Saturday, June 14, 2008

The plot to murder Ignatius, part one

At last, after two missed appointments due to bad timing, I met my new gynecologist. Like many contemporary physicians, she has ditched the traditional unisex lab coat and practical shoes. She has opted to sport a dress and heels, both of which looked uncomfortable to me.

Her assistant performed the usual preliminaries (height, weight, blood pressure) and asked me if I wanted her to be present during the examination. I am not sure I understand why having Stranger 1 in the employ of Stranger 2 present while Stranger 2 examines me would be desired. Having one stranger checking out your nude, vulnerable body seems uncomfortable enough without a witness.

The doctor met with me in her office, which was decorated with appropriate texts (Complete Gynecology), family portraits and candids, and knickknacks. Despite the touches, it didn't reveal any personality. Even the family photos could have been anyone's family photos, a thought that makes me sad. On the surface at least, we are not as unique as we like to think.

She asked the usual questions, then the conversation turned to my primary interest—Ignatius and his fellow fibroids. Her recommendation is a uterine fibroid embolization, or UFE, in which "microspheres" are inserted via the femoral and uterine arteries to block or decrease the blood flow to the fibroids (a form of slow fibroid murder). While not a surgery, the procedure is not without risks, of course, which I have to weight against the discomfort to which I seem to have become accustomed. I could carry on without a UFE, although Ignatius and company are showing a disturbing tendency to grow. On the other hand, a number of women say that they felt immensely better within days of their UFE and that they are glad they had it performed. As Virgil says, something that large can't feel right. And who doesn't want to feel immensely better, especially when they have a vague feeling they don't feel as well as they could?

Then we moved to the examination room and got down to business. At the sight of my scar, she expressed shock. "I thought you said you had an appendectomy? That's a big scar!" (Curious, I later measured it; it's about seven or eight inches long and one-eighth to one-quarter inch wide.) I explained my understanding of what happened, which is that my "hot potato" appendix was hiding demurely behind my bowel, necessitating a search-and-rescue party. Now even I wonder why it required an incision the length of two hands side by side.

Her first attempt with the pap smear was unsuccessful because the swab was too short, or, as she put it, "You have a long vagina," which, I think, qualifies as one of those things one doesn't need to know about one's own anatomy.

She must have struck the proverbial pay dirt with the second attempt because for an eternity it felt like an enraged pit bull had a very sensitive internal part in the grip in the grip of its sharp teeth and powerful jaws. I bit my lip. I tried, unsuccessfully, to suppress groans and even a tear or two. Finally, the pit bull let go. I'm sure I would have remembered that much pain during previous samplings! I blame Ignatius.

After the breast exam, always fun when I'm in the throes of PMS, it didn't take much effort for her to find my uterus, which is "huge." ("Enormous" or "huge"—take your pick. I gather that it's a bit larger than the norm.) Naturally, between the fat and the fibroids, she couldn't feel my ovaries—they've been in hiding for several years. Clearly an ultrasound was in order.

Next: Fun with the ultrasound technician.

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