Come Back Strong - Balanced Wellness After Surgical Menopause

CHAPTER 1

My Story

EVERY WOMAN WILL ONE day arrive in menopause; however, the intensity and duration of symptoms will vary. Surgical menopause is different than natural menopause in that it is often more abrupt, more intense, and depending on the age when it occurs, lasts longer. Here is how it happened for me.

 

A Woman of Strength

Strong. Empowered. Joyful. Confident. That’s how many of my friends describe me. It is how I feel. It is who I am.

I have a natural curiosity and sense of adventure. As a child, I was always smiling, exploring, and clowning around. I was a tomboy, always wanting five more minutes to play outside. In high school, I was the class flirt and prom queen who went to college to study Recreation. In my twenties, while training for the Vermont City Marathon, I would rise at 5 AM to get in my mileage. After I got home, I would shower, eat, grab a cup of coffee, and head to work with a skip in my step. I’d arrive at my job ready to conquer the day, smiling cheerfully and asking everyone in my path, “Hey, did you catch that brilliant sunrise?!”

Yes, I was that woman.

I spent over two decades running and racing any distance from two to 26.2 miles. In my late thirties, I became an elite cyclist who excelled going uphill. Then, my inner athlete found a home in the gym, adding strength to my endurance. I learned to do my first pull-up and went on to succeed at doing over fifteen in a row.

In 2014, at age forty-three, I was in the best shape of my life. I was strong and lean at 119 pounds. I had the six-pack abs to prove the work I had done both in the gym and in the kitchen. That year, I participated in a sixteen-week transformation challenge that involved a before and after photo and an essay. Out of over 3,000 participants, I was proud to receive an honorable mention.

Around this time, I was due for a routine colonoscopy. This may seem young to you, but the test was appropriate because my mom is a colon cancer survivor and I had a history of digestive issues including constipation, abdominal pain, diverticulosis, and irritable bowel syndrome. I postponed the procedure for a few months until my “after” photos could be taken and my challenge was officially complete. I didn’t want to take any unnecessary risks with what the prep, anesthesia, or recovery might do to my abs.

Hey, once you have them, you don’t want to give them up.

 

Testing and Waiting

The procedure went well. However, my gastroenterologist ordered an ultrasound and a CT scan to see if anything was pushing on my intestines that might explain some of the pain I’d been experiencing. This led to the discovery of a small mass near my cervix and an ovarian cyst. I was referred to my regular gynecologist.

Now, when my routine test results came back, and they included the word mass, my blood pressure went up a notch. Cysts I knew were common and relatively harmless. I knew they could come and go on their own. I was pretty confident that a cyst would not kill me.

The idea of a mass, on the other hand, had a whole different connotation and stress factor. I admit that the possibility of cancer crossed my mind. I wish I had asked more questions. I might have heard that while it could be cancer, it could also have been a fibroid. We would not know until it was removed and tested. A fibroid sounded much more manageable than cancer in my mind. Language is powerful, as is the reassurance of an answer to a clarifying question.

Did I mention it was December and we were in the middle of the holiday season? My stress levels might have been higher than normal. This testing and waiting didn’t help matters.

I made the call to set an appointment with my gynecologist. I was told he was booked solid for several months. When I explained my situation, they informed me I could get in sooner if I saw another doctor in the office.

In hindsight, I might have pushed a little harder to see my regular gynecologist with whom I had a seven-year history. However, in my rush to move forward quickly, get things taken care of, and get back to some form of normalcy, I opted to see the unfamiliar doctor.

My husband, Jim, came with me to this consultation and together with my new doctor, we decided to remove the mass and monitor the cyst. Just days after my colonoscopy, I was back in surgery to have the mass removed. More anesthesia. More recovery.

In the end, the mass was not cancer. It was a fibroid. Benign. I breathed a sigh of relief, took a few days’ rest, enjoyed the holidays, and got excited for the New Year and getting back to living my healthy life.

Four weeks after the fibroid was removed, Jim and I traveled to Palm Springs, California, for a wellness conference. We left our hotel, had lunch, and walked to the convention center. By the time we got there, I was doubled over in pain. I was carried off on a stretcher and transported by ambulance to the local hospital. We spent our entire day at the local hospital where I underwent a battery of blood work, tests, and X-rays.

Can you imagine? Talk about embarrassing. My life and passions are built around health and wellness, and I was carted off on a stretcher from a wellness event.

Nothing was found, and the pain receded. Looking back, it may have been pain from endometriosis that had yet to be discovered. Endometriosis is a condition where tissue normally inside your uterus grows outside it and can cause pain, fatigue, and constipation. It could also have been an incidence of irritable bowel syndrome (IBS). I had gotten dehydrated, hadn’t slept well, and had a high-fat meal at an unfamiliar restaurant. Also, my stress levels had continued to rise due to traveling. These are all variables that can lead to an IBS attack. IBS is a disorder that affects the large intestine (colon). Symptoms, which can include cramping, abdominal pain, and bloat, are very similar to the discomfort that can occur during a woman’s reproductive cycle.

When we got home from our trip, I wanted life to go back to the way I knew it before this six-week battery of tests and procedures. I was sick of doctors and of being poked and prodded and tested. I wanted whatever was going on in my body to go away. Fast.

I went back to the gym. I enjoyed our indoor cycling workouts. I knew I was not done, that I would have to revisit the ovarian cyst, but I was not overly concerned. I thought the worst was behind me.

Three months after the discovery of the fibroid and cyst, an ultrasound revealed that the cyst had not gone away on its own as we had hoped.

In fact, it had grown.

I decided it was time to have it removed and be done with this once and for all. My new doctor told Jim and me that in the best-case scenario she would remove one ovary where the cyst was attached and its connecting fallopian tube (a partial oophorectomy). The actual outcome, however, depended on what she found. She informed me that the worst-case possibility was that I would require a full hysterectomy. We accepted the first available surgical appointment four weeks later.

Done. We had a plan. I wasn’t worried. This was no big deal. I’d had a fibroid removed in December. It only took a week or two and my life was back to normal. When the doctor mentioned the worst-case scenario, I barely paid attention. I’d already had two procedures and recovered. I thought, All is well. This will be fine. In and out procedure. Piece of cake. I believed that the only difference between the best-case and worst-case scenarios was the amount of time it would take me to recover physically.

Did I say I wasn’t worried? I lied. I was worried, although I was telling myself not to be. My body, however, knew that I was. And for the four weeks between deciding to have the ovary removed and the actual surgery to remove it, I was worried. And scared. And stressed.

It wasn’t just that I had an ovarian cyst that wouldn’t go away. Many women have ovarian cysts that are harmless, without symptoms, and go away on their own. But there is the possibility they can continue to grow large, twist, rupture, bleed, and become painful.

While I was nervous about signing up for a third surgical procedure in four months, I chose to have the cyst and ovary removed because of my lifestyle. I’m a cyclist. Jim and I will ride one hundred miles or more in a week into remote areas with sketchy cell phone service. The concern over the cyst and the possibility of a painful attack were reason enough for my decision. I’d also had a history of heavy bleeding: a three-week menstrual period, a few days off, then three weeks of heavier bleeding. That alone was exhausting. As an endurance athlete, needing a bathroom every hour had an inconvenient impact on life. Furthermore, I did not plan to have children.

 

I’ve Fallen and I Can’t Get Up

On April 16, 2015, back into surgery I went, hoping and trusting for the best-case scenario: the simple removal of one ovary and its fallopian tube. I was excited to erase the pain that was burdening me. I didn’t expect anything else to happen. My new doctor would be in communication with Jim throughout surgery and decisions would be made on my behalf while my only task was to remain unconscious and trust that I was in good hands.

I awoke to learn that the worst-case scenario had happened: I had received a full hysterectomy as well as a double oophorectomy. Uterus, cervix, ovaries, fallopian tubes—everything had been removed due to the severity of endometriosis that had been found.

I expected to be pain free when I woke. It didn’t work that way. I was in severe pain. I was tired. I was afraid. I...