I’ll keep my uterus | Lifestyle.INQ

OCTOBER 27, 2022

Everybody should know: Any spotting, no matter how slight, from a postmenopausal woman my age, is worrisome. But who to call? My own OB-GYN passed away recently; it was she who, in a routine test many moons past, first spotted the lone endometrial polyp in my uterus—a growth attached to the lining of the uterus, not in the uterus itself, and that supposedly makes a world of difference.

Her advice, after a pap smear and a mammogram cleared me, was to observe it. In fact, she told me that if, after three consecutive “normal” pap smear tests, no sign of a certain virus (HPV in medical code) was revealed, I wouldn’t even need those yearly checkups, but in two- or three-year intervals instead. I think at that point I stopped the checkups altogether.

No one quite like my wise old conservative OB-GYN. She continued holding clinic until a few months before she died, in April, in her mid-80s. My daughter and I would have continued seeing her until we got a sign that we should go to a younger one.

She must have been in her late 70s when I took my daughter to her for a posthysterectomy checkup she had herself performed. She looked momentarily puzzled when no uterus was revealed. “Oh,” she remembered—she had taken it out herself—and now remarked, “We should have done a tummy tuck, too!”

I never saw another OB-GYN until five years ago. A friend referred me to a young female gyne-urologist for what might be bladder issues. In the course of urological tests, she spotted the lone polyp and quickly suggested a hysterectomy. “Anyway,” she said, “your uterus is already useless. Better safe than sorry.” I didn’t go back, but I’m grateful to her all the same for the cranberry capsules she prescribed
—I never had a urinary tract infection again.

For peace of mind, I consulted my old OB-GYN, although not for anything riskier than a second opinion. She saw nothing about the polyp that called for its removal—or for any hysterectomy for that matter.

“Hysterectomy,” she cautioned, “is still major surgery.”

No malignancy

For the recent spotting, I looked for yet another younger female OB-GYN and found one through a friend. On examination, she declared my cervix clear. When I asked her what that meant, she replied, “No cancer.” She ordered a pap smear and a transvaginal ultrasound and, once those were done, declared, “No malignancy!”

But, of course, there was no hiding the polyp. She ordered not only surgery to remove the polyp but a sort of cleanup operation that would preclude further suspicious growths—D&C in the medical language. She asked me to get a routine certification that my heart was healthy enough for the procedure. That’s when my GP got into the picture—I had no cardiologist.

I showed him all the test results and assured him, after those droplets, the bleeding had not recurred. He wondered about the rush when the tests had proved negative for malignancy. I also learned of a less invasive procedure, polypectomy. My GP himself thought a D&C too invasive and risky at my age.

Meanwhile, he ordered a CT scan of my abdomen for a separate case—digestive issues. The results served as well to confirm that my vital organs, including my reproductive ones, were “unremarkable”—that is to say, nothing remarkable for any alarm.

Until the spotting episode, I thought my gynecological problems were over. I was more concerned about keeping down my cholesterol, sugar, uric acid and weight, through regular exercise and a healthy diet. But I was shocked to learn that aging didn’t spare me from cancer; on the contrary, the older I got, the more vulnerable I became.

No wonder every young OB-GYN I’ve consulted wanted to remove my “useless” uterus, as a precaution. Older doctors seem more reluctant to do any major surgery on someone my age for any reason other than to save my life. I may be more afraid of unnecessary surgery at my age than I am of the possibility of cancer.

I was, however, becoming inclined to compromise on the D&C, until Gia, my daughter reminded me. “Don’t you remember what happened to you when you had one in 1990?”

Onset of menopause

The onset of menopause had been causing me stronger and longer periods. I consulted an OB-GYN, an old and male friend, Gia’s baptismal ninong. And he ordered an outpatient D&C. When I arrived home I collapsed. A doctor friend and neighbor who was with me took my blood pressure—it was nearly zero; in fact, I had a brief out-of-body experience. I was rushed to the hospital.

Gia was roused in the middle of the night to give her mom blood in an emergency transfusion; alas, her donation wasn’t enough. Two of my three sons had my blood type, but one had had hepatitis and the other had come from a party and had too much alcohol in his blood. It was Dr. Higino Laureta’s youngest brother, Tony, who stepped up.

But at no time until the last two OB-GYN consultations was a hysterectomy considered, even if, in my 50s, my uterus would have been as “useless” as it is today.

Is it good practice to surgically remove the uterus of an elderly woman even if she has no family history of cancer and when all tests show no malignancy?

My dad faced a similar decision when my younger brother, Danny, went under the knife for kidney stones in his early 30s. Wanting to kill two birds with one stone, the doctor told Dad while Danny was under sedation that he might as well remove his appendix, which could cause him some problem in the future—on the merest possibility. Dad said no. He didn’t believe any God-given organ useless. Danny has kept his appendix to this day, at 74.

I think I’ll keep my uterus and remove the polyp from my mind.

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