Diary of An Auto-Immune Survivalist - The Hemorrhage

Blood poured from my vaginal canal and into the toilet. Clots of blood slipped out of me like a chain of fat beads that plopped into the water below. Reaching my hand beneath my seated tush, I caught one of the warm bloody clumps and brought it into view. It looked like a thick slice of beef liver, larger than the palm of my hand. The frail red mass separated into pieces as it dropped back into the toilet’s bowl. Hurriedly, I pulled a hand towel from its hook and put it up, in-between my legs. Shoving the towel into my vaginal opening, I applied as much pressure as I could as a desperate measure to slow the blood flow. My panic grew. I squeezed my thighs together to hold the towel in place.

Hopping through the apartment, bent over, trying to keep my towel from shifting, I hoped that the blood would not spill onto the floors. I reached my bed stand, snatched up my phone, and hot footed it back to my seat on the toilet. I pulled the towel away, causing coagulated globs to be dragged out of me by the force of a fresh flow of slick blood. Weak and shaky, I pressed the numbers 9-1-1 on my phone, the buttons were tacky from the blood still drying on my fingers. My thumb paused and hovered over the send button, as doubt gave rise to a mutiny inside my head. Hypochondriacs call ambulances, but a normal person calls their doctor, my reasoning stretched. If my experiences over the last few years had taught me anything, I had learned that a panicked approach to my problem would not get me help in the hospital ER. The blood clots continued to slip freely out of me as I searched out the number in my phone’s directory and pressed the send button. A moment later I was speaking to my gynecologist’s office secretary.

“I would like to speak to my doctor, please,” I said, trying to hide the tremble in my voice.

“Name and birthdate,” she said.

I quickly answered the routine question.

“One moment, please,” she said.

A hospital advertisement praising the benefits of an anti-anxiety medication played through my phone’s speaker, as I waited. The pleasant and promising tone of the actor’s voice suddenly flipped to a rapidly paced race through a list of multitudes of possible and terrifying side effects. To my relief, his peroration was interrupted by a ringtone. There was a sounding “click” as my gynecologist’s voice rang out, “how can I help you?”

“I’m hemorrhaging,” I told her. “I can’t get off of the toilet, I don’t know what to do,” I said, carefully checking the tone of emotion in my voice as I tried to persuade her to help me.

The doctor listened.

“The blood clots are the size of my fist,” I added. Fear sunk into my chest, I imagined that I may have offended her. Wondering if any words had slipped out of my mouth that made me appear as if I were diagnosing myself. I knew my place; I was supposed to let her make the diagnosis.

There was a long pause as I waited for her to answer.

“I don’t think that we’re the type of doctor that you need,” she stated, in a flattened tone.

There was silence as I pondered what I had said wrong, and what she had said to me. I didn’t get to prepare my defense, as the phone had turned itself off. She had hung up on me.

Two months earlier, I had put in a request at my doctor’s office for a referral to see a gynecologist. My Physician’s Assistant agreed that it would be good, as part of our overall plan to rule out any gynecological cause for my lower abdominal pain. I hadn’t visited a gynecologist since I had my bi-lateral tubal, in 1995. My periods were heavy, like Niagara Falls, and the worst of my pain would often flare up around the same days of the month. I welcomed the idea of a new perspective. The appointment was scheduled, and several weeks later I was sitting on the exam table in the gynecological room, befuddled by the words coming out of the gynecologist’s mouth.

“My father, as he was declining into dementia, would tell me all about these overwhelming feelings of doom that he would have,” she said, rolling the hem of her latex glove downwards, then tugging at the rubber fingers to pull the glove off.

“But, it’s not the same,” I said, appalled that she was comparing my 3AM episodes of exploding nerve pain and convulsions to her geriatric father’s experiences with his deteriorating mental health. I was bent over, supporting myself with one arm and massaging that arm with my other hand. I was exhausted, weak, and had difficulty holding myself upright for lengthy periods.

“So, have you considered making an appointment with a psychiatrist?” She sat down and peered at the computer screen on her desk. “Oh, I see, your ultrasound results are in.” She squinted her eyes as she read the report, using her ungloved hand to scroll with the computer’s mouse. She then smiled, as she slouched into her chair. Her seat swiveled in my direction, allowing her to look directly into my face as she gave me the news. “Everything looks great, there’s nothing wrong with you.”

Chronic pain had caused my jaw to lock, for years, and I was forced to speak through my teeth. “They couldn’t find my right ovary,” I said.

The doctor turned back towards her desk and leaned her face in close to her monitor. Squinting her eyes tight, she concentrated her efforts on reading the test results. “I see,” she said. “It looks like it might have been hiding behind an organ or something. We should schedule another internal ultrasound.”

My muscular system clamped tight as she mentioned the internal imaging device. They called it a wand, but there was nothing magical about it. The ultrasound technician had used it as a weapon, pushing it up against the inside of my vaginal canal with enough force to cause me concern that she might puncture through the walls of my flesh. Pressing the wand upwards, towards my abdomen, the technician pressed the palm of her hand downwards, against the wand. It felt more like an assault than health care. The pushing and pressing and digging went on for too long, as she searched for that right ovary. It was hiding, alright, but I doubted that a second session of torture was going to coax it into making an appearance. I’ll pass on that, I thought to myself.

“And it looks like you will have to schedule another biopsy of your cervical tissue. The results were non-conclusive,” she tapped away on her keyboard, typing in personal notes about my own body, that I will never be privy to.

Now, I imagined that she was trying to frighten me away. The wand was a pleasure compared to the scraping knife that they called a curette. I had never had one of these biopsies performed in my entire life, until this past week. I would have skipped the ordeal if I had been aware that they were going to slice and remove the top layer of my cervical and vaginal cavity. I could still hear the noise it made, like the scraping sound of a lunch meat slicer on its thinnest setting. They told me that it would be moderately painful and recommended ibuprofen in advance of the surgery. I should have known better.

The doctor asked me if I wanted to schedule the appointment with her, now.

I told her that I needed to look at my calendar, to see when I was available.

“I see that you haven’t scheduled a mammogram?” The doctor played with the mouse, scrolling up and down.

The inflammation in my body, especially my breasts, made it unbearable for me to be touched by the people I loved, and those who loved me. I could not conceive of the pain that a mammogram might ignite in me.

“No,” I said, “I have not done that.”

“Well, I’m recommending that you do that as soon as possible.”

“And schedule a visit with a psychiatrist,” she added.

I nodded my head. I hypothesized that none of these doctors had ever needed to see a psychiatrist. My son had Asperger; we were on a two-year waiting list for his first appointment. I tried to schedule an appointment for myself, to find relief from my nerve pain with anti-anxiety medication, but there did not seem to be any doctor’s available for people who did not have a severe and immediate need for mental health care. I had been advised to call pain management, and I did, but they said that I needed to have a diagnosis, and a referral.

“Where do I go from here,” I asked.

“You won’t need to come back,” she said. “Your General Practitioner should be able to continue your care from here.”

“But what about my abdominal pain?” I asked.

“There’s nothing wrong with you. Your ultrasound was unremarkable.”

“But, my pain is real,” I said, squeezing my right arm with the hand that had been massaging it. “I had an abdominal injury a few years ago, I think that’s what’s causing my problems.”

“Call us if you have an emergency,” she said, as she opened the door to the exam room and pointed the way to the checkout desk. “Try to have a nice day.”