Thursday, October 3, 2019

OctPoWriMo 2019: Day 3: Aunt Cie's Soapbox: Leave My Old Womb Alone (Choka)

Image by Solarus from Pixabay

lay off my old womb
I am not a candidate
for new motherhood
I can no longer achieve
reproduction, no
but it would not bring me joy
to endure the pain
of removing my old womb
it is my life choice
to keep my organs intact
despite a slightly
elevated chance that I
develop cancer
somewhere well on down the line
any womb is not
only worth saving when it
is available
to serve as incubator


The poem references the incidents of 2018 when my life continued revolving around my uterus despite the fact that the painful periods I had endured for 40 years had come to an end. In April of 2017, and again in April of 2018, I experienced post-menopausal bleeding, and in June of 2018, I underwent a D&C to determine the nature of the endometrial cells.
Had the cells been abnormal or the endometrial hyperplasia complex, this would have elevated my risk of future endometrial cancer by 36%, in which case I would have opted for a hysterectomy.
My cells were normal and it was simple hyperplasia. This only increases the risk of endometrial cancer by 1.6%. In the end, I felt that the risks posed by undergoing a hysterectomy, which is a major surgery no matter how casual a spin doctors try to put on it, were greater than opting for a wait and see approach. 
Post-menopausal endometrial hyperplasia can occur for a variety of reasons. It is more common in Caucasian women, in women over fifty, in women with a larger body type, and in diabetic women. I am a large Caucasian woman over fifty with a large body type who has diabetes. As it turned out, I also had a number of small fibroids in my uterus which were probably irritating the endometrium and causing it to overgrow.
My primary care physician wanted me to have a hysterectomy.
My OB/GYN wanted me to have a hysterectomy.
The gynecologic oncologist whom I consulted wanted me to have a hysterectomy.
This despite the fact that all of them quoted a very low increased likelihood of the type of hyperplasia I was experiencing ever developing into cancer.
I had one of those obnoxious trans-vaginal ultrasounds in February of this year which showed that the endometrial lining was still slightly thicker than normal but had greatly reduced in size and was within the perimeters of acceptable. I did not experience bleeding in April of this year. My OB/GYN wanted to do another D&C, but I said no. There was no presenting reason to undergo a procedure that leaves me feeling like someone has been up in my business with a cheese grater.
I consulted with a radiologist who specializes in a procedure called uterine artery embolization, which utilizes tiny radioactive grains to block the uterine arteries and cut off the blood supply to the fibroids so they shrink and cease to cause trouble. As opposed to a hysterectomy, which is a major surgery, this is a minimally invasive approach. The doctor told me I was not a candidate for the procedure because fibroids will shrink on their own after menopause, but she agreed with me that since I had not experienced post-menopausal bleeding this year, the endometrial thickness is within acceptable boundaries, and my hyperplasia is the low-risk variety for future development of cancer, a wait and see approach makes sense in my case. She discussed this with my OB/GYN and the gynecologic oncologist, and they agreed with her.
During The Year Of Focusing Way Too Much On My Uterus, I learned just how quick doctors are to recommend a hysterectomy to post-menopausal women. If a woman can no longer serve as a baby factory, let's just yank the old plumbing out, risks be damned. The fact is, major surgery is always risky although sometimes the risks of surgery are necessary. It is also a fact that the female reproductive system provides benefits to its owner even after menopause and unless it is malfunctioning in a way that makes life unacceptably uncomfortable or poses risks to a woman's health, it's best to leave it alone.
Uterus: it's not just for incubating infants. 
That's been Aunt Cie's Soapbox, Ladies! Hysterectomy is sometimes necessary, but it tends to be overprescribed, particularly in post-menopausal women.


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