So, the surgery.
As readers of this blog know, my period has been the bane of my existence since almost as long as I’ve had it. Growing up, in a household of those of the female persuasion, including our cocker spaniel, no one but me had had pain during their period. I still remember the first time I curled up with pain on the bed – it wasn’t my first period, but quite early one – and my mother and grandmother hovering worriedly.
They had heard of this, but not experienced it – they didn’t even know a hot water bottle would help; I think I learnt about it through a sex education video. My elder sister’s period was so painless she sometimes stained her skirt without realising it.
Many of my friends had painful periods. Our very kind GP prescribed Meftal; my friends and I discussed it as a wonder drug.
In my 30s, I noticed spotting even after my period stopped. I was in Hong Kong, and looked up the list of gynaecologists on my insurance panel. I picked a female one and made an appointment. She did a sonogram, told me I had a 6 inch chocolate cyst on my ovary and needed surgery. I was flabbergasted. “Is is cancer?” I asked. “No,” she said, but didn’t explain further. She became the archetype for me of the kind of reticent doctor that I would later know to avoid.
Google gave me some more information (a chocolate cyst is like a boil filled with thick blood, non cancerous), but I decided to see another doctor. This guy was the opposite of the first doctor. He informed me that I likely had endometriosis. “Do you have painful periods?” he asked. “Isn’t that normal?” I asked back. “Er, no,” he said, the first time anyone had uttered such a thing in my hearing. He took almost 30 minutes to explain endometriosis to me and explained why I needed surgery. One of the issues, apart from pain, is that such a cyst could cause infertility.
I discussed the situation with my sister-in-law’s mother-in-law who is a gynaeocologist in India. She is also a yoga practitioner. She advised me to do a set of yoga exercises and take an ayurvedic pill for six months. If the situation didn’t improve, I could do surgery. I did some of my own research and modified my diet. Within a few months I was pregnant.
The cyst situation seemed to have resolved itself, but that was over a decade ago. In between then and now, I made an attempt to address my heavy and painful periods by trying the contraceptive pill. It did not agree with me, and I stopped it.
I have now come to recognise the nagging pain my right side, as a possible cyst. Now in addition to period pain for about two days, I have pain in my right side mid-cycle (during ovulation) for a couple of days.
Last year, my gynaecologist confirmed that I had a cyst on my right ovary, but didn’t think it was large enough to warrant surgery. Since I didn’t want to go on the pill, he recommended I try getting fitted with the Mirena coil, which releases the hormone locally, and can help with endometriosis. It wouldn’t make the cyst go away, but it would prevent it from growing further.
I decided to do it, then after a conversation with friends, decided against it. I was afraid that the hormone would still make me sick. [One of my realisations from this saga is that friends sometimes say things because they feel they need to say something. Even I do this. But you need to make up your mind of your own. And then stick with your decision.]
In recent months, I noticed the ovulation pain getting worse. I figured it was a cyst, and decided to ignore it. Omicron hit Hong Kong and I wasn’t keen on seeing a gynaecologist. There was nagging pain in my right side almost constantly. I called my gynaecologist only to find that he had retired.
For two periods, I noticed that a couple of days into my period a new pain, one that I associated with ovulation, would start and go on for another seven days. It was bad enough for me to need a hot water bottle some days. I resisted taking painkillers because I was already taking painkillers one day every month during my period.
Finally, when the pain began stopping me from exercising, I decided to bite the bullet and see a doctor. Back to the list of gynacs on my insurance list. I called one and got voicemail. I called the other doctor in my former gynac’s practice, a woman I had seen once but did not particularly like. I miraculously got an appointment the same day.
She confirmed I had a mid-sized cyst. She paused. It was like I was supposed to tell her what to do – another of those reticent doctors. I waited. I have learnt that it is not my job to fill a silence – especially in the doctor’s office. She said I could take painkillers. Or I could do surgery. Or I could take the pill. I told her I did not want to take the pill. She did not say what I should do. I asked about the coil. “That could help,” she said, and we decided to do that.
Later, I thought about the fact that while the coil would prevent the cyst getting larger (hopefully), it would not do away with it. And it was the cyst that was causing the pain. This doctor did not seem to be the type to really have a discussion of my options. Getting information from her was like pulling teeth.
I called another doctor and made an appointment. He thought I should do surgery and then put in the coil. He didn’t see the point of putting in the coil without cleaning out the uterus first. The surgery would be laproscopic, but require two weeks to recover. He wanted me to do it as soon as possible, before my next period.
Look, I got the feeling he was rushing me. But I had been thinking about this for 10 years. I’d have to do it some time. I wanted to schedule the surgery in early April when I had a week of leave but I’d need a week after anyway. There was no ideal time to take leave.
In the meantime, there was a chance the cyst could burst in between and be painful and cause complications. It might not also.
I discussed it with my boss and he was supportive about me taking leave as soon as I needed it. It required a colleague to give up some of his leave and I felt really guilty.
I should have been stressed about the surgery, but I was stressed about admin. First about squaring the leave at work. Then about getting insurance clearance – V has excellent insurance coverage so this is not something I usually need to worry about, but unfortunately, the first clinic had put int he request for the coil, and now the second one would put in the request for the operation plus the coil. I had only a few days to clear this up. I called the first clinic to tell them to cancel the coil request (which was awkward). Finally, the insurance company called up to clarify and they were cooperative.
Every night I would wake up with some worry or the other. Would the insurance get cleared? Would I get a private room (which I’m entitled to)? Should I even be doing this at all? Would I pass the Covid test on the day?
The day of the surgery dawned cold and windy. I had been booked into arguably Hong Kong’s best (and most expensive) private hospital on The Peak. V had had surgery for his ankle there. I remember a room with a sea view and a room service menu. I kept calling it “the hotel”.
On the ride up there, V and I joked that it felt like we were going to another country for a vacation. As we ascended in the cab, the air was thick with fog and we passed the bungalows and low rise buildings housing the very rich. We joked about the rarified air.
At the hotel hospital, we were directed to a cluster of tents to be tested for Covid. While the weather had been pleasant in our neighbourhood, up on The Peak it was windy and cold. We were not dressed warmly enough. The antigen test took 20 minutes to clear, but I had to do a rapid test. Here’s where it got ridiculous. While V was free to go and sit in the hospital reception after his test, I had to take a PCR test and wait – wait for it – two hours on a plastic chair in the tent for my test result.
There is absolutely no logic to this. Remember, I was not severely ill, but what if I had been old and infirm? Sitting in a plastic chair for two hours would be no joke.
Moreover, the tents had started to rattle and water leak in. Admin from the hospital and workers were milling about worriedly. And still, I, the patient, was sitting there. The whole situation reminded me of that period in February in Hong Kong when elderly Covid patients were shivering outside public hospitals in the cold.
But this was not a public hospital. It is an extremely expensive private hospital. This is an extremely expensive hospital. Also, I was a patient in a private room, where the fees for every treatment from the anesthetist to the medication would be at least doubled.
V told me to just tell them I was leaving and leave. But the nurses refused to let me go. I got tired of V grumbling and told him to just got sit in the hospital.
Finally, someone saw the stupidity of the (shameless) husband of the patient sitting in the warm and comfortable reception while the patient shivered inside a ricketty wet tent and they took me into the hospital.
After that, everything was as it should be. The admission process was smooth once the PCR result came in. I was scheduled for surgery at 11, and the result came in at 10.15. I was up in my room by about 11, and the operation theatre was ready for me. Pee, change and I was off. My nurse told me she was on her fourth coil and loved it.
I was pleasantly surprised that I felt relatively good after surgery. I had had a spinal anaesthesia during my C-section and Nene had been under general anaesthesia when he broke his arm. I remember we were not allowed to eat for hours. But here, they encouraged me to drink water and eat if I felt okay. I held off eating until the nurse told me I needed to eat. I ate a baked potato. For dinner though I ate truffle pasta. I was able to get off the bed and pee within hours. I dozed during the day and slept fairly well at night
The next day, the doctor thought I looked great, but asked me to stay another night (insurance in Hong Kong covers two nights of hospitalisation, so hospitals tend to use it. But I also felt that I should not fight hospital care) I was able to sit in the balcony -yes, the room had a balcony – and admire the sea view. I could have a shower (again, being able to have a shower so quickly after surgery is not something I expected). I was super careful not to get my stomach wet, but a week later when I changed the bandages I realised they were really water-proof.
That day though I began to feel incredible gas in my stomach and had a stomach upset. I felt it might be the painkillers, and feared it was the Mirena coil (that Google told me could cause these symptoms). I ran a slight temperature at night (according to one thermometer, according to another, I was fine) The doctor was not worried.
I was discharged the next morning. The pain was barely there so I stopped taking the painkillers. But my stomach was really gassy and uncomfortable. My doctor had not given me an anti acidity pill so I took my own. That helped.
I had been skeptical about needing two weeks of leave, especially the day after surgery when I felt fairly good, but on day 3 I developed a fever. It burned off overnight, but I spent the next two days sleeping … a lot. I would wake up, eat breakfast and go back to sleep. I was nap again in the afternoon. I was in bed by 9pm.
I got my period a few days later. The doctor told me to expect it to be light, and it was. But six days into my period, I was still seeing bright red blood. The doctor had asked me to go for a check up two weeks after surgery, but 10 days later. He said everything looked good and I could expect bleeding because of the coil for a while.
More than two weeks later, I am still bleeding. I feel fine mostly when I’m home, but even a short walk tires me. Again, I’m surprised, because I did not see this as major surgery. A friend said her friend who had this surgery took four weeks to be back to normal. So the doctors do know what they are talking about.
In the weeks leading up to the surgery, we had kept the kids home due to Covid, until they were vaccinated. After they were vaccinated, I wanted to them wait a couple of weeks so that the effect kicked in. And then, because of my surgery, we all stayed home to ensure we didn’t get Covid and throw the whole plan out of whack.
I was impressed at how I had adapted to this life, which had driven me mad in our last bout of lockdown. We played a lot of boardgames. We went on walks.
I have been pretty much at home since the surgery. Last week, I went to the park downstairs and the grocery store. I went out to lunch nearby. I had to rest after all these forays.
Recently, I realised I have reached my limit. The kids have been on vacation last week, but I can’t really go anywhere with them. Nene thankfully has friends to play with downstairs, but Mimi’s one pal has gone to India. They are bored a lot, and so am I. I am losing my mind slightly. Starting work again next week might be a good thing.
I lost some weight during surgery. I really liked seeing my cheekbones. Alas, once I started eating better, my cheekbones are less in evidence. My appetite hasn’t completely recovered though, so I’m trying to go with eating less. And I’ve cut out sugar. The thing I miss most is not my daily dose of chocolate but sugar in my tea (Note: Earl Grey tastes like soap water without sugar).
A week after my surgery, my mum had surgery in India. Again, I was not able to be with her. Had I not had surgery, I could have tried to go down. Thankfully, Hong Kong’s quarantine has reduced to two weeks and the flight ban to India lifted. But getting there and back is still a logistical nightmare.
My mum has had chronic urinary tract infection for years. She had surgery to lift up her bladder four years ago but the problem recurred. She is on antibiotics almost all the time. No doctor has been able to find a solution. She tries every home remedy anyone suggests.
Finally, she saw a uro-gynaecologist who felt her uterus has prolapsed, putting pressure on her bladder. He suggested a hysterectomy and pulling up the bladder. Fingers crossed it works.
My dad had to stay with my hospital for three nights and she’s been super uncomfortable at home since. But she’s getting better. She experienced much of what I did, but more intensely – feeling great right after surgery, the stomach discomfort and gas, tiredness, and she still has pain.
Let’s just say it’s been quite a month. It’s too early to say all this has been worth it for me. I didn’t have to think about the cost of surgery or the coil because I am well covered by insurance.
But I do think that we need to stop accepting period pain – and other “feminine” complaints as just part of the course of life. We need to push for solutions from our own doctors but also from the medical research community. We need to stop fearing the solutions, but give them a fair shot. Menstrual problems are underresearched. Period leave is an idea that is still controversial in workplaces. Menstrual products are taxed as luxuries. In many countries, including India, women do not even have access to these products, and are using rags during their periods.
There is so much that needs to be done.
for whom the bell tolls 