Monday, March 14, 2011

Day 1 Procedure

My boyfriend and I returned to the hospital's family planning clinic, where we had been several days before for our consultation, for part one of the D&E procedure: laminaria insertion.

Upon arrival, I needed to pee immediately (surprise, surprise), so by the time I left the restroom, they were ready for us to come back. The nurse directed my boyfriend to the same consultation room and then took me to take some final vitals. I joined my boyfriend in the consultation room, and we waited.

The head nurse eventually came in, cheery and spunky as ever. She went over some logistical details and made sure that I didn't need the services of a social worker or chaplain.

She rattled through more details:
  • I'd need bloodwork done before I left today, after the laminaria insertion.
  • I was prescribed an antibiotic (Doxycycline), a narcotic painkiller (Norco), and 600 mg Motrin (you're kidding me, right?). I could place the prescription downstairs at the pharmacy before going for the bloodwork.
  • The attending doctor wouldn't be in today for the laminaria insertion (she gets in later in the afternoon), but everyone else working on my case would be there: the resident who I already met, and the fellow.
  • The remains of the fetus are incinerated. ("Ok?" she added, glancing up at us. I swallowed hard. This information felt out of the ordinary run-down of things, but I suppose it's all part of the process.)
  • I'll be in some pain, nothing worse than a bad menstrual period. Call if I bleed through more than one pad an hour or have a fever of over 100.4.
Okay? Okay.

And off we went into the exam room.

I disrobed my bottoms while my boyfriend sat in a chair next to the table. I lay down and he held my hand.

The resident, fellow and head nurse all came in, and the fellow introduced herself to me. I liked her immediately. I liked all these women, I realized, and I felt a kind of calm and confident tranquility that surprised me.

To get things started, the resident explained she'd have to search inside of me to find the exact location of my uterus. Easy enough. She applied lubricant to her hand and began pressing inside of me. I sucked my breath in--it was surprisingly painful for me. I expect this is something that varies from person to person. For me, I perhaps shouldn't have been too surprised. I've found sex for the last couple weeks, when my cervix is hit, seriously painful. Lying on my back at night had become painful as my belly had swollen. I suppose it makes sense that physically spotting my uterus might be uncomfortable too. Fortunately, it was all over before I had much time to process the discomfort. She apologized for the pain when I sucked in and explained that we'd next do a local anesthetic.

More than anything, I was nervous for the shot of local anesthetic. I've never had any sort of anethesia except for general anethesia. I'm unreasonably scared of all needles. I'm kind of a baby. I focused on breathing while they inserted a speculum.

"Here we go," they warned me. I squeezed my boyfriend's hand hard, and... nothing. I didn't feel anything. No pinch. No burn. Awesome.

There was some shifting of the speculum before they said, "Okay, we've got to do one more local anesthetic on the other side."

Shit! I thought. Another one?! Is my cervix superwoman-sized? This I was not expecting, this is awf--

"Okay, it's done," they said. Again, I had felt nothing. Awesome!

They waited a moment for the anesthetics to take hold and explained that they would be inserting three laminaria into my cervix. Not many, they said. I took their word for it and made sure not to glance over and see what the laminaria might look like.

The room we were in featured some of the lovely gray, rainy skyline of our city, so I stared out the windows and thought hard about my boyfriend's hand. They started the first laminaria, and it felt fine. With the second, I winced, and my boyfriend began to stroke my hairline with his fingertips. I relaxed. With the third, the cramping began, and I thought back to a yoga instructor who taught me an amazing breathing exercise. I breathed, relaxed, and it was over.

Incredibly, it was not that bad. I had been so nervous, and here it was over.

They helped me sit up and answered some questions for me: I'll be a full centimeter dilated at the time of surgery. I really, truly did not have to worry about going into labor, they promised me. But the fellow explained to me the difference between my cramping and what labor contractions would feel like. Then she reassured me not to worry.

The resident and fellow wished me luck, said they'd see me the next afternoon and left. The head nurse offered me a heating pad, which I refused. I quickly remembered that I had wanted to ask about masturbation and tossed the question at the head nurse, who seemed baffled and didn't really answer me. Oh, well. She left my boyfriend and I in the darkened room, lit by the gray sky outside, to relax and talk as I curled up on my side.

I'm shocked at how smoothly and relatively unpainful the whole thing was. So relieved and feeling optimistic.

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