NovaSure and my Endometrial Ablation

by Alicia on November 6, 2017

Whoosah. I’m about to talk about my female insides, y’all. Specifically, my uterus.

At the end of August 2017, I underwent an outpatient surgery at my local hospital to complete an endometrial ablation. The procedure my gynaecologist used was called NovaSure. (Just this past weekend, I threw out the little pamphlet the hospital gave me on the procedure. I didn’t read it until a week before the surgery. I didn’t much care about the finer details of the procedure, I just wanted the damn thing done. If you’re considering endometrial ablation and are the kind of person that wants more information? I’m sure the website is a great place to start! I wouldn’t know, I’ve never read it.) Listen, it’s not that I didn’t care what happens to my body. I do definitely care about what happens to my body. It’s just that I trusted my doctor and knew that no amount of excessive knowledge prep would make me better prepared and less scared.

Why I Wanted An Endometrial Ablation

Basically, for around 5+ years, I’d been in and out of my general practitioner’s office with blood test requests and results. All of them said the same thing: “geez, Alicia, your iron is stupidly low.” And each series of appointments would end with a recommendation to increase the amount of iron I take in. Five years. Five years I thought that your stomach was just always supposed to feel like there was a rock formation in the bottom of it. Five years I just thought my body just needed a little extra time. Ok, like 4 years I thought that. The fifth year I got angry.

I’m young- currently 35. So the suggestion of a procedure which would end my ability to produce more children was out of my doctor’s immediate medical recall. In short, I didn’t know to ask for it, and he never suggested it. When I did bring up the possibility of this ablation thing, I was not rebuffed. He did not tell me no, he did not try to talk me out of it, my doctor was quite accommodating to my request, if a little hesitant to offer an immediate specialist referral. More blood work, more “your iron is so so low OMG how do you stay awake, ma’am”, more hand wringing. Basically, I needed a real medical need to become preferentially barren, is the short & brutal way to sum that up. I have three kids and zero interest in more. I got my referral- even if it took me 5 years. Persistence.

My gynaecological specialist took a pap smear and a uterine biopsy. He needed to rule out any other possibly outstanding medical issues that could be causing low iron and heavy periods. (My periods were consistently 7 days long, and obnoxious, though not as awful as some women I’ve heard of.) My tests came back clear- horray!- and my gynaecologist offered me birth control pills. FULL STOP. Say what, sir? No. This is where I caution you, Human Considering Ablation, to advocate strongly for your desired outcome. If the medical need exists for you to obtain the ablation, and there are no outstanding serious medical issues preventing that procedure from happening? Ask for what you want. Say specifically: “There is no need to offer me birth control pills I will not take. I would like to come back to discussing the endometrial ablation that I originally requested. Is there a barrier to you providing that for me?” Assertiveness doesn’t always mean bitchiness. If there is a barrier, ask to be referred to another gynaecologist and for access to your test results.

Why I Decided on Endometrial Ablation

Because I:

  • did not want to have a period (or at least not one as heavy)
  • did not want any more children
  • did not want to go through menopause at 35
  • did not want a long surgical recovery if it could be avoided

Now, there were some indications in my test results that pointed to very early stages of Poly Cystic Ovary Syndrome (PCOS). I never suffered any fertility issues, never missed a period, never had any symptoms of PCOS at all. So, take that for what it is. I’m at higher risk for cancer, but to be honest I don’t even know what that means, since that is a descriptor of nearly everything on the planet Earth.

What my Endometrial Ablation Experience Was Like

I dunno. I was asleep. The end.

 

Before my Endometrial Ablation, NovaSure procedureKidding. But almost not cause it was ridiculously chill. The hardest part was fasting for 12 hours before the procedure and only because I don’t like being told what to do. I showed up (starving) to the hospital 2 hours before my procedure, was given a hideously wonderful series of gowns and slippers, and everyone was very very nice. I sat in a second waiting room alone for around 30 minutes before where people asked me medical history questions and I was nosy as hell and listened to everyone else’s very exciting answers because my medical history is very dull because I am so lucky to be incredibly healthy. Then- and this blew. my. mind.- I walked into the operating room. No rolling bed, no wheelchair, just a 45 second jaunt down 2 hallways with a very polite nurse and into a very! bright! white! room! where my gynaecologist was like chatting with an intern and everyone seemed super chilled out. It was incredibly helpful to my expectations. Meaning I had none but I was just feeding off everyone else’s mood and they seemed to not think I was about to horribly suffer so I must be fine. I’d never had surgery before, no idea what to expect. I answered their questions after I laid down (do you know what you’re having done today? how old are you? what the hell does that tattoo even say?), got an IV put in, told them I felt a little sleepy and then I was out.

What they did while I was out was put a metal tube up my vagina, past my cervix, and into my uterus. This metal tube contains a net, which expands to the inside of my uterine lining. Electromagnetic waves are sent through the tube, into the net, which serves to burn and scar the lining of the uterus. This scarring and burning leaves the uterus inhospitable for an egg. Meaning, my ovaries work just as they always have, but my uterus just doesn’t bother creating a lining for the egg that gets released. My hormones are just as they always were, I just don’t have any lining to shed anymore.

Note: I inquired about several things before the surgery:

  • would there be smoke? No.
  • was there anything to keep after the surgery? No.
  • was it a big giant hoop like the kind they light on fire at the circus and a lion jumps through? No.

Yawn. Whatever man. So boring.

I woke up as I was being wheeled back in to recovery. I felt nothing. No pain, no aches, no cold or heat, no nausea, no flushed face, nothing abnormal at all. Recovery can be very different/ painful/ groggy/ nauseous/ whatever…but know that if you’re totally fine that’s totally fine. You have to pee before they let you leave. I was a stellar patient. Points, me.

My procedure began just before 2pm. I was home with pizza by 5:45.

My Ablation Recovery

Now! Do not be a brave asshole! I felt fine, so I carried on as if I had not just had surgery. And then as I was walking up my front steps I thought to myself, “oh dear, there are black walls closing in around the sides of my eyes and everything feels like it’s happening very slowly. I think I have overdone it.” I did not pass out, but I did not get to eat that pizza. I took a Motrin and fell directly asleep. Woke up 3 hours later, ate that entire goddamn pizza, took a Tylenol 3 (I wasn’t in pain, but I certainly didn’t want to be) and fell asleep again.

Suggested recovery is 2-3 days. I felt good by day 2, but I stayed the hell in bed because please refer to the fact that I have 3 kids and am actually healthy and have never had a great medical reason to stay in bed that didn’t involve a newborn. TAKE YOUR TIME, DUDES. I took Tylenol 3s for probably the first 12 hours following surgery, and I can definitely say I felt no pain. A dull cramp that wasn’t even like a period cramp, just like felt it. I was tired, for sure. So I slept and watched a lot of Netflix and read through almost all of Twitter dot com.

So here’s the not-as-fun, possibly gross part of recovery. Where I tell you that while I did not bleed after my procedure (which can happen and is totally normal), I did have a kind of brownish discharge. Which lasted…weeks. Like, so many weeks. Like, I should’ve read that goddamn pamphlet that told me it would maybe be up to four weeks because at week 3.5 I was so mad. Don’t get mad at your body trying to do its best, learn from my impatience. That’s totally cool. I mean, it’s gross (I could get by with one pantyliner during the day, one at night) but it’s fine. You’ve just scarred your insides, be chill.

I am now over 2 months post-surgery and have not had a period. BLESS ALL THE UNICORNS. My gynaecologist absolutely prepared me for the fact that my periods might come back. In fact, they are almost certain to come back. I’m very young. This procedure is generally done later in your 40s and into your 50s. Periods can be light for months following the surgery. It doesn’t mean it didn’t work, it’s just how your body has chosen to recover- meaning parts of your uterine lining are victorious little buggers and want to grow and shed like the old days.

I feel like I need to tell you a thing I asked my gyno never to say again. At my 6wk post-op check up, he told me that while I hadn’t had a period in September, I might expect one in October and it might be…chunky. He said that word. He said chunky. And then kept on talking like it was not the most aggressive thing to say in a sentence about my vagina. So, that can happen. Both the word chunky being spoken at you, and the fact that there may be some chunks of the dead lining/ scars that still have to come out. Best to know and not panic.

I feel great. I haven’t taken my bloodwork again to check my iron, but I do just generally feel like I can regulate my energy better. Not quite like I have more energy, but just like I don’t crash out. I’m hoping to see more of my short-term memory abilities come back, and I’m hopeful that my periods stay away. Because not having to consider all the possibilities of what I can and can’t wear, where I should sit, what I should pack and how I might have to work around my period to function in my every day life for 7 days of every month? It’s so incredibly mentally freeing.

 

So there it is. That’s the whole story. (It’s over 1800 words, it best be the whole story, dammit.)

It was the best decision I ever made just for myself. I’m glad I pushed for it. I’m glad I did it. I have no regrets.


If you have questions about why I chose ablation, or something I haven’t addressed here, you can either comment or send me an email . I’m happy to help where I can.


 

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