It was an out-patient procedure.  In many ways the worst part was having to get up so early, not having eaten, and then hang around while they waited for my doctor, who had some perfectly reasonable excuse for being late.

One interesting moment was when I asked the nurse for a sanitary pad and she said, "Aren't you pregnant?" and I said No.  She became less solicitous.  Not unkind, not at all, but an edge of serious concern and tremendous sympathy disappeared when she realized I wasn't undergoing a possibly traumatic experience of that nature but a lesser one.  She was still very fine, explaining everything very clearly and introducing me to the anesthesiologist and the blood technician, who were also very kind and cheery and full of information.

They gave me Valium and something else with an IV, and explained that this would probably take care of any pain during the procedure, but that if at any time I didn't like what I was feeling I could ask for the anesthesia to be upped.  This would at some point result in my being put under and then the side effects would be slightly more serious and I would probably have to stick around the hospital longer, but I should absolutely do it if I had the slightest doubt.

The hospital was air conditioned and the operating room positively cold, but they gave me a heated blanket and had heating pads on the table.  I felt one cramp, mumbled, "That's like a menstrual cramp," and heard the doctor ask, "What did she say?" and the nurse repeat it for her.

They let my mother, my husband, and my girlfriend wait in the little cubicle they put me in after the procedure, and they gave me toast and peanut butter and tea and orange juice once they ascertained that the IV stuff hadn't upset my stomach.  Eventually they asked me a bunch of questions and let me get dressed and go home, though they insisted I make the trip to the car in a wheelchair.

I had some cramping for the next few days, but actually my body sulked less than it had after my endometrial biopsy.  I was really wiped out, though, and didn't really feel myself until three or four days later. Not unpleasant, but very lethargic.

The lab results came back "Normal" but the D&C didn't stop the heavy bleeding.  I didn't have a polyp, though, so yours may have a better effect.

--  Pamela Dean Dyer-Bennet ([email protected])

You will be given a choice of anesthesia; general, spinal or 'managed anesthesia care' (local anesthetic with sedation).  Most Anesthetists (CRNA's or MD's) prefer spinals or saddleblocks (same thing, just that the saddleblock affects the legs a little less).  If they perform more than 500 blocks a year, go with that, as a general affects your entire body, whereas a spinal block consists of an injection of a local anesthetic into the FLUID surrounding the spinal cord (not into the cord itself).  The choice of the local injected allows the time of action to be controlled from 30 minutes up to over 3 hours.

A general is normally associated with postop nausea and a general tiredness the rest of the day, while the biggest risk from a spinal is the 'spinal headache', which hits maybe 1 in 3000 patients and is minimized by slowly changing positions the rest of the day (if you're lying down and want  to stand, sit first for a minute, then stand up, and the reverse for laying down) and drinking lots of liquids.

After taking you into the OR, you will be asked to move to the OR table and different monitoring devices will be placed onto you (ekg, BP, oximeter). Next theAnesthetic will be done.  If you are cold, ask for more blankets (don't blame the OR crew for the cold, the OR temp is normally set at 68 courtesy of the state public health dept.).  If you feel you are 'too awake', don't hesitate to ask for more sedation.

The actual surgery will take anywhere from 5 to 15 minutes.  The Hysteroscope is a miniature telescope smaller around than a pencil inserted into the uterus to allow the doctor to inspect the uterine cavity and the fallopian tube openings visually and to take photos .  The D&C allows the doctor to remove small amounts of tissue from both the uterine cavity endometrium) and the cervix (endocervical tissue).  While the endometrial biopsy done in the office is a fine procedure, it may miss a cervical cancer unless it is done with a Colposcopy (microscopic inspection of the cervix using special dyes).

When completed, a vag pad will be placed and you will be returned to the OR cart and taken to the post anesthesia care unit (PACU) or recovery room (for us old-timers). You'll stay their 30 min. to an hour, depending on the anesthetic used, then back to the short stay unit for an additional 30-120 minutes.

The worst part will the the 2-4 day wait for the Pathologist's report.  If you haven't heard from your doctor in 3 days, give his office a call and ask about the results.  The doctor will probably contact you before then if the results are bad, but often forget to call with good news. Most patients report having mild cramping and slight pain for 3 to 10 days postop. The majority are able to resume all normal activities ( except nothing going into the vagina for 4 weeks) within 2 days.

Hope this helps,
fredno, BSN, RN