celebration post - new doctor, great consult!

Hi all!

Since I came on here to complaint about my terrible consult, I wanted to share some good news: a positive consult! I ended up getting rescheduled with one of the female doctors at the practice, and it was fantastic. I'll write down my notes from the consult here just in case anyone else is curious and likes to compare notes (some of it will be repetitive if you've done a lot of research like I have):

  • Just to note how different this consult was from my last: asked me how long I've known I didn't want kids, was very understanding as I went over my childfree "history" (I guess I'll call it that). She said they are seeing 30-40% increase in patients requesting their tubes tied since roe v wade. She said as long as I meet the age requirements by insurance and state law, understand the permanency/risks, any woman should be able to get their tubes out.
  • She really walked me through how tubal ligations have evolved and why the bisalp procedure is the best (lowest risk of ovarian cancer, least risk for pregnancy) procedure out of the sterilization options.
  • These are the notes I have on the procedure itself:
    • 5-10% risk for ectopic pregnancy if the procedure fails
    • If we change our minds on getting pregnant, IVF is still an option (albeit expensive and not guaranteed to work)
    • recommends no heavy lifting, no soaking in anything, no sex for the first two weeks. (I know a lot of people say they recover quickly, but I was very happy that my doc didn't insinuate I should be up and running within a matter of days!) Says most of these activities are fine in week 3, and at a maximum, week 4.
    • 3 big risks with any surgery: bleeding, infection, damage to surrounding structures. Damage to surrounding structures has the highest risk at 5%, and the biggest areas of concern is damage to the pelvic walls and the ovaries.
  • Things I asked my doctor that I thought were helpful:
    • How long is the surgery (1 hour for prep and actual surgery)
    • Can I keep a picture of the tubes (yes)
    • What are the stiches like (sewn internally, then layered with medical grade glue)
    • What medications are in my IV (anti-nausea, 2 pain meds, stool softener)
    • What else will be inserted into me (catheter, uterine manipulator, breathing tube)
    • If you can't access my tubes, what would you do? (this is super helpful because everyone is different and there are rare instances where doctors can't reach the tubes due to organ placement. You should discuss with your doctor if this scenario comes up, would you be OK with clips or something else?)
    • Most common side effects? (cramping, discomfort, appetite may be decreased, may experience pain from gas, may experience anesthesia side effects like nausea, bleeding, spotting)
    • Rare side effects she's seen? (just allergies to adhesives/glue, but if you're OK with bandaids, you should be fine)
    • I asked some questions about scar tissues: How much scar tissue you make depends on your own body, but laparoscopic surgeries have the lowest risk for scar tissue. I wanted to know about the risk as I've heard some people on this sub comment that scar tissue can cause some pain during periods.
    • I asked about damage to the ovaries:
      • occasionally I'll see anecdotal stories of women who felt like they changed after the surgery. Most times this can be explained by stopping their birth control, but there are still some people who did not stop birth control at the same time as their surgery. I usually see a lot of comments dismissing these people's experiences, but as someone who suffered from a rare complication and wasn't believed by my doctor/others in the past, I don't like brushing these stories off, so I asked about how these could happen.
      • Based on my research and conversation with my doctor, it could be because of damage to the ovaries, which there is a low risk (5%) of.
      • The blood supply of ovaries is slightly impacted - the tubes and ovaries share less than 5% of their blood flow. the majority of blood for the ovaries comes from the pelvic wall. In a younger patient, assuming that the ovaries are not damaged from the surgery, there should be no impact to hormones. For someone who is older and closer to menopause, they could start having hot flashes.

My feelings have been like a rollercoaster throughout this process. At first I was stressed about scheduling anything, then enraged about my last consult, soooo anxious before my good consult, relieved at how well the appointment went, then nervous about the permanency of this decision! I'm not questioning my child-free ideology but really just mourning a version of me who, when I'm 35, won't have the choice to give birth. While I have been thinking about this surgery for 3 years, it does just sadden me that my decision and the timing is heavily influenced by politics. But it doesn't change my mind about my decision - and I've had several moments where I have recognized that this surgery will make me feel more at home in my body, so my uterus doesn't feel like a weapon against me. It's also initiated some conversations I've never had with my partner (who has a vasectomy), like what we would do if we ever changed our mind and wanted kids. I feel myself growing more excited as the days to my surgery date (edit: was 1/7 now it’s 2/4) approach.

Sorry, used this a bit like a diary. I am feeling so many things, lol. If you had a bad consult, please continue trying to find a doctor! I wish you all luck no matter where you are in the process!