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

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

Colposcopy: 15 Minutes With A Flashlight And A Scalpel

Should anyone looking for more information about what a colposcopy is and what it's like, I hope this can help. Regular readers: prepare to be educated.

After 8 years of perfect Pap smears, a month ago it came up abnormal. The doctor found a small lesion, which she called LG-SIL, or low-grade squamous intraepithelial lesion. She acted like it was no big deal, and more or less explained that women get Pap smears because cervical cancers often come with no symptoms, and tends to be discovered way later than it could have. As long as you have a history of normal Paps you get them every two years. An abnormal one means you get them every year, after whatever procedure is necessary to return it to normal. 

So today I went in to get a colposcopy (medical professionals call it a colpo - I guess they deal with a lot of -oscopies). As soon as my ID and insurance were verified, they sent me to the back for a urine sample for a mandatory preggo test (negative, yay!). I didn't even get back into the waiting room because the medical assistant was waiting to take me to the exam room. She sat me down, took my vitals, told me to undress from the waist down and gave me a sheet as a cover. Usually, you sit like that for, like, 10 minutes waiting for the doctor to come in, but no sooner had I sat back down than the doctor knocked and came in.

She explained again to me what was about to happen: there was a device to my left that looked like a cross between a microscope and a hydra that she was going to use to get a better look into my cervix. It would stay on the outside of my body, so the rest of the procedure would very likely go like a regular old Pap smear: speculum, gynecologist, and some swabs. Should she see anything abnormal she'd take a biopsy to send to the lab, otherwise she'd take a scraping just to be sure there wasn't anything the Pap missed.

I had a very strong feeling throughout the procedure that this was more of a liability issue, rather than a real medical concern. If I were to develop cancer and had a recent abnormal Pap that they ignored I'd have a case against them. Plus, Paps aren't perfect, and an abnormal result could indicate something more serious, so it really is better to be 100% sure it's nothing to worry about than assume it'll just go away on its own, even though it most likely will.

Since nothing really was going on inside my uterus there was no need for any anesthesia; the doctor explained even if she has to take a biopsy it will hurt more to administer the local anesthesia than the second or two it would take to get the sample. At first, everything felt a lot like getting a Pap smear - she found a smaller speculum to make it more comfortable (God, these doctors are amazing), I could feel the Q-tip as she cleaned and collected, and we chatted about my neighborhood and this restaurant that closed and how the owners of a beer shop down the street are reopening it, all while the medical assistant stood silent in the room. Then the doctor told me she didn't see anything abnormal, so she was just going to take a scraping.

She might actually have not used a scalpel... I couldn't see over the sheet what exactly was going on and didn't try to watch, but I sure as hell could feel everything and it felt like what I imagine a scalpel in your uterus feels like. Un-fucking-pleasant. She told me I would feel cramping, and seemed to hunker down to get this part over with as quickly as possible. I'm very lucky in that I rarely experience cramps, and the ones I do get are very mild. But this felt like the worst cramps ever. I kept trying to relax my legs and not tense up, pinching myself for distraction, but I ended up making some noise anyway. Any woman who has experienced bad cramps or a Pap smear will understand what that feels like, only times 10. Ouch. But it wasn't a searing pain and it was over as soon as she was done. 

As soon as she got the scraping she removed the speculum and told me I was free to sit up if I felt OK or I could stay laying down. The doctor housed her sample, cleaned up, asked if I had any questions, and was out. The whole thing took maybe 10 minutes. Crazy fast. I was allowed to dress, the medical assistant gave me a panty liner to protect against spotting, and I headed to the check-out desk for my paperwork.

Unfortunately, that's where it got a little scary. The medical assistant left her desk for a minute to retrieve the paperwork from the printer, and immediately I started to feel hot and lightheaded. This familiar wave rushed over me - the air in the room was gone, I was sweating, and I knew I was about to pass out. I held on to the counter and tried to focus on a word on the wall... but no one was around if I did pass out, so I found a chair in an exam room, sat down and fanned myself with a paper. The medical assistant found me after a few seconds and helped me to the exam bed to lay down, then went to get the doctor. When they came back they brought some water, a cold washcloth for my forehead, and the medical assistant took my vitals again, just to be sure. Apparently this happens - I guess messing around with your cervix has some other effects on the body. After a few minutes and normal vital signs I felt well enough to leave.

Things you should know about a colposcopy:

• They'll give you a sheet of things to prepare yourself - no sex and no putting any creams or products in or near your vagina for three days before the procedure.
• You probably want to take an aspirin or something before getting there in case you have cramps. I didn't and the pain was only during the procedure.
• My insurance would have charged me $100-200 to have it done in a hospital, where the original appointment was made, which a super awesome nurse informed me of and let me change my appointment to a medical facility that wouldn't charge the fee. That being said, I still have no idea how much my insurance will charge me for this whole thing (but I'm glad I didn't need a biopsy!).
• No sex and no tampons for three days after the colposcopy. 
• There might be spotting and cramping (I didn't have any effects after). 
• Wear cotton panties for breathability.
• Results come back between 7-10 days, and you should expect a call from the doctor that performed the procedure.

I hope anyone reading this who is about to have a colposcopy or knows someone who is has found useful information here. This was the fastest medical procedure ever, and all in all not as bad as I was fearing. Also, anyone sexually active (under 30, I think) should get the Gardasil vaccine - protecting yourself and/or your partner(s) against 75% of viruses that cause cancer and warts is a crazy good idea.

EDIT: My results came back normal, as expected. Now I just need to schedule my follow-up PAP for one year from now to make sure everything is still all hunky-dory.

Plan B (Or, Better Safe Than Sorry)

What an awesome name. Plan B. So succinct, so simple.

And what a great invention. Seriously. Forget a pill? Plan B. Condom broke? Plan B. Something awful happens to you? At least you won't get pregnant. Just plain wanted to have sex and didn't use any protection? At least you don't have to spend the rest of your life regretting those 15 minutes.

I've always been slightly paranoid about having one of those accidents. I've also always been, like, really in tune with my body so there never was a real worry. The closest I ever got to a pregnancy scare was when The Ex and I spent the weekend volunteering at a family fair for my internship and then went to see Knocked Up, which sparked a conversation about what would happen if I got pregnant... we discovered we had very different plans. I freaked out the next morning thinking my period was late and, despite having used birth control religiously, went to the health center at school to talk to someone. The pharmacist looked at me from above his glasses through the window and asked how late I was. I said I was supposed to have gotten it that morning. He asked if I felt like I was going to get it. I said yes. He told me to wait it out and come back in a day or so if I was still worried. I got my period hours later. I think part of the reason I was so worried even though I had absolutely no reason to be was because I don't fully understand how the little sugar pills in each packet work.

Anyway, back in January I decided to take a little hiatus from hormonal birth control. Turns out, the pill I was on was just not jiving with my body and I've felt way better off it. On the other hand, all that left the boyfriend and I with was condoms. 

And seeing how this post is titled Plan B, you can assume how that worked out.

Back to my not so scary scare story: even though I had no real reason to worry, I still did because the consequences of not taking action were pretty severe. Back then I wouldn't have had an abortion, which would have left me knocked up in college. Awful. Now the first thing I'd do is make that appointment, brave the picket lines, and get that abortion. Slightly less awful, but still not something I'm eager to do. So if there is any real chance I could become pregnant I need to do whatever it takes to make sure that doesn't happen. This is just one of those things I would worry incessantly about. I even had a backup stash of Plan B from a visit to Planned Parenthood a couple years back, but that had expired close to a year ago. So last week I went to Planned Parenthood and bought the Peace of Mind pill. 

And it was OK. I was expecting a lot more to happen... nausea, cramps, pain... nothing. The nurse told me to take it with food, and I could kind of feel something weird going on, but it's been a while now and it was not the experience I was afraid of.

So... good.

Although, I was also warned some changes to my period might be expected. It could come early. Or late. Or be heavier than normal. Or lighter. Or not come at all. Or be exactly the same. So there's that to worry about.

In the meantime, I had to cancel an appointment with a male gynecologist  (thanks UCSD for totally ignoring my request for the female doctor I had spent an hour selecting) because I'm not going to form this doctor-patient relationship with someone who does not even have the same parts, and now wait even longer to get back on reliable birth control. The only thing now is I wish Obamacare had kicked in already so it would be free. I'll have to pay for it for about a year until my insurance "requirement" starts, but at least after that it'll be free.

The Truth Behind Choice: Part 1

Today is the 40th anniversary of the groundbreaking Roe v Wade decision that allowed women in America to legally obtain an abortion. The decision no doubt saved lives (which is slightly ironic) and provided a way for women to move up in society, rather than begrudgingly be burdened with a child she does not want or cannot care for.

You wouldn't know it, however, if you looked at politics today. For whatever reason, 40 years later abortion is a huge issue. People who have not had abortions, especially people who physically cannot have abortions, are trying very hard to dictate what those who need and want them can or not do. The amount of outright lies, in addition to the extreme ignorance surrounding abortions is disgusting. Men (and the women who back them, for whatever reason) who advocate abstinence only and pro-life in every scenario are at the height of hypocrisy: if over 95% of American adults have had sex and 20% of women (just women, mind you) are choosing to remain childless, that points to a bit of an overlap. That means there are women out there who are having sex without the intention of becoming pregnant (gasp!). In this day and age, too. Women are educated just as much as men are (sometimes more), are earning almost as much as men are, and are found in every manly profession. We're getting married later, making more important decisions, and are pretty much real people now. And some of us are having abortions. And those abortions are helping us maintain our status in life, which often is being in a position to care for the children we already have.

Today on NPR's Fresh Air two very different women were interviewed. The first woman decided with her husband that it was time to have a second child and became pregnant, only to discover halfway into the pregnancy that the fetus had a severe developmental problem that would lead to certain suffering. The second woman runs a pregnancy center called Involved For Life, which counsels pregnant women on every option except for abortion. Both women live in Texas, a state that recently made it mandatory for women seeking abortion to undergo a sonogram (women in early pregnancy endure a transvaginal sonogram because it picks up a better picture), wait 24 hours, and listen to government propaganda.

Here's a (pretty comprehensive) summary of both of the interviews:

In America there were more abortion restrictions passed at the state level in 2011 than in any prior year, and 2012 had the second highest number of state level abortion restrictions. This is a country that made it legal in every state for any woman to receive an abortion for any reason 40 years ago, and is now back tracking, making it harder and harder for women to do so. The first woman, a journalist named Carolyn, wanted her pregnancy. Thanks to modern healthcare she was able to plan when she got pregnant and made a conscious decision with the help of her husband to have a second child when they were both ready. When they went in for the sonogram (the "jelly on the belly" kind) that was supposed to determine the sex of the baby, the doctor noticed an problem. The fetus had a major neurological flaw that caused his brain, spine and legs to not develop correctly. The doctor said he wasn't sure the baby would survive. If he did, he would live a life of crippling pain and be in and out of hospitals until he died. He would always suffer.

Carolyn says in the interview that any parent understands the innate impulse to protect your child from any pain. She and her husband realized that by bringing this child into the world they would be causing him a lifetime of pain and suffering. She says that the decision to have an abortion was "a terrible, a heart wrenching choice, but also a simple choice." She wanted to prevent him from knowing a life of pain, which made it a relatively quick decision, an "almost instinctive response." But it was heart breaking.

Two weeks earlier Texas passed a law that required any woman seeking an abortion to undergo a sonogram first, and then wait 24 hours. It turns out that women seeking an abortion due to rape, incest, or medical necessity (as was Carolyn's case) do not have to endure a sonogram, though her doctor didn't know that at the time. But the rest of the state requirements still apply, no matter what reason a woman is seeking an abortion, and these include:

• a 24 hour waiting period
• requiring the same doctor to perform the sonogram and the abortion (which can create a scheduling nightmare, which can result in delayed abortions) 
• the doctor must describe the fetus' characteristics to the woman
• the doctor must play the heartbeat for the woman
• the doctor must read a state-written script about the risks of abortion (that includes two parts that have been discredited) 
• the doctor must read a script describing in graphic detail the abortion process
• the doctor must read a script that informs the woman that the father is required to pay child support even if he wants the abortion and that the state may pay for maternity care.

Quite a bit of effort, no? Could you imagine going through this if you'd been raped?

Carolyn said having to hear that her baby had 4 healthy heart chambers was traumatizing. It was the only part of him that was healthy and her doctor was required to describe it to her. She said nothing anyone said or could have said swayed her in the slightest - she was making the right decision by not bringing him into a world of nothing but pain and suffering. But she noted that politicians want women to have a sonogram so they can see the life they're about to end. It's completely ideological, has no medical purpose, and does not belong in the doctor's office. After a while she couldn't take it any more - she wanted her baby and was devastated to have to have the abortion, and these state laws were horrible. The nurse in the room noticed her distress and turned up the radio. The doctor apologized for having to follow these new orders - no one in the room wanted to do this. How could someone who has no say in her personal decisions invade her private life, reduce her dignity, and give her such injustice? It still makes her angry, and that's why she writes about it so openly.

Obviously the goal of all of these obstacles is to get women to reconsider abortion. Texas slashed the family planning budget to two thirds of what it used to be in order to try to starve out Planned Parenthood. Instead, 60 small town clinics that served the poorest Texans went out of business. These clinics didn't just offer abortion services or birth control, they provided women who had no other means of health care with breast cancer screening and well woman visits.  State legislators are budgeting for an extra 24,000 births for 2014 and 2015, and need hundreds of thousands of extra dollars in their budget. (That's saying nothing about the cancer cases that won't get caught in time...)

Instead, Texas is giving the funding it used to give to clinics that performed abortions to Crisis Pregnancy Centers, which are usually Christian run anti-abortion centers. These centers claim to provide women in need with alternative options. As if the first thing women think of when they find out they're pregnant is "must...get...abortion." The centers convince women (most of their clients are low income women 15-24 years old) to keep their unborn children rather than have an abortion, telling them that abortions aren't the right decision for them. Medical professionals criticize these centers for giving women incorrect, inaccurate or incomplete information in order to get them to keep their pregnancies.

The state of Texas takes money away from family planning centers and gives that money to centers that encourage more births to women of all ages, abilities and incomes. Oh, and those centers are not required to discuss contraception with women seeking abortion (whether or not they go through with it), and the centers most often do not provide any detailed counseling on birth control options. Seems totally counterintuitive. Abstinence is 100% effective, so anyone not willing to immediately give birth to a child should not have sex at all. Even married women.

The centers, one of which is run by the second woman (also named Carolyn), offer alternatives to abortion, counseling, ultrasound, STD screening and treatment, and parenting classes. They also have mobile sonogram units, which they park in front of abortion clinics, and offer free sonograms to women. The second Carolyn says their goal is to provide nothing but education for women. She says that often women don't know their options (a claim I find impossible to believe), and the centers provide the support these women so desperately need. I agree that women who find themselves unexpectedly and unhappily pregnant do need loads of support... but the misleading half-truths these centers are known for telling are not the kind of support women can rely on once that baby comes. Carolyn says "we do not ever mislead;" they are up front about their unwillingness to perform abortions or even refer women seeking one to a qualified doctor. In fact, she tells stories of women who become successful even after "unplanned circumstances." But a pat on the back and go-getem-girl does not raise a child...

One of the most surprising parts of the second interview was when Carolyn (the second one) said that they have to point out on the sonogram what is a baby. They actually point to the image on the screen (which she says the women say is blurry and not clear in the abortion clinics and hospitals) and tell them that is a baby. And apparently the women are surprised that that's what's growing inside them. If that's the case we need to put a lot more money into Texas schools... Carolyn seems to have her heart in the right place, which is wanting to help women, but her ideals keep getting in the way. She says, "I don't think the Supreme Court had any idea that there would be thousands and thousands of women who regret that they ever had an abortion." Yes, women must regret their abortions. If I had one I know I would. But it would be far more regret that the abortion had to happen, not that I had one. If I were in these women's shoes I imagine I would know it was the right thing to do, not just for me but for the child I would unfairly be bringing into the world. Of course there would be regret... I imagine that's almost unavoidable. But regretting the situation and regretting my actions would probably be two different things.

Carolyn, the journalist, talked about a pamphlet that these centers give out to women called "A Woman's Right To Know" which describes the abortion process in unnecessary, graphic, upsetting detail. Women are told that now that they're pregnant they're already a mommy.

Women may have a legal right to have an abortion, but those rights are being chipped away by the states. Federal funding is not allowed to go towards abortions (family planning clinics that provide abortions are in a pickle), so any clinic or center that does want to provide safe abortions to women must charge for it. Which puts the poorest women at a significant disadvantage. Oh, and birth control funding is cut, too. Carolyn, who runs the Crisis Pregnancy Center, applauds the "progressive" nature of Texas schools that make it easier for young single mothers to stay in school by providing day care, but is this not something that could be prevented with education and access to birth control? Is that not the type of information these pregnancy centers mean when they talk about providing women with resources?

The moral of the story, here, is don't have sex unless you actively want a child; don't get raped; and no matter what don't have an abortion.

Here's Part 2.