Nina MacNamara Author & Bi-Feminist-Killjoy. Occasionally has something interesting to say. The importance is debatable. Your mileage may vary. Books: "Icarus" and "A Bitter Spring"

How to Avoid Getting Pregnant in the United States, Part 2

For how this started, read part 1.

The day of the surgery arrives. I have to bring someone with me, so I bring my partner, M. M is incredibly brave because they 1. Hate hospitals and 2. Are an incredible hypochondriac who is still afraid of catching COVID. (This surgery was perfectly scheduled at a lull between Alpha and the Delta variants. My timing couldn’t have been more perfect.) We are both fully vaccinated.

Speaking of perfect timing, I appear, wearing my N95 mask, at the check-in desk at exactly 9:45am, which is the time I was instructed to be there. I’m proud of how punctual I am. The medical assistant behind the counter gives me a tiny form to fill out that comes with two numbers: one is the place I’m supposed to sit in the waiting area, and the other is the number corresponding with my place in surgery. I can track the latter on the tv monitor above but the former doesn’t make much sense. In fact, the medical assistant comes out and tries to tell M and me both that we are sitting in “the wrong spot” and to move to another, which just confuses us. While we’re standing around trying to figure that out, another medical assistant calls my name and invites me back for more paperwork. 

This paperwork is all administrative: my name, address, phone number, point of contact, point of contact’s phone number, etc. She asks me if I have an advance directive (yes!) and if I brought it with me (no!). She checks my ID and insurance card and then asks for payment. More on this later. The whole thing takes about 5 minutes. When I’m done, I go back out to the waiting area, thinking I’m going to sit for a long time, but the medical assistant behind the counter is there telling me it’s time to go back to pre-op. 

M asks: “Do you want me to stay here?” 

I say: “I’d like you to come back until they wheel me in.”

M agrees to go back with me. The entire time, I know they’re thinking about MERSA, the Flu, and, of course, COVID. 

We follow the medical assistant through the heavy doors into the dim, yellow-tinged pre-op rooms. I’m enthralled by how quiet and calm it is there. There are a handful of nurses and other staff on board. I smile behind my N95 mask and give them a wave and they wave back. This is my first surgery other than LASIK on my eyes 8 years ago (fully awake for that) and some dental work about 15 years ago (also fully awake for that). I don’t know what to expect.

My medical assistant points to some lockers in a nearby wall. “We’ll store your belongings here for you,” he explained. “Or you —“ he points at M, “—can take them with you. But if you leave them here, we’ll make sure you have them when you wake up.”

When I wake up. It dawns on me that I will be put to sleep very soon. 

There aren’t a lot of people in pre-op, probably by design. I pass by one closed room and one open room with a woman sitting on a bed, anxiously paddling her feet over the side. The medical assistant leads us to my pre-op room at the very end, a comfortable but sterile – no pun intended – little space with a couple of monitors but nothing too scary.

“These,” he says, holding up three packages, “are for you to clean your legs, your torso, and your arms. This gown,” he picked up the dressing gown, “needs to be open in the back. “Here are some socks for your feet. There’s also a heated blanket because it gets cold. But first, can you give me a urine specimen?”

Lucky for him, I’ve had to piss since I got there. “I sure can,” I say. I can give him an entire cocktail. Does he want salt, too? He can make a margarita. 

Gross. I’m going to leave that one out of my set. Nervous Nina isn’t funny.

After taking care of that, I go back to my room and start undressing. M helps me place my clothes — I’m in a cute, hot pink Lilly Pulitzer dress and blue JCrew flats; I am not going to go in and out of the hospital looking like shit — in a bag the hospital had set aside for me while I wiped down my legs and stomach. Just before I put on my gown, I hear a knock on the sliding door — my pre-op nurse is here. 

I quickly throw on my hospital gown and let her in. As with all nurses and doctors who would come into my room that morning, this nurse asks me the same round of questions: name, date of birth, and reason for surgery. All of them seem impressed that I knew the medical procedure name, too, rather than the more colloquial “getting my tubes removed.”

“I bet you’re here to start my IV,” I guess, watching her rifle through some medical equipment. 

“Yep,” she declares. “How are you feeling so far?”

“A little anxious. As soon as I walked into this room, it all became real.”

“Don’t worry, everything’s going to be fine,” she assures me. “You’re done having children, you’re doing the right thing.”

M and I look at each other. “Yeah, something like that,” M says.

The nurse laughed. “Or, you’ve decided not to have children. Either way, you’ve made the right decision.”

I wonder if now would be the time to tell her I wasn’t anxious about my decision, just anxious about being put under and having a catheter shoved into my urethra. I decided to hold off on that. 

After my Q and A session, the nurse starts my IV. The only sip of water I had that morning was at 9am, just to take my medications. So my veins are tiny and she has to slap my hand a bit. I look away, but the woman is a pro at inserting IVs. Aside from the initial stick, which barely registers, I don’t feel anything. 

“This is the worst part,” she says. “Once you get past the IV, you’re in solid shape.”

“It’s really the catheter that freaks me out. That’s going in and coming out while I’m under, right?”

She laughs and assures me I’ll be asleep the whole time that business is going on. I tell her that she has calmed me significantly and I’m no longer a bundle of nerves. She gives me some mouthwash to rinse out my mouth, and I peel back my mask to swish. She also gives me a pair of massaging wraps that will prevent blood clots while I’m in surgery. “It’ll be like a spa day for your calves, but only while you’re unconscious,” she concludes. 

Before leaving, my pre-op nurse turns on the heated blanket. It’s a paper cover with a little vacuum hose attached to it, allowing the paper cover to inflate and warm at the same time. The hose can also cool the blanket down, too, but in a chilly hospital, who would want that? I cuddle beneath it, and wonder if I can buy this in Skymall. 

Thirty minutes or so after my pre-op nurse leaves, I meet my anesthesiologist. He’s a man that’s all business: straightforward, all facts, no bullshit. He’s a bit intimidating, but he’s polite and answers my questions without being condescending (“Does the anesthesia hurt my arm, or my whole body? How nauseous will I get? How long until I fall asleep?”) He looks in my mouth and has me say “ahh” — I think this is to see what my throat looks like and what size/shape of the intubation tube he’ll need to fit down my gullet. He only stays for a few minutes and I thank him for his time.

At this point, the anxiety comes back in. I’m not allergic to any known medications, but I have epilepsy. What if it turns out I’m allergic to one of the sedation medications? What if I have a seizure during the surgery?

M tries to reassure me. “They know right away if you have a reaction. You’ll be fine.”

I get quiet. I don’t want to talk. I’m afraid if I do, I might start crying. 

Time passes. My surgeon/gynecologist comes by about forty-five minutes later to say hi. I introduce her to M and tell her I’m ready. “Shouldn’t be long now,” she says. “We’re getting the room prepped.” 

A few minutes later, I hear banging outside my room. The door slides wide open. They’re ready to wheel me out. 

This is it.

A new nurse, my OR nurse, comes in. She reads off the questionnaire again (“we want to make sure we have the right patient,” she explains,). She helps me put my hair into one of the hair coverings and asks if I’m ok. 

“Let’s do this,” I tell her. 

She lets M and I say goodbye. M tells me to “be nice to the nurses,” and I’m affronted. I’m the nice one! My OR nurse wheels me through the other set of huge doors. 

“So,” I begin, “what happens if I’m allergic to the anesthesia?” 

She chuckles. “Don’t worry, we’re all trained every six months in protocols. You’re in very good hands here.”

“Ok,” I breathe. “I trust you all. Thank you.”

The OR nurse is the best — tranquil and serene, reassuring. She tells me about the monitors and the lights. She asks me if I could hear music (Hall & Oates “You Make My Dreams Come True” was on when she wheeled me in). The nurses are all chatting and chuckling, keeping the atmosphere light and easy. 

The minute we wheel back into the theater, I go into Polite Nina mode: hello, excuse me, thank you, please, pardon me. Remember, I’m the one on the gurney, here. My feet accidentally brush another nurse and I apologize. When I slide over to the operating table, I warn everyone and apologize for my rear end that is currently exposed due to my open hospital gown. Everyone seems to get a kick out of my self-deprecation. Polite Nina is a hit. Taking her on my tour.

“Can you tell me what we’ll be doing today?” another nurse asks.

“Bilateral salpingectomy,” I respond on cue. 

“Wow, do you work in health care? Because those are EXACTLY how we want those questions answered!” 

When I move over to the hospital bed, things get a bit intense. A blood pressure cuff tightens around my free arm while my IV arm suddenly gets bound down. I think I may look a bit panicked because my OR nurse says, “Here, let me hold your hand,” and I readily take it. 

“So what are you doing this weekend?” someone asks me.

“I’m going to relax and recuperate,” I respond to the ceiling. My surgical mask is off and I don’t even realize I’m speaking without it. “Oh wait, no — my doctor said I needed to get up and walk around. So I’ll be doing that. Probably take my dog on a walk. She needs to lose some weight.”

Someone else laughs. “It’s good that you’re listening to me,” came my gynecologist’s voice. “And that poor dog!”

The room starts to blur. A tidal wave of pure, calm delight washes over my body. “Ohhh…” I gasp. “I feel that…”

“Feeling relaxed?” Yet another nurse asks me. 

“Yes,” I mutter. “Is that the cocktail…?”

“Cocktails will make you relaxed.”

Ohhhhmygaaaawdd…” This is the afterglow of an orgasm without any of the work to get it. 

I lay back, without a care in the world, still holding my OR nurse’s hand, drunk off the Jesus Juice they snuck into my IV when I wasn’t looking. A loose breathing mask slips over my mouth and nose a second later. “Take a few deep breaths, sweetie,” someone suggests. 

I inhale. “A few…” 

And your girl was out

I woke up to another nurse, my post op-nurse, asking me if I was feeling nauseous. 

Here’s where my memory is a bit patchy. As I woke up, I remember him spoon-feeding me applesauce with an OC in it. He brought me a ginger ale and crackers1 for the anesthesia nausea, which was minimal but evident. I didn’t throw up or anything, but I did feel dizzy and groggy. 

At some point, M appeared to help me to the bathroom. I got to take a look at my three new incisions: one under my belly button, and two about an inch north on either side of my pubic bone. My gynecologist had mentioned the possibility of putting the third or possibly a fourth incision just above my pubic bone, but that thankfully didn’t happen. I’m symmetrical and that plays nicely with my OCD. 

Unfortunately, I could not pee this time around and wound up just sitting on the toilet in frustration. Nothing burned or itched, which meant whoever inserted and removed my catheter was a pro, or my urethra happened to be in good shape. After some time on the bowl, I asked M to help me up and wobbled back to the room.

The nurse told me urinating wasn’t necessary for discharge, but walking was — so I had to walk around the post-op area once to see how well I could do. M tied my gown (“Sorry about my butt,” Polite Nina would have said, but Groggy Nina just harrumphed) and I started the trudge. 

When I completed the journey — woozy, but steady — my nurse said I could get dressed and go home. 

The nurse gave me a pair of adorable, boy-short style underwear and a sanitary napkin (some rearrangement of your reproductive plumbing will result in some slight spotting for a few days) to wear home. The sanitary napkin notwithstanding, I wish the boy-shorts were more than one use because they were comfortable and cute. I wore them under my Lilly Pulitzer. Then he wheeled me out to the parking deck, which was right outside the pre-op rooms. This hospital is fancy, but constructed a bit like the Winchester House.

M and I drove home. I rested my hand on my bloated and sore belly. The seatbelt stretched right across the bottom incision. I asked M to brake gently. 

When we got home, I eased onto my chaise lounge — the one piece of furniture in the house I regret buying because 1. It was an expensive, emotional impulse buy and 2. Only the animals sat on it for the longest time. Now, I’m grateful for its presence. As I sat back against it, Roland, my big orange male cat, jumped up with me. I cringed, waiting for him to try to get on my lap, but he took three sniffs of my antiseptic-soaked legs and made an ewww face. Then he runs off. 

I feel rejected. 

“Are you hungry?” M wondered. 

I hadn’t eaten anything all day except for the applesauce and four crackers and peanut butter. I know M is starving. But I’m not in the mood for anything. I volunteered to nibble on a few Chicken N’ a Biscuit crackers, but mostly I just want to stare at the tv for a while. The residual anesthesia made me very drowsy. 

I wound up leaning my head back and just conked out for two hours with one hand curled tightly around the tv clicker. Roland eventually jumped up and slept against my head and I didn’t even notice. 

M plopped down next to me to wake me up for dinner. We had soup and more crackers. I used the bathroom again with M’s help (not very dignified, but I’m not having the easiest time bending). We watched a few more things on YouTube and Netflix before I tap out for the night. It was a long day and I needed to go to bed. 

I had specific orders from my doctor: 

  • Don’t pick at the patches and glue on my abdomen. They’ll come off on their own or she’ll take them off in our next visit
  • Rest, but don’t rest too much. Get up and move around to prevent deep vein thrombosis (blood clots)
  • Pelvic rest for the next two weeks. That means no tampons, no douching, no baths, and no (ahem) intercourse. I was fine with everything on this list until she got to the latter. Sensing my hesitation, my doctor emphasized, “None.2

The first two days of recovery were strange. The pain in my abdomen was minimal. I expected a lot of cramping and aching, but for the most part I had swelling and bloating — a “gas baby” that I couldn’t hide or fart out. And speaking of gas, my right shoulder, some of my collar bone, and my right side ribs ached from the laparoscopy inflation. That ache stuck around for about three days, but had dissipated by Monday. 

At the end of the first week, most of my bloating was gone and I could bend again. However, brushing against my bandages stung a lot. At one point during the week, Phoebe — my other cat — jumped on the chaise next to me and put her paw on my right incision. I tell myself this was because she wanted to sit on my lap but maybe she’s secretly evil and wanted to see me yelp in pain. Off the chaise she went. Don’t worry, she jumped back up ten minutes later because she forgot/did not care. 

Two-and-a-half weeks later, I went back to the doctor to get my bandages removed. My belly button and right incision had almost completely healed (despite Phoebe’s meddling), but my left one needed a few more days with a smaller bandage. 

My doctor said to her nurse: “Get me the silver nitrate.”

If you know what’s coming, please do not spoil it for the other readers. If you don’t, I’ll keep this short and as pleasant as possible: silver nitrate burns. A lot. At best, it feels like a match put out on your skin. At worst, well — it feels like someone lighting a gasoline fire on an open wound. The good news is because my incision was hardly an inch across and my doctor is an expert, silver nitrate did not burn as bad as it could have. 

“Are you ok?” she asked me.

“I’m fine,” I said, clenching my jaw. “Stings a bit, but I’m good.”

I handle pain pretty well. Maybe it’s the red hair. Or maybe I’m just a freak.

She applied a newer, tinier bandage to my left incision and said it would come off in a few days on its own. Other than that, I was free to resume my normal activities. 

Some of which I, um, already had3

A month and a half has gone by since the surgery. I’m at 100% capacity now and have been for a while. I’m pain-free and tube-free and have zero regrets. My abdomen has three small scars to show for it which will fade in time. 

The best part is that I no longer have the burden of pregnancy. It’s a weightlessness I don’t recognize, but one I’m already enjoying. The other day, I volunteered to help change my nephew’s diaper. It was the first time I’ve ever changed one before, and it was a bomb. Basically, the kid’s ass exploded. He’s a fussy kid when he gets his diaper changed, too, so I wasn’t going to have an easy time of it, either. But I powered through it and took it in stride. When I was done, I washed my hands and felt a sense of pride wash over me: I changed a diaper! And it wasn’t that bad! I mean, it was horrible and shitty, but I survived!

But immediately following, I got the feeling of, this will never be my life, and I’m ok with that. I was certainly ok with it before the surgery, but now it was final. My friends and family members could have all the babies they wanted and I could be happy for them at a comfortable distance. If I felt any regret, it was that I didn’t do this sooner. I had final word in my reproductive decisions, and that word was no

My body; my choice. 

Sidebar: While I completed part 2 of this entry, I got an interesting surprise in the mail: a check from my insurance company. 

Remember when I first arrived at the hospital and had all that administrative crap I had to do before they took me back to pre-op? One of the things I had to do was pay for the surgery. The woman offered me a choice between paying in full or paying in installments. Because I was still convinced that I could reason with my insurance company, I chose to pay half. When the bill arrived in the next week, I would call the insurance company and begin the arduous task of fighting it. I paid, had the surgery, and went home to recover. 

Then I waited for the bill. And waited, and waited, and waited. But it never came. 

One evening, M and I checked my insurance’s online statement to see if there was an issue. Perhaps they did send me a bill and it never got to me. I can never predict what insurance companies are going to do (or not do). There was a message in my statements from the end of July, a month after my surgery, that I hadn’t seen and hadn’t arrived via snail-mail. 

My insurance had credited the amount I paid the day of my surgery back to me. I should have a check in the mail soon. 

“What the fuck?” I exclaimed. 

So in order of events, the insurance company:

  • Mislead me about what form of sterilization it covered and wound up covering my sterilization anyway
  • Required some form of payment the day of surgery. Could I have said, “No, I’m not paying anything today?” Doubt it 
  • Gave me back that money in the end

Don’t get me wrong. I’m happy that my insurance covered everything. I just don’t understand the dance and headache I had to go through first. 

1M wound up not eating anything that day, going on an adventure while I was under the knife and got locked out of the hospital, and finding a bistro in the hospital but being too afraid to eat lest I get out of surgery before they were finished eating. Because of this drama, I let them eat the rest of the crackers.

2Thus began my line of questions: “Wait, we can’t even–?” “No.” “But what if we–” “NO.” “But what if I–?” “NO!”

3Everything in moderation…at first.

Nina MacNamara Author & Bi-Feminist-Killjoy. Occasionally has something interesting to say. The importance is debatable. Your mileage may vary. Books: "Icarus" and "A Bitter Spring"