Three Centimeter Incision

WARNING:  This story contains graphic descriptions of medical procedures gone wrong!

Most Intimate Reader,

Most people get PTSD from an event.  It was the circumstances around the second surgery on my right Bartholin gland cyst that caused my nervous breakdown and the biggest challenge I have faced yet in my quest to survive and make this world a better place.

Sure, I got drugged and raped starting when I was 15 until I got married at 28 years old.  And I’m sure I’m not the only one.  Sure, I got beat up by a gang of kids in grade school and ended up with a concussion.  That’s typical.  Sure, I got beat up by the first boyfriend I lived with when I was 18 years old.  It was so bad that the police came, thankfully.  It happens all the time.  Sure, I was impregnated against my will when I couldn’t even take care of myself let alone a baby, and he paid for the abortion.  Again, I am far from alone in that hell.  Sure, I got laid off, along with myriad others.  Sure, I woke up during my hysterectomy because they had to yank so hard to get my uterus out it was so riddled with fibroids after they waited too long and let me bleed until I was anemic before they finally removed it.  But it was the circumstances around the 3-cm incision in my vaginal mucosa years later that really pushed me over the edge and ended my marriage.

When I finally got together with the Archangel Michael himself, I fell so madly in love with him that I stayed with him and only him for 20 years.  Extreme circumstances finally broke us apart, and that’s what this story is about.

When Michael and I started dating, neither of us had had enough sex for way too long.  We, therefore, had a lot of sex together for extended periods of time.  He was a bicyclist and I was a dancer.  Even though Michael was quite ill and had profuse sweating and gastrointestinal distress, we managed to have as much sex as two graduate students could have, which was a lot for such a young and physically fit couple.

Just as Michael was becoming too ill to sustain our active sex life, I woke up more than a little sore after sex the night before.  In fact, it hurt to walk.  I went to the student health center on campus.  The doctor examined me and told me to drive myself directly to the hospital where he would meet me to perform surgery to save my life.

“But I have a final exam,” I informed him.

“You’re not going to be taking any exams today,” he assured me.

We didn’t have cell phones in those days, but I was able to leave a message for Michael with the technician in the laboratory where he worked.   

As graduate students, we did not have health insurance, for all practical purposes.  I remember the burden of paying a mandatory $300/year fee (that was a lot of money in the 1990’s), but that fee only covered the part where I saw the doctor on campus and he told me to drive myself to the hospital, which I did.  He met me there and he, or his resident (trainee), performed an incision and drainage of my right Bartholin gland cyst.  Michael showed up just as they were taking me into surgery, and I loved him even more. 

Have you never heard of a Bartholin gland before?  Well, don’t feel bad because neither had we and we were graduate students working on our PhD degrees, and Michael had already completed the first half of medical school and passed the boards.   

Bartholin glands were first described in the 17th century by the Danish anatomist Caspar Bartholin the Younger (1655-1738).  The Bartholin glands are two pea sized glands located slightly posterior and to the left and right of the opening of the vagina.  Bartholin glands secrete relatively minute amounts of fluid when a woman is sexually aroused.  The fluid may slightly moisten the labial opening of the vagina, serving to make contact with this sensitive area more comfortable.  It is possible for the Bartholin glands to become blocked and inflamed resulting in pain.  This is known as a Bartholin gland cyst.  A Bartholin cyst in turn can become infected and form an abscess.  Marsupialization is the surgical technique of cutting a slit into an abscess or cyst and suturing the edges of the slit to form a continuous surface from the exterior surface to the interior surface of the cyst or abscess.  Sutured in this fashion, the site remains open and can drain freely.  This technique is used to treat a cyst or abscess when a single draining would not be effective and complete removal of the surrounding structure would not be desirable.  Wikipedia 

What I am trying to explain is that I sustained a life-threatening injury from sex due to the nature of his anatomy together with mine necessitating special care and extra lubrication, especially during prolonged sexual activity.  We rubbed each other the wrong way, you could say. 

We had no idea. 

The surgeon gave me a special deal of only $500 to pay for the surgery, since he had a penchant for dedicated graduate students like me or felt sorry for me, however you want to look at it. 

I soaked in the bathtub, refrained from sex, and took care of my wound until it was all healed up.  I arranged to make up my final exam and I got an A+.  I married the love of my life.  Everything was fine, or so I thought. 

What the surgeon only told Michael and not me is that all of the cyst could not be removed.  It would inevitably, eventually become inflamed and infected once again and require another surgery once we had enough sex to irritate the gland again sufficiently so that the remaining cyst could be visualized and removed.   

Maybe Michael tried to tell me what the surgeon had told him, but my mind rejected the horror.  We lived under the threat of irritating my gland forever after.  It hurt, it was sore, it was festering.  We would wait for the angry gland to settle down before having sex again.  Sometimes we waited a long time.   

It was 20 years before I had to have the second surgery of my right Bartholin gland cyst.  My gland finally got taken care of for good, but in the process, I ended up with a whole new problem:  PTSD.  It’s like taking your car to a crooked mechanic who fixes one thing and breaks another to make sure you’ll be back soon, especially if you are a girl, and even more especially if you are a cute girl.   

Once a Bartholin gland cyst gets really bad, it gets really bad.  You cannot even imagine so much pain in the part of your body that’s the most sensitive and intimate.  We went to the emergency room after speaking with representatives of our insurance company, the state employee group insurance program.  We also spoke with a representative of our insurance company’s preferred provider.  We asked them to send us to a hospital where we could have same-day surgery.  Instead, they sent us to the hospital with all the homeless people loitering around in downtown Saint Paul, Minnesota.   

I was violated in the emergency room (ER) after they forced Michael to leave the room so I could be questioned about rape.  At the same time, the ER doctor shoved a speculum into my inflamed vagina, pressing the cold steel hard against the painful cyst on the right side.  Then he torqued the handles to open my vagina up wide.  I didn’t give him the satisfaction of screaming, even after he poked and prodded around in there just to make sure I understood exactly how much medical doctors hate philosophical doctors.   

Even though we requested same-day surgery, the ER doctor treated me like a drug-seeker.  He refused to prescribe me morphine, even though they would make me wait 10 days for the surgery.  Michael and I both thought the cyst was way larger than the ER doctor claimed it was.  Perhaps he did so in order to justify the wait while I had to take antibiotics to see if the cyst would go away.  I wonder if the doctors get paid a bonus based on how well the healthcare organization does financially? 

The ER doctor told me there was no such thing as morphine that was not tainted with acetaminophen.  I told him I discovered drugs at pharmaceutical companies and of course there were pills that were only morphine, without acetaminophen.  I cannot tolerate acetaminophen because it is very damaging to the liver.  But he refused to prescribe me morphine and would only prescribe morphine tainted with acetaminophen.   

During the 10-day waiting period, I quickly became so desperate that I took the prescribed morphine poisoned with acetaminophen.  Then I suffered from liver poisoning, with nausea and vomiting, for days afterwards on top of the already unbearable condition I was in.   

After 10 torturous days, Michael drove me to the hospital for my surgery.  He had to work.  I had to wait all day and then a different surgeon finally showed up because the one who was going to do my surgery was sick that day. 

Description of operation:

Patient was met preoperatively (for the first time).  Consent was signed.  She was taken to the OR where satisfactory anesthesia was established.  She was placed in dorsal lithotomy position using Allen stirrups ensuring proper positioning and cushioning.  A time out was performed. 

A 3-cm incision was made in the vaginal mucosa down to where the cyst was.  The cyst was incised and straw colored thick clear fluid was noted.  A culture was obtained.  The cyst was then irrigated with betadine and normal saline.  A small piece of the cyst wall was sutured to the vaginal mucosa with interrupted 4.0 vicryl.  Approximately 8 stitches were placed.  The site was noted to be hemostatic.  The procedure was then completed. 

There were no surgical or anesthetic complications. 

When I awoke from the surgery, I had difficulty talking because my lip and tongue were so swollen from being bit so hard during the surgery because it was so incredibly painful even under full anesthesia.  The surgeon did not even talk to me afterwards.  The nurse told me she had had a Bartholin gland cyst, too.  Michael took me home.   

During the follow up visit with the surgeon who was originally scheduled to perform the surgery but didn’t because she was sick that day, she shoved her finger deep and hard into my wound while saying to me that maybe I could at least refrain from having sex for the next two weeks.  Almost two years later now, it still hurts when I think about it.  She also emphasized nastily to me that it was two different cysts, not the same one for 20 years, although that is so rare, even by her own admission.  It seemed like she was bullying me because they were so afraid of a lawsuit about this case.  Now that’s hitting below the belt! 

From the perspective of a PhD, who trained even longer than MDs and worked more hours for less pay and no job security, it seems like what doctors really care about is their large incomes and any threats to them, like malpractice lawsuits.  They don’t really care about you so much.  If they do, then why don’t other medical care practitioners who have as much life-or-death decision-making responsibility get paid almost as much?  Or maybe it is the ability to perform emergency work under pressure, in which case it is not understandable that first responders get paid so little or are even volunteers, especially when they are putting their own lives at risk far more than virtually all doctors.   

When I was first diagnosed with PTSD not long after the surgery, no one believed it, least of all me.  I thought I was being insulted, as usual.  I was shamed and blamed.  I thought, see, I’m fine.  I started reading the literature to prove them wrong and eventually had to face up to the fact that I do have PTSD.  I was badly injured.  I needed help for the first time in my life.  That was perhaps the hardest part for me, especially since the only one who ultimately could or would help me, Michael, was the last person I wanted to be dependent on because he was a primary trigger of my PTSD! 

It has been rough, to say the least.  People with PTSD kill themselves every day because it is so unbearable.  I have stayed alive because I believe that consciousness survives physical death.  Death would, therefore, take away only the physical pain and not the mental anguish.  I decided that the way out is the way through.  It’s working!  I am just fine and can still enjoy sex just fine, too, thank you! 

I believe I am still alive because I love God above all, because Michael and I are doctors, because our love is true, and because of dancing.  I am also alive because medical marijuana is so helpful for PTSD as well as chronic pain, especially pain with underlying neuropathy, which I also suffer from after being hit by too many cars and drunk drivers.  I was t-boned one Christmas, I was hit by a speeding vehicle and knocked into the air while walking across the street in Basel, I was rear-ended by a drunk and drugged driver in Brooklyn Park and again by an antique driver in Denver, none of which was my fault!  I found chiropractors (even a specialist in PTSD), physical therapists and massage therapists who help immensely.  You can check my first blog post for more advice about how to survive PTSD.   

Mary is free of original sin because of immaculate conception but still must deal with all the same temptations of this evil world as everybody else.  I need a savior as much as anyone or even more. 

Thanks for reading my story.  May God bless you. 

3 cm incision crop