Endometrial WHAT?

This post is an educational lesson about menorrhagia, or Excessive Menstrual Bleeding.  If precursory details of my menstrual cycles are TOO MUCH INFORMATION for you, please do yourself a favor and discontinue reading this post.

I have had exorbitantly horrible menstrual cycles for my entire reproductive life.  My first period came at a volleyball game and my (male) coach made some comment about how I was a woman now.  Although I had never felt particularly comfortable around him, I was certain that he was creepy after that game.  Not long after, he threw a chair at a student during band practice and I believe that was the end of his interaction with middle school children.

In high school, my period settled into heavy bleeding for 7 days and an eighth day of “regular” bleeding.  This occurred every 5-6 weeks.  (Many women experience 3-5 days of “regular” bleeding, which may or may not be followed by a “light” bleeding day at the end, usually every 4 weeks.  Given the amount of variation among women and the interplay of hormones and other systemic factors, “normal” menstruation is not very well-understood or defined.  Since I had a longer but less frequent cycle, I averaged into the normal range.  However, I recently read that most women lose about 1/4 cup of blood during their period… so I am not anywhere CLOSE to “normal,” nor have I ever been!).  After I had my period for 3 weeks straight with a 3 day intermission at age 17, my mom and I went in for my first gynecological exam to find out what the hooty-hoo was going on… in my hoo-ha. 🙂  (Truth:  I didn’t learn the term “hoo-ha” until I watched the show Scrubs many years later).  The recommended treatment was birth control to manage the timing of my cycle.

I was 17.  I was not having sex.  I was a senior at a Christian high school where pregnancy was punished with expulsion, sexual activity was seriously frowned upon, and virginity was eulogized as the epitome of Christian holiness… among girls.  I perceived that birth control was for slutty girls and flat-out refused to go on it.  How could I tell my friends?  I was sure that people would just know by looking at me… and then I’d have to defend myself and say, “But I’m not having sex, I’m not!  This is for medical reasons!” and I didn’t want to have to say anything.  (Truth:  middle- and high-school students are convinced that everyone notices every uncomfortable thing about them.  In actuality, only the cruel people notice… everyone else is too busy trying to survive and avoid being noticed to notice anyone else!)

I only had that one “3 weeks from hell” continuous period incidence.  Throughout the rest of my senior year/college/grad school, it was actually rather nice to go up to 6 weeks without a period.  I didn’t mind the heavy 8 days, since it gave me such a huge amount of time off from the hassle!

I began taking birth control at age 25 when I was engaged.  Knowing that adjusting hormonal levels can be problematic, I wanted to get that all settled and working well before starting my marriage!  I was on birth control for several years and the predictable 7 day periods once a month were DIVINE.  I felt like a “normal” girl for the first time!  Getting married and having sex with Matt was also fabulous… so everything was exciting!  (Truth:  Matt and I had a “no babies for 2 years, God-pending!” handshake agreement that we established during our engagement.  It was one of our best ideas EVER!  When pesky women at church/people in our families/nosy strangers had questions about “So… when are you going to have kids?” we could whip out the “Let me tell you all about our handshake agreement!” conversation and shut them down.  We reconsidered on our 2 year anniversary and realized we still didn’t feel ready for kids, so we gave ourselves an extension… it ended up being a “no pregnancy for 2.5 years, God-pending!” handshake agreement.)

We discovered that I have polycystic ovaries.  Sometimes I launch an egg, sometimes I launch no egg, sometimes I launch multiple eggs!  I was off of birth control due to some issues with side effects, and my period was back to its previous formation.  But now knowing about my polycystic ovaries… no wonder my period is so crazy!  It made sense to me – I had always wondered if getting pregnant was a possibility for me since my reproductive system was such a mess.  Hmm, pun intended.

The most beautiful thing about pregnancy is that your period stops.  Like, you don’t have it!  (Some women still do… I’m so sorry about that!)  I loved my 7.5 months of pregnancy with the twins and I loved my 4.8 months of breastfeeding them for lots of reasons, but no period was one of them!  My 9 months of pregnancy with Nathaniel and my 9 months of breastfeeding him were also delightful for that reason.

And then my reproductive system went CRAZY.  When my period returned after Thanny-man was born, it returned with a vengeance.  (Truth:  I would NOT watch a Bruce Willis remake of this story, no matter how many gratuitous explosions were involved).  I continued having my heavy 8 days of menstruation, but they were even heavier than before.  And now, instead of every 35 days, I was having them every 28, then every 25, then every 24, and sometimes after only 21 days.

For the past 2.5 years, I have been bleeding excessively for 8 out of every 24 days on average.  That is one third, ONE THIRD, of my life!  On average, I am bleeding excessively for 1 out of every 3 days.  One out of every 3 hours… ONE THIRD.  I have just over a week of misery, then just over 2 weeks of a break, then I’m back to misery.  It is horrendous.  Last fall, when I became Zombie Jaime and was exhausted all the time and just fell over asleep in the middle of activities and was barely functioning?  Well, that was partially because I had sleep apnea and woke up gasping for breath every 3-5 minutes while sleeping.  We corrected that with my handy-dandy CPAP machine.  But my exhaustion, ESPECIALLY during a certain 8 days, continued.  I can barely function during my period – I’m so tired.  Not so much sleepy-tired, BONE-tired.  Everything is difficult and requires more effort than I can muster, for EIGHT DAYS.  Throw in 1 day of PMS beforehand and you have a miserable, mostly nonfunctional Jaime for 9 out of every 24 days.  Guess how much sex I get to have in those other 15 days?  Not enough.  Guess how much I can accomplish in those other 15 days?  Not enough to compensate for the time missed.  It sucks at every level.

So now we know that my iron levels are a disaster.  I am not anemic, but that is because I take iron supplements like it is my JOB.  My doctor and I are constantly checking my blood levels… I just can’t ingest/maintain iron fast enough to compensate for the amount I lose during my menorrhagic menstrual cycle.  And I can’t just take a ton of iron to compensate either… it is a delicate balance with disastrous effects at too low and too high.  I’m so tired of trying to get my health to a good place.  It is literally exhausting, and I want solutions that work!

After nearly a year of trying various things, both of my primary care doctors (family practice and OB/GYN) think that I would benefit GREATLY from an endometrial ablation.  An endometrial WHAT???

There are various ways to perform this procedure, but the main goal is to destroy the endometrium, the lining inside my uterus that sheds during each menstrual cycle.  My endometrium is an evil overlord trying to destroy me/my life, so the plan is to destroy it first!

My OB/GYN will first use a hysteroscope (yep, a telescope for the uterus) to look at what’s going on.  Then she will do a D + C (dilation and curettage) to get some sample tissue from my uterus lining.  The tissue will be biopsied and checked for symptoms of any current/future issues.  Then, and this is the crazy part, she will seal my cervix and spray hot saline water into my uterus to burn and cauterize the lining off.  (The seal is so that the burning hot saline doesn’t escape and burn anything else).  It is unlikely to grow back… which means that it is unlikely to shed… which means that IT IS UNLIKELY THAT I WILL CONTINUE LOSING ALL OF MY LIFE FORCE 8 OUT OF 24 DAYS OF MY LIFE!!!!!!

I admit it, I am EXCITED.  I am desperate to be functional.  I am desperate to not have blood rushing out of me at alarming rates that trigger fear inside the survival portions of my brain.  As my family practice doctor said with a smile, “Jaime, the fact that you are so relieved to have this procedure means that this is exactly the treatment we should give you!”  Seriously!  If I am excited to receive general anesthesia and get severe burns in my uterus at the hospital and need pain medication for the weeks following my procedure… if I am willing to be rendered nonfunctional by a procedure intended to help my body regain function… things must be pretty bad!  They are.  They ARE.  So bad.  And it is going to get better.  Forty percent of women who undergo endometrial ablation have no more periods.  CAN YOU EVEN IMAGINE???  Forty percent of women have light-to-normal periods after ablation.  “Light-to-normal” sounds like a dream come true for me!  Normal was previously unattainable, so YES PLEASE!  That still counts as success.  And twenty percent of ablations are unsuccessful, and the lining grows back.  After that, the options are to let it be, go with a hystercetomy (remove the uterus), or get a total hysterectomy (remove the uterus and ovaries and tubing).

I choose to believe that I will be in the 80% of success stories.  No early menopause, no more warding off anemia, no more utter exhaustion.  (Truth:  I’ll still be exhausted.  But it will be JUST from chasing my kids now, not from sleep apnea and menorrhagia!  Squee!!!!)  I have a family history of endometriosis, where the endometrium cells bust out of their uterus confinement and start growing elsewhere in the abdomen – on other organs, on the peritoneum (abdominal lining), etc.  With endometriosis, the menstrual cycle causes shedding from all of that lining all over the abdomen and LOTS more blood is lost.  In case that is happening to me, my doctor will surgically remove all of that extra lining as well.  The goal is NO endometrium – not where it is supposed to be (my uterus) and definitely not where it is not supposed to be (anywhere else).

I need to address this last part for those of you who share our delight in the 3 Olson Tinies:  no more Olson Tinies will come out of me.  I have had plenty of time to accept that, as had Matt, but for those who are just now encountering this information, we understand that you might be disappointed.  If you are, that’s totally fine and we respect your response.  But if you tell us about your disappointment, I might want to punch you.  So be disappointed if you will, but please tell someone else. 🙂  Whenever people ask me if we hope to have more kids, I still plan to say “YES!”  I’m excited about opportunities to expand our family in the future!  That doesn’t change.  We lean more towards foster care or “intentional love heaped on children who need us within our circle of influence in the same way that people heaped intentional love on tiny me and accepted me into their families” than toward adoption, but we’ll see what God asks of us.

I am not grieved to close the pregnancy/birth chapter of my life.  I have loved it!  I’m am so grateful for THREE amazing children – I was never sure I could have any!  I don’t take that lightly – I know that so many people deeply desire that God would give them a child and for reasons we cannot understand, He has not provided.  I don’t have answers for them.  I still pray that He will hear the cries of their hearts and give them beyond what they hope for, just as He did for us with Zach, Rissa, and Nathaniel.  So we are thrilled with the gifts we have in our 3 children.  And we know there are plenty of other tinies out there already, so if God wants us to love some of them up, we’re happy to do that.

Now you know (some of) the details of my reproductive system.  More than you prefer to know perhaps, but not nearly all that I could have shared!  Be grateful for the details I didn’t describe! 🙂  My procedure is on Friday afternoon later this week.  And just in time… my last period was TEN days!  AUGH!  Never again!  Miss Kathie is handling the Tinies to give them a fun day on Friday and to allow Matt to be with me for my outpatient procedure and to drive me home.  Then he’ll babysit me for the weekend while I recover and I won’t be responsible for my children on my own until Monday, when I am well sedated with pain medication.  Hmm… that sounded better in my head than it looks on my screen.  Suffice it to say, my pain from the burns should be under control before I regain my Mommy roles!  I’m so ready to do this thing!