It was like having my uterus power washed

So yesterday was my D&C and Hysteroscopy. I've not figured out if it was better or worse than I was expecting.

But perhaps I should rewind for a bit and explain what led up to this quasi-emergency surgery.


After a biopsy in January showed simple endometrial hyperplasia, I was put on Provera (synthetic progestins) for 90 days in hopes of slowing endometrial growth and allowing my body to self-correct the overgrowth. Simple endometrial hyperplasia is just a slight overgrowth of the endometrial lining- much like when you wait a bit too long to mow your lawn and it gets floppy. The OB said there was a less than 0.5% chance of it every becoming cancerous.

So 90 days (many tears, a few broken dishes, and several apologies to my husband) later I went in for a repeat biopsy. OB had difficulty getting a sample, which she took to mean that it had worked. So lucky me, LUCKY ME I was subjected to TWO endometrial biopsies.

Many people have asked what that experience is like. I found a great youtube animation (not for the squeamish) that highlights the procedure.

http://www.youtube.com/watch?v=at-CfWUiClg

Basically, OB inserts a solid catheter type implement into your uterus, and suctions out lining in a sweeping motion. Most women suggest taking 600-800mg of ibuprofen before the appointment. My first biopsy was a rather unfortunate surprise, and it was about a 1/2 day recovery in bed with some of the worst cramps of my life.

The second biopsy was slightly less horrific- I took 800mg of ibuprofen 20 minutes before my scheduled appointment time. It still felt like she had inserted a shop-vac into my uterus and turned it on high, but there was less cramping afterwards.

She said to expect the biopsy results in two weeks. I was leaving for a work conference in Nashville a week later, so I expected to hear back sometime after my return from the conference. The first indication that I should have known something was not right is when AF showed up unexpectedly the night before my trip. By the time I arrived in Nashville, I was soaking through a super+ tampon every 30-45 minutes. I didn't want to miss the conference, so I figured if the bleeding kept up, I'd fly home early and go to the hospital.

And then I got the call from my OB. Instead of my lining reverting to normal, it progressed into complex hyperplasia. Instead of just being a bit overgrown in a few spots, my endometrial cells were crowding each other out and creating dense patches of thick brushy overgrowth. It went from being that neighbor who didn't mow his lawn for 2 weeks to that neighbor who mows his lawn once a summer. I don't remember the entire conversation at this point, but she threw out "oncology consult" "need for a D&C and exploratory surgery as soon as you're back in town" and "don't panic yet".

Don't panic yet. Immediate surgery+ oncology consult= freaking out

So I kept changing my tampons and decided to fly home early. By the time my plane landed, I was bleeding so heavily that I had clots running DOWN MY LEG INTO MY SHOE.

Stop and think about that for a moment.

I called my OB, she said to quadruple up on my progestins and pray that it slows things down.

So I took 4x my regular dose, got behind the wheel of the car and prayed I didn't ruin my car's upholstery. It was a long 2 hour drive home from the airport.

By that evening the bleeding had slowed (but not stopped completely) and I was starting to feel a bit more human. We were able to get my D&C/hysteroscopy scheduled for that next Wednesday (yesterday).


The day of the surgery I had to be at the surgical center by 8:30 in the morning for an 11:30 procedure. Honestly, the surgery was over and done with by 12: 15 and I was home by 1:30 or 2:00. The doctor said it was like blazing a trail through the wilderness up in my uterus, but she feels that she got 95% or so of my lining. The best news is that there were no visible tumors, no fibroids, and no polyps. I'm glad to know there are no fibroids or polyps causing the bleeding, and the fact that there were no visible tumors leads us to believe that if there *is* cancer that we caught it at a stage early enough that a hysterectomy would take care of the whole problem (but the hysterectomy is obviously the last resort)

It wasn't too bad, the pain never peaked over a 3 or a 4, but I felt like I had been hit by a MAC truck. I slept from the time I got home until 7 PM, woke up for a few hours to eat dinner and then fell asleep again until 7AM today. I'm feeling much more human, still crampy and still tired, but I could have probably gone to work if I had someone to drive me.

The best surprise- I was prepared for heavy bleeding and spotting based on my last week, but I've not needed a pad in the last 12 hours. Here's hoping this is the reset my body needs, and it can keep itself in check the next 3 months.

Pending the pathology results from the lab at the regional cancer hospital, the plan will either be to do 3 more months of higher dose progestin therapies (if there is no atypia) and hope that it fixes the problem, or move on to more aggressive therapies with a gynecological oncologist (if there is atypia seen). Going back to the lawn metaphor, atypia would be the dandelions and crab grass of the endometrial lining. Starts small, but left unchecked chokes all of the good grass (lining) out and destroys your lawn (endometrium). Which in this case, would signal uterine cancer.

Two weeks until I know what's going on. It'll be a long two weeks.