Endometrial Ablation with Novasure: Personal Review


I had my endometrial ablation and hysteroscopy done yesterday in-hospital. My OB/GYN uses the Novasure method, typically in his office with oral sedation, but due to my long list of chronic issues and malignant hyperthermia susceptibility, it was decided I would have my procedure in the main hospital instead.


PatientBrochure

Here is the brochure if you want to look into this particular method.

But just to give you a quick overview, Novasure works by permanently removing the endometrium, or the lining of the uterus (the part that causes the bleeding), with a quick delivery of radio frequency energy. It supposed to eliminate or lower the amount of bleeding that is typical with the menstrual cycle. It’s not recommended for anyone who is pregnant or planning to ever become pregnant due to complications. In going over reviews, of course there’s always risks with any type of surgery, but for the most part a lot of what I read were great reviews and success with treatment. For some, they eventually had to have a full hysterectomy, but more than likely they were a better candidate for a hysterectomy to start with. Definitely discuss this with your doctor prior to having the procedure.


My check-in time was at 1:30 PM. The only prep I had to do prior to the procedure was to not consume food or water for 8 hour before, so I woke up extra early to get my Starbucks addiction in. I was extremely nervous, having read what to expect after the procedure on the internet the night before. Never a good idea, because your mind ALWAYS looks for the negative, despite all the good reviews. But anyways, I was extremely nauseous all day, but not sure if that was due to nerves, my illness, or a combination of both. I didn’t want my husband to have to take any additional time off, and considering the hospital is a 6 minute drive from my house, I had a friend pick me up and bring me to the hospital to be dropped off.

It was weird to go into a procedure like this in the hospital, let alone by yourself. I almost regretted it, as you’ll see once I get ahead in the story. I go to the front desk to check in. It takes them a while to get my paperwork done and they broke my hospital ID bracelet and had to reprint another. Finally they were done and they told me to hop in the elevators, head to the basement (The BASEMENT?!?!?) and go into the door right in front of me. So I do. You initially walk into a large waiting room, there’s a few people in there, but I can’t tell if this is recovery or if they were waiting on someone. I check in and I’m immediately brought back to get ready.

They started by taking my vitals, which of course the blood pressure cut off all circulation to my left hand because my blood pressure was extremely low again, but finally it puts out a reading. I then have pee in a cup to make sure I’m not pregnant. I joke that my husband would kill me if I was, but they didn’t see it as being very funny. Oh well. I return the cup and then have a seat in the waiting room again. I’m feeling a little more relaxed but still highly uncomfortable due to the nausea. A couple more minutes later, they’re taking me back to get completely ready for my procedure.

They take me down a long hallway, full of tiny recovery rooms and air pressured doors. It reminds me of the TV show House and the way their hospital is set up. They bring me to room 10, which has all my info written on the glass door. I had taken most of my jewelry off at home, but forgot my earrings. I didn’t expect to need to have them out since I didn’t when I had the colonoscopy and EGD a few weeks back. The nurse says I have to so there’s no chance that the metal will take any of the radio frequency and burn me. Fair enough. I hide them in my purse. She’s surprised that I came alone. I told her my husband would come and pick me up once he’s off work and we live really close to the hospital. She was concerned with my belongings, as it would be a while until I would be back in this room, but said they’ve never had a problem with theft. I told her I didn’t bring anything of much importance anyways. I get undressed and into my lovely hospital gown and lay in the bed.

Now the doctor played down the events of this hospital visit, I must say. As I’m listening to all the commotion outside of my room, I can tell this is the BIG surgery department. He told me the procedure itself takes five minutes and then I’d be out of there. I expected it to be similar to the endoscopy procedures I had in-hospital, where they prep me, I’m out, doctor does his thing, and then I go home as soon as I can stand. But this was not going to be the case, as I find out. I had to call my husband and tell him not to come as early as he had originally planned. He gets off work at 3 and I supposed to be in the OR at 3:30 and out by 3:35 tops. It was settled, the nurses would call him when I made it to the second recovery room, part 2. What do you mean part 2? Why is there a recovery part 1? I was so confused.

So I am laying in the bed, one nurse is taking my history on the computer, then other one is placing my catheter. She starts with a small needle and squirts in an extremely harsh medication in to “numb” my forearm. She then pushes the larger catheter in, it starts to feed but then it bends and blows my vein. She says she’ll try the other side and bandages my left forearm to stop the bleeding. She is able to get it in on the right side forearm, but of course not without injecting the burning med again. She tapes it all up and they start me on fluids. The nurse taking my history asks me if I get motion sick. I tell her I get sick whether things are moving or not. She orders a nausea patch as a precaution, even though they’ll be giving me anti-nausea meds through IV during the procedure. I thinks she was more worried about me vomiting than I was. But I’m grateful for the relief. She says they’re running early today, so I should be going to the operating room around 3 instead of 3:30. Awesome. She leaves to get the patch from the pharmacy, but I hear her talking to other nurses about my history, particularly the Nutcracker Syndrome. They need to call the doctor to see if I need to have my kidney blood levels checked prior to surgery. She comes back with the patch, and asks if I’m having trouble with my kidneys. I explain my blood work is all normal, it’s just the vein dumping into my lumbar plexus. They want blood work before they’ll put me under. Sure, no problem. They also switch out my fluids to compensate for my kidneys using another solution. Really, my kidneys ARE FINE, but OK.

The phlebotomist comes down after 30 minutes to take my blood. She sees that my left vein is blown but doesn’t want to mess up my working catheter, so she decided to draw from the left anyways. She sticks me with the needle so hard, it’s an instant bruise, but she gets the blood she needs and she’s gone. After what seems like forever, I hear the nurses talking again, they need my blood type, they want to do blood transfusions from what it sounds like, but it’s hard to tell because I’m eavesdropping. By now it’s past the 3:30 start for my procedure. Guess I won’t be going home early. I wish they would tell me what’s going on. Finally the nurse comes back in and said the anesthesiologist and doctor would be in to speak with me soon. I was getting nervous, are they not going to do the procedure today? But I felt relieved when they said they were about ready for me. They reviewed what was going to happen and what meds they’ll be using, and how once it’s done, I’ll spend an hour in recovery 1, where you can’t have visitors, and then finally another hour in recovery 2, where I would be allowed visitors.  This seems extreme but OK. The OR nurse comes in, puts pressure devices on my legs to avoid blood clots and wheels me back for the procedure.

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The set up was pretty similar to the above picture, not so scary. There’s five nurses in there, along with the anesthesiologist, and the doctor. I  guess it’ll be a show after all. They move me to the operating table and put the leads and monitoring equipment on me, as well as get me hooked back up to fluids. I feel a weird sensation in my arm. The anesthesiologist is standing behind me and leans over to say “I slipped something in your IV”. Now if I hadn’t picked up on his humor earlier, I might have been disturbed by this. It WAS kinda creepy. I say I thought I felt something… But I am pretty sure I didn’t actually finish my sentence. I was out cold.

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So this is what they did while I was unconscious. They also checked everything by doing a hysteroscopy to make sure there was nothing else that needed addressing while they were in there. I’m actually glad they put me out, so I didn’t have to experience any of the sensation while partly awake as other’s have when done in the doctor’s office. I heard it was pretty excruciating for about 90 seconds. When it was over, they took me over to recovery 1 to wake up.

I have no recollection of recovery period 1, it felt like I was only there for a couple of minutes before they brought me to my room for the second phase.
They said it was a full hour, so I guess they either gave me too much propofol or I was just really THAT tired. When I get to the second recovery room, I text my husband to see if he’s at the hospital already but he immediately walks in. I guess he didn’t trust anyone to call him, so he just waited it out in the main waiting room up front. The nurse brings me graham crackers, saltines, water, and ice chips. I’m really not even slightly hungry, but I wanted to go home, so I force down some graham crackers and suck on the ice chips. It’s enough for them to let me go. I get my discharge papers and have to stop for the two pain meds they called into the pharmacy. We grab the medications and home we go.

Recovery at home that night was nothing. Very mild cramping and light bleeding, but nothing as bad as I deal with on a regular with my chronic illness symptoms. I had some insomnia, but that’s probably due to my long, drug induced nap. Once I laid down, I was out for the night. This morning was a little rougher. I guess the pain and anti-nausea medications they gave through IV had worn out of my system. Anytime I make a sudden move or stay in one place too long, I get pretty sharp cramping, mostly in both of my lower side areas. The nausea has also increased substantially, but it’s still equivalent (maybe even less) to my usual level. I haven’t taken any of the narcotics for the pain, in fact I haven’t even taken any ibuprofen. I’m still bleeding, but it looks like it is drying up based on the color it has turned to now.

So if anyone has reservations about this procedure or are scared, don’t be. It truly isn’t that bad. They say I won’t know how the procedure took until about three months from now, but I have high hopes that I’ll be one of the lucky ones who has complete elimination of monthly bleeding and no further pain or blood clotting during that time either. I’ll try to remember to update in a few months to let you know how it goes. So far, no regrets.

But if anyone has ANY questions about this procedure, don’t hesitate to comment or message me.

 

The Doctor Is Going To Microwave My Uterus…


I’m serious… only, it’ll be with radio frequency ablation. I’m having the procedure done on Tuesday, in-hospital. Typically, the procedure is a quick in-and-out visit to the doctor’s office or outpatient facility, but with having Malignant Hyperthermia Susceptibility, all procedures being done in an extremely controlled environment. So back to the hospital it is. I have my pre-op with the hospital tomorrow morning and then pre-op again with my doctor on Monday.  Seems like a lot of prep for a procedure that takes about ten minutes to complete, but I’m glad my doctors are being safe and not sorry.  Amidst all the complicated and random symptoms, it didn’t even initially come to mind that something was wrong with my “lady parts”. I just assumed it was due to everything else going awry in my body.

When I went to the new OB/GYN to discuss the relationship of my ongoing bleeding and the Nutcracker Syndrome, we had a long discussion of my symptoms (in general), as well as the abnormal bleeding I’ve had since I was 13. It’s always been painful and debilitating. I remember missing school and practice every month when my period would come on, I’d just get so sick, barely able to move. And it would come and go at random times, or stay for really long times. Sometimes it wouldn’t come at all. I assumed it was from training (for swimming) and practicing twice a day, as well as going to the gym. In my later teens, I would often have cysts on my ovaries and they would be so painful when they would “burst”. Many doctors thought my chronic abdominal pain MUST be related to “girl issues” and “growing up”. 

I eventually went on birth control. The pills made my stomach turn, so I tried Depo-Provera. It worked great for many years. No weight gain, no nausea, and thankfully, no periods. Eventually when my abdominal pain and nausea came back, with panic attacks, I thought maybe it was the Depo. I had heard horror stories from people being on it for too long. Thinking maybe it was hormonal, I decided to get off it in 2008. Plus it was really expensive at the time. But obviously, getting off it didn’t help much.

Fast forward to 2013. My symptoms had come back with a vengeance, after taking a hiatus for a few years. Month after month, my period would get more intense, painful, and unpredictable. I remember the day I walked into my gynecologist’s office, my husband had to leave work and drive me, I was cramped up that I could barely walk on my own. The nausea was so intense, every move I made I felt like I was going to throw up.  I literally thought I would bleed out and die. The doctor gave me the shot on the spot. 

It seemed to work for the few months, only a few drops of breakthrough bleeding in the first few months. I thought, “Great. I can live again.” My abdominal pain kept continuing, but at least it didn’t get worse during my “time of the month.” A few months later, I notice that I’m starting to bleed a few days before my next shot is due. Then a week, then  two weeks, and so on. This is right before my wedding. So I call the doctor. He prescribes 800 mg ibuprofen, twice a day, that should make it stop. It makes my stomach ill, but the bleeding does not stop. He’s confused. Then he gives me birth control pills WITH the Depo, there’s no way I could bleed on both. I do. And again, my stomach is sick. They check for cysts and do a trans-vaginal ultrasound. Some free fluid and minor things noted, but nothing to explain the bleeding or the pain. 

Currently, I’m starting the bleeding cycle about a week after my shot, leaving me miserable for just under three months. And the clots are so large and abnormal, so the doctor wants to take my edometrium lining to stop the bleeding. 90% of patients either no longer have their period or have minimal periods. So I’m hoping this can at least ease SOME of my pain and symptoms. If not, then it’s on to a full hysterectomy. So we’ll see how it goes. Recovery is usually within a few days, as long as there are no complications. I can’t imagine it going to be any worse than what I’ve gone through already.

The hardest part is talking to friends and family about it. Even my GI doc thinks I’m too young for something so permanent. I will not be able to carry a child (although I technically COULD become pregnant), I know that is shocking to many people, but I’m OK with it. How could I even carry a baby to term? I can’t eat or provide nutrients. I’m constantly ill. And even if I could, what kind of mother would I be, lost in the world of invisible, chronic illness. And what if I pass down whatever this is down to them? Everyone can call me selfish and self-absorbed, but how selfish is it to bring a child into a world full of chaos and inadequate care? Knowing I’m sick and more than likely won’t ever get better, based on my history. My doctor thinks it’s best and so do I.

But I can’t lie, I do feel a little guilty. Not so much for the people who want us to have children for their own reasoning, but really, for those who CAN’T have children, which is true for a couple of my friends. How could I not feel guilty? I can only imagine how they feel . I can see the disappointment in their face when they ask about it. I hate disappointing people. It is partly selfish. And it’s permanent. But most people do not live each day suffering through chronic, debilitating symptoms. They have NO IDEA the drastic things you’ll do to your body for a small amount of relief. I literally can’t remember the last day I had  “good” day. I’d give up almost anything for some peace in my body, even it is momentarily. 


Information about my upcoming procedure: Endometrial Ablation.

I’ll post my review after Tuesday. 


“Let it all out
Get it all out
Rip it out remove it
Don’t be alarmed
When the wound begins to bleed

Cause we’re so scared to find out
What this life’s all about
So scared we’re going to lose it
Not knowing all along
That’s exactly what we need

And today I will trust you with the confidence
Of a man who’s never known defeat
But tomorrow, upon hearing what I did
I will stare at you in disbelief
Oh, inconsistent me
Crying out for consistency

[Chorus:]
And you said I know that this will hurt
But if I don’t break your heart then things will just get worse
If the burden seems too much to bear
Remember
The end will justify the pain it took to get us there

And I’ll let it be known
At times I have shown
Signs of all my weakness
But somewhere in me
There is strength

And you promise me
That you believe
In time I will defeat this
Cause somewhere in me
There is strength

And today I will trust you with the confidence
Of a man who’s never known defeat
And I’ll try my best to just forget
That that man isn’t me

[Chorus x2]

Reach out to me
Make my heart brand new
Every beat will be for you
For you

And I know you know
You touched my life
When you touched my heavy heart and made it light”