Novasure and Amenorrhea (a post for the google bots and women considering the procedure).

I'm blogging this because there are about 14 trillion, maybe even billion, stories about Novasure on the interwebz. Most of them are complete idiocy. Don't read on unless you want to become intimate with the uterus and the little scuffle I've been having with mine.

I read accounts of women with multiple large fibroids complaining that Novasure didn't work. I read about women with endometriosis complaining that Novasure didn't work. It took me about 3 minutes of 4th grade level reading to understand what Novasure is and IS NOT successful at treating. I don't know whether to be more angry at doctors performing a procedure unnecessarily or at patients for not being intelligent enough to READ about it. Argh. I read dozens of women saying "I've had a tubal ligation and Novasure, I really want a baby, what are my chances". Girls, your chances range from about zero to zero. Either adopt a baby or let go of the idea. I know how hard that "must procreate" feeling is to squelch, but you're only causing yourself pain to think this may work. If I ever have a bazillion dollars I am so starting a foundation to teach girls about their anatomy starting at age 4. Ignorance when it comes to the workings of your body is NOT BLISS.

Anyway, Novasure is a procedure that uses radio waves to toast the inside layers of your uterus. This cell layer is responsible for creating the blood lining that enables fertilized eggs to implant. It is this layer you shed when you have your monthly period. Under sedation a probe is inserted into the uterus via the cervix. No cutting is involved but it's rather uncomfortable to have your cervix forcefully dilated, even just a centimeter. Once the probe is inserted the doctor pushes a plunger, pushing a fan shaped copper device out through the tip of the probe. The fan fills the uterus, touching as much of it as possible. For 90 seconds high frequency radio waves damage the cells rendering them useless. They still get the hormonal message every month that says "time to make the donuts" but they are unable to comply, try as they might. The copper fan is removed and occasionally other procedures are done. Some women require D & C which is essentially a clean-out of whatever is still in there. The stage of your monthly cycle plays a role here. If you're due shortly for your period a D & C is performed so the doctor can get a visual confirmation (via tiny camera) that the Novasure did it's thing. Other things might arise as well, depending on your situation. Now that I've explained the procedure, here is my experiential timeline. This is what I was looking for on the web and couldn't find.

Symptoms: heavy bleeding, large clots, wacky timing, anemia (my largest complaint actually), fatigue, and a general sense of blah during (and later the days/weeks surrounding) the bleeding part of my cycle.

Diagnosis: Amenorrhea (fancy word for screwed up periods)

Back story: My pregnancy with my son Oak was horrid. I'd always started my periods quickly after childbirth, within about 6-8 weeks, but after Oak it was immediately. I had a light period 2 weeks after childbirth and like clockwork every 28 days for about 3 months. Then chaos happened. I don't know what or why but they started getting irregular. I would have super light bleeding (or none at all) but would behave like an irrational, emotional, *insert unhappy word here*, crazy woman. Or I would have no emotional symptoms or physical clues but would bleed heavily a week before I was due. Crazy. I was sick of the roller coaster.

1. I went to the gynecologist. I told her my back story. She nodded knowingly and said "have you ever heard of Novasure. I hadn't (which frankly shocked me because I'm smarter than your average she-bear since I did so much research during my pregnancies). She gave me a pamphlet. They scheduled an ultrasound to measure my uterus and to make sure there was no other explanation for the unusual symptoms. THIS IS ABSOLUTELY ESSENTIAL. If your doctor does not do this, find a new doctor. Novasure has risks that are not worth taking for no reason. I planned to do my own reading (beyond the company-produced pamphlet) and cancel the ultrasound if I chose not to go ahead with the procedure.

2. Ultrasound date was about 4 days away. Since it was nearing the end of the year I went ahead and scheduled the procedure. I wanted to squeeze it in before the new year because my deductible was already paid. I had done some reading but not as much as I was happy with. I could cancel or reschedule that as well.

3. I'd found little on my quest for info but from what I could piece together I was reasonably certain that I was a good candidate. Assuming I had no other problems, this was exactly what the Novasure procedure was designed to treat. The ultrasound was simple and not uncomfortable or painful. A wand is inserted into the vagina, just like in early pregnancy (if you have that experience). Your bladder needs to be empty so as not to get in the way. The ultrasound tech looks for anything unusual and takes some measurements. I found it pretty cool that they could measure the thickness of the lining that had already formed that way.

4. After the ultrasound the doctor met me in her office. She told me that there was nothing else going on that they could see. There was nothing that would prevent her from being able to do the Novasure procedure and nothing that would cause her to not WANT to do the procedure. I was a good candidate.

5. I continued my quest for knowledge, but aimed more in the direction of what to expect. I found almost nothing. The only "here's how it went for me" posts were from women who probably should not have had the procedure in the first place. Most had complications beyond just wacked-out periods. I ignored these because they didn't resemble my situation at all.

6. The night before the surgery I went on one final quest for reassurance. I wanted to know what to expect. What would happen first? Then what? How would I feel? How long would that last? I should have asked my gyn these questions but since I purposely sort of rushed this, I didn't get a chance. I didn't find anything helpful and went with the "it is what it is" approach. I trust my gyn and I knew this procedure was right for me. It would have been nice to know what to expect, but I didn't and oh well.

7. I was not allowed to eat or drink anything for 8 hours prior to the procedure. I was also supposed to pee in a cup when I arrived (at noon). I wondered how this would be possible but figured it would all work itself out.

8. My appointment was at a women's health clinic that specifically does outpatient gynecological procedures for women. That is all that they do as far as I know. It was a bit assembly line for my tastes, impersonal, but better than the hospital in that respect. Sometimes this procedure is done in the doctors office under oral anesthesia. I'd rather do it in a clinic under general than deal with swallowing a host of pills and being awake. Your feelings may be different.

9. I signed in and waited a bit. I was early. They did the usual doctors office stuff copying cards and such.

10. NOON: They took me back, telling my husband to wait in the waiting room until they had me settled into the pre-op area. They did the pee-in-a-cup thing, blood pressure, weight and put had me undress and put on a gown. The nurse came in and struggled to find a vein for the IV (well DUH, nothing to drink for 12 hours at this point) but eventually she got one into my hand. They forgot about fetching Neall so I had to ask them to do so.

11. 12:40 The nurse anesthetist came in and robotically asked me questions. I was concerned with nausea after anesthesia since I'd experienced that before. She assured me she would treat it pre-emptively. She was not my favorite employee. She was cold and business-like. I'd prefer someone with a bit more heart to be in control of my life, but she was similar to other NA's that I've dealt with. I knew not to expect a smiling happy NA. I figure their bedside manner is not as important as the doctor's is and let it go.

11. 12:50 The gyn came in and talked to me a bit. Within a few minutes they were asking Neall to wait in the waiting room and I was walking back to the procedure room. It was scary and here is where I wish I'd had the chance to know what to expect. There is a set that looks frighteningly medieval. It's a low bench with padded leg stirrups. They told me how to stand at the end and sit on the edge, then scoot. Once I was scooted and laying there nervously they started the IV meds to put me under. The anesthetist said I should start feeling dizzy. I was so I closed my eyes.

12. 1:30 I don't remember anything else until a nurse was shaking me and forcefully telling me to wake up and open my eyes. Apparently I was asleep longer than they expected me to be (20 minutes is how long I'd been out of the procedure room) and needed me to wake up. It took me several minutes to be able to comply. I was aware of the fact that someone wanted me to open my eyes but I couldn't do anything about it. I really just wanted her to leave me alone and let me sleep, lol. They got me to open my eyes finally by saying "your husband can't come in until you open your eyes and we know you're awake". Mean but effective. I was also very emotional, crying a bit though I didn't know why. I asked the nurse who said it was a common side effect of the anesthesia and that it should pass in a few minutes. It did.

13. 1:45 I sipped some soda and was surprised I wasn't feeling nauseous. They asked about pain. I said it was around a 5 and they gave me some Ibuprofen.

14. 2:00 15 minutes later I was getting dressed. They wheeled me to the front where Neall had pulled the car around. I was given a script for Darvocet which normally makes me nauseous. The pain wasn't unmanageable. It was really just bad period cramps. I was ravenously hungry so we went to get lunch.

15. 2:45 Neall drove me home and left me to go pick up the kids. I was feeling ok, tired and crampy but nothing crazy. About an hour after getting home was the worst of the cramping. I actually sent Neall to the store to fill the Darvocet script and to buy a hot water bottle. While he was gone I realized some of the pain was probably due to needing to pee, though it felt different than usual, and tried that approach. I was about 50% better after using the bathroom. Sitting in that position relieved some of the pressure and using the bathroom helped a lot too. By the time Neall got home I didn't want the Darvocet anymore.

16. 3:45 I DID want the hot water bottle. This is my biggest advice for anyone considering this. Have one ready. It felt really good, helped to take the edge off a bit and relax those muscles. It was also soothing to have this warm squishy bottle to snuggle up to. Might not be so nice in the summer, but it worked for me.

17. 6:45 I took more Ibuprofen but was not feeling desperate to take it. I took it because it was time and I wanted to be able to sleep.

18. It's now almost 10am and I've not had to take any more Ibuprofen. I felt well enough this morning to take the dog out and move a couple of trash cans to the curb. I had some coffee (heaven, lol) and think it is probably time to lay back down. I can feel a bit of crampiness starting and was warned this may be the case. I'll try to take it easy today. It's hard to keep me down for long. I got stuff to do, kids to feed, and a husband who is wonderful but not cut out for full time momming :P.