Recovery Journal: Six months later

This week marks six months since I had surgery to remove my ovaries and uterus plunging me into surgical menopause. I have had a number of requests for additional details of my recovery and menopause issues so I decided it is time for an update.  Last August I posted three "recovery journal" blogs about the surgery and its initial aftermath.  They can be found here: Part I, Part II, Part III. By a month after surgery I was feeling pretty normal, back into my exercise routine and preparing for the Kickin' Cancer 5k Run, which took place six weeks after my surgery.

A few days before the run I made my post-op trip to see my surgeon and fully expected to be given the all clear to resume normal sexual activity.  But alas, twas not to be.  I had developed a granuloma at the top of the vaginal cuff that needed additional time to heal.  My doctor swabbed it with a medicine that he said would speed healing and told me to return to see my gynecologist in another four weeks.  In the meantime, no sex.  In light of the fact that many women return to sexual activity four to six weeks after surgery, I was surprised by the news that I would be out of commission for 10 weeks.  But once I checked with a few other friends I learned that 8 to 12 weeks is not uncommon.

At 10 weeks I returned to see my gynecologist, who had assisted with the surgery, and was told that the granuloma was still not fully healed but should be sufficiently healed to resume sexual activity.  He also swabbed it with medicine and sent me on my way.  Because my husband would be appalled if the details of our bedroom activities were posted on the Web I am afraid I will have to leave out the graphic stuff.  Suffice it to say that all was not smooth sailing and I found myself back in my doctor's office two weeks later because intercourse was painful and resulted in increasing amounts of blood each time.  The granuloma had not healed and the scab that had formed had rubbed off resulting in pain and bleeding.  This time my doctor swabbed two different medications on it but because the wound was raw,  this was painful.  We waited a week and tried again: less blood but still painful.  A few weeks later I was back in my doctor's office looking for solutions.

The last time I saw my gynecologist every three to four weeks I was pregnant and the visits were fun, an opportunity to hear the baby's heart beat and measure how much I had grown.  Now, I was unhappy and looking for solutions to a complication I had never heard of until it happened to me. I told one friend that if I had known this was going to happen to me I would have hung on to my ovaries for a few more years. At my December visit my doctor's face mirrored my disappointment when he walked through the door.

"Still?" he said.

"Yes."

The granuloma, however, was almost fully healed and no longer likely to be the sole source of my problems, although he did paint it with the medication again just for good measure.  Then we talked about what happens to vaginal tissues without enough estrogen: lack of lubrication, lack of elasticity, and thin tissues that can tear easily and bleed.  We talked about the pros and cons of various lubricants (yes I had a variety on hand and yes, we had been using them liberally) then we turned to the issue of estrogen.  I am using an estradiol patch at a moderate level, which we could increase, or we could try targeted estrogen in the vagina, which would not raise my circulating estrogen levels but should dramatically improve the vaginal tissues.  My other menopause are under control; no massive hot flashes although I don't sleep as well and I often wake up hot, not melting just warm enough to be uncomfortable and awake.  We opted for the last solution and I left with a package of Vagifem tables to use twice a week.

The good news is that with the dawning of 2011, things seem to be steadily improving; not great, not what they were before surgery, but good and improving.  Many women I know have said that it takes a period of adjustment to "a new normal" and that was certainly the case after my mastectomies.  Somewhere between six months and a year after surgery my sex life was as good as before the surgery. Different, but equally good.  I expect the same thing will happen with this surgery; sometime over the next few months I will become totally comfortable with the "new normal."

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