Seven months after my surgery, I still dream that I am bleeding: I look down, and there is blood all over the place, soaking my underwear, running down my thighs. A lapful of blood. Damn, I think, and then Oh well, there it is again. Resignation sets in.
"They do run in families.""Well," he explained to me after I told him my symptoms, "it could be fibroids, but you're awfully young for that."FibroidsI was lucky. The surgeon was able to cleanly remove the cysts, leaving both ovaries in place. However, as I lay in the hospital recovering from the six-inch incision in my lower abdomen (below the "bikini line," as they call it), he advised me that I should now start taking birth control pills. Nineteen was a very young age to develop ovarian cysts, so it was likely they would grow back. Because the cysts form on the nodes that the ovaries create when they produce an egg each month, taking oral contraceptives to suppress ovulation was the only way to be (relatively) sure the cysts would not grow back. He also advised that I should stay on the pill until I wanted to get pregnant. If I never wanted to become pregnant, I should stay on the pill until menopause.He examined me and quickly concluded, "Yes, fibroids. Your uterus is the size of a small lemon, or a six-week fetus." He wrote me a prescription for a different formulation of birth control pills to attempt to reduce the bleeding and sent me on my way.Several years later when I was twenty-five, my periods changed. Suddenly, they were double or triple what I was accustomed to. My menstrual cycle still started on time, but I flooded the little "thin maxi" pads. I had to go out and buy tampons and try to remember how to insert them. The bleeding didn't stop by the weekend either; it dragged on. Certain that I was hemorrhaging to death, I went to see my new gynecologist.I also learned that fibroids are easy to remove without a hysterectomy (removing the uterus). Most common is procedure called myomectomy: the fibroids are excised and removed vaginally or through a small abdominal incision. Everything I read and heard pointed towards a wait-and-see approach and away from hysterectomy: "the last resort." I learned I should ask a lot of questions, become informed, take charge of my own medical decision-making, not let the doctor tell me what to do. (Ironically, my doctor didn't tell me to do anything, except for suggesting a change of pills.)The day after my nineteenth birthday, I underwent emergency surgery to remove a ruptured ovarian cyst. I had been in the university hospital all week as they tried to determine what was causing the incredible abdominal pain that had come over me suddenly on a Saturday night out with friends. Two pelvic sonograms (or ultrasounds) later, the university doctors decided it was probably cysts. They weren't entirely sure, but they needed to do something. So they sent me downtown to the "real" hospital for surgery.I have never wanted to have children. When I was a little girl, I did not play with dolls; instead, I read books, wrote stories and played with tiny ceramic animals who drove around in Matchbox cars on complicated roadways I constructed out of mud and sticks. When I was in high school, I wrote myself a note to read years later explaining the many reasons not to have children (the world is too crowded, I wanted to have a career, and--vainly--I worried about stretch marks), in case I should forget and need a reminder. When I got married, I was lucky enough to fall in love with a man who also did not want to have children. I spent several years arguing with my Jungian analyst who tried to convince me that the reason for this bizarre aversion was some sort of misguided rebellion against my mother, or a failure to mature, but it is less of an aversion and more of a lack of interest. It is the absence of something, not the presence: the absence of the desire to be a mother. I have a cat whom I love very much. I am looking forward to being an aunt some day. But I do not want to have children.In the Beginning ...But the new pills did work, and my nice, light periods returned.Growing PainsThen I wake up, and joy! No blood. No periods, no clots, no breakthrough bleeding, no cramps, no birth control pills, no aching lower belly. No tampons and pads in every purse, overnight bag, bathroom cabinet, glove compartment and desk drawer, just in case. No planning vacations around the periods (only to have them interrupted anyway by kamikaze between-period assaults).This is the story of my hysterectomy at age thirty-six: what my experience was like, why I made the decision I did. I know that hysterectomy is not the right choice for every woman, but here is why it was definitely the right choice for me."My mother has fibroids," I remembered. I didn't know what they were, but I knew she had had several procedures to try to alleviate heavy bleeding, with limited success.I did a little research on fibroids at that point--mostly looked through my dog-eared copy of Our Bodies, Ourselves, and of course talked to my mother. I learned that fibroids are extremely common (even in twenty-five-year-olds), affecting perhaps three-quarters of all women; that they are benign tumors, which do not become cancerous; and that most women don't even know they have them because they often cause no symptoms and therefore can be left alone. When they do cause trouble, it can come in the form of heavy bleeding or bleeding between periods, a feeling of abdominal fullness or bloating, or the need to urinate often. If they become large enough, they can cause reproductive problems as they take over the uterus and crowd out a growing baby. Or they can prevent conception altogether.Again terrified, I went back to the doctor after we returned home and again changed birth control prescriptions. I mentioned the factor of weight loss to the doctor, but he didn't see any connection. However, the fact is that whenever I have lost five or ten pounds, my periods have stepped up in severity. Perhaps a coincidence, but I thought it was worth noting. When I brought up the idea of hysterectomy, the doctor also brushed it away. I got the message that women in their twenties do not receive hysterectomies, certainly not newlywed women.I was only nineteen. I didn't much question the fact that I was given no choice in the matter. I felt grateful to the doctor for saving me and in awe of the medical system. So I went on the pill. After I got over the horrors of the possible side effects detailed in the package insert (blood clots, stroke, heart disease, death death death), I loved the pill. I enjoyed the extremely regular cycles--my menstruation now started precisely every fourth Tuesday at three o'clock in the afternoon and were finished by the weekend. I appreciated not having to worry about pregnancy, which I had obsessed about even before I ever had intercourse. And I very much enjoyed my now-tiny periods and complete absence of cramps. I had always had fairly onerous menstrual cycles throughout high school with very painful cramping. Now my periods were not even heavy enough to fill a junior-sized tampon in eight hours. It was grand.I stood in the subway station waiting for the train home, my hand tentatively down on my abdomen, trying to feel what the doctor had so easily detected. Something's in there! I marveled. Growing! It was sort of creepy and sort of fun in the perverse way that having undergone major surgery in college had been fun: yes, it was scary and painful, but it also made me special in a way. It made a great story. Now the story had another chapter.I went under at six o'clock on a Friday night, not knowing if I was undergoing merely exploratory surgery or would wake up with only one ovary. (I had been told that if both ovaries needed to be removed, they would schedule a second surgery.) The surgeon put a scope in my belly button and verified the presence of the cysts: one on each ovary. The left cyst had burst; the right one seemed likely to.
I have never wanted to have children. When I was a little girl, I did not play with dolls; instead, I read books, wrote stories and played with tiny ceramic animals who drove around in Matchbox cars on complicated roadways I constructed out of mud and sticks. When I was in high school, I wrote myself a note to read years later explaining the many reasons not to have children (the world is too crowded, I wanted to have a career, and--vainly--I worried about stretch marks), in case I should forget and need a reminder. When I got married, I was lucky enough to fall in love with a man who also did not want to have children. I spent several years arguing with my Jungian analyst who tried to convince me that the reason for this bizarre aversion was some sort of misguided rebellion against my mother, or a failure to mature, but it is less of an aversion and more of a lack of interest. It is the absence of something, not the presence: the absence of the desire to be a mother. I have a cat whom I love very much. I am looking forward to being an aunt some day. But I do not want to have children.
