I don’t mean to brag but, I have an abnormally large uterus.
Or at least that’s what my gynaecologist told me last November as she studied with, dare I say, intense awe at my uterine ultra sound scans.
It’s hard to know how to respond to a statement like that. And she said it not once, but twice! Emphatically, along with “It’s huge! And very chunky!”
Instead of saying, “Oh go on with you! I’ll bet you say that to all the girls!” I just said, “Okay…"
The inspection of my scans continued in between glances at my file and explanations of what I didn’t have.
“You do not have fibroids!”
Back to my file.
“Your ovaries are fine!”
Back to my scans.
“You had an endometrial biopsy! Who gave you that?”
Back to my file.
Back to my scans.
“What is that?” I asked. The word meant nothing to me except that it sort of sounded like endometriosis and as it turns out, sort of is like endometriosis. You see, while endometriosis is when the endometrial tissue grows outside the uterus in all sorts of places, adenomyosis is when the endometrial tissue, instead of just growing in the uterus like good endometrial tissue is suppose to, grows in the muscle of the uterus. So, every month, when my uterus gets rid of the tissue in its painfully dramatic fashion, it also gets rid of the endometrial tissue in the muscle of my uterus.
While I listened to my gynaechologist give me the story of adenomyosis and all the issues that come with it, my symptoms suddenly made perfect sense and I was flooded with relief. I wasn’t crazy! It’s not all in my head! My pain is real and I have good reason to feel miserable a great deal of the time!
After the explanation she immediately launched into a talk about treatments. They were four-fold.
“One! You could have an ablation, but I would not recommend it (didn’t she just do that?). It won’t work and you will come back to me saying you’re in more pain!”
“Two! You could get an IUD that would release progesterone into your uterus thereby slowing the bleeding! But, in a uterus of your size (thanks?) I wouldn’t recommend it.”
“Three! We could try pain management with a stronger pain killer and continued use of Tranexamic Acid to slow the bleeding.” (You know, the stuff they prescribe to people after they’ve had dental surgery? To stop the bleeding?)
“Four! A partial hysterectomy. What would you like to do?”
I sat quietly for a few seconds, mulling over my situation and the four, but really two, options laid out before me.
“Um…” I said, “Let’s try pain management first and then if that doesn’t work…a hysterectomy?”
“Ok!” she said as grabbed her prescription pad and started writing. "I'll prescribe enough for three months and then you can come back in for a follow up."
I thanked her very much but before I left I needed to have a peek at my scans. I leaned over her desk to get a good look at my large, chunky uterus. The endometrial tissue was all over it, peppering the entire surface. It looked like a constellation with a concentration of stars in the top left corner of my uterus. I pointed that area out to her and said a lot of my pain seemed to be focused right there.
She said, “Well yes! Look at it! This area…”and with a gesture akin to jazz hands she exclaimed, “This area commands respect!”
I did not laugh. I did not say, “Damn right it does!” but smiled because it was one of the best things, regarding my physical self, that I’d ever heard.
And now, here I am on my 44th birthday. Last week, after three months of not so much pain management as much as learning that stronger meds don’t really help, and my life is still being interrupted by being bouts of stabbing pain, I’ve decided to have a hysterectomy. I am nervous, but I know, once it’s all said and done, I will feel a whole lot better.
And I will look back fondly at the girl who once had an abnormally large uterus that commanded respect.