The PA

PA stand for Pathogen Analysis. It’s a standard procedure after an operation. PA needed to make sure, were the preparatory, the myoma from my uterus might sign to be dangerous or just an ordinary substance. That’s why sometimes the surgery ask or recommend the patient to do the pathogen analysis. This was made to make the patient sure and feel free from the unnecessary and negative thought.

So, to ensure that everything’s good and normal, my hubby took the preparatory to the pathogen analysis laboratory.  It usually took around 1 or 2 weeks, to finish the analysis. Little did we know that the process can’t be replaced, so my hubby go to the lab to fill the form and finish the administration. Later the result also can’t be deliver to another person, only the patient or their family.

Later when result has been done, the conclusion on a single note, need to be brought to the gynecologist to the next treatment the patient needed. It was just a normal fibroid, non cancerous. It’s written clearly and briefly signed by the head of the facility, for attention to my gynecologist. I couldn’t imagine how it would be such a horrible nightmare if the result different. How I had to prepare the next treatment and the medicine I had to take, the special diet and strict food restriction. Thank God, it’s fine.

For the detail I must wait the next examination and consultation. The physical  examination also needed regularly, every 3 or 6 months to control the early stage growth or regrowth inside. Actually, there are common case that most women don’t visit their gynecologist regularly and take a pap smear test every certain months as recommended. Mostly, including me only see the doctors when I feel something wrong with my body and felt not well. Oh well, at least the pathogen analysis makes us a little bit safe and secure.



On Tuesday evening after the examination, I can get down from the hospital bed and try to walk. Lucky there’s no sign of dizziness or nausea. I could change into my ordinary clothes, I might go to the bathroom by my self. No need to put the yellow ribbon again. No more fall risk patient. It’s very relief that my patience waiting more than 24 hours,  has a good result.

A little bit accident turn into blessing. I accidentally put off the intravenous drip valve, so the nurse need to put it in in another vein.  So I ask the nurse to contact the doctor whether  I didn’t need it anymore. Well finally the doctor agreed and it’s a good news. I could sleep tight and easily without the infuse valve.  It’s free to move, I even try to roam on the nurse station outside.

My husband had to go to work on Tuesday so he visited me after the office hours in the night. Actually, a family member allowed to stay to accompany the patient for a better caring and to make the patient more comfort.  My roommate’s husband always stay beside her. I think he should take some unpaid leave from his work. But with his wife condition labile and so weak, how can he work easily? My husband  not always stay by my side after the surgery. But our daughter need him too. Beside how could I ask him to sleep there in a folding bed or mattress on cold and narrow corner of the room. Our house only around one or two kilometers from the hospital. If something bad happened to me, he  could be contacted easily.

It was so relief the second night in the hospital, I could sleep tight until the next morning. The nurse even pull the curtain close it tight and turn off the lamp. I think the best dream I had, was going home tomorrow,


The Roommate

The first class in patient facility that my health insurance cover, has two beds for two patient as the hospital roommate. It was coincidence. My name and my roommate’s  name were almost similar. She’s one of the referral patient from other health facility who needed intensive care and nursing. So she was being sent in.

The case was her weak uterus, earlier contraction led to miscarriage.  It’s the second chance. The first one didn’t make it, so they, the young nice couple decide to have intensive care pre natal treatment. It’s a complicated case. Need a lot of patience, time, energy consuming and a high cost hopefully their insurance company cover it.

With the myoma, the fibroid inside, my uterus force to contract as a reaction that led to high and heavy bleeding periods. Well actually both of our case could lead to dangerous situation, in her case involving her unborn too. How lucky I was. My two pregnancy healthy with no serious indication and problems. In many cases, the pregnancy it self could be a threat to both mother and the baby.

I was just lying in my bed, waiting for after 24 hours to lift my head and my chin then I can try to sit.  I was able to sleep on two other side, so I wouldn’t feel  my body ache n shore. I hadn’t come down my bed, waiting for the nurse to prepare and check my condition. But for sure it soon will be done.

My room mate, must obey the doctor’s order to just lying still, she couldn’t barely change into the  other position. Every single move consider to have a serious impact to the womb and could harm her baby inside. Since I was in, there are many kind of treatment that must be done to keep her and the baby safe. I remember a very old story about an Italian actress who desperately want to have her own baby and need a total bed rest for her two pregnancies. That’s a mothers instinct.  A truly sacrifice. Her name is Sophia Loren


It was a middle hot bright day on the third Monday of November when they push the bed through the isles, into the elevator up to the third floor. My body was barely cold, I felt so cold for the next 2 or 3 hours later under the influence sedation effect. I can sense the cold, but couldn’t  move my limb, my half body.

The thought about the paralyzed body that permanently can not move, made me feel grateful of how lucky I was healthy and complete. Sometimes we just missed something when we don’t have it anymore. We used to think and felt walking, running and moving anywhere freely as an ordinary, but how if we were the paralyzed body that need tools, device and help only to move, a single subtle move.  How lucky, I couldn’t imagine how frustrate and bad I would be.

The anesthetist told me to move and exercise my muscle, anytime I regain my nerve back. He also asked me to lye side by side, to a better body adaptation. But he told me not to lift up my head in 24 hours after the surgery. It could lead to dizziness and nausea that should be avoid after a surgery. Soon I regain my half lower body consciousness and try to move it little by little.  It didn’t feel hurt, just a little bit heavy sensation. A bit hard on first trial.

The nurse told me to eat anything I want,  No diet an restriction.  So my Husband fed me. I was so thirsty yet hungry. The last meal I took was the evening before. The food and the fluids intake were strictly prohibited before the surgery. Well I was glad I could drink and eat again.

The paralyzed sensation only temporary.  That’s the way the gynecologist could pull the myoma out without incision. I felt relief because the procedure end up succeed. No incision and I sill have my uterus with me.

The Surgery

It was almost the middle of the day when the gynecologist arrived to do the myoma surgery procedure. She was a bit surprise met me two week after she gave me the surgery referral. I was supposed to come the week before, but there’re some situations prohibit me from earlier treatment. I was lucky on that day no other surgery schedule, the anesthetist  even look sleepy and a bit boring while waiting. So everybody feel relief when she finally show up, after finishing the other surgery in another hospital.

The anesthetist  gave me two shot on my spinal. It felt hurt, a bit strange but what can I do, it was the only way it should be done. It felt strange and didn’t  take so long before I couldn’t barely move my limb. I felt motionless, I could feel n sense but couldn’t barely move my lower body even for a single gently motion.

The lamps was so bright, I was awake with eyes wide open couldn’t move my half lower body but wasn’t feel pain at all. The surgery assistants even try to mock each other and asked me some silly questions, just to make me feel relax. The blood pressure monitor in my upper arm beeped the signal every several minute to make sure my condition was stable.

I sense a bit pulling down move from my stomach. It must be the time when the surgeon pulled  the myomat. the uteri fibroid out  my womb. It just a little bit weird sensation but not hurt at all. All I could do was waiting, praying, have some thought and always in state of positive thinking. The surrender to whatever will be, made me peaceful, relax, positive and unafraid not  worried at all.

Thank God, the procedure succeed. As the plan before, the fibroid successfully been pull out without incision. There some blood and normal bleeding. The gynecologist check it again later, make everything’s good before they send me to the in patient facility. It was the middle day around 2.

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.