Monday, July 30, 2007

Menopause Chronicles--2nd entry: Red Tides

Then comes another sign. The sign has a color and it is RED, and of course it’s blood. We all have periods, but this is the period from hell. Instead of a normal period, this is MAJOR BLEEDING. A tampon and a maxi pad will not handle the flow. But at first it only lasts one day and then the next month, things are back to normal. There are months with normal flows and then there are months with major flows. Soon, the definition of normal flow changes to mean “major flow.” When did I turn into Mt.Vesuvius? This is not fun. This is when I started wearing so much “undergarment protection” that I walked bowlegged. Sitting down with all the padding was a major feat. Getting up was even more exciting as I had no idea what I was going to find. I discovered that pastel colors are bad and black is good. Back then Depends and its clones did not exist, but if they did, I would have wanted them for periods! I needed whole bottom protection, not just a pad with wings!

I hope it will stop, but it is getting embarrassing. One evening we went to a fancy dinner spot with another couple. I had on a nice dress, a light colored dress, no inkling that a period would come, and I looked good. We made a handsome foursome, without kids! We walked into the restaurant, were seated, ordered wine and appetizers and dinner…then I felt that horrible “leaking” feeling…I waited thinking I really was not feeling anything unusual. It would go away. In the back of my mind, I knew it would not go away, but the evening was going so well, why spoil it? I knew better. Soon, all the denial in the world, could not erase the feeling of sitting in a puddle. I scooched over on my seat in the quiet booth and saw the puddle. The leaking feeling was real. Now what to do? My girlfriend does not have a jacket, nor do I, but my husband does. I asked my husband, the ever sensitive college professor, that I needed to borrow his jacket and go to the restroom. In what seemed like his loudest voice, he said “WHY DO YOU WANT TO DO THAT?” I don’t want everyone to stare at me, so I say “just trust me (I’m a doctor afterall)…let me have your jacket. Gina and I are going to the restroom; we should be back by the time dinner has arrived.” I finally convince him to take off his jacket, I put it around my waist and we try to make a quiet exit to the Ladies. I’ll stop the scenario there. No more explanation is needed. If this has happened to you, you know what I did. If it has not happened to you, I don’t want to put braces on your brains by giving you a solution, as your solution might be so much better than mine was.

At least I had practice at dealing with the situation as this was not the first time it happened. The first time was at a faculty Senate meeting at my University. I was one of about 35 faculty senators. Every other week there was Senate meeting, so I was at that meeting. I was wearing a white suit, this was in the days before I decided that black was good. I had no clue what was going on with my body and my period was not due for another week. The meeting ended and I rose from my chair when the secretary quietly said, “you have a spot on the back of your skirt.” Even though she said this rather quietly, everyone was there and they could see very plainly what she was talking about. I was the only one in the room who had no idea what was going on. I looked back and sure enough, I did. I took off my jacket, put it around my waist and nonchalantly she and I walked to the Ladies for a quick clean-up. Since then, I’m getting good at taking off my jacket and wearing it around my waist. In fact, I started buying a lot of outfits with jackets as they have more than one purpose.

What was happening to my body was a “normal” result of aging. It has the unscientific name of “flooding” and it’s relatively common. A lot of women flood. I don’t remember my mother talking about it, but then she was of a generation that did not talk about anything “personal.” When flooding happens, lots of blood starts to flow. One time I went thru 3 super maxi pads in 20 minutes and then started all over again. I finally learned to go to a public restroom with damp paper towels to clean up the mess. But this was not solving the problem…it was just making clean up a bit easier.

It was time to get some medical attention. I cannot be lecturing and leaking at the same time. I talked to my gynecologist and HE said, it’s nothing to worry about. If it gets bad, then we can do a hysterectomy. That’s when I decided that going to a male gynecologist is like asking a priest for marital advice …neither of them have any direct experience with the issue. What do they know about things that affect women! I found a woman OB/GYN and she said “normal…yes, but there are things we can do about it and hysterectomy is the last resort.” I finally received an answer I could live with. She said that flooding might be the result of fibroids, so I was tested for fibroids.

Have you ever had a vaginal sonogram? Male researchers and doctors must have a sick sense of humor. They think of more fun ways to invade and test a woman’s body in order to discover what is right and wrong about it than any one around. I’m sure they discovered that freezing a speculum before a vaginal exam is a good way to relax a patient? Is there an equivalent “penis-ogram” that works something like a mammogram? Anyway, a vaginal sonogram and a mammogram are in the same camp. The inventors do not know what it feels like to be probed and prodded and poked by cold medical instruments. I mean, have you ever had a warm mammogram when they try to see how skinny they can squish your breasts between two very heavy duty metal plates? Maybe someone likes the idea of boobs under glass…a new medical treat. Anyway, I digress. A vaginal sonogram is simple…a nurse inserts a tube in the vagina and takes a picture of what it finds in the uterus. Sure enough, I had about 10 fibriods that could be seen easily. The largest was 9 centimeters, by 7 centimeters. The smallest was 5 centimeters by 3. That’s another irksome detail. I’m a scientist, but I work in inches, feet and yards, not centimeters. How big is 9 by 7 centimeters? I try to remember my fifth grade lessons on the metric system and I convert that number to roughly 3 ½ inches by 2 ¾ inches. That’s a good sized piece of tumor in there…and there are ten. They are definitely irritants.

After we discovered a mess of fibroids, I asked her if the flooding could be cured? She said, it could be alleviated some, and by the time I was finished with menopause, the fibroids would diminish. She prescribed a medication called Aygestin which I was to take 2 times a day for about 3 months. I did the research, remember I’m a social scientist, so I want to know what is going into my body. I read what the PDR has to say about Aygestin, and decided the side effects are ones I can live with and if means keeping my uterus, I give it a try. Aygestin is a type of progesterone and is used for heavy bleeding. It is not recommended for all women, but after looking at the consequences and (remember this is 20 years ago), after all, it might work. I decided that this might be a good thing for me. I followed the directions, as I was not going to have a hysterectomy, and the flooding stopped. Another hated vaginal sonogram and the fibroids had shrunk. It worked. Aygestin did the trick. The flooding stopped and I stopped taking the medication. The flooding had rare occurances after that, but after about two years of surprises, I was happy to see it was gone. I still had my uterus, and all the wonderful natural hormones that made me the happy person that I sometimes am.

What I did not know then is how common fibroids are in women. At least 1/3 of all women get fibroids, and African American women have more problems with fibroids than any other racial group. They are noncancerous tumors that grow inside the uterus. The good thing, they do shrink after menopause. Until then, they can cause bleeding and discomfort. If they get really big, they can cause frequent urination, constipation and lower back pain. A friend of mine had a 25 pound fibroid. She had lived with it for years until it was causing so much pain, she had it removed. In my case, they just caused heavy bleeding, and no pain. Because I did not have pain, I did not feel a hysterectomy was right for me.
Nowadays, there are more alternatives to treating fibroids. There’s a procedure called “uterine artery embolization” which decreases the blood supply inside the uterus, thereby causing the fibroids to diminish in size. So, if the problem of flooding is due to fibroids, this somewhat noninvasive procedure might take care of the problem. Twenty years ago it did not exist.

While all this is happening, I started to wonder about the etiology of the word “hysterectomy?” It sounded like hysteria and I’m wondered why. Why do women have a hysterectomy and not a uteroectomy or womb-ectomy? Calling a surgical procedure by the name of the organ makes sense. I researched hysteria to see if it is a female problem. Are only women hysterical? I discovered that hysteria is an old medical condition. It’s been around for 2000 years. Sure enough, women became hysterical, men become thoughtful (that male medical profession strikes again). And the source of that hysteria was that uterus. So by removing the source of the hysteria, women would be cured of the problem. However, sometimes whe the uterus is removed, depression results and then the hysteria worsens…and in the old days, there were no modern medical advances to help with depression. Hence hysterectomy was “born” and the name has stuck. Men do not have any conditions that border on a formal title like “hysteria. In fact, if men have their testes removed, it’s called an orchidectomy. Go figure. They get orchids and we get hysteria!

I was two years down the year path to where I am now. I did not know all that was to come, but I did discover that there were no good answers. For every action there was a reaction that was not always better than what I had to begin with. I was beginning to learn to take one day at a time, a tribute to all those AA folks out there, and to enjoy the good days as there were going to be some bad ones along the way.

This is when I decided that I would try to do things with a combination of traditional and herbal medication, and NO SURGERY for as long as I could. I believe that if surgery is not absolutely necessary, then do not have it! For every positive action (surgery) there is an equally negative reaction (pain, unanticipated consequences, etc.) I also started buying larger purses to hold maxi pads, lots of tampons, and baby wipes, dark blue and black suits…and outfits with jackets.

No comments: