sterilization surgery

After My Tubal Ligation: Recovery & Insurance

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If you’re curious about my actual tubal ligation surgery, you can find a full breakdown of my hospital experience here. This post will pick up from the moment I returned home.

Day 1

day1As expected, the actual day of surgery was a bit rough. It was extremely difficult for me to stand up or sit down by myself without a lot of pain & bit of blood, so I mostly just lazed around the apartment and watched Netflix. I had been prescribed anti-nausea & pain medication but I didn’t really feel like I needed either. My newly purchased heating pad, on the other hand, was a necessity.

More than anything, I was bloated & experiencing a lot of chest pain from the gas that they pumped into my abdomen during surgery. Although I was familiar with the pain because it mimicked my brand of anxiety attack, it also eventually tricked my body into full-blown panic. By the early evening, I started to cry and hyperventilate until Andrew (my partner) managed to calm me back down. I ate a little bit (even though my appetite was practically nonexistent) and took an Advil to help control the pain until bedtime.

In hopes of getting a full night’s rest, I had forced myself to stay awake all day. I asked Andrew to build me a nest in our recliner around midnight: heating pad, blankets, enough pillows so I wouldn’t roll onto my incisions, and all of my medicine/TV remotes/books within arm’s reach. I finally took one of my prescription pain pills and fell into a restless sleep, waking up every few hours to try and get comfortable.

Day 2

Andrew went back to work and I was on my own (with strict instructions to call if I needed him). My day consisted mostly of Netflix & napping. I was still experiencing chest pain, but moving around on my own was a bit easier — even if I was still extremely slow. I also ate my first meal since surgery.

By early evening, I was getting bored and we decided to venture out to a friend’s get-together. I did pretty well at the party (only really struggling with a slouchy camp chair), but I was completely exhausted after a few hours and extremely glad to get home to my heating pad. Andrew helped me get into & out of the shower, I took another painkiller, and then promptly curled back up in my recliner-nest for a much better night of sleep.

Day 3

Tubal Ligation: Day3Andrew had another day off, so we got to spend it at home together. (You guessed it, watching more TV. Yay!) I was continuing to feel better and move around faster. My chest still hurt intermittently from the surgical gas, but it was obviously dissipating.

The incision inside of my belly button started itching like hell, but that could have been exacerbated by the fact that I had a latex band-aid over it for a couple of days. I got fed up and decided to chuck the band-aids just to be safe.

Otherwise, the only truly notable moment was when Andrew & I were lying on the couch and he accidentally sent me into a giggle loop. This simultaneously hurt AND caused my menstrual pad to leak, which we only found more hilarious. Jokes on him though: he was the one who had to help me clean up, because I still couldn’t bend over.

Where is the mystery in our relationship, you ask? It is gloriously dead.

Day 4

Aside from bending, movement was pretty much back to normal by Day 4. However, I came to the scary realization that I hadn’t pooped since the day before surgery — and I needed to desperately. I was bloated and gassy, but absolutely nothing was moving. In a panic, I asked Andrew to bring home a box of laxatives & hoped for relief.

That night, I decided to sleep in our bed for the first time (with a body pillow to help keep me from rolling onto my stomach). Unfortunately, sleep did not come easy. I was constantly getting up and going to the bathroom without any luck. My fear of painful post-surgery poops had been replaced by a fear of having to go to the emergency room with fecal impaction. Super sexy.

Day 5

I called to leave a message with my doctor’s office and started doing some online research of my own. Apparently, a few days of limited mobility and a total of 3 pain pills had left me with killer constipation. I also discovered (too late) that we bought the wrong kind of laxatives: the ones that cause your muscles to move, but do nothing to soften your stool.

I spent most of my morning on the toilet because my body was cramping & straining involuntarily, causing me to worry about both busting my abdominal stitches and bringing back my hemorrhoids. Finally, I experienced what I can only describe as “the most painful shit of my entire life.” Crying & exhausted, I curled up in bed, canceled my work meeting for the day, and texted my partner to pick up stool softeners in case the insanity wasn’t over.

Day 6

Day 6 was supposed to be my first day back at work, but I called in sick. I didn’t know yet if I would be constipated or have diarrhea, and I really didn’t think that I could handle being on my feet for 8 hours either way.

I did manage to put shoes on by myself though — which was a major win.

Days 7 & 8

Tubal Ligation: Day7Heigh-ho, heigh-ho, it’s back to work I go!

At this point, I’m an overly-cautious mess. My wardrobe consisted strictly of sweat/yoga pants, and my purse was holding both my pain medication & heating pad. I also realized that what I thought was a normal speed at home was actually the speed of an elderly turtle at work.

There is good news though! Despite my frustrating slowness, I was able to do pretty much everything I had to — except for lifting heavy things. I was scheduled for approximately 13-hour days between both of my jobs (one with lots of moving/one with lots of sitting) and I never had to bust out the emergency coping supplies even once. By the time I returned home, I was both sore & exhausted but otherwise okay.

Days 9-12

Tubal Ligation: Day10Thanks to placebo pills, I had been off of hormonal birth control for about 2 weeks at this point and my natural hormones started RAGING.

Even though I was nervous about how my abdomen would feel during orgasm, I couldn’t resist masturbation. And amazingly, there was only a bit of discomfort; no actual pain! With my fears behind me, I channeled my 15-year-old self and masturbated frantically for hours at a time. My partner & I also spent the next few days experimenting with positions that avoided contact with my belly. I was pretty much insatiable.

I never would have believed it, but my sexual health problems had all magically disappeared! Insertion no longer sent me screaming downstairs for my She*Pak. I started to notice a little bit of natural lubrication again. I could even use my beloved Good Clean Love without that horrible burning sensation. The surgery basically proved itself to be a fucking miracle!

Days 13 & 14

Tubal Ligation: Day13I went in for a follow-up visit with my doctor. When she asked how I was, I had to refrain from crying and telling her that I felt more alive than I had in months — maybe years. She took a quick look at my stomach, saw that my surgical glue had mostly fallen away but my thick incision scabs were still holding firm, said everything looked normal, and sent me on my way. It seriously took 5 minutes.

The next day, I got brave enough to try wearing jeans for the first time and tentatively lifting boxes at work again. Both were slightly uncomfortable, but completely manageable.

Day 16

Tubal Ligation: Day17With a little bit of help from my own impatience, one of my scabs came away with the rest of the surgical glue. The incision was a little pink & puckered (definitely going to scar), but otherwise looked just fine.

 

Day 22 (or so?)

Tubal Ligation: Day24My other scab was stubborn. Eventually, I couldn’t stand it any more and simply decided to remove it myself. Attached to the underside of the scab was a small chunk of surgical glue. Removing it left a fairly large divot in my skin, but at least it was able to start healing properly.

Nearly 3 Months Later…

Tubal Ligation: CurrentThe divot has filled itself back up with scar tissue. It is definitely still more noticeable than the other side, but neither of the scars bother me (except for the fact that they are not symmetrically placed). I wear them proudly.

My period has not yet returned to its pre-hormonal birth control levels. I am still using a small Lunette cup with no overflow issues. I anticipate that this will change and that I will once again have super heavy flows & cramp-filled weeks… but I’m enjoying this while it lasts.

Although my sex drive has not maintained the initial state of over-excitement, there are still plenty of noticeable changes. I can use any lube that I want without discomfort. I can enjoy insertion (with toys or my partner) without even a hint of worry. And best of all, I actually experience arousal again; mostly responsive, but also occasionally spontaneous. I tweeted recently that every time I find that I have lubricated naturally, it’s like Vagina Christmas. I’m not used to it, but I’m fucking ecstatic each time it happens.

My overall emotional state is also much-improved. I am having feelings again, and even though that has been scary sometimes (Election Disaster 2016), I still wouldn’t change it for anything in the world. I do find myself crying more, but it’s from the pure range of emotions that I experience — not the suffocating weight of anxiety & depression. I’m no longer walking around in a fog.

It may sound dramatic, but there is no doubt in my mind that this surgery saved my life… by both relieving my depression AND removing my ability to have children. I am actually in control of my life again and it feels absolutely wonderful. 

Insurance Updates (On-Going)

Altogether, the surgery totaled $17,884.42. After insurance, I have still been charged $3,506.86.

When I called United Healthcare, I anticipated a fight over the details of the Affordable Care Act in relation to sterilization. Instead, I was informed that my tubal ligation was incorrectly coded as a bilateral salpingectomy. I have spent nearly the last 2 months playing phone tag with Indiana University Health, wracking up detailed notes from dozens of calls, trying to get them to change my billing code to reflect the surgery that I actually had performed. (And being mildly freaked out by the fact that if they did perform the wrong surgery and remove my fallopian tubes, how would I even know?)

As of today, I have been told that my case is finally in review at the hospital. Afterwards, they should resubmit my corrected claim to insurance. And at that point, I will find out if I need to file an appeal with United, citing the ACA. It’s proving to be a long, stressful adventure.

[I will update this as my battle for free reproductive health care continues.]

I’m 27, Childfree, and I Had a Tubal Ligation!

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Why a Tubal Ligation?

I’ve always known that I didn’t want children. Or rather, I’ve known since the moment that I realized it was an option.

I grew up in a rural, conservative area where raising a family is an expectation. The only people I knew who didn’t have children were those who were not able to. Still, by the time I was 14, I had decided that I never wanted to be pregnant or have my own biological children. I didn’t particularly like kids under the age of about 10 or 12, and I figured that it was more socially responsible to foster or adopt anyway.

After I moved to the city for college (and was exposed to a wider range of people and ideas), I realized that I could choose to simply not have children at all. I could focus on a career. I could travel the world. Finally, my future seemed exciting — and most importantly, right.

I did a lot of research on sterilization and I heard the horror stories of not being taken seriously. I lost hope that a doctor would trust my ability to make my own reproductive decisions before I was in my late 30s. So, when I became sexually active at 22, I simply went to Planned Parenthood and started oral contraception.

My experience on hormonal birth control went from scary (depression, anxiety, & suicidal thoughts), to manageable (breast/nipple discomfort & possible decrease in libido), to potentially destroying my life & relationship. My depression was back, my sexual desire & arousal was non-existent, my ability to lubricate naturally had stopped, some of my favorite artificial lubricants suddenly started to burn, and insertion/orgasm ranged from uncomfortable to downright painful.

I was desperate to find a solution to my problems — and getting my body off of hormones seemed like the perfect place to start. A friend recommended me to a gynecologist who believes in reproductive autonomy (Dr. Kasper in Indianapolis), I mentioned permanent sterilization at my annual exam, and we scheduled surgery. Simple as that.

Happy Little Uterus

The rest of this post will be a chronicle of my surgery experience, primarily for those who want to know what to expect when going in for a tubal ligation.

The Night Before

The night before surgery, I did all of my prep work. I avoided food & drink after midnight. I showered with Hibiclens, removed my dark nail polish, and took out all of my piercings. I tried to do my “deep breathing” homework, but got distracted and figured that falling asleep to some ASMR videos would be just as helpful.

Surgery Day: Pre-Op

5:30 AM – We arrive 2 hours early to the hospital, as per my instructions. I check into the registration desk to receive my hospital bracelet and sign my consent form. Then I take my paperwork down to the basement where I give permission for the doctor to notify Andrew (my partner) when surgery is over. We sit down in the waiting room and wait.

6:00 AM – We get brought back to my pre-op room. I get asked a lot of questions about my medical history, current medications, and allergies — which I will repeat several times to multiple nurses, residents, and fellows throughout the morning. I pee in a cup so that they can do a last-minute pregnancy test. I wipe my entire body down with wet wipes that the nurse provided for me and then put on my hospital gown and grippy socks. I had started my period the day before, so I also receive the most ridiculous & uncomfortable pair of mesh underwear that absolutely will NOT cooperate with a maxi-pad with wings.

My nurse comes back to put my IV in, for which I promptly request that all needles stay far, far away from my hands. She inserts it into my forearm instead, near the radius bone — which might not have been much easier. From then on, it’s a waiting game.

7:00 AM – Shortly before my doctor arrives, I get informed that she has started to do bilateral salpingectomies in place of tubal ligations. (Recent research is showing that it may help to prevent ovarian cancer in the future. And removing the fallopian tubes altogether obviously reduces the risk of ectopic pregnancies.) Thankfully, I was prepared for this question.

A friend of mine went in for a tubal with the same doctor just a few weeks before and agreed to the salpingectomy. I had spent the last couple of weeks trying to get information from the nurses (who insisted that a last-minute change would never happen) and compare coverage through my insurance company. My friend & I are still waiting for our respective bills, but from what insurance told me, the salpingectomy would not be considered preventative care according to the Affordable Care Act — and would therefore not be covered 100%.

I explain this whole confusing & somewhat disappointing ordeal, my doctor agrees to the original plan (a laparoscopic tubal ligation with cauterization), and I am wheeled off to the operating room.

7:30 AM – I think that the nurses were a little surprised that this was my first time having surgery, because of how calm I seemed. My bravery only softened a little once I was actually inside the operating room; suddenly, I started shivering. To be fair, they had told me that it would be very cold and would soon be covering me in blankets. But it didn’t seem that cold.

The room is full of medical staff, all working swiftly on their individual tasks. They push my bed as close to the operating table as possible and help me shimmy over. They put special wraps on my legs to maintain blood flow. And then they inform me that they have started my anesthetic. It only takes a few moments and I am out.

Surgery Day: Post-Op

9:30 AM – I start to wake up gradually in what I assume is the Post-Anesthesia Care Unit. I don’t remember much aside from overhearing two nurses: One asks what procedure I had done, the other responds “She had her tubes tied. Yay!” I smile.

10:00 AM – I am somewhat awake and they wheel me back to my private recovery room. My nurse from before is there and asks about my pain; I tell her I’m probably only at a 4. She then asks if I want my “husband” to be called back. I giggle on the inside, but am still too sleepy to correct her, so I simply say yes. Once he’s there, she gives me some Sprite & crackers and he helps me eat & drink. (I don’t remember much of what we talked about during this time, but I know he was cracking jokes because I gave him the bird when my nurse wasn’t looking.)

I can’t leave the hospital until I pee, so I ask for another Sprite and wait. Eventually, I think I can go and my nurse helps me out of bed and down the hallway. I’m surprisingly unsteady on my feet and very slow. My nurse confides in me that her & her husband also decided not to have children and I instantly develop all the warm fuzzies for her. She asks if I think I’ll need help in the bathroom, but I insist that I can manage. I pee, she helps me back to the room, and then it’s Andrew’s job to help me get dressed in my pajamas again.

Thankfully, my friend had suggested that I bring my own baby wipes with me, so we’re able to get most of the orange surgical stains off my skin. I have 3 incisions: one on either side and another inside of my belly button.

11:00 AM – My nurse sits down with both of us to go over my discharge & recovery instructions. Andrew signs the paperwork, since I am still a little loopy. Another nurse arrives with a wheelchair to transport me back up to the hospital pharmacy for my anti-nausea & pain medications.

My prescriptions aren’t quite ready yet, so Andrew & I decide to relinquish the wheelchair and wait by ourselves. When they’re ready, he insists that he will take care of it so that I don’t have to move around more than absolutely necessary. He then helps me shuffle my way back to the front doors of the hospital and finds me a place to sit while he gets the car. After a long morning, we’re finally on our way home.

For details on my recovery, the amazing effects of going off hormonal birth control, and potential insurance battles… click here!