This story actually starts over a year ago, before I started medical school. One of my goals before entering medical school was to lose some weight, because let's face it, no one will take advice about obesity from an obese doctor. I started to go on morning runs in the nearby park. Every once in a while, if I ran too far or too fast, I would get really bad cramps followed by some spotting. Sometimes, the pain would be so bad, I would have to sit down on a bench and breathe through it until the episode died down. My mom convinced me to go to a doctor to get it checked out. At the time, I had insurance under Americorps, so I figured, why not, preventative care is free.
When I told the doctor at North Eastern Medical Services (NEMS) about my symptoms, she told me it was most likely a fibroid. She said that she could give me a referral for a ultrasound, but mostly likely, the ultrasound would only confirm the diagnosis. My symptoms were relatively mild and, in most cases, doctors choose to leave the fibroid in unless it is seriously detracting from the quality of life. I wasn't about to pay $100+ for a test that would only tell me something that I already knew, so I filed away this fibroid business to the back of my mind and just accepted the cramps as a part of exercise (No pain, no gain, and all that).
Fast forward to three months ago, when I started learning about pelvic exams in school. We were taught to palpate the inguinal region to see if we could detect any bumps (we shouldn't) that could correspond to problems with ovaries or even the uterus. As any good med student would do, I immediately went home to palpate the heck out of my inguinal region. I lied in bed and followed the oblique line of my inguinal ligament until my fingers pressed upon a large lump. Deeper pressure elicited a crampy sensation. A general rule of thumb when detecting a lump/abnormality is to check for symmetry. If the abnormality is equal and present on both sides of the body, it's less likely to be something bad. I checked hopefully on the opposite side and felt nothing. Crap.
I lied awake in bed and contemplated my own mortality.
The next morning, I made an appointment at the Student Health Center. The physician was super helpful and confirmed the presence of the lump with a bimanual exam (something that the doctor at NEMS never did). Things moved relatively quickly from that point on. I was given a referral to the radiologist for a pelvic ultrasound. The ultrasound revealed that the fibroid was larger than my uterus (11.5cm x 11.6cm), but fortunately, it was pedunculated (or attached by a stalk) so it would be relatively easy to remove. I tried to make an appointment at the UCSF OB-GYN, but they informed me that the earliest appointment would probably be in December. I may have shamelessly pulled the "I am a medical student, please help me so that I can get this done before I take Step One and disappear off the face of the earth, Queen Fibroid and all" card. Miraculously, the doctor called me the next day and squeezed me in for an appointment in early October.
Those two weeks seemed surreal. I didn't tell anyone about what I had found or what I was doing. If it turned out that I didn't need to have surgery, why worry my family prematurely as they waited for news? I confided in my sister after I scheduled my appointment with the OB-GYN, but we decided that I would tell my parents only if it turned out that I needed to have surgery. It was a time of high stress and uncertainty. Two weeks, three appointments -- it felt like I had more things inserted in my hoo-ha than I have had in my entire lifetime. (Let me tell you, pelvic ultrasounds are NOT fun. The ultrasound technician may have laughed at my face of horror when she showed me the transducer.) I would get asked the same questions over and over again: "When was your last period?", "Is there a possibility you might be pregnant?", "Have you ever had an STI?" My personal favorite is the doctor who asked me if I might be pregnant, to whom I responded, "Not unless Jesus is coming again." and then she proceeded to give me a STI test just in case. Thanks for the vote of confidence, ma'am.
Once I met with my OB-GYN in October, she confirmed that I would be needing the surgery. Though I wasn't having the worst symptoms (heavy bleeding, bad cramps during menstruation), the fibroid was large enough that it was compressing my bladder and they had concerns that it might continue to grow. When Dr. Illagansakare (YEAH. TRY PRONOUNCING THAT. Took me at least three encounters to get that right.) told me about the bladder compression, I was like "OMG. That's why I always need to pee!" Rotations are looking up, y'all.
I was scheduled for surgery on December 15th. A huge shout out to all the school admin who helped coordinate everything -- to Dean Jones who met with me personally to express his support and to Dr. Hyland who was so sweet about rescheduling my exam and checking in on me.
After all the dates were set, I was able to forget about the surgery for a good month or so. I had a minor scare with the insurance company two weeks before the scheduled date, when they rejected my insurance claim for the surgery. When I received the call from UCSF, I was incensed. I was ready to sue everybody. Who are these people to deny me this surgery, telling me it's medically unnecessary?? TELL THAT TO MY BLADDER. I spent an hour on hold with the insurance company the next day, and it would later turn out that there was a mistake on UCSF's part. They had coded the procedure as a hysterectomy and my insurance company, seeing I am a healthy 24yo F, was like "Um. Why are you removing her healthy viable uterus? Let's re-think this."
The run-in with the insurance company gave me another moment to reflect on how lucky I am. After a day of despair and anger, I was able to sort out the situation and eventually get the procedure that I needed. I can't imagine what would have happened if I didn't have the medical/bureaucratic literacy to navigate the system or the inherent inflated sense of entitlement to be like "No. I am getting this procedure." Or if I wasn't a student and I didn't have time to just spend essentially 1.5 hours on the phone with the insurance company during business hours. Or if I didn't have the necessary English proficiency to negotiate with the insurance representatives. This minor headache could have been a real nightmare.
The two or three days before the surgery, I had the worst sleep of my life. I was nervous about my exam and anxious about the surgery. By the morning of the procedure, I was almost looking forward to it -- sedation guaranteed the best sleep of my life.
The worst part about the whole surgery was the IV. I have the worst veins. Every phlebotomist I have ever encountered has called me a "hard stick". Once, a nurse told me that if I exercised more, my veins would be bigger (Dis Bitch. I now run 3 miles a day and lift and still have no palpable veins. All that exercise for NOTHING). Anyways, it took them three sticks to get a usable IV. A nurse tried, then the anesthesiologist's nurse assistant, and finally the anesthesiologist got it to work. I was super close to begging them to just give me laughing gas before they stuck me to their heart's content. Once the IV was in, they rolled me down the hallway and to the OR.
Upon getting in the OR, I remember them telling me to get up on the table. I remember saying "Wow, this table is super comfortable. I want one of these pillows for my bed." I remember someone saying, "I don't think anyone has ever said that before." Then laughing, then nothing.
The next thing I remember is coming to in the recovery room, distraught about everything. My nose was stuffy, snotty from apparently crying for the past 30 minutes. My sister and Dad were there trying to comfort me. I had just found out that I had to stay the night in the hospital, and I remember moaning, "I'm OK. I can go home. I can go home, I'm fine. I want to go home." My Dad told me they got a parking ticket and I think I cried about that for another hour. My sister claims I cried for 3 hours straight. Of course, she provided ample video documentation. At the risk of tearing my stitches, I watched these videos and I can attest that they are hilarious. I'll wait before I'm completely recovered before I share them. Too good, comic gold.
A brief preview:
Me: "TICKET!!!! (sobs)"
(brief pause)
Me: "Is there Wifi?"
or
Me: (look of intense betrayal) "You took my phone?"
Me: (Throws head back dramatically and starts sobbing)
My family has been super supportive through the whole thing. My sister took two days off work. She spent the night before my surgery with me in SF and took me to eat wings to help me keep my mind off things. My parents left San Jose at 4AM to take me to the hospital at 5AM. My family sat with me in the hospital as I humiliated myself and cried all the way from the recovery room to my hospital bed. My sister brought me jajangmyun and fried chicken for dinner (I hadn't eaten since midnight the night before. The doctors didn't believe I would be up to eating for a while...I proved them wrong.) Amy also stayed with me overnight in the hospital, brought me my First Aid book when I deliriously requested it in my semi-conscious state, and was an overall trooper through this entire experience.
I cannot express how thankful I am for my family for being with me from the start to the end. Even now they insist on feeding me foods I like and making soup "for my recovery". I also appreciate all the friends who have checked in or stopped by to drop off home-cooked meals and pray for me. I definitely feel the love!
As for the procedure itself, it was a success. They got Queen Fibroid out completely and we are now waiting from the report from Pathology to know the final weight. The surgery was supposed to be laparoscopic but I was losing too much blood so they had to make a fourth, larger incision from which to remove the fibroid in strips. They kept me overnight in the hospital to monitor me for any negative effects from the blood loss.
Anyways, yes, I am now home eating donuts and doped up on Norco. Overall, a happy recovery! Another big thank you to everyone who has supported me along the way. I really appreciate you guys being in my life. :)
