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Had endometrial ablation with Novasure yesterday--panic disorder--VERY LONG Had endometrial ablation with Novasure yesterday--panic disorder--VERY LONG

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Unread 11-07-2009, 08:58 AM
Had endometrial ablation with Novasure yesterday--panic disorder--VERY LONG

Hi, I know this is REALLY long, but maybe it will be helpful to others...especially if you have phobias. There are some lessons embedded here. Please let me know if I can answer any questions--anything I can do to help someone, I am glad to do.

I had a myomectomy in 2002 which removed 7 fibroids (1 was huge); I was 35 and wanted to retain fertility a little longer, so that's why I opted for myo, and it went well. Now I'm 43. I've had a period since I was 9, and those have been painful for the majority of those years--worst in my 30s and 40s. The myo helped for a long time (about 5 years), but eventually the pain and fibroids started returning. In an effort to try one more thing before hysterectomy, I opted for endometrial ablation with Novasure. The doctor also routinely performs a hysteroscopy and D&C as well (yes, I have pics of the inside of the uterus...funky!) He only practices at our small, local hospital. They have only 1 OR and a tiny pre-op room that can only accomodate 2 (possible 3) people.

I guess I am here just to share what happened and maybe vent a bit (not about the procedure, really). I posted a note earlier (it's not letting me list the link) before I had gone to pre-op (Thanks to reefgirrl--she had great info). LSS: I have a severe medical phobia and perhaps a form of PTSD due to a horrible, horrible incident at this same hospital (small town local hospital) when I had gall bladder surgery in 2004. I was discharged with pain, nausea, and inability to void. No one was helpful--not the surgeon (AWFUL; luckily, he's gone now) or the hospital staff. I was sick for weeks; later, looking at the records, I found out my liver had been torn. I got no followup care. I avoided hospitals for 4 years...I could not even visit sick friends without vomiting afterwards, assuming I could get in the door in the first place.

Earlier this year, I had to have surgery on my neck to repair 2 herniated disks (I had spent over a year avoiding it, but I was starting to lose nerve and motor function in my arm). I went to a larger teaching hospital an hour away, was upfront about my phobia, and got VIP treatment and understanding. They made sure I had Valium to take regularly 3 days before surgery and that all the doctors came and talked to me before surgery; the anesthesiologist was particularly wonderful. I had excellent treatment and pain management as well and even went home earlier than expected. At my followup appts., the surgeon was amazed at my progress--fading scar and almost completely fused neck bones (that's what we want).

When my GYN, who is great, suggested the Novasure, I begged him to do it in his office, but he's not equipped to do so. I then told him the horror story about the hospital. He promised it would not happen again. I got my preop appt. set up, wrote a short (just over 1 page) explanation explaining my phobia and some requests (i.e. a family member with me during prep), and also asked a good friend who is an RN to go with me to the hospital. I had an appt. scheduled at the doctor's office first--both were in the AM 2 days before surgery.

In a weird reversal of fortune, the nurse practitioner at the doctor's office was certainly polite, but rather cool and unempathetic. She told me that she had nearly died where I had the wonderful neck surgery and they were terrible to her, while meanwhile, at the local hospital, she'd had great treatment. I didn't know what to say except, "I'm really sorry that happened." She did not return the favor. One of the requests I had was to get Valium to take for the next 48 hours before surgery. She gave me just 3 pills (I didn't find out until I went to the hospital--I can't read prescriptions). She never said, "You are going to get good care, and nothing that happened before will happen this time." I had really needed to hear that. She did say, "Good luck with your surgery; you know Dr. G. is the best," but that's it. I would have taken my friend with me there, but the office where I have been a regular patient for 7 years was the LAST place I expected any problems. Maybe she simply didn't really understand how serious my fears were.

My friend and I met and walked over to the hospital. We sat with the OR nurse, who briefly read over my statement. She probably apologized 5 times in the next 3 minutes and kept saying, "This is so awful, I am so sorry, we will never let this happen again." I was so grateful, I almost cried. During all the pre-op questions, my friend said, "Hey Dee, take off your jacket." I had hives all up my neck and face. The OR nurse realized I wasn't making all this phobia stuff up at all. She'd taken me pretty seriously before, and she *really* took me seriously after. She looked at my Rx and said "Call your doctor back when you are done here and ask for about 5 or 6 more Valium. Take one about an hour before you get to the hospital on Friday and definitely the afternoon and night before, or as needed, maybe even after you get home today."

I called back and had to leave a message that day, Weds. No one called back. On Thursday morning (I had taken 2 of my 3 Valium and had been up since 4 AM crying and having a panic attack and dry heaves), I called and told the lady who answered I had another question about surgery and also needed more Valium. I asked my question ("My problem isn't so much bleeding, but terrible cramping--does that still make me a good candidate for Novasure?") She said yes, yes, it's fine, it will work, just do it. I then said that the OR nurse had said I needed more Valium to take before the procedure. The woman replied, "You can't take any medication before surgery, didn't you know that?" I got really upset, crying, and tried to explain I didn't think I could do this. She said, "You're yelling at me." I then dissolved into a total mess. I couldn't breathe, but I was telling her I was sorry, I didn't mean to yell, I was a teacher and a nice person normally, that I needed help. I heard her tell someone that I was having a panic attack and then she said she would call me back. I meanwhile called my DH and my RN friend (who hit the roof). The woman called back (turned out she was a med tech, not a nurse) and said my new Rx had been there since Weds. and why hadn't I picked it up? I still cried a lot and just said, OK, I didn't know, no one had called, I will get someone to get it.

DH got my meds, and the minute I got home from school, I took the Valium. Luckily, the doctor called me and reassured me that this was going to go well, there would be good care, and that *of course* I should take the Valium that next morning. He also said, "I feel confidant the procedure will most likely stop your periods and cramping. However, you should know it is not 100%, but that it is a good option to try before we look at a hysterectomy. Can you do this?" I said, yes, I would do my best, and that he'd told me what I needed to hear. He's a nice guy and even joked about bringing a hammer to get me in the door, so we did end the conversation on a light note. I spent the evening with DH and son watching movies, and that was good. I did have to take some Zantac for nausea. I slept so so, but got up and got ready to go to the hospital on time, thanks to my Valium.

One of the things that we had to "negotiate" was having DH present during prep. This hospital doesn't want anyone with the patient ("due to space and other patient's privacy') during prep (although someone can come and sit with you after prep). Boy, am I glad DH came in. The really sweet OR nurse had a heckuva time finding a place to start the IV (even though I had drank and drank and drank water the day before). It took a while. But it was all okay. My friend came in and sat a while, too. I was the second case of the day, but there was an emergency, so I got moved to third. It wouldn't have been a big deal (stuff happens), but the Valium wore off by about 8:30, and I was soaked in sweat and had more hives and just curled up in a ball for the next 45 minutes or so. The doctor and the nurse anesthetist came in after they finished the previous case to ask questions, etc. My friend said, "She needs some Versed, right now," but I had to answer all the questions first. My doctor again was very reassuring and said he was really sorry things had run behind and the Valium had worn off. I finally got the Versed (3 mg, a hefty dose, via slow drip) right before I was taken to the OR at 9:30 or so. I was groggy and light headed, but certainly not out. They showed me the Novasure device and moved me to the table; then, I was out (propofol). I woke up in recovery about 30-45 minutes later and came out of it pretty quickly. I drank ginger ale, they took vitals, and unplugged everything, and then my DH and friend came in. They monitored me about 10 more minutes, and I was free to leave. I had been given an anti-inflammatory called Toradol IV and then 2 tablets of Percocet. I was in pain, but it was manageable (4-5 range). So I was home by 11 AM or so after checking in at 7:30 AM that morning, and really would have been done sooner except for the emergency case before me.

At home, I had a bit of toast and ginger ale, and went to bed. My friend the nurse was keeping an eye on me and monitoring my meds. By about noon, the pain was pretty bad--about a 7. I took 1 more Percocet and also ibuprofen and a Valium. I got a little rest, but not much. At 3 PM, I took 2 more Percocet, and by 4 PM, I felt much, much better, enough to sit and knit with my friend. I didn't take anything else until bedtime at 11 PM (1 Percocet, 2 ibuprofen). I was able to eat some bread and cheese and applesauce, and then later, some spaghetti. I didn't have any pain at night, but was a tiny bit crampy this AM and DH said, go ahead and take 1 more Percocet just to make sure the pain doesn't return. I have been drinking lots of water, ginger ale, and juice to keep hydrated.

As far as discharge and bleeding: I have had "light spotting" but nothing else. This was a LOT less than expected. I imagine there will be more based on what folks here have said. I am not, however, planning to play tennis this weekend, like some people said in the Novasure ad, lol.

I have some suggestions for folks considering this procedure, and do remember, this is from the point of view of someone with a real panic disorder and medical phobia--you might need less of these things. I pray that none of you EVER have to endure a panic attack or medical phobia because it is one of the most debilitating things I've ever experienced (Teaching while having strep throat and influenza a few years back was easier):

1. Take someone with you--a partner, spouse, or dear friend. Let him or her take notes for you. They will hear things you will miss. Take them to the hospital AND to your doctor's appt.

2. Make a list of questions for: 1) the doctor, 2) the anesthetist, 3) the OR admitting staff. Make sure they are answered. Get help from the person you've brought along.

3. If you need someone with you during prep, even if the admitting staff says "No, we can't do that," remember it's negotiable. They will say it's due to lack of space, protecting others' privacy, or just because it's regulations. IF you stress how important this is, they will listen. If they don't, find someone who will.

4. Unless it makes you more stressed (and I know it does for some), read read read and research the procedure. Do look at the company's commercial site, but be sure to look at "neutral" sites that are not paid ads by the company (i.e. Novasure).

5. IF you have a special need (i.e. like my phobia), be upfront about it. Put it in writing. Insist that it go in both your doctor's file at the office as well as the hospital's file. (The nurse pract. at the office didn't want to include it; I insisted).

6. BE CLEAR that if you need medication pre-op to keep you calm, that you need a sufficient amount. You might only want it the night before or the morning of the surgery. However, if there is a significant delay, check to see if you can get or can take additional medication (i.e. bring your Valium or ask to get the anesthesia questions out of the way early so that if you need something to stay calm, they can get it to you without a delay). Everyone is different--some folks may not need it at all, but remember that you are an individual, and need to be recognized as such.

7. IF someone treats you well, do thank them. It may be routine for them, but their kindness makes all the difference to you. One of the things that happened to me was that the OR nurse said, as I was checking in, "I went back and read your chart from the gall bladder surgery in 2004. I just wanted you to know that I was in the OR with you that day, but someone else did your post-op, and that again, I am so sorry that happened, and I wanted you to know it wasn't me." I took her hand and wept, and told her that really made me feel 100 times better. As it turns out, her daughter is coming to the college where I teach, and now I'm going to keep an eye on her and help her get registered and settled in since her major is in the division where I teach.

8. As for any surgery--make sure things are ready at home for you and your family--plenty of water and healthy drinks, plenty of easy-to-prepare foods, your comfy bed all ready, lots of movies or books, a charged phone close at hand, a list of numbers in case you need help (i.e. the hospital and doctor), that you have pads and clean underwear/lounge jammies, etc. Have any needed medications at your bedside.

9. Don't overdo it, but don't forget to get up and stretch your legs to avoid sore muscles or (heaven forbid) clots. Get help with dishes, laundry, etc. as needed.

Thank you for reading this--I know it was long. Again, if there is ANYthing I can answer, anything at all, just ask me.

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Unread 11-08-2009, 04:50 PM
Re: Had endometrial ablation with Novasure yesterday--panic disorder--VERY LONG

Thanks for posting your story, Dee

I hope this will be a long-term solution for you. Keep us updated
Unread 11-08-2009, 05:03 PM
Re: Had endometrial ablation with Novasure yesterday--panic disorder--VERY LONG

Thanks, I appreciate it.

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Unread 11-10-2009, 10:21 PM
Re: Had endometrial ablation with Novasure yesterday--panic disorder--VERY LONG

As someone who also has panic disorder, I can relate to how you must have felt. I'm medicated to the eyeballs for my anxiety and panic most of the time but if I didn't have my medications, I have no idea how I would handle any of this stuff we're all going through.

I'm glad that in the end, your experience ended up good.
Unread 11-11-2009, 04:49 AM
Re: Had endometrial ablation with Novasure yesterday--panic disorder--VERY LONG

Thanks. I am still upset with the office staff who were needlessly unsympathetic, but very thankful that the nurse at the OR was so very helpful.


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