for their bodies is important and necessary. /endrant

The Procedure: I go in tomorrow (Friday) in the afternoon. I will update as soon as I'm feeling up to it, and let you all know what went down and how the recovery is going. So, wish me luck! And if you've read this whole novel, thank you.

Update:

Ok, I'm on mobile, and in a bit of a haze from the Percocet, so please forgive any spelling or formatting issues.

Yesterday, I was told to stop eating and drinking 8 hrs before the surgery. We got to the sugery center 1 hr before the procedure as I had been instructed. I had to sign a form indicating that they would be using leg compresses during surgery to help prevent blood clots, and 2 forms about knowing all my privacy rights and after procedure stuff. After a brief wait, I was brought back to be prepped. First off was a quick pee in a cup so they could run a pregnancy test.then I was weighed and measured, then brought to my bed to put on the ever popular hospital gown and put my stuff away. Once I was set, 2 nurses came in to do a medical history and put in an IV for fluids, and later, the anaesthesia. I tend to have small veins, and bless his heart, the nurse doing the IV waited until he was sure he'd got one, so it only took 1 poke. I was a little nervous, but was able to joke a bit with both nurses and keep things light. My husband was allowed to come back and wait with me at this point. After a bit, Dr. F came in to talk about the procedure, go over some after care, and ask again if I was sure this is what I wanted to do. She also made sure to warn me that I would be in a pretty good amount of pain after. gulp

Next came the anesthesiologist. Oddly enough, of all the people I dealt with, he was the only one that gave me the, "Aw, are you sure you want to do this? You don't want any more babies?" I informed him I didn't want ANY babies, and heck yeah I was sure. So, he told me about how the drug would be administered via my IV, and I may feel a brief stinging in my arm, but there would be a moment of good feelings, then I would be out. Finally, thd OR nurse came to put on the leg compressor things (they looked kind of like blood pressure cuffs with clear hosing coming out.) I said bye to my husband, and off we went.

Once we reached tbe OR, I was walked to the table (had a brief amusing moment as the Dr. and nurses messed with the controls to get it low enough for me to actually get on it.) and got situated on the table. I have to say, I still wasn't nervous at this point, just a little giggly and curious. Once I was on the table, they put my arms out to the sides on supports, and then I guess they hit the switch on the anesthesia, because I remember they were still getting me situated and covered and putting on monitors, but it suddenly felt like my vision got a little blurry......

And the next thing I remember is being aware of a nurses voice and my husbands voice, and I was in some of the most incredible pain I'd ever felt. I don't really recall coming around per se, but I did start to register that the nurse was talking to me, and telling me the sooner I could get up and moving, the better I would feel. I also remember thinking she was nuts, and how the heck was I supposed to get up when I could barely move. My lower abdomen, back, and upper legs felt paralyzed from the pain. My husband says that when they brought him back, I was curled in the fetal position with my face screwed up in agony. He thought I was still asleep, but then I started coherently answering the nurses questions, which I really don't recall. The next 25-30 minutes were absolute hell. Apparently, to make plenty of room in the abdominal cavity, they pump you full of gas. They do not remove it, it is left to be absorbed by the body. This is where a great deal of the pain comes from. The falopian tubes and surrounding area are also spasming and cramping from the procedure. And there is an incision in my belly button, and one way down by my pelvic bone, just a bit left of center. So this initial pain is like a combo of your worst ever period cramps times 10, plus intense gas pain (both from the pumped gas and you intestines producing extra because of all the activity) plus a couple-of-holes-in-the-abdomen type pain.

Luckily, they had started a Motrin drip via IV, and after my wonderful hubby helped me eat a few bites of grahm crackers an some water, I was able to get down a Percocet, and things started to subside a bit. Don't get me wrong, it was still freaking awful, but I was finally able to sit up and move to the edge of the bed. The Dr. came in one last time to let me know things went well, and to give me some sympathy, cause I know I looked and sounded absolutely pathetic. They gave my husband my prescriptions to fill when we got back to town, and then he helped me get dressed, and I was loaded into a wheelchair to go to the car. Total time from start to finish with the whole thing was about 3 hours.

All I can say is thank jeebus the weather and roads were good. Did any of you see that video last week of the semi blowing over on top of the HyPo car? Yeah, this is that same streatch of road, just a section further East. I stayed in the car while my husband dropped off my scripts, grabbed some food, and then got home. Once I was in bed, be put up a barrier to keep our 2 dogs off me (they were very upset at this, they just wanted to comfort me, but with a combined weight of 180 lbs, we figured it was best to keep them back for a while.) Husband then went and got my pills, I downed another one immediately, and was able to eat some food.

Last night was alright, the pain fluctuates, and I was waking up fully every 4 hours to take pain pills. The gas is still moving around, sometimes going up under my rib cage, and when I stand up, it moves into my shoulder. Sitting propped in bed feels the best, and is how I slept last night. Walking is still tough, but getting better. Also, the wife of the couple we bought our house from had MS, and some of the accessibility things worked into the house remain. All I can say is that the support bar next to the toilet is a life saver. As for further recovery, the Dr. said the first 24-48 hours would be the roughest, but should get better from there. So, for now, I'm just going to stay in bed and rest. Oh, and I highly recommend a heated matress pad, and or heated rice bags. They have been my best friends. I'll update again once things start looking to be on the mend.