shell's tired of waking up tired

So, that was a week.

Tuesday was a middling day, not too terrible, not fantastic. Started taking the birth control pill Tuesday night--the first of 4 doses to be every 12 hours instead of every 24--and by Wednesday it was already helping decrease the bleeding, so that was good.

Unfortunately, I had an incredibly crappy night Tuesday night, and after taking my second pill, spent the day exhausted, nauseated, and just generally feeling like shit. Fortunately I had my meds assistant there for clinical, because I wasn't really up for doing much with the students. I was also fielding numerous emails from my mom wanting to know details of what was going on, plus basically telling everyone in my family I didn't actually want any of them to call me to wish me a happy birthday, because I was planning on taking a nap as soon as I got home (which was the time they were planning on calling).

I started to feel a little better Wednesday night, and panisdead brought me a cake--made with my mom's recipe, otherwise known as THE BEST CHOCOLATE CAKE IN THE UNIVERSE, and I will fight anyone who tries to disagree and hung out for a little while, so that was nice (and pretty much the only thing I really enjoyed on my birthday).

I slept well Wednesday night, and Thursday I actually had some energy and was able to enjoy clinical, mostly, although I am still SO BEHIND on my grading. I was very pleased to find out that a) if I had the procedure and stayed overnight at the hospital, I'd be staying on the floor where I've had clinical for 8 years, where everyone knows me and would take really good care of me, and b) everyone on that floor sang the praises of the radiologist I'd be seeing, saying she was very caring, concerned for her patients, safe, thorough, etc. Which was a huge relief, because trust me, the nurses who work with physicians are really the ones you want to consult to find out if someone's a good doc or not.

Also, my students brought in cupcakes and cake for my birthday (on Thursday, because they didn't know about it until Weds.). So that was super sweet.

Thursday night I again didn't sleep well, but got up in plenty of time to head to my 11:30 appointment at the radiologist's office. Got there around 11. Found out I had to pay for parking. Found out I had a $100 co-pay. Found out I was getting an IV so they could do contrast. Found out they were running late and I wasn't going to have time to go grab lunch or a snack or anything. Talked to one tech, a paramedic, who was interested in the mobility program. He started my IV but contaminated the site, sigh.

All the people I dealt with were extremely pleasant and tried to make me as comfortable as possible, despite the wait. I finally got called back to go into the MRI around 12:30, an hour after my original appointment. They gave me earplugs, which helped, and thankfully I am not claustrophobic. I was in the machine for a while (no watch, so who knows; they told me it was about 20 minutes before they injected the contrast, then another 10 after the contrast). Then I met with the guy who works with the radiologist and coordinates everything, going over my history again. Then the radiologist came in.

She was wonderful. She asked how I wanted to be referred to (as in, "Professor" or whatever), and when I said my name, told me to refer to her by her first name as well. She spent about an hour with me, maybe more (I'm not sure exactly when she came in as my watch was still in my purse), going over my MRI results very thoroughly, answering pretty much all the questions I had before I even had a chance to ask them, and making me extremely comfortable both with the decision to go ahead with the procedure and to have her as my physician for it.

The scoop is, I have 3 fibroids, one of which is encroaching pretty significantly on my bladder and another of which is very close to impacting my sciatic nerve. I also have some adenomyosis, which is some ectopic endometrial tissue in the muscle layer of the uterus. Because of where the fibroids are, my endometrial lining is all kinked instead of being in a nice flat line--she said it was like my menses had to traverse a bunch of mogels to get out, which is why my bleeding has been so prolonged/severe (the adenomyosis also contributes to the heavy bleeding). As long as I am still perimenopausal (as opposed to post-menopausal), the fibroids will continue to grow, and the birth control pill also means they'll continue to grow while I'm using that for the bleeding. She was surprised I haven't had more bladder-related symptoms given how much it's already been impacted.

There's also the matter of my blood pressure, which was WAY up when they checked it (at least 20 minutes AFTER the MRI). I remembered that it seemed like it was creeping up during the last year or two I was on the pill before, and that's a concern with the pill (plus my mom has hypertension, so). Like, my BP on Monday was something like 110/70, which is about what it's been the last couple of years. The first time they took it on Friday it was 142/92. The second time it came down to 132/74 or so, which--okay, it's good that the diastolic came down 20 points, but the systolic was still borderline high. I guess it's possible some of it could be due to the situation and/or getting the contrast, but the doc and I were concerned enough about it that I agreed to keep checking it regularly (easy enough to do while at work).

Anyway, she agreed that it was okay to not schedule the procedure (uterine artery/uterine fibroid embolization, which will also help with the adenomyosis) until after the end of the semester, because that really is the best time for me. But if my symptoms get worse, including if I have to go back off the pill because of BP, we can always move it up. Our final exam is May 12th, and the procedure's scheduled for the morning of May 14th. I'll spend that night in the hospital and go home the next day. Then I'll take it easy over the weekend (although I can still do some stuff, including drive) and probably be back to normal within a week or so. She wants me to take a baby aspirin before getting on the plane in June, which is really just being extra cautious considering I'll be a month out from surgery at that point, but that's okay. Probably wouldn't be a bad idea for me to start doing that anyway, given that being on the pill also increases your risk of blood clots.

She also gave me a big hug when we were done :-)

The pill is just--gah. I don't know if it's my age, the fact that I had to take extra doses for a couple days, the combo with the stress and the contrast medium and everything else, but it's been doing a number on me. I've been on this exact pill at this dose before--for a few years, even--but I've never felt this crappy on it. Nausea, mostly, although I had a headache that woke me up in the middle of the night (resolved with tylenol and ibuprofen), and I had some major diarrhea last night (which I think might have maybe been from the contrast, even though it's a very rare side effect), and I am SO TIRED. Thursday's really the only day this week where I had much in the way of energy. I mean, yes, I am a LITTLE anemic, but really only a little.

Anyway. That was my birthday week, which, as I pointed out to Sara on Wednesday, was only the third worst birthday I've ever had, woohoo! When I blew out the candles on the cake she made me, I wasn't even sure what to wish for until she suggested wishing that the next decade was awesome, which, yes, I am IN FAVOR.

Like, seriously, a lot of my forties sucked, y'all. So even though I don't at ALL feel like it's even POSSIBLE that I could be fifty years old, here's hoping the 50s are an improvement.

Tonight I am going out to the Melting Pot with friends, mostly from the ACL, to celebrate. Hopefully my stomach will enjoy the fondue as much as I would normally. It's way the hell up north of McNeil, but every restaurant in a more central area I checked was booked up, both because there's something happening at Bass Concert Hall tonight and because I didn't actually feel comfortable making reservations until yesterday afternoon (and I didn't get home until almost 4 pm; thank you, Austin traffic). Hopefully it won't be too horrible driving through downtown to get up there tonight (currently Google says 38 minutes, as opposed to the 25 it would take if there wasn't much traffic).

Anyway, today I have so far NOT BLED FROM MY UTERUS, so that's a good thing.