“Where’s your IUD?” Dr. El-Taj asked.
“Somewhere in Florida,” I answered.
I think I left it behind a Burger King dumpster off U.S. 1, somewhere between Miami and Marathon Key.
I’d been having an especially heavy period before my vacation, one that had been running on and off for about three weeks. I’d been alternating between pantiliners and maxi pads, and didn’t want to take any chances on American Airlines, so I’d worn an overnight pad for the flight just in case. I felt something happen during touchdown: a surge of movement inside me, like my uterine lining was disembarking in time with the passengers on Flight 3697. I felt dimly satisfied that I’d planned ahead by bringing heavy-hitting sanitary products, but when I got to an airport restroom I quickly realized that my extra pads were in my carry-on bag – which I’d had to check at the boarding gate because there wasn’t enough room in the overhead bins. So much for planning ahead.
Miami airport is a maze of terminals. My friends Nicole and Cori, who were traveling from Washington D.C. and Connecticut, had wisely chosen to fly into Ft. Lauderdale instead, where they’d picked up a rental car. With no time for a second restroom break post luggage claim, and nowhere for my friends to park at curbside pickup, I had approximately six seconds to climb into the backseat as the rental car came to a rolling stop outside arrivals.
About an hour into the ride, we pulled off at an exit with a Burger King to use the restroom, but the Burger King was closed. Nicole, ever practical, headed to the dumpster behind the restaurant to relieve herself, with Cori right behind. I joined them and pulled down my pants, and was confronted with what had been happening in my underwear since I’d last looked – a river of blood and gore had overflown the maxi pad and soaked through my leggings. I removed my leggings, changed pads, balled up the used one, and threw it in the dumpster. My best guess is that’s where my IUD and my uterus parted ways. If my uterus was going to unilaterally reject effective, long term birth control, it makes sense that it would happen in Florida.
“Did you see anything white in your discharge?” Dr. El-Taj asked.
“Not that I could tell, but I wasn’t looking for it,” I said.
“You know why this happened, don’t you?” she asked.
“No! Why?” I asked.
“You didn’t take me with you to Florida.” As unpleasant of an experience as this had been, I’d been so happy to find Dr. El-Taj and Dr. Brown, the gynecologists who’d been treating me for various ailments over the previous year. They’d been informative, sensitive, and even funny.
Six months prior to the events in Florida I was diagnosed with fibroids, a not uncommon occurrence – about one in four uterus owners develop fibroids in their lifetime, but one I was fairly unfamiliar with.
I’m 53 years old; when my periods started getting heavier a few years ago I thought it was part of menopause, or perimenopause. Then I had a period that lasted almost two weeks and never got lighter. My interactions with my uterus – whose name is Bertha, have been limited to menstruation; I’ve never been pregnant or given birth. I more or less live my life as if I don’t have a uterus, and it makes me queasy to think about exploring it. When my period wouldn’t stop, my primary care physician got an order for an intravaginal ultrasound. During the procedure the ultrasound tech studied the screen and typed commands into a keyboard with her left hand while maneuvering a wand that was inserted into my vagina, with her right. It was an impressive display of ambidexterity. The ultrasound took longer than I expected, the tech kept poking the wand around in my twat like it was a purse and she was looking for her house keys, while maintaining visual contact with the computer screen. I craned my neck to see what she was studying, but had no idea what I was looking at. The only ultrasounds I’ve seen have shown the outlines of fetuses; these images were incomprehensible. Eventually I stopped looking, and tried to subdue all the inappropriate jokes bubbling up in my mind… what would happen if I let loose with a lusty “ooooh, yeah!” The longer it took, the more jokes bubbled up: what if, on my way out, I lit two cigarettes, handed her one, and mouthed: “call me.”
In the end I did none of those things. When the exam was over I politely said, “thank you,” the tech left the room to give me privacy, and I dressed with the gravitas appropriate to the situation. How could I embarrass the ultrasound tech with my stupid vagina jokes? She’d even asked me if I’d like to insert the wand myself, which was very professional of her.
The ultrasound revealed four fibroids, which made me feel like I was carrying kittens. How could there be so many, and what were they doing in there? How long had they been there? Why did they exist? A search on the Johns Hopkins website brought me face to face with this disappointing fact: “The cause of fibroids is not known.”
There aren’t any satisfying answers to my fibroid related questions. An article by Olivia Dimmer, published on the website of the Feinberg School of Medicine, describes them this way: “For most women, uterine fibroids are harmless, but nearly a quarter of those afflicted will suffer from excessive uterine bleeding, anemia and recurrent pregnancy loss. Despite their prevalence, uterine fibroids are notoriously understudied…” If I had erectile dysfunction there would be seven hundred different pills for me to take, but the female body is just really mysterious, I guess. What did fibroid sufferers do a hundred years ago? Maybe they’re the root of the diagnosis for hysteria, a condition believed to affect women when their uterus moves around the body, making women “hysterical.” While that theory has been debunked, I did have debilitating cramps, felt a strange pressure in my pelvis that was so prominent that I went to urgent care, convinced that I had a UTI (I didn’t), and the occasional sensation that my cervix was being pierced with a skewer.
My gynecologist recommended a myomectomy, a procedure that reduces the size of the fibroids, together with inserting an IUD, which makes periods lighter. It sounded like a pretty benign procedure: it was outpatient, there were no incisions or stitches involved, and I wouldn’t have to be awake for any of it. I didn’t anticipate just how many people would talk to me while I was in pre-surgery, an IV in my arm, and halfway in the bag with intravenous fluids. The intake nurse introduced herself and explained her role, then the anesthesiologist, then the rest of the surgical team, and finally the surgeon. By the time an intern approached and explained that he was a student of gynecology and obstetrics, and would I grant him permission to observe the procedure, I just said “Sure.” Then I turned to my husband, who’d accompanied me to pre-surgery, and said “everybody wants a piece.” I fell asleep as I was being rolled into surgery, and the next time I opened my eyes, it was all over. For a couple months everything seemed great – light periods, no cramping. And then… Florida.
Clearly, I had to have a second procedure. My options were: get another IUD inserted, which… no thank you, Bertha had spoken definitively on that issue; a uterine ablation – where they cauterize the area; or a full-on hysterectomy. I talked it over with the friends that I’d traveled to Florida with.
“Just get a hysterectomy and get it over with,” Nicole said. I wasn’t convinced.
“What if it’s a load bearing uterus?” I asked. As it turns out that’s not far from the truth—if you remove a uterus, everything in the area shifts around and can cause other problems you never knew you could have. I texted Ben Hamar, an obstetrician friend, to get a professional opinion on the ablation procedure.
“It’s minimally invasive,” he wrote, “and if it works, your symptoms are controlled. Even if it only works part way, the area that is scarred will not bleed and you’ll have lighter periods. Hysterectomy sounds simple but it’s a big thing… best to try to run down the less definitive options to see if you have a sufficient therapeutic effect.”
“Something less invasive is appealing,” I wrote back, “particularly since I’ll be entering menopause soon, so why have an organ removed so close to that time?”
He wrote back: “I mean, just because you don’t use your den doesn’t mean that you dynamite it, right?”
I had the ablation six months after the myomectomy, and by then I knew the drill. I undressed, wrapped the flimsy hospital gown around my body, put the lunch lady hair covering on my head, and climbed into my hospital bed. When the intake nurse pulled back the curtain to check in on me, she took one look and asked: “Getting comfortable?” After the procedure I had experienced a light, watery discharge for a few days, which I willed myself to believe was my last period ever, since I was told I might never experience another one. I was wrong about that. It’s been over a year since the ablation, and my period still keeps showing up, like an uninvited party guest who just can’t take a hint. “Oh, come on Bertha,” I grumble every time it happens. “Wrap it up, the party’s over.” I keep getting periods but at least now they’re manageable, and I don’t have to worry about bleeding through all my clothes regularly. I’m still waiting for that magic postmenopausal moment when I can walk right past the feminine hygiene aisle at Walgreens with nary a thought of menstruation in my head. It’s something to look forward to during these dark days when the future seems so murky and unstable. When it gets here I’m throwing myself a crone party. You’re all invited.
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J.H. Palmer is a Chicago based writer and performer. She earned an MFA in Creative Nonfiction from Columbia College Chicago in 2017, ran a nonfiction literary series called That’s All She Wrote from 2012 to 2017, and her work has appeared in Hypertext Review, Chicago Story Press, and The Toast.