The Procedure

Just imagine I must start from the beginning to make the insurance cover all the surgery procedure made me afraid and limp. A new doctor will interview me, examine and recommend me the next treatment. It would take a month or more for a queue in the public hospital that provide the procedure.

So to secure and close the gap and administration fuss later, I will go back to the hospital as a Emergency Patient. The first treatment was fully covered in cash. It was too hectic and critical situation when I need the card but I couldn’t barely find it. The administration procedure ask how I and my husband will the bill later. And because I couldn’t find the card while my hubby want me to get help as soon as possible, we pay it with the credit card.

Of course it a bit expensive, but at least the hospital record me clearly in the data base, so when I must come back later, it would be much easier. When on Friday and Saturday night. I had the heavy bleeding again, I know there are no other cancellation for my own shake and safety.

We came nearly 5 in the morning to the Emergency Room again. We had to wait, because it was rare, no patient that early morning. We wait about a half  hour before they start to do some test and put the intravenous needle in. The test for some blood indicators, the ECG (Electro Cardiogram) to record my heart beat, the thorax X Ray and than I can wait outside, waiting for the doctor to come.

I must fasting straight away even for drinking a little spoon of water. They’re all prohibited. Unfortunately, my gynecologist couldn’t come in time. Her schedule changed suddenly when she must do a C section surgery for another patient. I waited until almost mid day when finally she came and ready for the surgery.

I Made My Decision

Thorn between the two, if I choose laparoscopy instead of laparotomy, there’re only a few hospitals that have that medical procedure and services. I might have to pay it myself outside my insurance. The insurance can covered it, but first I have to wait in queue to have that procedure fully covered. I was so afraid that it would take a very long time and I didn’t have any.

Many public hospital can do the laparotomy for both myomektomy or hysterectomy. But imagine have a scar from the incision made me sick and nervous although I would going under the knife in half or fully sedated condition.

The procedure it self will be done only about 1 hour or 1 and a half. With regional anesthesia,  I wouldn’t feel any pain. Why would I risk my life hostile by something growing inside me. I just want to live my life normally, easily and full of productive activity. What can I do by lying helplessly and do nothing. In this case the time is key to save my own life.

Still the idea of hysterectomy made me have some butterfly in my stomach. So, the more I think of it, my choice was the myomectomy with the gynecologist that looked after me in the hospital before. She offered me to try her way first to remove the uteri fibroid out than move to another option if the first one is to difficult and dangerous. I think I should give her a chance to do the procedure, the myomectomy.

To entertain and cheer me me up and  my spirit I went out driving for a gathering with some friends.  Enjoy the meal and the time. Enjoy their company. I was a bit pale, my make up help a little though. The joy and happiness they bring boost my mood and spirit to carry on.

Going Home

I started Wednesday, the day after by taking shower. It was a bit cold but so fresh. I ate the breakfast and feeling so glad that there no negative indication that force me to stay longer. Yesterday the nurse, check my temperature and blood pressure every 1 or 2 hours and today a bit easy.

My aunt and uncle visited me in the morning. They came a bit earlier so I decide to meet them up on the waiting room outside. So we have some chit chat. I was healthy and didn’t look pale anymore, so the meet up was like ordinary one.

The last time I met her was about one month a go on a relative funeral. It’s been a very long since I met her and she straightly notice there were something wrong with me. I was so pale and not as usual. So I told her about the uteri fibroid, the myoma that made me on extreme dismenore condition.

Later we have an intense conversation on Whats App about it. She told me about her friend who has the same conditions and fainted, several time while teaching or in the office. Her condition and health improve much when she did myomektomy as the doctor’s order.  That’s why I told her about the operation and she seemed very relief.

It was the middle day when my hubby coming and we waited together for the doctor’s visit. The last examination before the patient can go home must be held. The doctor has to sign the patient status and condition. The gynecologist finally show up in the evening.

Well I was very relief  when they release the clear check and I can freely go home now. Actually it was a bit longer than we though, the administration process but it worth enough. We didn’t pay a dime for the procedure because we use the insurance exactly like it meant to be.

 

The Insurance Coverage

The insurance company offer a certain full coverage option in my case.  The surgery it self, since they must refer the hysterectomy in the memo as final treatment, consider as major surgery.  My insurance company explain it fully covered clearly, so nothing to worry about. The hospital usually has the mutual agreement but because it’s on different province, there would be a little bit complicated administration. For a better preparation, avoid the unnecessary fuss later, I even went to the branch office to correct my full name on it. Just a little different but better make it correct  before, so it won’t bother me later.

I also did some research and read a lot of articles about the cost other hospital and the insurance company coverage. It depend on what procedure I take. There are commonly two option : laparoscopy or laparotomy, both mostly apply on myomektomy and hysterectomy.

The laparoscopy let you only have two small incision and make you recover soon because the scar wouldn’t take too long to heal. The different with the laparotomy is the well known classical technical surgery with on stomach  incision to pull out the myoma. Laparoscopy is a new Technic in myomektomy  using the ultimate and expensive laser device. Only some big hospital provide the procedure.

In my case that need a fast treatment it may not good and I must wait for some months.  I just need to start from the first grade health facility to ask a referral again if I want to use my insurance and get the most benefit of it. It just an administration matter but sometimes bothering and ridiculously applied. Both of them fully cover in my insurance. I just not sure whether I have enough time.

The most important part is I need the surgery as soon as possible, I manage to prepare my self as good as I can. I took a good rest, eat good and enough food. I also try to relax and not thinking and worry to much for the surgery. Life must go on, right? I still am not feeling well  enough though. The low hemoglobin level made me a bit suffocated. It was hard to take a deep breath and breathing easily and freely.

The Consultant

The thought about which one I must chose because lack of time and  the urgency, brought me to the third consultation. The third female gynecologist in a big and fancy hospital. She was a bright star in gynecology section. A gynecologist consultant and sub specialist in fertility hormone. She has done many laparoscopy surgery and has a well known reputation among the gynecologist.

The gynecologist consultant examined me with 4 dimension Ultrasonography. It showed the myoma geburt as the diagnose before. The other additional yet detail is the root is deep down to the fundus. It also measure the size of it stem and the size of the myoma itself, roughly the size of a tennis ball. The normal size of a womb, a uterus has diameter around 7 cm, roughly as big as a duck egg. Some part of the myoma came down there in my cervix, so it easily be observed. The consultant also find more than 5 small sign of myoma to be in my uterus. There’s a possibility another one will grow replace the myoma removal. All that signs, lead to the conclusion and the doctors order before, that the myoma need to be removed out immediately.

I asked her about the myomektomy instead of hysterectomy, because soon I will entering my menopause cycle but she said that her patient is 57 and still has the menstruation regularly. If I chose hysterectomy I don’t have the cervical cancer risk anymore. Beside there are no correlation between the hysterectomy and woman sexual ability to have orgasm. some myth spread only the negative rumors not the clinical facts. The uterus itself didn’t produce any hormone and I don’t need to worry about earlier menopause. I still have my ovary to produce the ovum the egg and some hormones my body need,

Well it was clear that the doctor told me that the laparoscopy it self is the best option she would recommend me to do. it considered as a safest and lowest risk procedure for my condition.

The Option

The gynecologist seem didn’t surprise when I told her about the irregular yet heavy bleeding. The surgery option worried me much. The problem is the myoma need surgery soon, but I still am hesitated to that option. If I hold on to my decision, it could hostile me with anytime heavy bleeding, 3-4 times uncontrollable heavy periods in a month. That’s way too much and could lead to a shock for losing too much blood.

My doctor saw that it was hard and scare me to do the hysterectomy. So she ensure me about the surgery option.  First,  she will try her best first to pull the myoma out barely with her hand and examine my uterus, make sure everything’s good and nothing else to worry about. She would do that on a certain conditions that  my half upper body sedated, so I wouldn’t feel the pain. If it can’t be done, than she would make a stomach incision to pull the myoma out.

The surgery without incision  lower the bleeding risk and I can recovery so much sooner than with incision. Maybe in 1 or 2 days I will be good enough to go home and have a full recovery in 1 week with proper and good rest. The gynecologist recommended me to have the surgery as soon as possible. She even gave me a referral treatment  memo for the internist as a preparation before under the knife. But just in case the hysterectomy must be done, the myomektomy procedure  will be set as the priority and the first choice.

it so much dangerous and risky to put my self hanging and hostile by uncertain condition like this. The bleeding could happen anytime. Though the doctor gave me some medicine, the hormonal pills, the iron booster, also some pain killer to ease the pain and reduce the uterus contraction that made me heavy bleeding, the myoma inside was to big and dangerous to grow on.

My Periods

My periods usually very regular. It used to be every 24-25 days. It’s usually started with a thin layer of pink blood or 1 or 2 blood spot followed by the heavy bleeding on the day 2 or 3 around 3 days. Even though my periods a bit too heavy, I still manage with the iron booster pills.

Usually as I was in my childbearing years, a fertile phase, I use intra uterine device to avoid the pregnancy. My little girl is a teenager who doesn’t want a baby boy presence as her younger brother either. The intra uterine device (IUD) meant to stay good within with regular check up for 5 years. The gynecologist put it in nearly middle of 2013 and it went well until one day when I went to a shopping mall and need to use public toilet, it came out suddenly with the urine.

Of course I was shocked, a bit worry and have a bad thinking of that. First I thought it was something else on the toilet paper a piece of thin wire or wood.  It was not hurt or painful so while waiting for meet the gynecologist I consult my aunt who was a retired midwife. She told me it could happen in a very heavy periods. She even offering me another one if I need it, to make me comfort and easier.

Actually the pregnancy controller not only women part. Men can actively take part of them. There some option for men beside the condoms. If I chose the IUD it was because it’s easy, practical and not contain any hormone substance that bothering my periods cycle.

I never though that when the IUD came out, it’s a very early sign that something growing abnormally inside my womb. The very intense and heavy periods could lead to some very serious problem we must pay attention more.

He was far far away

My husband work as a public prosecutor in Attorney General Office. Some of his duty send him across the country. Some job ask him to fly far far away to European Country for around one week. An international event  or invitation must be attended by inter department delegation. My husband usually do the speech, involved in mutual agreement, mutual legal assistance and cooperation among the countries. His role is important enough so he even had to be an overseas frequent flyer.

Because of his busy daily schedule, I decided to be a stay at home mom, so every time my children need their parent, at least one of them, I always there for them. When I was sick, actually it was not a big problem because I live and stay in a big house with my parent in law. My  parent in law can take care my children. Not so much because the were old and got their own health problems. They even had to reschedule their trip for a doctor visit in other city around 7 hours trip by the train, while visiting their home town every 2 or 3 month.

That time, my husband must fly to Vienna, Austria, nearly a 20 hours direct flight from our city. He must be checked in that Saturday afternoon when I must revisit my doctor for a week control after going home from the hospital. So after preparing and do the last checking for the flight, my husband dropped me in to the hospital, waiting for around 1 hours together before the doctor arrived.  But he must leave soon. The traffic jam on Saturday could be very horrible sometimes. He could miss the flight.

So I sit alone on the lobby, waiting for my daughters to come. It’s their turn to accompany me. I couldn’t barely move even to the bathroom, afraid I might collapse, walking unbalance to the toilet.

Even though he love to stay, he couldn’t and I know I must be strong enough to carry on.

 

The Assistant

In my country, it’s common to have an assistant to do the chores. When my children were small, I have an assistant too, so I can take care and nurturing my children better. Some working usually hire a baby sitter. I prefer to take my children all by my self. It’s a good chance to make a strong bonding with them. A special relationship between a mother and the children. Beside, mostly I work from home. It makes my schedule flexible.

Some assistant paid to stay with us, do the chores and whatever household task she’s been ask for like cooking, cleaning, take care for the children, drop the children of to their school and pick them up. Some baby sitters are even waiting for them while they’re in school or play group class. It’s a bit different because some family spoil their children with so much attention just for the parents need of secure feeling while they must leave their children for working.

Actually my husband think that our children spoiled too much without giving them the house chores. so in middle of this year, I started to do all the chores again with some delegation to my girls  to make them more responsible and not spending too much time in their room. As for me it’s a chance to a little bit activity and exercise because  usually I spend too much time sitting in front of my laptop doing some work.

The assistant took the chores especially in cleaning the house, manage the laundry, grocery shopping. The meal easily to find out there or just make an order to be delivered. I cook a little, only simple and easy meal for another option. But it’s clearly the assistant only help my house, not me. My body still isn’t feeling well. I got exhausted soon and easily.

 

 

Not good enough yet

It was very glad to go home. It just felt right. How good and fancy the nursing room you can afford in a hospital, it still was  not a home, it’s just a room. I tried to do some activity, the chores, slowly not force my self. Just to have something to do than lying in the bed almost all day.

My husband drove our girl to school. Dropped her by on the way to his office early in the morning. Later in the afternoon she could use the public transportation home. It’s just about 1 kilometers or 2 so it did’t take so much time that make me worried. She even can walk from home to school if she want and not so tired. But she rarely do that. A high school student always carry many book for some lesson. The school doesn’t have locker facility for the pupils. Some on line based transportation also help with another option. There’s gojek, grab and uber bike to chose. Mostly easier to call and have economical rate.

Well, although I was going easy with the chores, not took to many activity it’s clearly that I became tired soon. I just felt it’s different. A bit fever, unbalance mood, sleepy, weak and feeling incompetence. maybe because physically, the transfusion of some blood bags only consider to a minimum standard. I must boost the hemoglobin with the foods and medicine. How can we operate the system regularly if there’s a lack of oxygen on our blood delivered by a fewer transporter. But the food I took even though rich in iron, sometimes it doesn’t help much when I loss the appetite. I just ate when I was hungry to make my organ function well.  The appetizer didn’t help much.

It was clearly that I wasn’t good enough. Oh well not yet.