CW: surgery, gross body things
Two weeks ago, I underwent my first (and hopefully only!) major surgery, a gender-affirming hysterectomy. I wrote beforehand about the preparations for surgery; this post is about the surgery itself.
Fair warning: this post details both uncomfortable medical experiences and some highly specific medical information. It may gross you out, and I'm not judging you for not reading it.
The days before surgery were hectic; I was trying to pack my belongings in advance of our move to the new place, frantically finishing all the work I could manage before my leave, and preparing for surgery. My surgeon's office sent me an antiseptic soap I had to wash my body with for the three days prior to surgery, and a pair of carbohydrate drinks to take the morning of.
My arrival was scheduled for 10:50a at an outpatient center about an hour away, and I had to stop all fluids three hours before arrival. So I woke up at the luxurious hour of 7a - which, as those who know me can confirm, is not my preferred wakeup time - and chugged the two carbohydrate drinks. To my immense relief, they were strawberry-flavored, one of the few flavors I reliably tolerate; but they were a little sickly and a little gritty and not at all the breakfast I wanted. Once they were down, I showered with the special soap one last time and went back to bed for a couple of hours before we departed.
Having arrived at the hospital, things got off to an uncomfortable start; while I had arranged everything through the MGH Trans Health program, and while MGH uses a system that does display pronouns, apparently the receptionist did not get the memo, and misgendered me approximately five million times in the process of explaining where to sit and when my partner should expect to get me back. But once through check-in, everything smoothed out. The nurse who came to get me was about my age and more up-to-date on transness, and we had a nice chat as she confirmed what I was getting done and went over the process with me. She had me pee in a cup for my pregnancy test (why is it so hard to pee in a cup without peeing on myself???), and cracked up when a friend messaged me to ask whether, if the test came back positive, I would get an abortion thrown in for free. (Unfortunately not.)
Once checked in and settled in a pre-op room, I changed into a gown and the infamous grippy socks (which, I'm sorry to report, I did not get to keep) and settled under a hospital blanket to read the book I'd brought with me, interrupted only occasionally by supportive and silly messages from my friends and by the preparations around me. An RN came in to give me a water IV in the back of my hand, which I've never had before and did not altogether enjoy; the surgeon and her fellow stopped by to say hello and reiterate the process; the RN came back to help me and my IV get to the bathroom and to cover me up with a freshly warmed blanket. A word of advice to anyone getting intravenous water: ask for the warmed blanket right off, because a) the IV makes you cold and b) the blanket is the toastiest and most lovely thing you'll experience the entire time you're there.
At last, around 1, they were ready for me. They added anesthesia to my IV, and I only remember being wheeled out of the room before I was out.
Waking up, I'm sorry to say, was not a joy. I was in a tremendous amount of pain, and needed to prove that my bladder was working in order to go home without a catheter; I can say with complete certainty that I have never had a more uncomfortable peeing experience, including two UTIs, but I did succeed at peeing, and was dimly aware through the pain that the RN was saying encouraging things. I have absolutely no memory of getting dressed, though I went home in my own clothes, and I don't really have a consistent stream of memory until they were wheeling me out the front door in a wheelchair to deliver me to Jack.
The ride home was, without a doubt, the longest 50-minute car ride of my life; I was in agony, nauseated, and felt like I needed to pee, but was still having trouble with it. At the time, I don't think I realized it, but in retrospect, my pain was at a 10, and I don't have the foggiest notion of how I got up the stairs and into my room. I tried to nap, but only succeeded after a fresh dose of pain meds around dinnertime.
When I was more functional, I found that I had four incisions: one in my belly button, one on either side of my belly, and one down by my left hip (stab map below). All four had been sealed up with "skin glue", which was jarring to see but pretty comfortable on the whole.
To my surprise (and amusement), I received a message on the patient portal documenting the stats of my ex-organs. My uterus, as it turns out, weighed 35 grams and was 7 x 2.5 x 2.2cm - on the whole, significantly smaller and lighter than I thought an organ would be - and was "maroon-gray". My cervix was "lavender-gray" and about the size I expected a cervix to be. But the real point of interest for me was the fallopian tubes. I didn't get my ovaries out, because I'm 26 and have no interest in early menopause, but there was no reason to keep the fallopian tubes, and having them out provided some surprising information.
My right fallopian tube was 7cm; my left was only 5.5cm. Both of them were "congested and convoluted", which were not adjectives I had ever expected to have applied to my fallopian tubes. I didn't know a fallopian tube could be either of those things. So I did some digging.
A congested fallopian tube is not uncommon, and is often the cause of infertility or trouble conceiving. It can cause pain and other complaints or be completely asymptomatic, and a partially congested fallopian tube is frequently the cause of ectopic pregnancies.
A convoluted fallopian tube seems to be much less common; while I found a wealth of information on the former from sites like WebMD, the latter seems to exist primarily in academic papers, which are much less accessible. What I did gather, though, was that convoluted tubes may cause or contribute to a number of mystery ailments I've had and will hopefully stop having, or at least have less of: nausea, pain in the lower quadrant relative to whichever tube(s) got twisted, sudden sharp pains, and back pain. (Lower abdominal pain, which has been the most frequent and irritating of the mystery ailments, was the dominant symptom in a majority of cases from the studies I read!) Convoluted tubes are frequently comorbid with hydrosalphinx, which is fluid blockage in the fallopian tube - which is itself congestion.
People with uteruses: if you have unexpected pain in your abdomen, especially if it's concentrated on one side or the other, bring up the possibility of a convoluted tube! It's difficult to diagnose without knowing what you're looking for.
Interestingly, I didn't find anything about having both tubes convoluted; the studies I found noted one side or the other. That's right: not only did I have a rare condition I didn't know about, but I also had double the condition! Clearly I am an overachiever in all things.
Given that the tubes are no longer in my body, this is all more interesting than impactful at this point, although I'm decidedly more optimistic about my future pain levels. But it definitely brought me face-to-face with the knowledge of just how little I know about my body. After all, I had whole organs twirled like spaghetti inside me and assumed that the symptoms of it were normal, or at least not abnormal. What else in my body might be a fucked-up shape and I have no idea? Also, how many rare conditions can one person possibly collect? (Seriously, was being in a medical textbook due to my scientifically fascinating deafness not enough?)
All that said, it's pretty cool to be permanently incapable of unplanned pregnancy, period-free for the rest of my life, and apparently even more of a medical marvel than we knew. There is so much to learn, even about our very own bodies. I don't know that I'll take a bio class for fun (spoiler: I won't because I'm much too squeamish), but I at least did some reading, and will probably do some more.
We are such complicated machines, and we know so little about those machines, both on an individual level and a universal one. Who knows what other mysteries are lurking in our bodies?
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