Laparoscopic Bilateral Salpingectomy FAQs

In October 2015 I got my fallopian tubes removed, which is called a laparoscopic bilateral salpingectomy. As I'm writing this it's been 15 months since surgery, and I still get a lot of comments on my previous posts about this procedure. To make one easy-to-reference location for the most common questions I've gotten, I made this post.

Anyone is still free to post here or on any of my other posts with new questions! But now no one will have to read through dozens of comments to find out if their question has been answered.

Best of luck to anyone considering this procedure or recovering from it! I do love hearing your stories, so continue to let me know about your experience.

My experience:

• Getting my laparoscopic bilateral salpingectomy
• My 6 week update
• Dealing with insurance
• My 1 year update

About laparoscopic bilateral salpingectomy:

• What is a laparoscopic bilateral salpingectomy?
• Salpingectomy is the surgical removal of both fallopian tubes.
• Laparoscopic refers to how the procedure is done: through a tiny incision with tools that go inside the body, rather than big cuts into muscle. Much faster and easier recovery.
• Bilateral refers to both sides: both fallopian tubes were removed, so the procedure was done on both sides of my abdomen.
• Who needs a laparoscopic bilateral salpingectomy?
• It's a great sterilization procedure! Removing the fallopian tubes is getting pretty darn close to making it impossible to get pregnant. 
• If you have an ectopic pregnancy this is what you'll get to save your life.
• I chose this procedure over a tubal ligation and essure because I wanted the most effective form of sterilization and I didn't want anything left inside me. It was the best combination of pain, recovery time, and long term effectiveness for me.
• Why did you get fixed?
• I don't want kids.
• I don't want to get pregnant.

FAQs 

Pre-Surgery

• How much time off work do I need?
• How long until I can go back to exercising or working my physically intense job?
• How did you find a doctor to perform this procedure on you?
• Did your insurance cover this procedure?
• How much does laparoscopic bilateral salpingectomy cost?
• Do your ovaries get removed?
Post-Surgery

• Did your period change?
• Did you get heavier periods after surgery?
• Did cramping get worse?
• Are your periods more irregular after surgery?
• Did your hormones change?
• Will you get early menopause?
• How long do the scars take to heal?
• How long until the bloating goes away?
• Did you have shoulder pain from the gas?
General
• Don't a lot of women regret sterilization?
• Why not just get an IUD?
• Do you still worry about getting pregnant?
• So you really don't want kids?


Answers
Pre-Surgery

• How much time off work do I need?
• It depends on your job. I had an office job, so I only took the day of surgery off (a Monday). I worked from home the next two days, and by Thursday I was back in the office. I could walk around the office and to and from my car fine by then. I did take the elevator, though!
• How long until I can go back to exercising or working my physically intense job?
• I took the full 6 weeks off exercising, but I was also recovering from an ankle injury at the same time. You could probably go back to a physical job within two weeks, depending on what you do and how fast your body heals. You're not supposed to lift anything more than 10 pounds for up to 4 weeks, though, and I don't think I could have run sooner than 4 weeks even if my ankle was good.
• How did you find a doctor to perform this procedure on you?
• Check this site: https://www.reddit.com/r/childfree/wiki/doctors
• I had a couple of consultations before finding my doctor. I felt a real connection with her, like she truly understood what I wanted. She did not push me or talk down to me. I highly recommend finding someone who makes you feel this way.
• If you're young you might have more trouble finding a doctor to sterilize you. Also, I live in California which is pretty liberal about this stuff.
• If all else fails, Planned Parenthood will sterilize you, and it'll probably be less expensive than in a hospital.
• Did your insurance cover this procedure?
• Partially. Mine was covered as a general in-network surgery, but it was not 100% covered as a sterilization (a requirement of the Affordable Care Act). This is because laparoscopic bilateral salpingectomy is not considered "birth control only". If you need a sterilization procedure that insurance will cover 100% you might want to consider a tubal ligation (which is only done to prevent pregnancy, unlike salpingectomy).
• Every insurance company is different. Check with yours before surgery. Get the codes your hospital will use and ask for everything: doctor code, surgery code, anesthesiologist code, etc. Ask your insurance company what your cost will be for those codes.
• How much does laparoscopic bilateral salpingectomy cost?
• A lot. My cost was just over $2,000 after insurance covered a portion.
• Do your ovaries get removed?
• Nope! The only things that were removed were my fallopian tubes.

Post-Surgery

• Did your period change?
• Did you get heavier periods after surgery?
• No.
• I was not on hormonal birth control before surgery, so my periods were normal for me. Many forms of hormonal birth control make periods lighter, so going off them makes periods heavier (though heavier really is just back to normal). Since most women who get this surgery go off hormonal birth control at the same time, they attribute the heavier period to the sterilization.
• Did cramping get worse?
• Nope! See answer above.
• Are your periods more irregular after surgery?
• Nope! My periods have always been very regular, including after sterilization.
• It did take a few months for them to find their new groove, though. I had my surgery in October, and skipped my period that month. By January I was back to my regular cycle.
• Did your hormones change?
• Nope! Fallopian tubes don't have anything to do with hormone production, so removing them doesn't change anything.
• I was not on hormonal birth control before surgery, so there was no hormonal change before and after surgery.
• Will you get early menopause?
• Nope!
• See answer above.
• How long do the scars take to heal?
• The scars fade quickly - mine started to fade within 6 weeks, but were still noticeable.  
• The incisions are low on my abdomen, so they're covered by clothes. One incision is in my belly button, which is not noticeable at all.
• It's been over a year now and one of them is 99% gone. The other looks like a light birth mark now, and will continue to fade until it's gone.
• It was surprising how quickly they faded!
• How long until the bloating goes away?
• I felt back to normal within two weeks. 
• I wore jeans a week after surgery.
• Did you have shoulder pain from the gas?
• No, not really. It was all in my abdomen.
• Other women do have shoulder pain, though. Walking around should help.

General

• Don't a lot of women regret sterilization?
• Not as far as I'm aware. So far I sure don't!
• From what I could find online, the women who regret sterilization tended to never want the procedure in the first place. They were coerced into it during childbirth. Many regretted it after their relationships ended and they realized they wanted more children with their new partners. 
• I've never heard of anyone who never wanted kids regretting sterilization. Doesn't mean it never happens, just that it seems pretty rare.
• Why not just get an IUD?
• Because I wanted something permanent that didn't leave anything inside me.
• Laparoscopic bilateral salpingectomy is as close to being 100% risk-free as you can get. IUDs are great, but not as great as salpingectomy.
• Do you still worry about getting pregnant?
• Nope! It's awesome.
• So you really don't want kids?
• I really don't.

Getting Fixed: One Year Later

It's been a year since my laparoscopic bilateral salpingectomy. Unless you know that I've had surgery (or are a medical professional, probably), you'd never be able to tell. Now that it's been a year I feel even more secure that it was the right decision. I know I can't get pregnant and will never have to worry about what-ifs. Instead of raising children, I'm in grad school, hoping to use my life to make a big difference in the world.

Here's what I look like now. The only visible scar is on my left side.

If you need a recap of my tube removal experience:

• In depth diary of reasons, research, surgery day, and the first 10 days of recovery
• 6 week update
• Dealing with insurance

One year later, and here's what changed:

• The Boyfriend and I don't need to think about pregnancy prevention anymore. I still do sometimes, but I was taking pills for 10 years and habitual worrying takes time to die off completely. The panic that I didn't take my pill subsides as soon as I remember I don't need to.
• This means we've been able to have more spontaneous sex. 
• This also means sex has been better because we aren't worried about the time of the month or that slim chance pills and/or condoms will fail. I went off birth control pills 10 months before getting spayed and we relied on condoms, which unfortunately meant we used them on occasion and tried to time sex for when I wasn't fertile the rest of the time. Since I had just started tracking my cycle, this was recklessly dangerous and I 1000% do not recommend it. Not to mention, it made both of us worry a lot about sex (mostly me, since I'd be the one actually pregnant).
• I use an app to track my period now because I'm in less control over when I get it than when I was relying on a pack of pills (meaning I have no control). Fortunately it's crazy regular (more on that below) but it's been helpful having an app.
• I've been extremely personal on this blog. Before I tried to be pretty vague and not use it as a completely personal platform, but I've since shared about being cut open, my personal decisions for not wanting to be a parent, details and advice about pooping, discussed my period in depth, shared photos with my face in them, shared photos of my bloaty and scarred belly, and now I've shared more details about my sex life than I thought I ever would on the internet. But, you know, I've said before I wanted to shout this from the rooftops and now that I've seen how helpful the previous two posts were to women considering this I'm more than happy to have been as candid and personal.

More importantly, some things haven't changed.

• I still don't want kids. I got fixed 10 days after turning 30 and I'm 31 now. My biological clock didn't magically start ticking. In fact, my beliefs have strengthened. People in our lives are starting to have kids or talk about having kids and while they can have nice moments they are still so much work. Every time someone we know talks about how challenging it is being a parent I'm like, "...yep." 
• My period hasn't changed. I've always been fortunate in the monthly cycle department. It came right on time when I was 13, is usually very light and cramp-free (I know, lucky), and is extremely regular, even without hormonal birth control. My first period post-surgery kind of skipped - I had all the symptoms of being on my period without any bleeding, but then it showed up a few weeks later. It took a few months to return to its normal mid-month cycle but now I can depend on it within a few days. I did have one period that was really crampy, but on rare occasion that would happen before surgery, too.
• My hormones haven't changed. Because the only thing that changed was my fallopian tubes were removed, and they don't affect hormones, everything else has and will continue to happen normally, including menopause. That's also why my period hasn't changed. No weight change, no mood change, no change in appearance, nothing.
• I can still wear bikinis. Not that I wear bikinis often due to circumstance (more of a mountain person than a beach person) and I would have even if my scars were bigger (because judgmental people can fuck off), buuuut my scars are totally not noticeable. In fact, on 4th of July The Boyfriend took a photo of me in a patriotic bikini and my belly button ring hole is more visible than my surgery scar. (Can you see it? I can if I squint.)

Quite a few women looking for information on laparoscopic bilateral salpingectomy as a sterilization method have found my previous posts, and I'm so very glad to have helped them. The biggest selling point for salpingectomy for me was there would be nothing in my body - no copper or plastic IUDs, no clips, and no metal coils. Even the stitching dissolved and glue came off. My risk of ovarian cancer is potentially reduced, my risk of pregnancy is essentially gone, and I won't have to think about having an IUD removed in 5 years. Win-win-win-win-win.

Edit: Now that we know the election results I'm even more happy I've gotten this taken care of. The next president could, and likely will, significantly roll back access to and affordability for procedures like this (and birth control and abortion access). I would be quite worried for my future if I was still dependent on temporary birth control. 

I doubt there will be much to report back on but maybe I'll do a 5 year or 10 year follow up or an update if there's anything to update on. Until then, I've been really enjoying the comments on the previous two posts and love hearing all of your stories. Please continue to leave comments! I may not always respond right away, especially over the next couple of years as grad school takes up most of my time, but I will respond. This has been a fantastic experience and I'm so glad to be in the company of the many, many women out there who decided they don't want (any more) kids and are sick of dealing with temporary and inadequate birth control. Much love to you all.

Photos in order of when they were taken:

Day of surgery

6 weeks after surgery

1 year after surgery

Dealing with Insurance for my Laparoscopic Bilateral Salpingectomy

The least fun part about getting spayed has been dealing with insurance.


Let's start with the end: I lost.

Backing up a bit, before you go and get this or any surgery call your insurance company and ask what your costs will be. First, get the precise codes from your doctor. Make sure to get all codes, all of the codes that each doctor will use (I had two), the code the anesthesiologist will use, the code the hospital will use, and any other code they might need. Second, tell that code to the insurance company, have them read it back to you so you know you're on the same page, and ask what your total costs will be. DO NOT ASK IF IT'S COVERED. "Covered" in medical insurance language does not mean the insurance company will pay for it, it simply means it's an approved procedure (wtf an unapproved procedure is I have no idea). This was mistake #1 for me. Third, before you actually go in for this surgery call your insurance company again and make sure they're giving you the same answer as before. If your plan suddenly changes and they don't inform you (cause they're dicks like that) you'll be on the hook.

Another important point: the Affordable Care Act states that all birth control costs are 100% provided by insurance companies, including female sterilization. HOWEVER, sterility is only a side effect of a bilateral salpingectomy. Fallopian tubes were historically removed as part of a hysterectomy in order to reduce the risk of ovarian cancer, and only recently are women turning to the procedure because of how effective it is at stopping pregnancy (no tubes, no babies). Compare this to a tubal ligation, which is only done for birth control purposes. This makes sterilization an off-label use of bilateral salpingectomy. Some insurance companies have this procedure labeled as sterilization because of its quickly growing popularity (up to 33% of sterilization procedures are bilateral salpingectomy), but mine did not. In principle I felt that insurance should have covered it because my primary reasons were for sterilization. 

Further, and this is an argument I had with many people at my insurance company over many months, is that even if laparoscopic bilateral salpingectomy is used for other things, I used it for birth control, as a preventative measure, so why isn't it paid for? The only answer I got was the code didn't specify either of those things.

What I learned is that there are generally two codes a doctor can use for laparoscopic bilateral salpingectomy: one that says it's birth control, and one that doesn't. There were two codes in my paperwork: one that described it as "female surgery" (no shit) and one that described it as a "medical procedure" (imagine that). The super weird thing was when I asked the insurance rep to read the codes back to me she said it "tubal ligation." Which would be paid for. When I asked why it said tubal ligation and they still weren't paying for it she said that's where that second code comes in, the one that called it a "medical procedure." Apparently, in order for Blue Shield to pay for this surgery, it would need to have a code that indicated it was a "preventative procedure." What differentiates a medical procedure from a preventative one is something I still don't know. 
Call your insurance company and find out what their rules are. If they consider it birth control, awesome. If they don't, do your best to find out what your costs are going to be when all is said and done (hospital fees, doctor's fees, anesthesiologists fees, medical waste fees, administrative fees, any and all fees they can throw at you). Honestly, I'm an educated person and am used to talking with medical professionals and I feel insurance is needlessly and possibly intentionally complicated so people will just pay to avoid the headache.

Since this was the surgery I wanted and I wasn't going to get a less-effective surgery with a longer recovery period and more potential for risk because it would be cheaper (some things you just need to pay for), I didn't try too hard to determine all these things. Plus, I knew my company would pay my deductible so my risk of actually paying anything out of pocket was pretty small.
I had my surgery in October and finally paid up in April. When all was said and done, it cost just over $2,000 (less than my deductible, which my employer pays as part of our medical benefits package). The upside was the hospital was very understanding and worked with me to try and get Blue Shield to reconsider. They resubmitted the paperwork twice, I talked everything over with both my doctor and the billing department multiple times, and they put several holds on my fees to give me time to get it sorted out. I still can't believe it took 6 months. 

Here's my six week update, the official "back at life" time for anyone currently considering this procedure and the recovery period. And here I am one year later. Good luck to anyone considering a salpingectomy! Despite the struggles with insurance, it has been 100% worth it.

Getting Spayed: Six Week Update

It's been six weeks since my laparoscopic bilateral salpingectomy. It's a ton easier (and admittedly more fun) to say I got fixed. Now, except for two tiny little incisions that are still healing, you wouldn't be able to tell I had surgery.

As a reminder, here's what I looked like the day after surgery:

I covered the big events of the first month after surgery in my previous post, and really there wasn't much to talk about. Like most people who have surgery, there was bloating and a small amount of pain, which was managed with extra strength ibuprofen for about a week. But I was working from home and visiting friends the very next day, back in the office on three days later, and eating and drinking normally that week, though not as much as I usually do. 

I haven't shared this with a lot of people yet. Part of me really wants to, because I'd love to shout this from the rooftops. But part of me understands how sensitive people can be to things they aren't familiar with and, as it was put to me, being so sure you don't want kids that you'll change your body is such a foreign concept. However, those I have told have been almost uniformly supportive. My close friends and family members who do want kids have been the most supportive, saying they're happy for me and reminding me I'll be a great aunt. 

One thing I am very, very happy to be doing again is running. I had taken a few months off due to an injury, combined with an extra hot summer, so adding the surgery was just one more reason to not exercise. Now everything has fallen back into place and running feels so good again. I've even started doing some weights. Since I'll never be pregnant I'll also never have to work as hard to stay fit and in shape. It's amazing how quickly the body readjusts to exercise; even taking almost three months off any form of exercise except walking the dog, after only a few short runs I feel my muscles returning and my jeans are a little looser. It's lovely.

The final thing I'm still waiting on is that sweet, uncomplicated, risk-free sex. Six weeks was the time I had to take off from both sex and tampons, and it was something I didn't think would be so hard (that's what she said) to stop, especially when you're still going to bed every night next to this person you think is really sexy.

However, it's Thanksgiving. Which means traveling and staying with family (his) and a further moratorium on sexytimes. I would say I'd give an update on what this risk-free sex is like once we get back, but I'm not. So here's a photo of what my scars look like today, because that's basically the same thing, right?

And here are the two photos, six weeks apart:

Feel free to leave a comment if a salpingectomy is something you're considering, or share your stories from your own spaying!

Getting My Laparoscopic Bilateral Salpingectomy

Today was surgery day! After about a year of consultations and trying to find the right doctor and not one who would do it begrudgingly, a couple years of giving surgery serious thought, and close to ten years knowing I don't want kids (and more importantly, never want to be pregnant), I am finally sterile.

Pre-op selfie

I stopped taking birth control about 10 months ago because I couldn't start another year on it. What used to work really well turned on me in my mid-twenties and I started getting side effects: mood swings, dryness, irritability, low libido. When I stopped I felt much better, but every time was a risk. And boy did we risk it... I honestly started wondering if one of us was naturally sterile. Part of my consultations was to decide which procedure to go with, and after a long time I settled on a laparoscopic bilateral salpingectomy: full removal of both fallopian tubes. I cannot wait for my 6 weeks to be up for 100% worry-free and baby-free sexy times!

Why a laparoscopic bilateral salpingectomy? 

1. My fallopian tubes are completely removed. There is no chance I can get pregnant!
2. There is no chance this can be reversed. I imagine this being particularly helpful for anyone who tries to tell me I can get it reversed if I change my mind.
3. There's nothing inside me (and never will be, hey-o!). Other sterilizations like tubal ligation and essure leave things behind. A tubal is traditionally done with filshie clips, while essure is a tiny coil that is pushed through each fallopian tube and in about three months is covered in scar tissue. Essure was really appealing to me at first, but I liked the immediacy of the salpingectomy and the fact that there isn't anything left.
4. There are early studies that show that some ovarian cancers originate in the fallopian tubes. With them gone, my chance of cancer is reduced!
5. My hormones were not messed with at all. I'll still ovulate, still have a period, still go through menopause, and still get all those glorious hormones that make me a woman. (Yay?)
6. No chance of an ectopic pregnancy! I'm really excited that this can physically not happen, as it's super dangerous. No fallopian tubes=no ectopic pregnancy! In fact, women who do have an ectopic pregnancy have a salpingectomy. 
7. If I do end up getting pregnant, my doctor said she'd write a case study on me. :)

Consultation:

I met with a couple different doctors about being sterilized before finding the right one. I knew Planned Parenthood would perform the surgery, but since I'm a big girl with insurance I figured I should try the doctors in my network first. I found an office that primarily performed essure and made an appointment, but was wary of that doctor for several reasons (including his reluctance to do it, and his reluctance to consider a tubal). If I was going to be going under the knife or having any sort of permanent procedure performed, I wanted someone to be 100% on my side.

The doctor I settled on I found through the childfree subreddit, which has a list of doctors willing to perform these procedures on people who don't have kids. I liked everything about this doctor, especially that she seemed fully supportive, possibly even excited for me. 

She did a pap since I was due anyway and we set up a day for the surgery about 6 weeks away.

Surgery Day:

Check-in was at 8:15am. At the front desk I showed my ID and got a wrist band (so fancy) and was whisked away almost immediately for a urine sample for a preggo test. No one told me the result but I'm guessing it came up not preggo, since they didn't tell me they threw in an abortion.

In a curtained waiting area I was given a gown, hair net, and adorable purple socks with grippy paw prints that they let me keep! I'm pretty excited about those, and will always remember my surgery when I wear them. There were also these weird compression sleeves for my calves, apparently to encourage blood flow and reduce the risk of blood clots. The Boyfriend came to meet with me once I was changed and to take my pre-op photo.

During the next hour my doctor, the attending, the anesthesiologist, and a couple of the nurses came in to say hi or introduce themselves. I kind of already have a girl crush on my doctor, but I really liked the anesthesiologist, too. They asked me several times to state my name, birth date, and procedure and my doctor verified a couple of times that this is 100% what I want and that I know this is 100% irreversible. Yes and yes! 

Finally, closer to 10am, I was taken to the surgery room. It was so intimidating! I've never seen a surgery room before and it was both exactly like what they show in movies and the exact opposite. First of all, it was huge and felt domed. It was full of incredibly white light and lots of it, and so many machines and tubes all over the place. The entire crew was already in there, in scrubs and hair nets and shoe covers and face masks. The nurse asked me one last time to state my name and procedure to the surgeons, so I said, "I'm Lindsay, and I'm getting my tubes removed!" I figured they weren't backing out then.

The nurse helped me onto the table, loosened my gown, and got me comfortable. The nurse wrapped me in a warm blanket – the anesthesiologist told me this is because keeping bodies warm before and throughout surgery leads to a better recovery. The anesthesiologist then started the IV in my wrist. He warned me that the drug causes pain at the injection site. I could feel it working almost immediately – I was fuzzy and knew I'd be out within seconds. But I asked him why the medicine hurt, and he definitely started to answer, buuut I was already asleep.

Some time later I woke up in a recovery room with a nurse by my side. She talked me awake(ish), asked me how I was, and helped me sit up a little bit. I was really out of it but responsive and felt fine, though I know I had a whole bunch of drugs in me still. She offered me water or apple juice, and I said both. That was some good apple juice. The Boyfriend was brought back to see me and take my post-op photo.

Someone took out the IV and wrapped it so I look like I survived a suicide attempt. The nurse helped me get dressed and complimented my choice in comfy clothes. She said I wouldn't believe how some women want to walk out in heels after surgery! I picked my superman shirt on purpose: not only did it make me feel a little stronger and braver, but it's super comfortable and loose. Then she told me about my dressings and wheelchaired me out!

The Boyfriend dropped me off at home and went to the pharmacy and grocery store (and had to deal with madness from a home football game). The first thing I did was pee and OW. Catheter. What a bitch.

I had soup ready for me for lunch and also tried to eat some crackers. But that was a bad choice... my throat was sore from the breathing tube. The cat jumped directly on my stomach while I was napping, not cool, and then threw up a massive hairball (on the rug I just washed), and I had to clean it up. Cats are the best. I spent the rest of the day napping, Netflixing, watching the Chargers almost win, and took the dog on a very slow walk with The Boyfriend.

Sweet dog follows me around

My belly button was plugged up with cotton and a very good tape all the way around it. The two incisions on either side were covered in some sort of body glue, and I was told to keep all three dry overnight. I feel pretty huge right now.

Post-Surgery

Day 1:
Slept on my back all night. It wasn't uncomfortable, but the dog loves is most adorable in the morning (when he's at peak cuddly) so I had to keep him off my belly. I wasn't in pain, just bloated. My big morning disappointment was no poo. My whole day is off if I don't have my morning poo. :(

I worked from home (in our new home office) and made soup. I threw in all the fiber I could think of, and it was actually really good. I took a 600mg ibuprofen just because, even though I wasn't really in pain, but then I was eating just because, even though I wasn't really hungry. Surgery is weird. 

The cat tried to jump in my lap while I was at my desk, and I pushed her and she hit her head. Poor lady cat. 

I experienced a little bit of shock over having had surgery yesterday. I think I should feel worse. Bending is uncomfortable, but that's all. I also have the realization that I am sterile. This is something I wanted for a long time but sort of never thought I'd do. When I was a kid I wished there was a pill to get you pregnant so you wouldn't have to have sex with your husband (because gross). Now I've taken out parts of my body so I can have sex without getting pregnant. Super weird. I wonder if this is the part where some women start to regret it.

I pooped! The soup worked! Tip for pooping after surgery: elevate your feet. This is a good tip for any pooping where you don't want to strain too much. Put your feet on a roll of toilet paper and sit up straight. Seriously, just try it. I might do this every time from now on. Even princes and unicorns agree this is good for your sphincter. 

I showered! And took off my belly button bandage – there's a staple* there! It looks really weird. I'm glad I have a belly button ring to hide it a bit, though it's not like people see my belly button very often.

The surgery center called but I missed it walking the dog. They were just checking in, reminding me to call if I need anything. My doctor also called for the same reasons, which was nice.

The Boyfriend and I went to a restaurant for a friend's birthday and I had like 2 ounces of beer before giving it to The Boyfriend. I wore my skinny jeans because they are the most stretchy around the belly, but after 2 hours I was done. It might have been the pizza, might have been not being able to fart, but I had to unbutton my jeans in the car on the way home (and then immediately stunk the place up). The Boyfriend remarked that this is as close to being pregnant as I'll ever feel. I'm grateful for that, and that my giant bloaty belly will soon go down, and that The Boyfriend doesn't even bat an eyelash at my gassiness (both post-surgery and normally).

At home we shared a slice of pumpkin cheesecake (it was treat yo' self day) in comfy pants. Glorious, glorious comfy pants.

*I learn on Day 8 that it's not a staple, it's sutures. Makes more sense, though I swear it feels like a staple.

 BLOAT.

The only belly photos I'll ever take.

Day 2:
Feeling a lot more normal today, but I'm really tired. Probably just didn't get enough sleep, but I look exhausted. My dark circles are out in force today and it's a struggle to keep my eyelids open. It doesn't help that I'm working from home again and it's horribly hot and muggy. I'm pretty sure my minor bloody nose is from surgery, not the heat.

I'm fascinated by my cuts. There's a staple* in my belly button and some weird body glue on the incisions on my sides. They look so weird, and I just look at them sometimes.

I get wine with my lady friend and tell her about the surgery. She had known I was talking about it but was still shocked and had a bunch of questions. I like that she lets me talk about this sort of thing, not everyone is into seeing cuts and hearing stories like that. We then talk about how some of the people in our lives are baby crazy and we don't understand why. Gonna hang on to her.

*Still not a staple.

 Quality photos are not taken with a phone in front of a mirror.

How am I bigger?!? Oh yeah, wine.

Day 3:
Back to work! I wore a skirt because fuck pants. I took the rest of my soup for lunch, though I was still eating far less than I usually do. 

Dinner was pho because The Boyfriend is lovely and puts up with my need for all the pho when I'm feeling even a little bad. It's bad, the lady who owns the place knows my phone order.

While I'm not in pain, I definitely like relying on the heavy duty ibuprofen. I get this pain like I've had a tampon in too long and it sort of resonates through that whole area. Surprisingly almost no spotting, though.

 Dog <3 comment-3--="">

Surgery + soup = giant

Day 4:
Office again, and Friday! Skirt again, but it rained so I was that person wearing a skirt and flip flops in the rain. It was muggy and warm so I wasn't the only one not dressed for the weather, but inside the office was freezing. All I want is for this heat to be over so I can wear jeans and shoes and sweatshirts, and when it's sort of cool I'm stuck in a stupid skirt.

I go to a happy hour after work and don't finish my beer. I don't need bloaty beer on top of my bloaty self.  

At home we order Thai foods, because it's Friday. I'm feeling rather back to normal, outside of the bloat, but not 100% yet.

Shhhh... they're on the bed together.

Day 5:
More skirt. I'm pretty sick of skirts and want to wear jeans again but I volunteered at a workshop for a women's hackathon and didn't want to commit to pants just in case. I'm super in love with these culottes I have for housewear (see Day 2 and 3 photos). They're so comfy and stretchy.

I realized the reason my appetite hasn't been as big all week is because there's still gas that's probably pressing against my stomach and making me seem full all the time. I'm starting to get hunger pangs again, but I've been relying on when I need to take a pill for my meals. I like feeling hungry. On the other hand, I've been eating so well all week that my poops have been fantastic. It's been a great experiment!

Day 6:
The Boyfriend and I went to Pour It Black, a dark beer festival at Stone Brewery. Stouts and porters are my fave and I've been wanting to go to this for a couple years. We arrived a little late (because drinking a whole bunch of really strong beer at 10am just really isn't my thing) and didn't make it through all 15 of our tasters (3oz each x 15 = 45 ounces of beer, or almost 4 full beers). But we had a really good time, got some great food, ran into a friend, and I got pretty drunk. I took an ibuprofen in the afternoon and that held me all day.

In the evening we went to some friends' for the night football game and I got some work done. For dinner I had my first post-op burrito (potato, egg and cheese!), though I saved half for breakfast. Soon I will have my full burrito.

Day 7:
It's been a full week! A week ago I was having surgery. Kind of weird to think about. 

Other than that, regular day, back at work, nothing too exciting. Still only taking 1 ibuprofen, and this one I didn't need until after lunch.

I was able to take closeups of the incisions, with the glue still on. The first two are the incisions over where my fallopian tubes were, and the last is my belly button. I found out during my post-op appointment that at least one of my fallopian tubes were larger than average, and had to be re-routed through my belly button, which explains why my belly button incision felt worse than the others.

Day 8: 
I WORE PANTS. Holy shit did that feel good. I haven't missed jeans so much in my life. 

Still only taking one ibuprofen (and at like 2pm, too), but today I feel like I did a lot of sit-ups. It's like that weird good pain you get, only it's not good because it's surgery, only it is good because it's surgery. I don't know. It wasn't bad. Now I'm wondering when I can start working out again. After an ankle sprain a couple months ago I've been out of commission for way too long. Feeling the flab.

I called the doctor's office and learned that it's stitches in my belly button, not a staple like I thought. They should dissolve on their own, or might come out. I dunno, feels a lot harder than thread... But I have orders to not pull them out. 

I can also take the glue off my side incisions. Maybe tomorrow.

Day 9:
I peeled off the body glue after showering. I'm healing! They're going to be almost invisible! I'm so excited! 

I wonder if anyone else that gets surgery like this is as fascinated with the human body as I am. It just fixes itself. I was cut open and soon you won't be able to tell at all. Amazing. The surgeons did such a good job making the incisions as small as possible so they'd heal, for which I'm very grateful. 

Except now my belly button is itchy. But it's itchy on the inside and scratching doesn't do anything. The nurse said I could take Benadryl if the itchy is too much but that would just put me to sleep. Fortunately it's not so bad and working gets my mind off it. Really looking forward to this being done.

Shitty cell phone pictures are shitty.

I also didn't take an ibuprofen today. :)

Day 10:
Honestly, there's not much to talk about. I wanted to update this to 10 days (then my six week update) but things are pretty much normal. I'm feeling a lot less bloated and almost like I could begin light jogging again. But then whenever I move too quickly I'm very aware of my belly.

Overall, this was a lot easier and less painful than I was anticipating. Pretty surprising, but I'm happy about it, obviously. Check my update for more, and I'll do one about dealing with insurance once that's settled.

What Really Happens When You Stop Taking Birth Control

I'm going to preface this by saying that this is going to be an account that some dudes who are not close with their girlfriends or wives or sisters or lady friends may be a little shocked by. This isn't just TMI… this is all the information. But I encourage you to read on anyway, so you can be the dude that gets it. Lady readers, hope this educates you!

Shitty Birth Control Options

I've been on and off birth control for a decade. I started the pill when I was 19 and just started having sex after 6 years of very regular periods that were about as pleasant as they come. PMS wasn't an issue, I barely had cramping, and other than the learning curve that comes with trying to figure out this whole period thing and how to manage it, I didn't really run into many problems. In those ten years, I tried the patch, at least half a dozen different pills (both the ones like Ortho Tri-Cyclen, and those like Desogen), and the ring. There were a handful of instances that I took a break from hormones, usually when I was not having regular sex. But I always went back, because condoms just kind of suck.

I also want to say that it completely sucks that men have exactly two options: condoms and vasectomy. This total lack of options for half the population means that women are forced to be the ones to take care of the family planning, and even our options are limited: hormones, barriers (do women still use those?), and surgery.

Shitty Birth Control Effects

You already know the pill, or any hormonal birth control, can affect things like acne, weight, mood, flow, and sex drive. Likewise, this all changes again when you stop taking birth control. Do a Google search for "what happens when you stop taking birth control" (Google auto suggest will pre-populate the search for you). That's right, it's highly likely that as soon as you go off the hormones you'll be far more interested in sex, and it will feel better thanks to your body's natural lubrication that gets suppressed on the pill. It's the worst irony. Unless you're trying to get pregnant, in which case it's probably awesome.

I, however, am not trying to get pregnant. The Boyfriend and I are actively looking into some more permanent methods because I just don't like pills anymore. I'm not happy. In fact, I feel unhappy more than I should, and I can't help but think the pills have a lot to do with it. My boobs are almost out-of-control huge and losing weight (not that I've tried even a little bit this year) is near impossible. A lot of the time I'm completely uninterested sex, which pains me almost as much as it pains The Boyfriend, and it's even gotten to the point where penetration hurts. It's so much fun, guys, really. I like being able to plan when I'm getting my period but that's a very small price to pay.

Shitty Everything

I wanted off the hormones, but also wanted to not get pregnant. Right now it's a three-way tie between a tubal, a vasectomy, or an IUD. (Take a look here in the next couple of months for the winner.)

With less than two weeks to go in 2014, I stopped taking my pills. I couldn't stand the thought of starting another year on them. Hormones leave the body within a few days, and there have already been some changes. Some subtle, like how I just feel better. But some not so subtle, and that, my friends, is what this is all about.

I'm talking about the mucus. The pill works in part because it thickens the cervical mucus so much that sperm have a really difficult time getting to that egg. Now that we're not all hopped up on the hormones anymore that mucus doesn't have a purpose. So out it goes. And oh boy, is that noticeable. Not only can you feel it coming out, but it's super thick to the point where now I know how good the pill is at preventing pregnancy. If I didn't already know this was a normal and healthy part of going au natural again, I'd be worried. So just be more prepared with a change of undies, but it's not so sticky like normal discharge that a little wipe won't clear it away. Honestly it's the weirdest thing… biology is crazy.

I'm hoping the abundance of mucus will stop after this first cycle, but so far it's not the worst thing in the world. You can find plenty of information elsewhere about having to deal with acne and weight issues and flow and all those other things everyone talks about when you stop your birth control, but this is one of those things most women – for whatever reason – don't talk about.

Image: Flickr

Changes

The last few weeks have been quite a whirlwind of downs and ups and things that would be so frustrating if they weren't a little funny.

First off, the cat and dog have been living together. Mostly unhappily...

August started with my two year anniversary with the boyfriend (aww). We went to a sushi restaurant in La Jolla that I had a Groupon for, and it was underwhelming. The atmosphere was nice, and going somewhere we've never been before was fun, but the sushi is way better in North Park. Which actually is great, because we eat at one of three nearby sushi places every week, and it's nice to know that we're getting the best without paying an arm and a leg or driving 20 minutes each way. We walked the long way back to the car and stopped at a little cafe that had cakes for dessert.

The very next day was his bff's birthday, so we went to a pizza/beer place, where we met some random southerners who were in San Diego before going to Vegas for a gay wedding. We stayed up late, ate burritos, and fell asleep on the couch until the very early hours of the morning. The day after that I was supposed to go to a meet up with my coworkers, partly because our boss was presenting, but my throat had been hurting all day and I had a mini anxiety attack when I got home from work; the thought of skipping it made me calm down. So I did and spent the evening cleaning my apartment and made one of my night-by-myself dinners. The next day I got a call from a fraud center informing me my debit card was stolen (even though it was still in my wallet). There were four attempts from Honolulu to Baltimore of someone using my card, and one was successful to the tune of $76 - at a Food Maxx in Union City. I went to my credit union to fill out a fraud affidavit (at, like, 515 on a Friday) and raced back home because my mom was in town for a visit... waiting in her car.

Over the weekend my sore throat turned into a full blown cold, but we pretty much spent the whole time at the beach and that made it a lot less severe. We hiked Torrey Pines one day and walked from Torrey Pines to La Jolla Shores the next (I stepped on a bee and got stung on my foot and got to experience seeing a whole lot of old man penis with my mother). Oh, and a pipe beneath my room sprung a leak and we came back Saturday night to discover my carpet was all wet. That awesomeness is in much more detail here.

The boyfriend and I had been talking about living together for a little over a year and had recently decided to aim for the fall, after wedding season was over and he had more time to devote to the process. The ordeal with my apartment made us decide to move that up, so we spent the next week on Craigslist, emailing our favorite listings to each other. We also took a couple nights after work to drive around our target neighborhood looking for rent signs and made a few appointments to see apartments.

On one such night I got a call from my gynecologist - I had a yeast infection (fucking antibiotics) and something known as LGSIL - a low grade lesion. This can be caused by HPV. I got the Guardasil shot series after breaking up with the first person I'd had sex with but Guardasil doesn't protect from all forms of HPV - or cervical cancer. Soooo there's that. Now I get to have a colposcopy (where they go in to the cervix with a flashlight and scalpel) and a biopsy. The chances of this being anything more than a random lump is super small, and it will very likely just go away on its own in a year or two. However, now I've had an abnormal PAP and need them every year rather than every two. It was weird though, hearing the doctor say the word cancer. She told me that most women don't know they have cervical cancer because there are no outward symptoms (I wouldn't have felt this lesion), which is why PAPs are so important.

The rest of the week was full of apartment hunting. One night we went to see a place in our second choice neighborhood, which was right by a dog park. Long-story-full-of-emails-back-and-forth-short: we loved it, applied for it and got it! Deposit is sent, lease is signed, and in a few weeks we'll be living together. I didn't expect the boyfriend to be as excited and enthusiastic about moving and living together as he's been since we got the official notice, because the next month or two are going to be much more complicated for him than they are for me. He owns his condo, which means he'll have to rent it out and all of the responsibilities that come with that. On the other hand, I'm super grateful that he's willing to do this to live with me and to live in an area that's close to my work. In the long run I believe it will be beneficial for us both (extra income and a shorter commute for him, an area I already love by work for me), but the initial effort is definitely more one sided.

Days after we got official notice of the new apartment I had my year review at my company. My boss shared with me his vision for the company, told me he wants to support those who share his vision (which I do completely), and gave me a huge vote of confidence in the form of a high profile client. After years of odd-jobs that were fun and other jobs that sucked, I'm so happy to be in a solid position in a company that is not just doing well but has plans for the future, and a company that has a future for me.

So, after more than a week of downs-that-weren't-that-bad, I had more than a week of ups-that-were-amazing. And the next month or two will certainly be stressful and life changing, but they'll also be exciting and happy. I can't wait.