My Story: Laproscopic Tubal Ligation (aka: I got my tubes tied)

Warning: Possible triggers in this Post; Photos of incisions, IVs, and internal organs.

Well, Hello! It's been a minute (more like 3 years)...

I recently had a procedure done that I thought might warrant a blog post; yes, this is a nail blog. I fully realize this isn't really a typical post you would see here. Before I decided to get my tubes tied, I researched to learn as much as I could. I also watched a lot of YouTube videos on people's experiences to prepare myself. My experience ended up being different from a lot of them. This is not due to any pre-existing health issues. As a result, I wanted to put this out there for anyone looking for information and wanting to know what to expect and what can occur. 

Before I delve in, I do want to give an update and talk about why I don't post here regularly anymore. I'm sure none of my regular readers are surprised as my posts had been dwindling down and I did explain as to why that was in those posts. Pretty much the same thing; The job has me working full-time on a 9/80 schedule (I work my 80 hours in 9 days, instead of 10 days); this leaves me with long work days, trying to squeeze in a workout, eat a healthy dinner, and get to bed at a reasonable hour. It's tough to do. My extra day off is typically filled with running errands, vet appointments, grooming appointments, etc. I think you get the point. 

I'm not gonna lie, I miss the blog a lot. I have thought of coming on and posting more but it takes up so much time to take photos, edit them, type up the post, edit the post, etc. that it just becomes too long of a process to manage. Today is one of my flex days (a Friday) and I actually put this day aside to put this post together.

There have been some changes as well; We finally bought our own house and moved into it in late August of 2016. We are very happy with the location, area, and the house. Plenty of room, and space for my nail polish set-up and of course my makeup and vanity table. I would love to take photos and show you the set-up but I still have a lot of work to do in that room; I need to paint and organize things a little better. Some things were also damaged in the move as well. One day I will get there and maybe I'll be able to get back to the blog a little more regularly (that would be really nice).

On Friday, March 29th, at 1:45pm I was on the way to the hospital to have my tubes tied; A Laparoscopic Tubal Ligation. I Arrived at the hospital at 2:00 pm. Admitting checked me in and directed me to Ambulatory Services down the hall.

Lisa in Ambulatory Services went through my medical history and details. Provided me with my hospital gown and booties. Once I was dressed (no undergarments or jewelry) and under a blanket, Lisa hooked up my IV on my right arm/wrist, blood pressure cuff on my left arm and finger monitor on my right hand. I did request to have my IV done on my left arm but she had already set-up everything on the right. Doing it in my arm crease would have been in the way for the surgeon so she compromised for me and did my arm/wrist in lieu of the back of my hand. I had never had an IV before (at least that I could remember) so I was pretty anxious about it but she did a great job. I get queasy just thinking about an IV on the back of the hand. 

But check out them cute Saint Patrick's Day nails though...

My husband was there with me and would be staying there at the hospital during my surgery. I was required to have someone drive me home due to the anesthesia. The actual procedure of clamping off the tubes only takes about 7 minutes but the preparation takes longer. They have to get you on the operating table, hook up monitors and arrange equipment around you. Then of course you have to be fully anesthetized, a breathing tube is inserted, and the surgical area is cleaned and prepped. Initially, I was told that my surgery wouldn't start until 5:00 or 5:30pm so I was expecting to sit there for quite awhile. While my husband and I waited in my room, I could feel my anxiety starting to build up and I started crying. Not sobbing but tears were just running down my cheeks. I don't have experience with surgery; I had my lazy-eye corrected when I was 4 years of age, but other than that, NOTHING. Never had a severe injury, broken bones, no hospitalization. The risks are very minimal with this procedure but I was starting to get very scared the longer I waited. Luckily, I was wheeled to OR for staging at 3:30pm. Once we started moving I felt a little better. As long as it was progressing, it was closer to being over, and that's pretty much my goal at this point. I'm looking at that light at the end of the tunnel. 

My anesthesiologist, Dr. Rabe, went over my chart with me, and then the OR nurse (didn't get her name) went over my chart with me. Everyone in the hospital was excellent about verifying my name, date of birth, and the procedure I was there for. I walked into the OR Room and got on the very narrow operating table. It was very cold and I began shivering right away. My anxiety was peaked at this point and tears were flowing from my eyes. There were two very large lamps above me; reminded me of the lamps dentists’ use but on steroids. Monitors were taped to me; 2 on my upper chest, 1 on the left side of my ribcage. My arms were placed out at my sides and were secured. Weighted mats were placed over my body. The nurses were talking to me letting me know everything was OK. The anesthesian let me know she was giving me a medication to help me relax via my IV. She placed an oxygen mask over my mouth & nose and told me to breathe deep. She then advised me she was administering the anesthesia; it would burn a little as it entered my vein. I remember feeling the burn for 30 seconds, I thought of my husband & dogs. I heard my doctor, Dr. Guha ask if I was out yet. I closed my eyes and that was it.  

I awoke at just a hair past 4:30 pm as I was being lifted from the OR table and placed in my recovery bed. I remember I was dreaming about makeup (LMAO) and I felt like I slept really well. I mentioned that to the nurse who was next to me and she said ‘I hear Tramadol is a really good anesthesia.’ As she smiled. I noticed a clock on the wall and while my vision was blurry, I could still make out the time. I felt really good. I was happy to know that the procedure was done. I felt immediate relief and was smiling. I came out of the anesthesia really well; the nurses even commented that most people don’t come out that well. There was an oxygen mask over my nose and mouth and I was told to breathe deeply to help expel the anesthesia and the carbon dioxide. I requested to sit up and I was asked about my pain level; I said ‘4’ but I probably should have said  ‘6’. I was given a very low dose of a powerful painkiller, can’t remember the name of it. After a few moments I felt a little drowsy and I felt the pain improve but it was still there. It felt like a constant dull cramp. I was also hella thirsty and my throat felt really dry (no doubt from the breathing tube). I was asked again about my pain level and I said ‘2’. I asked for another pillow to better prop my head up. Shortly after that, I was wheeled back to my regular room where I could see my husband. As I was being wheeled out of the Recovery Ward, I noticed a heart on a dry erase board; it was done the way I draw my hearts, which I started doing when I had my forever dog, Otis. It felt like a sign that she was watching over me.

Back in my patient room, the nurse from Recovery showed Lisa my bandages and told her to keep an eye on the lower one; it was seeping a little so they marked it with a black sharpie so they would be able to see if it continued to do so. a heating pad was placed on my lower tummy. I began to feel sleepy (the nurse who gave me the pain medication in Recovery told me it might make me drowsy). Lisa brought me some ice chips and then 10 minutes later I got some water. I was in the recovery ward for less than 30 minutes when she asked if I wanted to go home. Of course I responded with an enthusiastic 'YES'. There's no place like home.

The lower incision on March 31st; it had bled a little right after the proceedure.

I was able to get dressed in my own clothes; I had worn comfy clothing there; the looser the waist band, the better. Lisa got me a wheelchair so she could wheel me out. I felt like I had to urinate but when I sat on the toilet, I couldn't. I was told I should pee within the next 6 hours and if I didn't, to call my doctor's emergency line. They also provided me with prescriptions for pain; Tylenol with Codeine and 600mg Ibuprofen. On the way home we stopped at the drugstore to get them filled. It took about 20 minutes and I carefully walked around and checked out the clearance makeup (what?!? LOL). We then headed home.

At home I set-up on the couch with pillows, blankets, and lot of water. My mouth and throat was still very dry and scratchy. My throat became increasingly irritated and sore over the next 48 hours. I was drinking a ton of water. I was instructed to eat something light like soup after my procedure but I continued to eat soup because it felt good on my throat. Ice cream too. I was propped up because laying flat felt uncomfortable and it was difficult to get up from that position. During the procedure, they pump air (carbon dioxide) into your abdomen so they can get your intestines out of the way. The air pushes them down and that way there is a clear view of the fallopian tubes and they can easily access them. I was told to expect pain in my shoulders as a result of the air but I didn't; I just felt incredibly bloated, uncomfortably so. I wanted nothing more than to void my bowels and pass gas. I finally urinated later that evening and it wasn't painful, but it did feel odd. I didn't have a bowel movement until the following night. It took a few more days before I began to pass gas and I was so happy when I did. The relief was very welcome. When my bladder would get full, my guts would hurt and once my bladder was empty, it would feel like my guts were bruised. Very odd feeling and it lasted a good 2 1/2 weeks. 

I had a difficult time sleeping; the cramping was pretty bad and I woke up several times during the night. I was taking the Tylenol with Codeine initially but it was only a 4 hour pain pill so I started taking the Ibuprofen in the evenings to try and sleep through the night. I also had to pee a lot from all the water I was drinking. I tried sleeping flat in my bed the second night and I had a hell of a time trying to get out of bed. It hurts to engage your core muscles and you don't realize how much you use them to right yourself out of bed. My husband had left to go to the store so I had to take my time and find a way to do it on my own. Sleep was difficult until Tuesday (the 5th day); then I finally slept better, only waking once during the night to urinate. I finally started to feel better, not 100%, but better. I was under the impression that I would feel better much sooner because all the info out there says 24 - 48 hours down time for recovery but in all honestly I didn't want to go to work on Monday & Tuesday. Be aware that you might need to take additional time off.  

Going to work on Monday was much more difficult than I had expected. I was still sore with cramping (my guts felt like they had been kicked) and bloated. I showered the night before and I had bandages that had waterproof tape so I could take a shower but I wasn't supposed to soap up the area. I was instructed to leave the bandages on until my post-op appointment the following Friday. I had to find some pants to wear to work that would not bother my stitches as well, not an easy feat. I ended up wearing some wide-leg linen pants with a stretchy waistband. I only had 2 pairs so the rest of the week was challenging too. I wore some long stretchy skirts. My cramping lasted a good two and a half weeks. I was cleared to start working out after my 1 week post-op appointment but it was very uncomfortable to run for 3 weeks. At 4 weeks I would sometimes feel the scab in my belly button poke me when my waistband was on it. The lower stitches were tender to the touch only; sometimes if I leaned on the kitchen counter it would be right on the lower stitches and it would hurt. 

The Consultation: 

When I met with the surgeon for the first time, a pap smear was done and I had to sign a consent form verifying that I had taken at least 30 days to 'think on it' and that I knew the procedure should be considered permanent. 

Because I had done a ton of research; I knew there were different methods for Tubal Ligations. These are some of the most common used today:

Electorcautery, The fallopian tubes are burned shut and sometimes a piece of the fallopian tube is removed to ensure the tube does not grow back. This was the method that I originally thought would be done for my surgery.

Filshie Clip, A titanium clip is clipped onto the fallopian tube to create a blockage. Originally, I didn't want foreign objects in my body, but once my doctor had a visual of my pelvic organs, he found that I have a fibroid. Electrocautery can irritate fibroids and create complications so he ended up using filshie clips for my procedure. 

Hulka Clip, a soft pliable plastic clip.

Falope Ring Band, a silicone band that is placed at the bottom of the looped fallopian tube.

There are a few other methods, but from what I have read, they are not widely used anymore because they have been found to be either problematic or ineffective. 10 years from now it will be interesting to see what new methods are being used.    

Initially, my surgeon was not going to go over the method so I actually had to bring it up. Once I asked the questions, he was forthcoming with the information. I think some people don't actually want to know what will happen, but I'm someone who wants to know exactly who, what, when, and where. I do best when my expectations are set and I know what to expect. In my case, my doctor explained there would be two small incisions; one practically in my belly button, and the other just above the mon pubis hair line. A scope is inserted through the incision in my belly button. The other incision is used for a probe and the filshie clip applicator. They use a sheath so it is easy to swap these instruments and load the filshie clips. I actually found lots of YouTube videos where they show actual footage from these procedures and you get a view from the scope. It might be difficult for some people to view them but after watching a few, I found my uneasiness go away. It was very interesting and I'm glad I watched those videos. 

My surgeon asked about any existing health issues, my medical history, allergies to medications or latex, and prescriptions I was taking. He asked why I wanted a Tubal Ligation and if I had any children. He didn't blink when I told him I didn't have children or that I wanted to simply get off birth control. He simply notated it in my chart. He did not request my husband's consent or ask if I discussed it with my husband. In all honestly, I find that very odd. I think spouses should be involved in these situations, not necessarily required to consent, but I do think that it's important to verbalize the importance of discussing a permanent procedure like a Tubal Ligation with your spouse. I'm sure doctors have a lot of liability in these situations so I fully understand why they would avoid that discussion. However, if we are talking about doing the right thing, then I think a patient should be encouraged to talk to their spouse. 

My procedure was scheduled two weeks out. Yes. That's how quickly this whole process was moving. I ended up getting bronchitis so I has to push my procedure out two more weeks. 

Pre-Op Appointments: 

My pre-op appointments were scheduled for the Wednesday before my procedure. 

I had to go to my surgeons' office to watch a video on Tubal Ligations (once again emphasizing that it is a permanent procedure). The video was much more in-depth in discussing the risks, which are actually very minor but they wanted to make sure that I was fully aware of the various risks and possible complications. I also signed some more paperwork that told me how to prepare for the day of surgery; basically don't eat or drink 10 - 12 hours before the surgery (depending on your anticipated surgery time), don't wear any makeup, wear loose clothing, have a designated person there to drive you home, and do not bring valuables to the hospital.  

Then I had to go to the hospital pre-op appointment where they take my vitals and have me sign more paperwork. This paperwork went over consent for the surgery and pain management. They use a numerical rating scale for pain.

Then, I had to go get blood drawn so they could do one last blood panel screening. They are also looking to make sure that I'm not pregnant.

I ended up having to do this twice; the first time was super quick and I got through all of my appointments real quick. Then, I started to realize that my bronchitis would not be resolved in time for the surgery so I had to cancel. The doctor had been really hoping that it would work out but I was coughing like crazy. The 2nd time, each appointment took extra long. I'm not sure why either since I had already gone through it once before.

Post-Op Appointment:

My post-op appointment was scheduled for the Friday after my procedure (which was also on a  Friday).

April 5th: After removing my bandages at my post-op appointment.

My doctor had me remove the bandages and told me I could have removed them sooner (I was told to leave them on til the post-op appointment). He glanced at them and said they looked good. I mentioned that I was still cramping and not quite feeling 100%, he said that some people take a little longer to resume to normal. This is also when he notified me that he used filshie clips for my procedure and talked about my fibroid. He provided me with some photos as well. I'm not gonna lie, I was super excited to see the photos. I asked if my procedure was recorded too but it was not. They only record if they are using it as an instructional aid. He showed me my ovaries, my fallopian tubes, the fibroid, and my uterus.

Upper Left: Showing the fibroid, uterus, and the right fallopian tube with attached filshie clip.
Upper Right: Showing another angle of the fibroid, uterus, and the left fallopian tube with attached filshie clip.
Lower Right: My left fallopian tube moved to show my left ovary.

Misconceptions & Social Media:

I've seen some things shared on social media in regards to women's reproductive health rights; specifically I have seen women accuse the government and/or health care providers of violating an individuals right to a tubal ligation. This was not my experience. I also think that there were probably other factor's involved as to why these individuals did not get what they wanted at that moment. There are good doctors and there are bad doctors. An individuals perception can also be skewed when in an emotional state. There are also a lot of highly controversial beliefs that some individuals want to pass off as fact floating around out there.

My personal experience in talking to my doctor about the Tubal Ligation and the process to get scheduled was very easy. My general practitioner didn't bat an eye and my referral to a surgeon was done in days. The surgeons office called me right away, before I even knew the referral was authorized, to schedule my consultation. My appointment was set a week out; super quick. My surgeon is an older gentleman and at no point did he 'paternalize' me on my decision.

Here's an article from Snopes (which, ironically, is supposed to be an organization that fights misinformation): https://www.snopes.com/news/2018/10/19/requirements-women-seeking-get-tubes-tied/

They use bias, not fact, to direct the spirit of the article. If you read carefully you can actually see that they discuss the factual requirements after creating a very strong bias. They also breeze over the fact that you need to take at least 30 days to consider all aspects of the procedure due to the brevity of the procedure.  Are you really seeking a permanent form of birth control? Are you aware of the risks associated and willing to accept them? More and More women are reporting issues with Post Tubal Ligation Syndrome. While it hasn't been medically proven, I would still educate myself on it; you just never know.

Here's another article: https://www.reference.com/government-politics/legal-age-women-tubes-tied-2a7f83487aaf5223

"Patients still run the risk of complications from surgery, and the procedure may not even work. Many doctors feel that long-acting reversible contraceptives are better for patients."

I think that's actually not a bad thing to consider. Now, if you have used other forms of birth control and they didn't work for you, then I can see eventually getting to a point of a Tubal Ligation. Also, if you have health issues that you don't want to run the risk of passing onto children; a Tubal Ligation could give you a very secure format of birth control so you would never have to worry about getting pregnant. I had a few close calls (but they were more than enough for me) and I know how stressful that can be.

I see a lot of discussions about Reversals; it's become very trendy lately. You see announcements of successful Reversals more and more these days. It's creating a false flag in a way because now if the doctor tells a patient it's permanent, the patient still believes it can be reversed because they see people having successful reversals on the internet and social media. The reality is, a reversal is a difficult, much more invasive, procedure. There is a very low success rate. Reversals are very expensive because most insurance will not cover it. 

Age is definitely a factor when considering a Tubal Ligation. Many women who have opted to do a Tubal Ligation in their 20's have had regrets (just look at the increase in talk about reversals on social media). It's incredibly difficult to make a lifelong decision in your early 20's than it is to make it in your mid to late 30's. Things change quickly in only a few years and you could decide that you do want children or more children.

I've never been a 'kid' person; I've never had that strong desire to be a parent. I'm plenty maternal when it comes to my dogs and my husband, but the desire was never strong to have children. Even in my 20's I knew not to assume that I would never have children because things change and I never felt like I needed to essentially 'jump the gun' and get it done right away. There are so many options out there to practice birth control that it seems like over kill to automatically just jump right to a Tubal Ligation. As life changes we make adjustments as needed.

April 19th: 3 Weeks Post-Op.

6 Weeks:

Yesterday was my 6 week mark. The belly button incision is healed and the scab is gone; I only have the red scar left. The lower incision is still there and crusty. The stitches have begun to dissolve but are still there. It's pretty red but I've been told it's healing fine. Doesn't bother me, I've almost forgot it's there. I haven't had anymore cramping. I haven't felt any more emotional since going off my birth control. I took my last birth control pill on April 14th; I decided to finish the pack out. On April 17th I started spotting and had my first menstrual cycle; I did have a rough week sleeping, not sure if it is related to the procedure or something else. My flow wasn't bad at all; typical 7 day cycle. Some spotting, normal flow for me, and then end spotting.  

I'm quite happy with my decision; it is allowing me to move forward with some other things I need to focus on. I have had some moments that have made me feel at ease with my decision and I realize it took a little pressure off of me. It's like 'Ok, you made a decision, and it's the right one for you, so let's move forward.'. I have no regrets on not having kids. Today is National Dog Mom Day and I am quite excited about it; I spent the day with my pups and husband and there's no place else I'd rather be.