Tag Archives: hospital

Part Three: The journey to recovery

The last thing I remember is waiting on a trolley outside the operating theater , my fingers crossed, hoping I was doing the right thing. Dr Lawrence and the anesthetist both came in and said in unison, ‘We know, no Gelofusine.  Now go to sleep.’ I woke up in a four bed ward with no pain. I couldn’t believe it and thought that maybe I was still numb from the anesthetic.

bed

2.08 am…..2.09 am. Why can’t I sleep? I’m still not in pain, which is amazing. A catheter means for the first time in years I have the opportunity of sleeping through the night, but I have tubes in me I don’t want to crease or bend . I know I need to sleep to heal and try to close my eyes and relax. Useless, so I drag out my journal and start writing. It is my salvation as the minutes slowly tick by…2.19 am.

ward

I turn on a small down-light and a nurse pulls the curtain around my bed so I won’t disturb the other patients. Their regular even and deep breathing makes me wish I could do the same. I have made up names for them all. Opposite is Dementia Doris. Beside her is Happy Helen and next door is Pacemaker Pearl who has sleep apnoea and snores loudly above the regular hiss of her C pack machine. A considerate nurse offers me earplugs but I reassure her the snoring makes me feel at home. My husband starts with a stage one whistle and progresses to a stage three guttural snore. I’m usually asleep by stage three. It is the lullaby to my nightly dreams.

At least I am resting comforted by black scratchings on paper and I have all tomorrow to doze to my heart’s content.No cleaning, paperwork , classes to organise or honouring the promise to catch up on filing and tidying I keep saying I’ll do…one day. Paul and Marian are visiting again tomorrow and we will chat and laugh at ordinary things.  Last night they fixed my phone, rang relevant people, kept Alan informed and arranged for my trip home. All I have to do is eat, sleep and heal.

paola Rafa  menu brochure

I do just that. The meals are superb, as good as any five star restaurant. It only takes two night’s stay in hospital with wonderful nurses like Paola and Annie who treat with compassion and respect, spoon feed and calm two dementia patients. One old lady keeps calling out all night ‘Where am I? Where am I? I want John. Where is my Mum? Where am I?’ The nurses gently tell her she is in Cabrini Hospital but in five minutes she has forgotten and it all starts over again. How sad to not know where you are or what has happened to you. About 3am I hate to see her distressed and toddle over to her bed taking my ‘bag’ with me. I put my finger over my lips, ‘Shh’ I say. You’re in Cabrini Hospital and it is late at night’. ‘I want John’, she says. ‘And Mum.’      ‘They’re asleep,’ I reply. ‘Well bully for them’ is the answer. I laugh all the way back to my bed.

The next morning I blissfully shower on my own. Dr Lawrence calls and informs me that I’m better than ever and tomorrow Paul can take me home…if the catheter  is removed, I void twice, two ultra sounds show my bladder empty and my bowel behaves itself.  Fortunately all happens according to plan and I am soon heading down the freeway.

Conclusion

I follow instructions to the letter. No lifting and plenty of rest, but I am, and have been all along, pain free. A week after the repair when I step into the Godfrey Street Neighbourhood House ready to take the Memoir Writing group I realize how lucky I am to be able to get anything fixed before it breaks and that I can survive an anesthetic. I have gone from making sure I have a medical power of attorney signed and sealed to facing the future with confidence. I hope more women my age research and talk about their ‘girly bits’ and see a professional about any problems ‘down there’. In the meantime the receptionist at Bayside Womens Health gave me a sample of a pH Plus intimate wash  which helps promote a healthy pH balance. I didn’t know such a product existed.

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Next week I promise to post a light-hearted Christmas piece

 

Part Two: To mesh or not to mesh

Many women suffer in silence when they have a vaginal prolapse . However, if they decide to do something about it there are many decisions that need to be made.
Gynaecology - Bayside Womens Health

It felt right for me to have my prolapse fixed now instead of putting my head in the sand hoping it would all go away. I did not want to wait until I had female urinary incontinence due to my prolapse, both common, though seldom discussed consequences of childbirth and ageing.

But who to see? My gynecologist retired years ago. I remember going to see Janet Duke when I was fifty-one and had debilitating period problems. I explained the drugs I was taking to alleviate the condition. She lent back in her chair, fixed me with a steely gaze and asked, ‘Is your husband still alive?’ ‘Yes’, I replied. ‘That’s a wonder’ she said smiling. ‘I thought you might have killed him by now.’ She went on to explain that the extreme levels of testosterone in my medication usually resulted in aggression. Alan was lucky. Instead of attacking anyone I hauled huge honeycomb rocks and placed them around the edge of a new garden. I look at them now and shake my head in wonder.  I was a much calmer person after the hysterectomy.

The main cause of vaginal prolapse is the weak muscles, tissues, and ligaments that support the vagina, surrounding tissues and organs. The factors that can cause vaginal prolapse include frequent lifting of heavy objects, chronic cough, severe constipation, menopause, childbirth and advanced age.

Surgery is done to restore the vagina and the pelvic organs back to their respective positions and provide symptomatic relief. It helps to prevent further damage of pelvic floor muscles. Vaginal prolapse surgery may be done through laparoscopy or other forms of surgery.

There has been no need for a gynecologist since 1994. I spoke to my GP who had been to a lecture on prolapse at the Royal Women’s Hospital only the night before my visit. Armed with a referral to a well recognized surgeon I went home and intensively researched anything I could find on a bladder prolapse. There is a lot of information on the web but you have to be careful it is not just an advertisement. I decided to go to the source and looked up articles in medical journals.

The surgeon I was going to see practiced the latest techniques. He did keyhole surgery called Sacral colpopexy.  In this procedure, one end of a strap of mesh is attached to the top of the vagina and the other end is attached to the upper part of sacrum situated at the base of the spine. When I saw him he discussed the procedure at length and took time to explain in detail what he recommended. It was a positive experience and I came out feeling that this may well have been the answer to many women’s problems.

However, I’m allergy prone, even to not using Elastoplast and also have an arthritic spine. I had seen reports in some of the journals that mentioned possible problems with the mesh. At a social gathering I met a friend who had this procedure done, had developed complications and was part of a class action against the mesh manufacturers. This led to more research. The details of the class action papers were very disturbing .  Everyone is an individual and I seriously began to question if this procedure was right for me. Then the out of pocket expenses information arrived. The doctor’s fee was $2, 500 above medicare and my private health fund. I knew he was worth it but that’s a lot to find. One comment was, ‘You could go on a cruise around the islands for that’.

I threw myself onto the mercy of a nursing friend and begged for her assistance. I wanted the name of a caring gynecologist who gave you a choice of not having mesh. She recommended Dr Mark Lawrence at Bayside Women’s Health 622 Centre Rd Bentleigh.

My GP, who knows Dr Lawrence,  reassured me that he is an excellent gynecologist who for many years has been treating women’s problems and is constantly doing vaginal repairs. I immediately checked out the website and was suitably impressed, not only by the range of services offered but the obvious long term connection with well known hospitals. And he looked kind with just a hint of a quirky sense of humour.

Bayside Womens Health

The waiting room is full of women of all ages. Two young women are heavily pregnant and sit in comfy chairs. Hanging on the walls are cloth covered boards filled with pinned pictures of smiling parents and newborns. Many are cradled in Dr Lawrence’s arms. Thank you letters abound. ‘Thank you for our family bliss’ etc. Beside me sits and eighty-five year old woman . We flick through magazines, watch fish  lazily swim around their aquarium and wait our turn.

After checking me out, Dr Lawrence talks about a procedure that he has done successfully for many years. No mesh, no external cuts, push the bladder, and anything else, back into position, and use self dissolving stitches to strengthen and repair the vaginal wall. He is positive, friendly and willing to discuss everything on my now long list of questions. He made it sound run of the mill, simple, an in and out job. Two nights in Cabrini and then home to rest and recuperate. Would I need pain relief, like morphine? Unlikely. Would I be able to take my Memoir Writing Class, for two hours, only a week after leaving hospital? Definitely. He was confident that the problem would be fixed and I believed him. But could it be so easy? It sounded too good to be true.

However, I decided to book in that day with Dr Lawrence at Cabrini Malvern  for the tried and true method of repair.

No mesh for me.

I just wanted to get in, get done and get over it 

Malvern-building.JPG

I’ve just received notice that if anyone is interested, there is an Amazon promotion of the book by Ian Richardson, God’s Triangle . For the next 24 hours. it is being offered for free. This is an amazing opportunity to get your hands on a great book covering the true and touching story of why the marriage of Australian Baptist missionaries, Frank E. Paice and Florence M. “Florrie” Cox, fell apart in mysterious circumstances in East Bengal (now Bangladesh) during the First World War. An investigation into why the Supreme Court of Victoria in Melbourne considered the divorce so sensitive that the file was ordered to be “closed for all time”. It is well researched and a thought provoking story.

godstriangle

Happy reading.

Part One: Women don’t talk about ‘below the belt’

Women my age are reluctant to talk about what my mother called their ‘nether regions’ or ‘girly bits’.

10pm: fasting isn’t a worry – getting to sleep is.

5am: the shrill of the alarm ensures a swift shower, no breakfast and leaving in pre-dawn darkness. A large, round moon bathes the world in a gentle glow. I’m glad the full moon was last night, I don’t need any banshees , bogymen or hobgoblins any where near Cabrini Hospital tonight.

This journey towards vaginal repair started long ago during childbirth. A titchy depression in a weakened vaginal wall meant the bladder dipped ever so slightly forward like a brief nod in recognition of a job well done. I blessed that dip and the two boys who have bought so much joy over the years.

Now fifty years later the dip had become a bulge which meant getting up every two hours at night to empty the bladder. But the prolapse didn’t hurt. I hardly knew it was there. A prolapse is a medical condition where an organ or tissue falls out of place, or “slips down”. Pelvic floor exercises didn’t cure it but it certainly wasn’t getting worse, well, not much anyway. So why see a surgeon about a getting it repaired?

I decide to ask some of my women friends whether they had the same problem. That’s when I hit a brick wall. Women my age are reluctant to discuss things relating to ‘below the belt’. I discovered that men still had, according to them, a tossle (never a penis). This reluctance isn’t anything new.  I had recently read about a woman in earlier years who married and didn’t know that she was born with no womb and a one inch deep vagina preventing her from having sex or children. A close friend gave me a copy of God’s Triangle by Ian Richardson.

godstriangle

Below is a section of one of many positive reviews.

Poor Florence probably never knew what was different about her or why. It is difficult to imagine the early days of the early 20th century where just about everything controversial or distasteful was suppressed. I thought this was a fascinating story (and wonderfully well written, if you don’t mind me saying!) It held my interest throughout. – NL, London.

I am not one to go quietly into the night and by constantly bringing up the subject I uncovered the best kept secret ever. Nearly every one of the women  among my family and friends had a prolapse of varying degrees. I was staggered. We talk openly about problems with cancer, osteoarthritis and hip replacements. We compare notes, with a tinge of pride, about hearts, lungs and kidneys.  So why don’t we talk about problems with our vaginas? Just mention a prolapse and the subject quickly changes or the conversation dies.

However, when I did get women talking I found out that at

60 yrs: there was ‘A bit of a problem.’

70 yrs: ‘It doesn’t hurt.’

80 yrs: ‘It rubs against my nickers and I get infections.’

85 yrs: ‘I’m incontinent. I wish I’d had it done and could still live in my flat.’

90 yrs: I’m in trouble but it’s too late now. I can’t take an anesthetic. How I wish I’d had it done earlier.’

From the women I spoke to it was like discussing childbirth and horror stories were plentiful. ‘It’s like being kicked in the stomach by a horse’ (ouch). etc. etc. I asked all age groups and from the sixty and seventy year olds I was given many reasons why I should, ‘Leave things alone.’

‘Why have it done if it’s not hurting?’ ‘You can get dementia after an anesthetic.’ ‘It will collapse and you’ll have to have it done again.’ ‘I don’t want to be asleep and can’t tell them, ‘Don’t touch that.’ ‘Every operation is risky.’

I know that can be the case.  During my second hip replacement I was given gelofusine. After going into anaphylactic shock, (a severe and sometimes fatal allergic reaction to a foreign substance to which an individual has become sensitized, often involving rapid swelling, acute respiratory distress, and collapse of circulation) I woke up in intensive care wondering why my hands looked like balloons.

However, a close friend has had to give up her flat and move into assisted care because, among other things, she is incontinent due to a prolapse. She suffered constant bladder infections, pain and suffering. Her only option, because an anesthetic is out of the question, is to have a ring inserted which only lasts five months and then has to be replaced. She’s had three so far and one became infected. I feel like an old car and want to say ‘I’ll have my 70,000 ks service and make sure you repair my vagina before it collapses.

It is time. Now the research begins in earnest. What type of vaginal repair will be best for me?