She didn't see any blood, but did see signs of genital warts, something I picked up when (as my husband says) I was perky. She thought they were maybe causing the spotting, but wanted me to have a transvaginal ultrasound. Fine. I'd had those before.
I drank a quart of water two hours before the ultrasound. Silly me, I drank it an hour before I got on the bus, not taking into account the other hour of travel and waiting in the reception area. By the time I was taken back to radiology, I was having to dance to keep my bladder in check. And of course, the tech was pressing the ultrasound doo-hicky all over my belly, as if my bladder wasn't about to burst.
They couldn't see the the endometrium too well because of a large and decaying fibroid, so they wanted a biopsy of my endometrium. The head of Group Health's OB/GYN did the biopsy. She was great. The procedure was uncomfortable. I'm pretty sure the extra-large speculum she used was made by the same person who made the Jaws of Life. She dilated my cervix and threaded in some tool that sliced and grabbed bits of tissue.
The lab results showed what they think are "necrotic polyps". What the fuck. What's up with all these things in my uterus that aren't supposed to be there?
They wanted to be sure they were necrotic, which means there's no blood flow, which means they're probably not cancerous or pre-cancerous. To do this, they needed to do another transvaginal ultrasound. I thought it was going to be like the last one. It was not. Yesterday, right before the procedure, I learned that a radiologist was going to inflate the endometrium with saline water, to get a better look at the polyps. Holy crap! Then he said he was going to use a balloon to block the cervix, so the saline water wouldn't leak out during the ultrasound. When I heard "balloon", I thought of this. Actually, it was like fishing line. It was nothing like a balloon. It felt odd. I could feel things moving in parts of me that I ought not. I experienced a little cramping, but nothing like the menstrual cramps I used to have.
The radiologist told me that if he was not successful at seeing around the fibroid to see the polyps, he might have to stop the procedure to drag an OB/GYN into the room. This person, he said, would put a clamp on my cervix and I stopped listening.
When it was over, the radiologist showed me some of the images. He'd point at things and tell me what I was seeing. I'd nod my head and make approving noises, but I didn't know what the hell he was talking about or what he was seeing.
A few hours later, I had my second procedure of the day. This one was to remove and biopsy genital warts. It was the second time I saw Jane Dimer and I think she's the best physician I've ever had. She asked me about the morning's procedure, told me what the report showed, told me what she was going to do, and when she was done, talked about next steps. Her pace was measured and considerate of me. She told me something that no one else has in the 2.5 years since I was diagnosed with cancer; that my immune system remains compromised because of the cancer and its treatment.
She told me that the ultrasound images from the morning showed that enough saline had been in my uterus to float the polyps, which for some reason was a good sign.
Throughout the past 2.5 years, when I first went back in for a follow-up ultrasound and mammogram because my annual mammogram had indicated something was wrong in my left breast, through yesterday, I've been struck with the information conundrum of being a patient being treated for a deadly disease. I've seen a number of medical professionals, and each one has given me different information. Being under-informed I often made assumptions based on the information I received, and my assumptions were often wrong.
Why didn't the radiologist in the morning mention that my polyps floated? It seemed to me, when Dr. Dimer told me about it, that it was a big deal. I imagined that when he was reviewing the images with his peers, he might have said "Look! Her polyps floated!", and they all would have clapped their hands in response to this happy news. All I remember him telling me was that it was hard to see what he wanted to see because of the monstrous fibroid I have in my uterus, which has become friendly with an unknown number of polyps that float.
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| The exam table prior to the procedure |
She showed the nurse what she was going after. She then explained to me that she was going to numb the area with two topical agents and then inject the labia and surrounding area with another, stronger numbing agent. She did this, and while she was gentle, it was unnerving, no pun intended. She told me she was going to use a tool that both took samples and cauterized the wound, and that the nurse was going to use a suction device to remove the smoke. That was hard to hear. I did indeed smell burning flesh when she was going at it. The nurse put an adhesive pad on my leg and she said it was the ground for the tool the doctor was using. It was like a big EKG sticky.
It didn't take too long to get the samples. It didn't hurt. Both tools she and the nurse used made noises that distracted me from thinking about what she was doing down there. When they put their tools aside, Dr. Dimer said she was going to stitch me up. I have stitches on my labia. In a normal world, I would never have had cause to write that.
She said she wanted to see me in four weeks, and that they may need to do a more robust biopsy of the polyps. I have no idea what that means and I'm not going to think about it.
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| The exam table after the procedure |
