Question for the Ladies... tubal ligation

[I*heart*MickeyMouse]

I was not referencing the procedure itself, but the GENERAL ANESTHESIA. Talk to any anesthesiologist and he/she will give you the risk of cardiac arrest or stroke on the table. It's a lot higher than 4 in 100,000...

There is a baseline risk. Then, for every pound a person is overweight, that risk goes up. For every health condition (known or unknown) that person is dealing with, the risk goes up.

The bottom line is, being put to sleep is dangerous. No matter what procedure is being done.

http://www.anesthesiaweb.org/risk.php
"
Chance of dying as a result of general anesthesia alone = somewhat less than 11-16 deaths per 100,000 persons, depending upon general health of the persons (0.01-0.016%) (Lienhart 2006, Arbous 2001).

Chance of dying as a result of pregnancy in the USA or Western Europe = 5-10 deaths per 100,000 live births (0.005-0.01%) (Chang 2003, Hill 2001).

Chance of dying due to complications resulting from the operation of removing the womb (hysterectomy) = 120 to 160 deaths per 100,000 operations (0.12-0.16%) (Bachmann 1990, Loft 1991).

Chance of dying due to complications resulting from the operation of removing the gallbladder = 150 to 1400 deaths per 100,000 operations, depending upon health and technique of operation (0.15-1.4%) (Feldman 1994, Hannan 1999).

Chance of dying due to complications resulting from the operation of removing the large bowel for cancer = 800 to 5000 deaths per 100,000 operations, depending upon health and technique of operation (0.8-5.0%) (Nelson-2006).
This is a wonderful illustration of how public opinion, socio-cultural factors, and rumor determine perceptions. Most women who are to undergo a hysterectomy are not at all afraid of the most deadly procedure - the operation - yet they are scared out of their wits by the thought of general anesthesia, the least deadly of these two things! Furthermore, these women were ecstatically happy during their reproductive lives when they discovered themselves to be pregnant, a condition whose mortality is comparable to that of general anesthesia. They were happy with pregnancy, but afraid of anesthesia. "


These stats are found on many different sites, and my uncle - a surgical nurse for 30 years - has assured me that given my health, age, and history he forsees no problems with me waking up from general anesthesia.

My best friend is ALL UP MY BUTT about getting this surgery done, and she is misinformed as well. She's excited about giving birth in January, yet she doesn't "get" that her child birth is more risky than my going under. My mother had a hysterectomy, and she came out just fine. My sister in law had her gallbladder removed, she came out just fine. And the hysterectomy and the gall bladder surgeries were all way more risky than someone going under.

These are all personal experiences that I am taking into consideration as well...

 

[brymolmom]

But OP, the difference in all those statistics, yes, while scary, is that in (I am assuming here) every one of those other scenarios of surgery - there is NOT a safer, non-surgical alternative. I guess that perhaps there might be herbal remedies in some of the cases, but I would guess their effectiveness is not the same as, for example, removing the gall bladder. THAT is the difference those of us on the other side of the fence are seeing staring us right in the face. It's apples and oranges. If a safer alternative existed, I would guess that many, MANY people would choose it over risking the numbers you posted here.

And to keep bringing childbirth into this discussion is strange to me - it's a no brainer, every parent I know would risk their own life for that of their child's. I don't get how it's in the same category.

 

[I*heart*MickeyMouse]

But the alternative - a vasectomy - IS NOT AN OPTION... so there is no other option here for permanent sterilization except a tubal ligation.

(well except for the Essure, which I have to look into, sounds good but kind of a new thing so I've got to talk to the doctor as well about it, so for the sake of this particular discussion, there is no other option...)

 

[MaumeeMom]

PARTIAL...

I am sorry you are in constant pain (from a tubal?) and I welcomed every single piece of advice pertaining to the tubal.
...

Yes, from complications stemming from the TL.

Again, if I knew ahead of time what would happen, I would never have done it. I would gladly abstain for the rest of my life than have the pain that I have. If there is another option, I hope you explore it (and I'm not just talking VS).

I apologize if I misunderstood but you really came across as belittling people who had contradicting opinions from yours. Believe me, I am not misinformed about the procedure.

Good luck!

 

[I*heart*MickeyMouse]

Yes, from complications stemming from the TL.

Again, if I knew ahead of time what would happen, I would never have done it. I would gladly abstain for the rest of my life than have the pain that I have. If there is another option, I hope you explore it (and I'm not just talking VS).

Good luck!

I'm sorry, I can't imagine being in the kind of pain where I'd say that I'd abstain for the rest of my life to get out of the pain Like I said, I am going to research more about the Essure (online/talking to my doctor) and I'm going to find out more about how SHE does the tubal. I haven't had a consultation with her, I just mentioned it quickly at my last pap when she told me that there would be no more birth control pills once this prescription runs out (I just asked her the basics - do you get put under, will insurance cover it, will you do it or someone else in the office...)

Do you mind if I ask what method your doctor used? From what I've read the patients who have the "burn" method are the ones who are more likely to have complications and pains. The next biggest complications group are women who had the clips/buckles and were allergic to the materials.

 

[arihillfarm]

I'm sorry, I can't imagine being in the kind of pain where I'd say that I'd abstain for the rest of my life to get out of the pain Like I said, I am going to research more about the Essure (online/talking to my doctor) and I'm going to find out more about how SHE does the tubal. I haven't had a consultation with her, I just mentioned it quickly at my last pap when she told me that there would be no more birth control pills once this prescription runs out (I just asked her the basics - do you get put under, will insurance cover it, will you do it or someone else in the office...)

Do you mind if I ask what method your doctor used? From what I've read the patients who have the "burn" method are the ones who are more likely to have complications and pains. The next biggest complications group are women who had the clips/buckles and were allergic to the materials.

PLEASE do your research on PTLS. For many women, the only relief is to try a tubal reversal which of course is not covered by insurance. My mother had a tubal right after I was born and by the time I was 11-12 years old, she had had at least 2 D&Cs that I know of because of very heavy period bleeding and lots of pain, none of which were a problem before the TL. By the time I was 15 (which has been now 22 years ago), I was helping her recover from a full hysterectomy and she'll be on expensive HRT for the rest of her life. It's now thought that disrupting the blood flow to the fallopian tubes is what causes the issues surrounding PTLS although the why is not yet known.

I've been doing a lot of research on this since I'm on my fourth pregnancy and hopefully third live child due in March 2011. I WILL NOT take a chance on getting pregnant again as it's getting harder and harder on me at my age. I also will not get a TL because of the risks involved for both the surgery and the prospect of living life with PTLS. DH either gets a VS or he gets nothing, if you know what I mean...

-Astrid

 

[I*heart*MickeyMouse]

LOL Astrid!!! I know what you mean

From what I've read about PTLS (again, I'll talk w/ my doctor about it) it's most common in women in their 20's/early 30's, and also very common in women who have been on the pill for a long time before getting the tubal. Being that the pill regulates their periods and often lightens them, they don't know what their real, non-birth control pill- normal period cycles are like... The pain that some have appears to be contributed to using the 'burning' method (can't think of the medical term), and if the tube is burned in a few places and close to the ovary.

I obviously need to speak with my doctor more in depth about this (my list of discussion topics is long LOL!) and I need to assess my risk level...

I'll keep you and your baby in my thoughts and hope that when March comes around you've got a new little bundle!!!!

 

[bas71873]

OP, my OB recommended the Essure procedure. It's done in the office, one day of recovery and is permanent. I was scheduled to have it done but had my appendix rupture. After 2 weeks in the hospital 4 weeks after giving birth to a preemie in the NICU, I sent my hubs to the doctor! Figured I'd done enough already.

I would have no reservations about getting the Essure procedure. My friend had it and was back to work that afternoon. You can google it.

MY OB just mentioned this procedure to me this week and gave me a pamphlet to read. I haven't broached the big V subject with DH yet, but in the past, when I've joked about it, he's said no way. His very own sister is the product of a V gone wrong....33 years ago, but still.....that concerns me a little.

I am going to look into the essure a little more and then we'll make a decision. Need to check with my insurance about all this too!

 

[RMulieri]

I have had a couple of abdominal surgeries, and I will pass onto you the most helpful advise I was given; lay flat as much as possible the first couple of days.

Especially if you start hurting. Most of the pain is from gas, due to how they do the surgery. It can be a "crampy" feeling or it can radiate from the small of your back up to your shoulder blades. Laying flat relieves the gas pressure. Saved me from having to use a lot of pain meds. Worked for me.

Best of luck with your decision. I had a tubal years ago...think hubs should "take one for the team".

Actually laying flat all the time can lead to postoperative pneumonia, blood clots etc.We tell our patients as soon as they are awake to get up and get moving.Blood clots and pneumonia are 2 of the BIGGEST post op complications that occur the most.Less of an issue with Lap tubals, but not unheard of.

 

[RMulieri]

MY OB just mentioned this procedure to me this week and gave me a pamphlet to read. I haven't broached the big V subject with DH yet, but in the past, when I've joked about it, he's said no way. His very own sister is the product of a V gone wrong....33 years ago, but still.....that concerns me a little.

I am going to look into the essure a little more and then we'll make a decision. Need to check with my insurance about all this too!

Back in the Day vasectomies had a higher incidence of failure.Now not as much...In short , they now snip, cauterize and titanium clip .Whereas before they didn't.Even now ,those few oopsies are more of not having and using an alternate birth control until the 3 month mark when they get checked to make sure there are no "survivors".I remember going with DH and the Dr pretty much told me that now, it is alot HARDER to reverse a V, but not impossible.

 

[I*heart*MickeyMouse]

My friend is pregnant with TRIPLETS - a huge huge huge "oops" because her husband had a vasectomy last March!!! OMG I'd die. LOL! Triplets! Wow!

But yes, there is a very very low "oops" rate with V's nowadays, especially if you heed the warnings and use backup method for 3 months.

eta - because I KNOW someone's thinking it - my friend's oops has no bearing on my dh's being afraid of the V. She's an online friend and he doesn't know her or about her story.

 

[tlbwriter]

My friend is pregnant with TRIPLETS - a huge huge huge "oops" because her husband had a vasectomy last March!!! OMG I'd die. LOL! Triplets! Wow!

OMG... that one failed with a vengeance!

 

[brymolmom]

My friend is pregnant with TRIPLETS - a huge huge huge "oops" because her husband had a vasectomy last March!!! OMG I'd die. LOL! Triplets! Wow!

But yes, there is a very very low "oops" rate with V's nowadays, especially if you heed the warnings and use backup method for 3 months.

eta - because I KNOW someone's thinking it - my friend's oops has no bearing on my dh's being afraid of the V. She's an online friend and he doesn't know her or about her story.

Actually a BIG one with V's and success/failure is following up on the follow-up testing....Many men opt not to do these (something about the whole cup things freaks them out I think). And almost ALWAYS people who have 'oops' babies after V's did NOT go back for their 1 month and 6 month follow-up tests to measure the # of sperm in the semen. As long as you follow all instructions as stated, it is almost 100%.

 

[I*heart*MickeyMouse]

Actually a BIG one with V's and success/failure is following up on the follow-up testing....Many men opt not to do these (something about the whole cup things freaks them out I think). And almost ALWAYS people who have 'oops' babies after V's did NOT go back for their 1 month and 6 month follow-up tests to measure the # of sperm in the semen. As long as you follow all instructions as stated, it is almost 100%.

They followed all instructions... Vasectomy in march 09, follow ups as required (1,3,6 months i think) and she got pregnant feb 10!
Absolute total fluke and even they say they would do the V again if they had a re-do... Because it WAS such a f'd up fluke lol!

 

[Carl Fredricksen]

I am a dude and just went this week for a consult for the Vas. going to be snipped in a few weeks. Going to have it done and when it is over, I am still a dude, still producing testosterone and all. Sexual functions will still be the same, less a few million swimmers.

The procedure for the man vs women, is outpatient vs inpatient, local anesthesia vs general anesthesia(all the way out) and recover time is 2-7 days vs several week(not sure exactly how long) Cost is probably less, mine is just $15 with insurance.

Not sure why your man is unwilling or if he is scared of losing his man hood. Not trying to sound gruff, but overall it is easier on everyone and he still can beat his chest.

I agree. I had a vas 8 years ago, and am glad we went that route. Was in the office for 20 minutes, and no problems right after or since. Cost me the $20 copay, and was easy enough I drove myself home after. That is the right way to go IMO. Much less invasive procedure and no recovery to speak of.

 

[mapmakerj]

I am confused why your Dr won't let you stay on BC pills. My current OB/GYN and my previous one both said that as long as you are healthy and do not smoke there is no reason to stop taking the pill after 35. Both said that as long as there are no underlying medical conditions a woman could safely stay on the pill right up to menopause. In fact, that is the current information given out by the OB/GYN's at the Mayo Clinic.

 

[moparop]

We looked long and hard into our options after our daughter came along. She was also a surprise and I had just assumed that I would go ahead and do TL because she was a planned c-section. I have three good friends who had TLs done in the past 2 years and all were on the pill to regulate their periods post the TL. I was doing the TL to avoid this! I got to talking to my mom who had a TL done at 40, also had the same problem.

I've also read about the Essure. My SIL had one done shortly after she delviered baby #5. Baby #6 is 2 years old. She did all of the testing post procedure that you are supposed to do and it came back clear.

Long story short, we have done nothing on the subject yet. Good luck OP!! I hope you and your OB figure what is going to work best for your family!

 

[RMulieri]

I am confused why your Dr won't let you stay on BC pills. My current OB/GYN and my previous one both said that as long as you are healthy and do not smoke there is no reason to stop taking the pill after 35. Both said that as long as there are no underlying medical conditions a woman could safely stay on the pill right up to menopause. In fact, that is the current information given out by the OB/GYN's at the Mayo Clinic.

Because there are some studies that are now linking BC use past age 35 with increased incidence of cancer.So some Dr's are being cautious.My OB did the same thing.

 

[marcemc]

We looked long and hard into our options after our daughter came along. She was also a surprise and I had just assumed that I would go ahead and do TL because she was a planned c-section. I have three good friends who had TLs done in the past 2 years and all were on the pill to regulate their periods post the TL. I was doing the TL to avoid this! I got to talking to my mom who had a TL done at 40, also had the same problem.

I've also read about the Essure. My SIL had one done shortly after she delviered baby #5. Baby #6 is 2 years old. She did all of the testing post procedure that you are supposed to do and it came back clear.

Long story short, we have done nothing on the subject yet. Good luck OP!! I hope you and your OB figure what is going to work best for your family!

I was very irregular before I had TL. A couple of months after the procedure my periods started being more and more regular, so in my case, the surgery help me.

I agree with you, it's all about what is the best choice for each family. We are all different, thank goodness there is more than one choice.

 

[I*heart*MickeyMouse]

I am confused why your Dr won't let you stay on BC pills. My current OB/GYN and my previous one both said that as long as you are healthy and do not smoke there is no reason to stop taking the pill after 35. Both said that as long as there are no underlying medical conditions a woman could safely stay on the pill right up to menopause. In fact, that is the current information given out by the OB/GYN's at the Mayo Clinic.

There are studies out there now that indicate a potential link between using BCP's past 35 and cancer. I am healthy and do not lead a sedentary lifestyle, but my OB is very cautious when it comes to BCP's and prefers her patients over 35-36 to use alternative form of BC. She does prescribe it to women for whom the benefits of pill outweigh the potential risk. She also told me if I REALLY wanted to I could go to my GP and she'd probably continue prescribing it to me, but it would be against her recommendations. I trust my OB over my GP on this issue. My GP is the nicest woman in the world, but the majority of her patients are elderly and she likely doesn't read the kind of journals and studies that the OB does...

I don't mind having to come off the pill. I've been on it for such a big part of my life that it would be nice to be just me, as far as hormones go.

Good luck moparop making your decision. I haven't done much research yet into the Essure, but it *kind of* makes me nervous, having something inside my body that god didn't put there. I tried both IUD's (hormonal and copper) and both of them my body rejected... not sure if rejecting the Essure is something that can even happen but that's a concern for me.