After my required month waiting period to confirm that yes, I really am sure about this whole tubal ligation thing, I returned to the clinic this week for my preoperative appointment so I could be cleared for surgery. This involved repeating most of the patient history I’d already given, with a particular focus on allergies and medication reactions, since that sort of thing can go badly in an OR rather quickly.
I was also reminded, repeatedly and in several different ways, that tubal ligation is permanent. I was surprised to learn that 20 percent of people later regret their ligations; Dr. Thorough noted that the reversal surgery costs approximately $10,000, takes much longer than the initial surgery, and isn’t very effective. In other words, they aren't messing around when they say this is a permanent procedure.
“I get it,” I said. “I’m breaking it and buying it.”
“Patient understands and consents,” he noted in my electronic medical record before discussing the specific surgery I’m having, which is a laparoscopic bilateral tubal ligation. Using a clamp to stabilize my uterus and move it around as needed (much like a hay hook!), he’ll locate the fallopian tubes with the assistance of a camera inserted through my navel, and then insert another tool through an incision just below my, er, hairline. He said it, not me.
Then, he’ll be snapping some rubber bands over the offending tubes to cut off the blood supply and allow a chunk of the tissue to die.
“Sounds like an elastrator,” I said.
“Well, yeah,” he said, with a slightly pained expression.
The bands are successful about 95% of the time; if there’s a problem, he can cauterise the fallopian tubes instead, and if that doesn’t work, it’s time for some good old fashioned surgery.
Dr. Thorough also listened to my heart and lungs and then apologetically examined my breasts (“We want to make sure you don’t have cancer, because that would be bad”). I was somewhat amused to note that he averted his eyes during the breast exam. Dude, you’re about to cram a tenaculum up my cooter while I’m unconscious and strapped to an operating table, I think I can handle you looking at my tits.
Not all of the preoperative appointment went quite as expected. Namely, I didn’t expect it to take two-and-a-half hours, nor was I prepared for the surprise!pelvic that popped up in the middle, despite being aware on an intellectual level that the surgeon would want to map unknown waters, so to speak, to prepare for surgery1. Knowing that the surgeon would want to check my uterine position and wearing a ridiculous paper skirt in preparation for taking the crash position are two different things, as vagina owners know.
Luckily Dr. Thorough was in and out quickly; that man knows his way around a vagina, let me tell you. Once he allowed me to get dressed, I signed a whole stack of paperwork, including a consent form noting that I’m seeking treatment for “undesired fertility” and that the alternatives are “other contraceptives.”
He also delicately suggested that I might want to eat lightly on the day before the procedure in addition to stopping all food and drink after midnight.
After checking a few more times to make sure I understood that the procedure was permanent and that I was consenting of my own free will, he sent me off to the hospital for pre-registration, where I got to fill out even more paperwork and get some preoperative bloodwork. They slapped a wristband on me and sent me off into the bowels of the hospital and the phlebotomy lab, where a nice lady took several tubes of the red stuff from my left arm.
For those who don’t spend a lot of time in hospitals, the identification procedures used these days might seem a bit superfluous, but they’re actually really important. Hence, I tried to keep a straight face when she called me by name in the waiting room and asked how my work was going, and then asked me to tell her my name 30 seconds later, while allowing her to look at my wristband. And then I had spell my name.
She just really, really wanted to make sure I was who I said I was, which I appreciate. Especially on the day of surgery, I’m all about everyone being on the same page, because I don’t want to wake up with breast implants or something.
She left me with a wristband to wear until my surgery, warning that if I took it off, I’d had to redo my blood tests; it’s the band that goes with my blood typing record and apparently hospitals get fussy about that kind of thing. That along with a long list of other instructions is what I have to look forward to with the days counting down; Dr. Thorough warned me very sternly that if I swallowed one thing after midnight on the day of, they’d cancel my surgery.
Now I'm terrified I'm going to accidentally swallow a spider at 12:01.
In the next installment of the Totally Tubal Adventures, I’ll be sterile! And high, because where’s the fun in writing about surgery if you wait for the anesthetic to clear your system? For what are bound to be an entertaining series of post-surgery Tweets, be sure to check out @sesmithwrites.
1. FYI and possibly TMI: My uterus falls roughly in the middle, not tilted too far back or too forward. Maybe it’s just right? Return