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PMS, TBD, and TMI

Spoiler Alert: This post is all about my period.

Last night my period started, which, after approximately 33 years of fertility, is not exactly news. Still it feels momentous because it may, in fact, be my final period ever. As I have been warned by my doctor, he may not be able to save my uterus when he removes the fibroids, and if my uterus goes so does my period.

I don’t remember if I was 10 or 11 when my period started but I do remember I was in 5th grade. Mrs. McGrath was my homeroom teacher, and she walked me down to the school office where she exclaimed to the secretaries, “One of my little girls just became a young lady.” One of the secretaries—yes, that is what we called them back then—opened up a cache of emergency supplies and out came a sanitary napkin that was pretty much twice the size I was. Not only that but it was the kind that was designed to be worn with a sanitary belt. I made do with two diaper pins instead.

Later that evening, my mom gave me the talk. It went a little something like this.

Mom: Do you know how you get pregnant?

Me: (tentatively) By playing with boys.

Mom: That’s right.

To be fair, my mother remembers the conversation rather differently, with her version having a little more detail. Whatever the actual exchange, I got the gist. Given that I’ve spent most of my adult life either as a virgin or celibate, with only a handful of years of being sexually active, I’ve never really paid that much attention to my period. Sure it’s annoying but I never worried much about tracking as I didn’t have to worry about pregnancy. I figured it would just get here when it got here. It’s actually embarrassing the number of years (and by years I mean decades), it took me to pay enough attention to realize that my body actually gave me plenty of signals when Aunt Flo was arriving to spend a few days on my couch.

I did, however, finally notice a few years ago that the several days a month when lines of poetry presented themselves unprovoked by prompts or any my usual poet’s tricks coincided with the days preceding my period. So while I don’t exactly look forward to the physical mechanics of menstruation, I do look forward to that time when, for whatever reason, I seem to have greater access to my creative spirit. I sometimes think about the Old Testament prohibitions that say women must be separated from the group during their cycles. I’ve come to believe that it’s less about cleanliness and more about giving women a time apart to fully engage with their creativity. Even as the body physically cleans itself of the unused mechanisms of physical creation, the mind itself shakes off and shakes out the lines, the scenes, the characters that have been waiting for fertilization. Some land on the page, some are reabsorbed to gestate a little longer. Yes, I realize I’m willy nilly mixing my metaphors here, but hopefully you get the point.

I wouldn’t say that I’m scared that my creativity will suddenly disappear if I no longer have a uterus and get a period. But I am mindful of the metaphoric implication of giving up that place in myself that was designed to harbor life.

I’m not sure how to write my way out of the end of this post, and I guess that’s where the TBD comes in. The poems will still be there hidden in my body, I will still be capable of creation regardless of which body parts I may or may not possess after surgery, and while something will be lost, I am expectant that out of that loss, something else will be born, some new metaphor for creation that I’ll only be able to hold onto if I’m capable of letting go.

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A return to normal?

Twenty-three days still to go till I have my uterine surgery and I’m beyond ready for it be April. I’m ready to have my wound be healed up, I’m ready to not look pregnant any more, I’m ready to be exercising again and working toward my weight loss goals, I’m ready to not be worrying about where I sit for 10 days of every month and having to cancel engagements at the last minute cause I’m woozy from menorraghia, and I’m definitely ready to buy new sheets and have my only worry be that they’ll become ink-stained because I insist on writing long-hand in bed. I’m also ready to have my brain back. Currently it’s abuzz not only with my usual to-do lists for work, but also “write down French Press instructions for Mom” and “schedule someone to help with laundry and making the bed” and “make an e-mail blast list for people who’ll want to know how surgery went.” I’m also ready to be rid of the low-grade anxiety that starts my heart racing at the oddest of times, like when I’m trying to enjoy an episode of Bones and one of the characters whips out a scalpel.

In other words, I’m ready for life to return to normal. I keep cautioning myself, however, that I won’t actually feel normal, or more precisely, that, for me, normal doesn’t mean asymptomatic. I’ll have lighter periods if all goes well (and maybe no periods at all if the only option once I’m on the table is a hysterectomy), I’ll be slimmer, and I won’t be chronically exhausted. But I’ll still have trouble breathing on warm moist days, I’ll still occasionally have trouble not breathing heavily while walking uphill no matter how diligently I’m working out, and I’ll still occasionally get dizzy on those days when both my allergies and my asthma are conspiring a to keep my intake of oxygen to a minimum.

I wish I could say I am ready to just accept my battered body the way is, but I’m still struggling with that one. Even before the fibroids became an issue, I found myself frustrated and angry whenever I had an asthma attack. Sure I knew I was incredibly blessed to still even be breathing and above-ground. Sure I knew that an exacerbation of my lung issues were par for the course during pollen-heavy or humid times of the year. But still, I’d convince myself, on the long stretches of days that I felt great that I was finally well. That the next time I went back to the doctor, she was going to tell me to ditch my inhalers and stop taking the laundry list of medications that is usually way too long to fit on the “what medications do you take” part of any medical intake form.

I wish I could tell you that after the surgery, I’m going to return to living with grace. And maybe some days—hopefully most of them—I will. And as for the other ones, I’ll just keep limping through them till grace kicks in again… as it always does.

First Comes Mourning

I spent my morning in the wilds of Rockville seeing a specialist to see if my fibroids could be removed laparoscopically. I was hoping he’d say yes, in great part, because the surgery would then have been done via robot and, come on, who doesn’t want to be able to say they’ve been operated on by a robot? I did, however, have an inkling going in that because of the size of the largest mass that laparoscopic surgery, which would’ve meant basically cutting the mass into smaller pieces so it could be extracted through tiny incisions, wasn’t going to be an option for me. Turns out size wasn’t the doctor’s concern at all; rather there was a line in my ultrasound report that hinted that there was a slight possibility of cancer cells, and so it’s best to remove the mass intact so that if it does turn out to be at all cancerous, there’s no risk of accidentally spreading it throughout the body because the surgeon’s sliced and diced the tumor into little bits. And while the fact that Dr. B raised the “c” word made me face a possibility that I’d steadfastly been avoiding, it’s actually a conversation that happened after my exam that was more troubling.

Somehow Dr. B thought I wanted a hysterectomy while I was looking for a myomectomy, which would remove the fibroids but leave my uterus (hopefully) intact. It was while I was filling out paperwork to secure my surgical date that I noticed the error. Dr. B popped in again to talk to me and said that he would be happy to do just a myomectomy, HOWEVER, I had to understand that given the size of the mass I might end up with a hysterectomy as the only course of action once they had opened me up and could really assess the situation.

My feelings about my uterus have always been ambivalent. It was the reason I was grouchy once a month, but, for the most part, except for one abnormal pap smear in my early 20s, it’s behaved itself quite admirably. As for kids, well, when I was in college, I was convinced that I wanted to be a mom, but as the years went by and I remained unmarried—a prerequisite for me when it comes to having children—I decided I was fairly ambivalent about the situation. I figured that if my husband wanted kids, we’d have some, and if he didn’t, we wouldn’t. Also, having watched a dear friend struggle with the heartbreak of fertility treatments that just didn’t work over a period of several years, I decided fairly early on that if I couldn’t get pregnant the old-fashioned way, I had no interest in pursuing assisted options.

Given all that, I was surprised, after my fibroids diagnosis shortly after my 40th birthday, to find out that I did want kids. In the initial consultation with the gynecologist, the first option she asked me about was a hysterectomy, which would immediately relieve my symptoms. The obscenely heavy bleeding during my period, the chronic anemia, the heartburn, the difficulty breathing that was unrelated to my pneumonia-generated issues, the insomnia. But I found myself telling her that she needed to only give me options that meant I could still conceive a child. I had taken the whole day off from work, even though my appointment was in the morning. The doctor’s office was in Takoma Park and I had planned to walk to Old Town Takoma and treat myself to lunch cause I believe everyone deserves a treat after poking and prodding from lab-coat types. As I wandered the long stretch of Carroll Avenue from Adventist Hospital to Mark’s Kitchen, I was overwhelmed by my longing for a child. It occurred to me perhaps my ambivalence was only another protective spell, a way to stave off the true grief at not having found a partner though I’d fully expected two decades prior to graduate with a Mrs. degree, or at least to “earn” one fairly soon after graduation.

For various reasons, I did not go through with the surgery that year. And sometimes, I think it’s a minor miracle, or maybe not so minor, that this time around, I’ve been researching my options and making doctor’s appointments to find out which procedures are viable for me if I’d like to keep my womb.

I’ve had more than a few conversations with my best friend D, and she doesn’t quite understand why I’m so attached to my uterus. I sort of see her point given how many sheets I’ve ruined because of the fibroids, or how many overnight visits to friends I haven’t made because I’m scared of damaging their furniture, or how many times I’ve spent the day dizzy and semi-delirious at work because my flow has been so relentlessly heavy that I’ve done a good approximation of “bleeding out.” But somehow it feels like if I give up my uterus, it means that I give up my chance at marriage, which makes absolutely positively no sense to my brain, but is absolutely positively the view my heart takes. I am terrified of the emotional devastation I will feel if I come out of anesthesia and Doctor B. has to break it to me that my uterus is no more.

Do I know that I can adopt or foster? Of course, I do. Do I know that given the age range of men I’m looking to date that there’s a good chance I’ll have stepchildren to love and mother? Of course, I do. But again, that part of the conversation’s taking place in my head. My heart really can’t see past the possibility of the emptiness inside me. Somehow she seems to think that not only babies, but also love is born in the middle of me, at my center.

I can’t help but think that maybe it would be easier if there was some ritual, some way to grieve this loss. Even if I don’t lose my uterus in the surgery, the fact is I’m turning 43 tomorrow, which according to most gynecologists is when a woman’s fertility significantly plummets. The italics aren’t mine. They’re the way my primary gynecologist emphasizes the word every time she reminds me that my biological clock is winding down. And yes, I know women have conceived in their 40s, but the fact remains that for women who have never been pregnant, it’s a possibility to have baby mojo past that point, but not a probability. (And yes, for my believer friends, I know that God can make anything happen, but I’m talking about the purely biological view right now.)

Don’t those of us who didn’t make the choice to not have children, but for reasons of just not finding the right person in time, or medical issues, or whatever reason, that’s the end result get to grieve that loss? There should be some symbolic way of saying goodbye to our fertility when we’re desperate to hold onto it for a few more years but biology or health issues won’t allow. There should be a way to mourn that hollowness radiating from that place where you were sure that some day you would feel the squirrellings of life.

I’ll end here with the fact that I know some of you will want to post comforting things. Sure, it could be worse and I’d be better off worrying about the cancer possibility if I’m going to worry about something. Sure I can adopt. Sure my life can be—and is—significant and meaningful and worthwhile irregardless of the state of my uterus or whether or not I have kids. But none of that should mean that I don’t get to grieve. That I don’t get to fill my mouth with wails of grief and loss, to sob an ocean of tears. Morning will come, but first comes mourning.

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