Surgical Menopause

 “Thanks a lot, Dr. Nargis! for being supportive throughout my treatment from day1 of my consultation to my surgery to my post operative care till today.” said Roohi as and when she has been asked to put the comments, as a feedback on Google page of her gynaecologist, 

 and, on the official website of the hospital on the FACEBOOK.

 But, actually, this wasn't the first time or the single time that the latter had expressed her gratitude. MANY TIMES would also be an inappropriate, incorrect way to measure the intensity of thanksgiving. But, certainly, THE-NO-OF-TIMES Roohi must have visited her gynaecologist or phoned her would give an accuracy to describe it.

Roohi still remembers the day when she actually visited the gynaecologist that she searched on- the-internet on Google with 4.3 stars rating for the Multi Super Speciality hospital---Columbia Asia Hospital in Panchsheel Park, New Delhi and here she got her name under the women's health care section on the hospital’s website that showed the picture of Dr. Nargis, with her mild, soothing smile, along with her phone no next to the calling icon for an appointment, along with the areas of skills, she specialized in

LAPAROSCOPY! GYNAECOLOGIST! HIGH RISK PREGNANCIES! MENOPAUSE.

Though, there were other numbers and names of doctors enlisted under the gynaecology department, but Roohi chose to dismiss others and opted to get go with Dr Nargis as her name was placed on the top, secretly, wishing and praying to God --"All should go well" in her treatment with the same doctor with no further change, or no further confusion.

Then, on the following morning, at around 9:30 am, worried, troubled and tense Roohi went to meet Dr. Nargis and waited in OPD, in front of room no--15 till quarter-past-ten, till the doctor reached there. And, on the basis of first- come- first- served theory, obviously, her name was being called first for consultation.

Troubled by her illness, by the disturbed quality of life Roohi told all physical problems clearly in detail, she's been going through all these past days. At the same time, the nurse checked Roohi's vitals.

Her, body temperature--98.4 degree F

 blood pressure--110/70 mmHg

pulse rate--88 per min

weight-- 73 kg

And, then, Roohi has been asked to lay down on the bed for an examination.

POST- EXAMINATION, back to doctors table, 

As Dr. Nargis busily writing the tests, Juhi noticed the warmth, the care and the politeness in her new gynaecologist’s words as she spoke gently and softly to her patient. Roohi started feeling safe now.

"Roohi, I wanna diagnose the disorder. So, go for all these tests.”

CBC( Haemogram)

HbA1c

Liver test

TSH, FSH

URINE ANALYSIS

X-RAY

ELECTROLYTES (NA,K,CL) “and, for an ultrasound.”

USG PELVIS (TVS)

“and get back to me with the related reports so that I can reach to some conclusion.”

"Please , go to counter no--8, for any required details."

And with an introduction with her coordinator-- Miss Janaki, the doctor told Roohi to contact the former for any further assistance.

"And, DON'T WORRY! I'm here to help you, to treat you in the best possible way I can."

" OK ! doctor"

"Thank you, doctor" said Roohi as she left the room, with a relief, with the reminder set by her -- "Atleast, I should feel safe now.”

At Columbia Asia Multi Super Speciality hospital, Roohi didn't have to run errands related to these tests

for urine and blood samples,

for X-ray, for an ultrasound and,

for reports collection.

With all such facilities, related to laboratory,

The drug store,

The cafeteria, etc.

under one roof everything went smoothly, conveniently and on-time and after she had some snacks and tea and after the duration of almost 4hrs, Roohi re-appeared in room no-15, with her entire reports.

AFTER AN INVESTIGATION PROCESS

"So, you are anaemic, Roohi.”

 "Hb--7.1 gm/dl and,”

"You have FIBROIDS, too"

"LONG, BIG fibroids that need to be treated.”

   “and,,

    to be treated urgently." alarmed Dr. Nargis

"You understand what I mean, Roohi?”asked the gynaecologist.

"No, doctor. I don't know about it," replied Roohi in complete ignorance.

but, in-her-heart, wishing to know about it.

"OK! just see here" holding a pen.

"These, fibroids are a common , very common

usually, non- cancerous tumor

 that grows in and on the uterus wall."

" They are generally asymptomatic. "

"But when the symptoms arise, the woman suffers physically, as you are facing now." Dear doctor explained diagrammatically.

" So, am I at risk, doctor?" asked Roohi worriedly.

" Of what!" the physician asked.

"Risk of death.” Roohi lowered her voice.

"No! There is no such danger.”

“As you have large, long fibroids, we'll treat them with surgery.”

 “And, everything will be alright, then.”. The doctor tried to comfort her patient.

"So, what next, doctor?" Roohi asked as if wanted to be aware of her gynaecologist's next treatment plans.

" Roohi, as now, you know, you are an iron deficient, first we need to work on your iron levels."

 "Injectables--, 750 mg of ferric carboxymaltose." the doctor prescribed on her patient's OPD card. 

"And, you can get it from the hospital's drug store, which is in front of room- 20.” suggested the doctor to Roohi.

"And, meet me the day-after-tomorrow for...."

"For this INJECTION? - iron related, car-bo- xylic...." interrupted Roohi to repeat the medical term in her layman style.

"No!”

“for an---ENDOMETRIAL BIOPSY.” corrected the physician.

"But, why this biopsy test, doctor? "

" To examine if there is any cancerous cell or any other cell abnormalities.”

"Yes! Doctor,”said Roohi.

“But, doctor, please do this under complete sedation.”

 “Yes, I'll do it under general ANAESTHESIA..”

 “OK, then”

"Thank you, doctor." said Roohi, as if released from the stress; from the fear of PAIN.

As planned, BIOPSY was being performed on the same day by the surgeon-- Dr. Nargis, following which the nurse injected the first dose of ferric carboxymaltose as was being instructed, and Roohi was discharged on the same day in the evening along with the sheet summarized with the instructions;

with the medicines; 

with the follow up advice, that says---

TO REVIEW AFTER 7-10 days

But, in this week's duration, Roohi was-in -touch with her gynaecologist, phoned the latter for further queries; for her doubts and everything was being clarified by her dear doctor.

On the 8th day, Roohi re-visited the hospital to meet the doctor ; to get things done finally.

But, as Dr. Nargis already cleared Roohi, on her previous visits, about the surgery- HYSTERECTOMY that would be performed on her, now the latter has come up with a bunch of questions, enlisted, under a page labelled as "Dr. Consultation" in the Color Notes app of her realme 8i.

And, as the agitated Roohi entered the doctor s room with a greet--

" Good morning! doctor"

" Good morning, beta (child)." replied the doctor lovingly as the mother addressed her own child. 

“ Doctor, I'm stuck up with a few queries for which I feel restless."

 “Alright, please go ahead.” said the doctor.

So, Roohi, loaded with her doubts, negativities and insecurities, went on to unload them--.

"Why complete HYSTERECTOMY, why not the partial HYSTERECTOMY, doctor?"

 “To prevent you from any danger of cysts or cancer( ovarian) ahead, and”

“Because, you are already in forties, very near to menopause.”

"I' m in fear of losing my feminism." told Roohi emotionally.

“But, you need not to be”

“You are married, and have children too.”

“So, think strongly and beautifully about yourself; about your health.”.

"Which way would you opt for the surgery?" asked Roohi her 3rd query.

“LAPAROSCOPIC hysterectomy, but if conversion is required(in OT), I will switch over to ABDOMINAL hysterectomy, as your case seems to be a complex one.” clarified the surgeon.

“One last query, doctor!" Roohi felt guilty inwards, for so many questions, so many doubts.

But as the doctor, permitted her to go on, she asked--

"During my first examination, you told me clearly that I 've an Umbilical Hernia, also...."

"And I didn't pay heed at that time."

"Can I go for both surgeries together, I mean one-after-the-other.?" Roohi seeks the advice of her trustworthy doctor but actually the idea sprouted in her hubby's mind to have the benefit of single recovery time, and was being forwarded to his wife.

"Of course, yes." the doctor answered.

And, that's how Roohi was being referred from one physician to another physician- Dr Mahinder Paul--- Consultant( General and Laparoscopic surgery) at Columbia Asia Multi Super Speciality hospital.

But at the same time, Dr. Nargis prescribed Roohi for a new set of tests.

CBC

Covid 19 RT-PCR Test

Viral marker test(HIV)

and instructed her to go for them before she leaves the hospital.

which will actually validate the eligibility for her surgery date that was just decided by the surgeon on the approaching --TUESDAY.

"Will be OK!" said the doctor checking her table calendar, for any surgery or delivery. due on that day.

The gynaecologist also assigned her, coordinator Miss Janaki to route Roohi's way to . Dr Mahinder Paul at his room no-30

and later,

to the Financial Officer for the final estimate of the payment plan, pre and post operative.

As Roohi just met her new physician, she was being examined and questioned by him--

"So, Roohi! Has any surgery happened before?"

"Yes, Sir! 

Two."

"Related to what?"

"My first surgery --Caesarean section

and the second one was-- Ectopic pregnancy."

Dr Mahinder also studied referral, and all related Roohi's reports carefully and confirmed the date and day TUESDAY decided by the referring practitioner, as he also had no scheduled surgery to be performed on the same day.

Accordingly, Roohi was admitted on MONDAY night, accompanied by her mother, for emotional support.

After the registration process, Roohi and her mother went to the deluxe room, Room no--312 that she booked a day before.

During an admission process, the fair complexioned nurse introduced herself as Miss Latika.

To Roohi, Latika seemed a sweet, dutiful and responsible nurse as she, smilingly enquired Roohi about her current health status; checked her vital signs and put the figures on the chart named as Roohi under the patient's category.

After, an hour or so--

Latika gave the anxiety tablet to the patient and left the room as she said -- “GOOD NIGHT, madam.”

On Tuesday morning, as promised, Roohi's husband along with his teenage daughter reached the hospital at 7:30 sharp.

And, as Roohi 's attendant, was about to take her to the Operation Theatre, 

after she was dressed in blue and white cheque hospital gown,; after she removed her jewellery,,

then all the three--

Roohi's caring mother,

her dear daughter and,

a loving husband wished her GOOD LUCK along with a kiss on her forehead.

In an Operation Room, before Roohi was drugged with an anaesthesia, she chanted, the most powerful mantra, 

"OM NAMAH SHIVAYA" for the blessing of God.

The surgery went for complete 4 hours and 20 minutes, consecutively, the HERNIA surgery, after the HYSTERECTOMY. It was an open surgery, an incision was made near the Roohi's navel by the surgeons.

Roohi was back to her senses, after an hour or so after the surgery, and she found herself in post operative care under the complete observation of the nurse. 

That day was really very tough for Roohi as she wasn't allowed to have water. She had to be satisfied with just an application of "water-dipped-cotton-on her-lips" by the nurse. She lay dormant, inactive with pain, with a wide bandage that covered her navel. In the evening, after 5 hrs, she was shifted to her room no-312, where,

her mommy, 

her hubby and 

her daughter waited.

In a POST OPERATIVE CARE, with both the physicians' on-rounds; with their bedside manner; with their directions and instructions, her healing was boosted and recovery got faster.

And, finally the day came, after two days, when she was to be.discharged.

Roohi thanked both the doctors, by her side, and, back home, Roohy, teary-eyed, also thanked God for being with her; for saving her life as--SHE LOVES HER LIFE.