Bilateral Salpingectomy 10 Years Later

Wow. It’s been ten years since I had my laparoscopic bilateral salpingectomy. Well, it was ten years last October, but I had a lot going on then and forgot I meant to do this update. And then I started this and moved on to writing about other things. So now it's ten and a half years. Oops.

Post surgery apple juice

I wrote my original post mostly because I knew I’d always want to remember, but also because it was the hot new thing at the time and there wasn’t a lot of information about the procedure or recovery. I figured other people would want to know. And they did! That first post has had 42,000 views and 140 comments (though half are my replies). My 6-week update has had over 6,000 views and 43 comments, my 1-year update had 4,000 views and 18 comments, my insurance rant had nearly 3,000 views and 2 comments, and my FAQ post had 2,400 views and 10 comments. Altogether that’s close to 58,000 views and 106 original comments (not counting my replies).

One day: Gnarly incisions

Most of the comments expressed gratitude for the posts. It’s a little disappointing that, even a decade after I documented my experience, these types of detailed accounts are not that common. There are reddit communities with written accounts but lacking photos and other accounts that don’t have the same level of detail or follow up, and loads of fear mongering stories about what went wrong and phantom side effects. This can leave people confused and afraid. Any surgery has risks, and some people are more at risk than others, and those should be discussed in depth with a doctor. But there’s also a targeted effort to remove the ability for women to take complete charge of their fertility, and fear mongering is having a moment. The truth is that most recoveries are as easy as mine was.

6 weeks: I forgot I had a belly button ring!

One year later: the scars are still there but hard to see.

But let’s talk about the downsides for a minute. The biggest one is that I still had a period all this time. It didn’t occur to me that this would be a downside, but after the first few I was like, wait, what’s the point anymore? It used to be a nice signal that I wasn’t pregnant. But as soon as I knew I couldn’t get pregnant it became unnecessary. And because I stopped taking birth control, I also couldn’t control when I got my periods. Which meant trips, birthdays, anniversaries, and other times you don’t want to have a period would get inconvenient. Ten years later I’m still annoyed by my period. I asked a doctor once about getting a uterine ablation to remove the lining, but she said the approval process would almost ensure I’d be rejected. Which is genuinely bonkers. Why can’t I, as a grown-ass adult who doesn’t want a period, choose an elective procedure to take care of that need? Do all people with nose jobs have a medical need? Fuck no. At least my periods were predictable. I always had a 28-day on the dot cycle. Now that I'm probably in perimenopause my periods are becoming less predictable and I’m having to be in an office for work, there’s an element of anxiety once again that I don’t appreciate.

I struggle to think of any other downsides, honestly. As long as I have ovaries there remains the risk of an ectopic pregnancy, but those almost always happen in the fallopian tubes which no longer exist. They can happen on the ovaries themselves or outside the uterus, but that’s really uncommon. I’m also positive that any ectopic pregnancy would have happened by now. So, intellectually, I know I can’t get pregnant.

Unfortunately, knowing that I can’t get pregnant didn’t stop me from panicking about it for about six months when I skipped a period. I was almost 39 and had been sterile for 9 years at that point. The only other time I missed a period was the one right after my surgery. I bought and took a pregnancy test, which was obviously negative, and I only did it because I knew it would be the first question a doctor asked. I started having severe anxiety, irrationally worried I was 8 months pregnant and it would be too late to do anything about it, and then lamenting how my life would change. At one point husband offered to get a vasectomy just to ease my totally irrational worries. Thankfully those have passed and I even had another very late period and didn’t completely lose it.

Did sterilization push me into an early perimenopause? I’m not sure. I’m not 100% sure I’m in it because it’s not something you can really diagnose with certainty. Hormonal tests aren’t reliable, most doctors know next to nothing about it, and as much as I’m trying to learn the information is still hard to find and trust. Forty is admittedly earlier than most but not unheard of. I remember my mom having symptoms when I was in high school, which would have made her around that same age. So it could be genetic. Or I’m just stressed and it’s finally causing erratic periods and rage. <shrug emoji>

Positive: Group then solo trip to Africa

Now, the positives. This was without a doubt the best gift I could have ever given myself. Even if husband had been willing to get a vasectomy at the time, I’m sure I still would have ended up having this done. The peace of mind is unreal, except for those weird months where I was freaking out for no reason. There’s no preparation that needs to happen before sex, I’m not supplementing with hormones, my period tracker app is as reliable as it can be in the perimenopause age, and I generally feel as natural and normal as ever. If the apocalypse happens I won’t have to worry about avoiding pregnancy, and if this deranged administration starts forcing women into pregnancy I’ll escape that fate. Last, I’m not sure this is a positive (because I kind of wish I still had a visible reminder), but for years now when I look for my scars it takes a few seconds to find them, and you have to know what they are to know they’re scars.

I’ve been tracking my periods since going off birth control nearly a year before my surgery, so I still have a decent idea of when to expect my period even though there’s some hormonal fluctuations. Fluctuations mean highs and lows, and the highs include being absolutely randy during my ovulation week. So that’s been the fun side of perimenopause.

It took about a year to stop feeling like I forgot my birth control pills, which means it’s been a solid nine years of not having to think about preventing pregnancy at all. Once it was normalized in my head, it just was. To the point even when I learn that friends still take pills and use condoms I can’t imagine that life anymore and wonder why anyone puts up with it, especially those who don't want kids or any more kids. Sterilization is the most set it and forget it way to stay unpregnant. And I’m also really glad that I had the forethought to get a salpingectomy rather than a tubal ligation, even though it was still new-ish for sterilization purposes and not covered by insurance.

What’s the difference? A tubal ligation is cutting the fallopian tubes in half and doing something to the ends to stop them from growing back. Often they’re tied off (which is why it’s called getting your tubes tied), but some doctors cauterize the ends and others used these little chip clips for a while, but that fell out of fashion when they became associated with complications. My understanding is that now doctors that still do the ligation tie and cauterize the tubes. But salpingectomy is the gold standard for sterilization, so most women go full tubeless.

Just because I think it’s interesting, here’s what a laparoscopic bilateral salpingectomy means in English:

• Laparoscopic: Surgery in the abdomen made with itty bitty incisions and a camera so the surgeons can see
• Bilateral: Both sides of the body
• Salpingectomy: Salping means the fallopian tube (Greek for trumpet, apparently), and ectomy means removal

Altogether, removing both fallopian tubes via tiny incisions in the abdomen. The tubes connect to the ovaries, so the biggest risk with this surgery is that an ovary will get nicked. That can cause all sorts of problems. But surgeons tend to be very good at their jobs and don’t do that. The other risk is that they leave too much of the tube next to the ovary, and somehow little sperm gets to an egg and there’s an ectopic pregnancy on the ovary itself. It’s happened, but it’s extremely, extremely rare.

Husband gets me cards like this on my surgery anniversary

So, what have I done in the last 10 years? Lots! I got married. I got a masters degree. I grew out and cut my hair 3 times. I traveled by myself to Namibia and Kenya. Husband and I bought a condo. I was diagnosed with celiac disease. I quit a job with nothing new lined up. I bought a scooter. I fostered small pets. I ran a marathon. I had six pets at once. I've witnessed two solar eclipses. I paid for chemo for my dog and did subcutaneous fluids for my cat and administered medication that causes reproductive harm. I got tattoos. I traveled for work. I touched the water in the Mississippi River and the Colorado River. We traveled to Colorado and Louisiana and Utah and Montana and Nevada and Hawaii and New York and New Mexico and Washington and all over California. Not all of it was because I’m sterile, but I definitely wouldn’t have been able to do some of these things if I’d become a parent. And I’m so grateful to not have to have taken hormones for another 10 years or dealt with the excruciating pain of an IUD.

What’s next? I might write a book. I’m writing a book. I’m going to figure out what I want to be when I grow up. I’m getting really good at being an aunt. We’ll get more pets. I might run another marathon. I might finally convince husband to move to Seattle. I might try to get my 5k time under 20 minutes (which is really fucking fast). We’ll finally go on our honeymoon. I’ll get more tattoos. We’ll enjoy our quiet nights at home, making dinner together and watching a movie and appreciating the opportunity we get to choose how we live.

Since this ended up being more about how perimenopause is going than an update on sterilization, mainly because there isn't much to report (still don't need to worry about pregnancy, scars are too small to see), I'm not going to do another one of these. Nothing will change at 15 years, 20 years, or beyond. Eventually I won't have had a period for a full year and will be fully and completely barren. It's just nice to be one of the few voices on reddit with this longer term perspective to reassure scared women that, yes, it's going to be fine and this is worth it.

Let Go and Let God

Let go and let god car sticker.

I used to see that phrase on a bumper sticker most days. It was on a truck parked on a street on my old run route. It’s Christian hakuna matata: don’t worry about it. Curious young minds in my CCD classes asked over and over again how we know god is real, how we can know god’s plan for us, how we can know the Bible is true, how can we believe without knowing. We spent our days in school learning about scientific experiments, facts, history, math, reality, and how to uncover the truth. Twice a week we’re expected to forget all that and just believe for no other reason than a book says to believe the impossible. The adults always told us that our puny human brains couldn’t possibly understand god’s plan and to just trust that he knows what he’s doing even when it seems like things couldn’t get worse. God is a mystery. Just believe.*

(*You can’t just slap a “believe” poster on a wall and manifest your way to victory. It worked on Ted Lasso because they tried. They thought that maybe victory was possible, and knew that if it was, it only was with teamwork and a shit ton of effort. You do need to believe that change is possible to work towards it (the influencers call this *manifesting*. If you think nothing can ever change no matter how hard you try or what you do, you’re less likely to try in the first place. There are powerful and well-coordinated people in government trying to make sure we don’t believe that change is possible so we’ll stop trying.)

I understand the appeal. When you believe that a higher power has everything all planned out since before you were born, knows exactly what’s going on at all times, and that everything that happens really does happen for a pre-determined reason and exactly as it’s supposed to, even if you don’t understand it, you don’t need to try. Trying is hard. You might try and fail and failure is bad. Instead, simply trust that this is the way it’s supposed to be!

On a small scale, it’s probably fine. Not everyone is a great thinker. Lots of otherwise decent people need a religious crutch to get through their days. It’s when you pair the “let go and let god” mentality with structural inequity that it becomes a massive problem. Because if things are they way they are for a divine and unknowable reason, then the way things are is the way things should be and we shouldn’t try to change them.

Gender pay gap? Women have children and spend fewer years in the workforce. Why shouldn’t the men get paid more to support their families?

Racial pay gap? Non-white people attend college at lower rates than white people. Why shouldn’t people with college degrees get paid more?

These extremely simple arguments allow people to stop thinking any harder about it. On the surface it makes sense and these are such big problems to solve, so maybe they aren’t problems at all.

Does god favor the United States? Does god favor white skin? Does god favor traditional gender roles? Yes, yes and yes, according to Christians, and not just historically. They will tell you that these aren’t racist or sexist beliefs, it’s just the way things are, the way things are intended to be. Which, funnily enough, sounds a lot to me like understanding god’s mysterious plan.

The root of this probably isn’t overt malice, at least not on an individual scale (though it one hundred percent is on the governmental scale). There’s probably loads of plain apathy mixed with selfishness and a lot of ignorance. If white, straight Christians have it pretty good, they aren’t exactly motivated to make things worse for themselves. And since we have a tendency to believe that making something better for one group means that it will be worse for another, if we’re the beneficiaries we’d like to stay that way. And if someone tells you that being the beneficiary is god’s plan? Well, who am I to refute that.

However, this falls apart when you read the Bible. Most Christians haven’t read it, at least not in its entirety. Or even all of the New Testament. (I was shocked to learn a few years ago that my most devoutly Christian friend hadn’t even read it all. I’ve done it twice, it’s not even that long a book.) If you just read the words Jesus said you’d have a hard time pairing modern Christianity with this person. But most don’t do this, they only listen to priests or pastors or influencers interpret the message. As if priests and pastors and influencers don’t pick and choose which parts of the Bible to preach, or don’t want to change the status quo, or don’t see racism and sexism in the world.

“It is difficult to get a man to understand something when his salary depends on his not understanding it.” - Upton Sinclair

This more or less explains why white Christians are so reluctant to do the radical work that Jesus preached. Things are good for them. They don’t want to rock the boat lest they end up like the other racial groups who experience the structural inequality that white people “oh no” about but don’t dismantle. Loads of white Christians follow the prosperity gospel. Look at these riches — god must have smiled upon them! It is the way it is because it’s the way it’s supposed to be. Forget about the camel and the eye of the needle.

Women who believe in traditional values, even at their own expense and the expense of their daughters, kind of make sense in a way. Many of these women are raised with these values so it’s not a leap to adopt them in adulthood. Existing in this world and providing for yourself is hard enough as it is, letting a man do all that hard stuff and contribute by having sex and having kids is simple. And if this is the way it’s supposed to be anyway, especially if you want kids anyway, it’s a lot easier than doing all things. Except that religious folk love to talk about the gift that motherhood is while making it harder and harder to be one.

I have a harder time understanding non-white Christians. God is apparently not smiling upon them, yet their devotion is arguably stronger. Christians used to believe that dark skin was the mark of the devil, which justified slavery. People were torn from their homes and sold into slavery and then adopted the religion of their captors. Generations later, they strongly and genuinely believe. They also don’t want to rock the boat but for different reasons. Many still think that being polite and friendly and submissive and unthreatening will be good enough to spare their lives or earn them the same rights their white counterparts enjoy. Except that it’s been a century and that still hasn’t happened.

Anyone can use religion to justify anything. Because god’s plan is so unknowable. Influential people can claim god is on their side and millions will believe it. The most glaring recent example is JD Vance telling the fucking Pope to stay in his lane. Which is being the leader of all Catholicism, of nearly 1.3 billion Catholic souls (almost half of all Christians), and an international spiritual leader. The Pope, as you’d expect, is not a fan of the administration claiming religion in the war on Iran and said so. He called for peace. He said that plans to wipe out an entire civilization were abhorrent. Vance (who calls himself Catholic) said sftu, this doesn’t concern you. And honestly, that he and his team didn’t respond with more bite showed impressive restraint (or, just as likely, that they’re playing political games).

Regular people aren’t immune to this. The real work that Jesus did, and preached, is fucking hard. Our whole society looks down on this work so much that the prosperity gospel is thriving. Rich people are good! They must be. Billionaires donate money! And we’d all rather have riches than live in poverty so much that most Americans are more likely to believe they’re closer to making it than the reality, which is one medical emergency or lost job away from the streets. So Christians divorce themselves from the reality of who Jesus was and the political time he existed in by listening to their favorite interpreter and not reading the Good Book themselves, refusing to see parallels, and choosing to believe in a white destiny and that the US is a chosen land and people, as long as you’re white and Christian. Jesus was radical. He was threatening to the status quo. He was killed by political leaders following the law, and would certainly be killed again if he were in the US today.

People I Used to Know

The quote starts that people come into your life for a reason, a season, or a lifetime. Sometimes hindsight makes it crystal clear which one it is. I’ve always been fascinated by the people who disappear from our lives. People we were so close to at one time and now we don’t speak, don’t follow each other on social media, maybe don’t even think about at all. A 40-year life means a lot of people who come in and out for one reason or another. I was recently thinking about three.

Me doing something I'm not supposed to at the best job I had and the backdrop for two stories.

I was volunteering at a friend’s event and one of the guests he was interviewing came up to say hi. He knew my name. It took me a second to place him: we’d lived in the same building for a year and hooked up shortly after we both moved out. My friend used his name a few times during the interview, and I’d only known one person to use that variation of the name. But I was still surprised when he approached me. At the event, he was promoting his mead company (I was helping distribute samples). But when we lived in the same building, I thought he was in software or accounting or something way less interesting than mead. I mean, he was on the older side and had a one-bedroom, so he must have had a real job. Twenty-four year-old me thought he was sophisticated, especially compared to the other residents who made the building feel like a 20s and 30s dorm. But he also had a corner bar in his apartment and a keg, which was the height of coolness in 2009. (He was also easily the most attractive guy in the building, helping cement my fondness for glasses.) One day I came home with a headache from a particularly bad day at work to a party in the courtyard, including a DJ directly outside my window blasting obnoxious music. I thought I had the best place in the building because I could easily see when friends were hanging out and go join them. But that day I was in no mood, so I shut the window and closed the blinds. Except my apartment absolutely reeked of yeast. I looked for the source of the smell and discovered a brown sludge running down the insides of my cupboard. Turns out the keg in cute-upstairs-neighbor’s apartment leaked. I soured on him for a couple weeks, until the smell dissipated. Looking back, maybe he was home brewing, and that led him to mead making. Our hookup was months after we both moved away from the building (the only time I ever cried leaving a place, I loved the weirdness of my studio and the freedom it gave me). I didn’t enjoy it and we didn’t see each other again until my friend’s event. Part of me felt good that he recognized me without any context or introduction, because it meant I must not have visibly changed much in 16 years. But would I have recognized him? Since he was older than me back then, he’s probably close to 50 now and looking more like it. I’m also terrible at recognizing people out of context: I’d had no idea he was a brewer so even after hearing his name a few times I still didn’t make the connection other than it was a reminder that this person existed.

Some of my neighbors in the courtyard at the infamous Halloween party in 2009.

There was another time someone approached me completely out of context after not seeing each other for a very long time. Right around that same time in my life, when I was living in my studio, I got close to someone from work. He was a giant mess and basically homeless, but nice to me so I let him crash on my itty bitty couch for a while. This was a person who was obviously in my life for a very specific reason: I’d broken up with my long-term boyfriend while working at this job, but the break wasn’t clean. My ex came to a Halloween party I helped throw in my building courtyard dressed as Patrick Bateman from American Psycho. But not like a jackass in a suit, wearing a poncho and wielding an ax. I found out the next day that it was a real fucking ax. That he brought to a Halloween party. The break got very clean after that, but not before the party moved to a hotel bar a few blocks away, where my ex got in my face and said some awful things. When my friend came to my defense, my ex got in his face. Well, my friend was not the type to let that happen and he slugged my ex in the face, knocking him down. Truth be told, my ex needed to get punched. He was pompous and thought he was above reproach, better than anyone else and no one would dare. He learned he was wrong that night and I guarantee it changed how he acted in certain situations. We scattered from the bar, my friend discarding his costume and jumping in a cab and my other incredible friends talking my ex down from calling the cops. I was surprised when our friendship started to fizzle a few months after that, until I realized that I could no longer provide him the support he needed and he was moving on to others who could. He was still a giant mess, and still basically homeless, and had his own ex problems that were getting far worse than mine ever were. When I left that job I didn’t see him for seven years, until he came up to me in a brewery. I was there with husband (boyfriend, then), celebrating our dog’s 10th birthday. We had a dog cake for the dogs and cookies for the people. In the middle of talking and laughing with friends, he suddenly appeared inches from my face. I was taken aback by the invasion of my space more than anything, then I recognized him. He offered me the booth that he and his friends were about to leave. A couple years after that I saw his name on one of the beers at that brewery. Guess he knew the owners. A couple years after that, the brewery was named of the beer #metoo movement. Honestly, I wasn’t that surprised. He had a lot of strong words but I never knew where his true morals or loyalties would lie. Like most men, I wouldn’t have been surprised to hear if he defended a man against sexual harassment hearsay. Most don’t believe women.

Argo with his birthday cake on his 10th birthday.

Perhaps most jarring was the first boy I ever loved. Many years after it ended, I wondered whether I’d recognize him if I saw him, or even if I’d ever see him. We didn’t have social media so I had no idea if he still live in our hometown or what he did for work. Our relationship, probably like most high school relationships, was intense. We were convinced, just like everyone else, that we’d last forever. The time I felt that most powerfully was when my mom forbid us from seeing each other because we went stargazing at the park literally across the street from my house and she thought… who even knows. I was determined to show her that our love was even stronger (do parents know anything? you never forbid love). But I had plenty of doubts. He’d started getting into drinking (not that unusual) and some harder drugs (a little unusual). I didn’t like it and told him. He wanted to stop but wanted me to be his anchor and motivation. Even at 17 I knew he needed to do it for himself. But he was also hinting at getting engaged soon. I didn’t have a lot figured out then but I knew two things for sure: I did not want to be married young and I did not want to be anyone’s sole purpose for existing or having a good life. For a while after we broke up his mom (and probably lots of other people, he was popular) blamed me for his turn into darker and riskier behaviors. I felt bad about how I handled the breakup but I was naive and inexperienced. Then a year ago my sister called to tell me she and some friends were telling high school stories and he came up. They looked him up on Facebook and found out he died a few years earlier from a drug overdose after being clean for a while. I hadn’t spoken to him in 19 years, so all I felt was weird. This person was so close to me at one time, and when they died I didn’t even know. I wonder how often that’s happened with other people I used to know. I knew how unlikely it was that I’d ever run into him, even when I visited my hometown, but now I know it’s impossible. And that’s still weird.

There have been a lot of other people who have exited my life, including parents, people I might have called best friends, relatives, work friends, and relationships that burned bright for a short time. It will always fascinate and sometimes sadden me when this happens.