For the ladies... in office ablation

[proud_canadian]

OK, if I can give you any advice, I would think very carefully about if you want to go through with this.

I had this procedure done 3 years ago, at the hospital, but not in the operating room. It was in a "procedure" room, but we were at the hospital. The doctor inserted something into my cervix the day before to start it dilating, I was quite uncomfortable that night before, it was like very bad cramps. The next morning he gave us a "super advil" to be inserted rectally before we came to the hospital. I say "we" as there were 3 of us having it done that day.

The day of we were given the option of taking an optional "relaxant". Well all 3 of us took it and all 3 of us said we felt nothing different. I don't know if it took awhile to work or what but I remember the entire procedure, yet do remember feeling a bit groggy on the way home.

Anyways, I had the heat kind and everything was fine, just like an exam, until he started the burning. He told me he has to burn for 6 minutes and after he starts, the uterus will clamp down in a cramp. Now, in this day and age, I have no clue why they didn't give us a shot of morphine or demoral,.... or SOMETHING... ANYTHING!!!! The pain was probably the most intense pain I ever had in my entire life. There were two nurses holding me down. I didn't dare move my lower body as I was too worried of it burning something it shouldn't burn, but I found it very difficult to stay still. I really, really wanted the procedure to work, so I tried my best not to complain or let on how much pain I was in, as I didn't want the doctor to rush or anything. But after probably the longest 2-3 minutes of my life I was in excrutiating pain. The nurses tried to help me breathe through it as if I were in labor and then the doctor told me to count. He said if I count to 90, it will all be done. I counted to 90 and was so relieved it would finally stop, but then he said I counted too fast and I had to count to another 25 seconds. I was pretty hysterical crying. I felt pretty violated, because the doctor obviously knew how painful it was going to be, even though he kept reassuring me before hand it wouldn't be bad. There is no reason I couldn't have had something for pain before. Afterwards wasn't too bad. He inserted a tampon into me after the procedure, and told us to remove it after I think 4 hours. I had a lot of cramping until I took out the tampon at the designated time and after that it seemed better. The next day I worked from home, but likely could have gone into work. That was a Friday and by the weekend I was fine and work Monday was fine. Afterwards I leaked this clear fluid (completely normal) for a couple of weeks which was really annoying, as I am not a pad type of girl. The procedure otherwise was fine. Oh and one of the other girls who had it done the same day as me was very hysterical aftewards as well, the other one said it was "a lot worse than she thought" but she wasn't crying. Anyways, I would never do that again, but I think if I'd had something for pain, or even something stronger to make me not "care" what was going on it it could have been more tolerable.

Anyways, as for the procedure itself, it didn't work . I ended up having lighter periods after the procedure (prior they were insanely heavy - like needing to change a super plus tampon every hour 24 hours a day, and very long, up to 14-16 days long), but I ended up having spotting in between all my periods, so I ended up pretty much bleeding every single day. A year later I ended up undergoing a laprascopic hysterectomy and even though I had some minor bladder complications, I found it to be less traumatic for me than the ablation.

The hysterectomy was absolutely the best thing I ever did and I feel so much better physically, emotionally and in general afterwards. I am glad I gave the ablation a try though, I just wish I'd been more prepared about how painful it would be and had pushed for something else to take.

Oh and I did end up having a biopsy in between the ablation and the hysterectomy and the doctor did tell me it would be more painful for me, than for a normal woman because my lining was already burnt. It was quite painful, I was surprised, but it was NOTHING compared to the ablation.

Good luck! Be your own advocate!

 

[MrsPete]

I cannot actually answer your question . . . but I can describe my experience having an ablation in the hospital under general anethesia. My doctor never even mentioned the option of doing it in the office. Probably because I had three procedures done while I was "out", and that'd really be too much for an in-office deal.

In retrospect, I am very glad I was in the hospital, out cold. The doctor never knows what she's going to find once she "gets in there". Case in point: One of my three procedures ended up being MUCH more complicated than anticipated (because once she was inside me, she realized that one of my fallopean tubes was huge and swollen, probably from an infection years ago). My surgery ended up lasting more than an hour longer than expected -- my husband was not at his calmest and best when I finally came out of surgery! Anyway, I'd hate to have the doctor find mid-procedure in the office that your simple procedure is more complicated. I'd rather be in a full-scale operating room knocked out cold so that she's fully prepared to go ahead and do whatever seems appropriate if things aren't textbook.

In contrast to Proud Canadian's experience, I was aware of NONE of the burning. I felt no pain whatsoever, and I knew nothing 'til I woke up in recovery -- I woke up briefly there only because the man in the next bed was in distress and medical personnel were crowding around him. I was completely unaware that they'd had to do more than originally planned. I had no sense of time. Juuuuuust as I wanted it!

Also, I did not wake up nicely (maybe because I was out longer than expected?). I threw up more than I would've thought possible -- this is a common reaction to the ablation. And although I was able to hop off the gurney and walk to the restroom with little help from a nurse, I had great difficulty urinating (they won't let you leave 'til you've "gone"). Even lightheaded and woozy as I was, I was glad to be in the hands of people who deal with post-surgery patients every day -- not the office nurses, even though they're very nice people.

As for the ablation, my results have been ideal. I am thrilled. I was tired and in some pain for 3-4 days afterward, but the pain meds were more than enough to get me through it. On the day after surgery I ate normally, walked around the house without fear of hurting myself, and slept (quite a bit) comfortably. Because I had three procedures, it's hard to say how each one affected me . . . but I think the ablation was the least of them all. The incision on my stomach was the worst.

A few weeks after my surgery the doctor gave me her stamp of approval, and ten months have passed without incident. My excessive bleeding is entirely gone; I haven't even had spotting. My cramps and backache have not returned. As I said, I am thrilled with my results.

In contrast, I have two friends who had ablations, but it wasn't enough. They went on to have hysterectomies. Regardless, I would start with the ablation. If your results are as good as mine, you will avoid that much more invasive, complicated surgery.

 

[MrsPete]

I had mine done in an outpatient surgery center with short term anesthesia. My OB won't do an ablation without the patient or her spouse having been surgically sterilized so we did a tubal ligation and NovaSure at the same time.

My doctor said the same thing. She said that given my age and the ablation, pregnancy would have been very unlikely . . . but IF it were to happen, it would be very, very bad. Life threateningly bad.

Even though the possibility was remote, I didn't want to face the choice of abortion or a threat to my life. Removing any possibility of a dangerous, unwanted pregnancy just made good sense.