Thursday, June 9, 2011

Moisturize, Lubricate and Stretch

It was nice to get a break from cancer Hell yesterday. My Matron-of-Honor, Jen, and I met at Foxwoods Casino for the day and talked and ate and gambled. I even won $300 in Bingo! But instead of heading to a nice, cozy hotel room when we were tired and ready to leave, I had to get in the car and make the three hour drive home at 11:00 PM. I know it would've been easier to stay, but I couldn't. One free day was all I had.

Another doctor would be waiting for me in the morning.

After barely four hours of rest, I stumbled out of bed and stood in the shower trying to wash the exhaustion from my eyes. I can't remember the last time I had a full night's sleep. Either I'm up all night worrying, or I'm jolted into consciousness too early from the panic attacks.

I yawned as I blew my hair dry and made sure Jimmi was awake so we wouldn't be late. It was 8:00 in the morning, and I needed to be at my appointment at Sloan-Kettering in New York City by 10:45. I'm actually only an hour from the city, but between rush hour and normal city traffic, you never know how long it will take. We were in the car by 8:40, and hoped two hours would be enough.

Sex therapist.

I never thought I'd need to see a sex therapist. I don't have a problem. I don't have any complaints. There's nothing wrong. I mean there's nothing wrong yet. But there will be.

We managed to get to the appointment barely five minutes late. Not too bad. But upon announcing myself to the receptionist, I was told to head down to Financial on the third floor because he couldn't sign me in until they saw me.

Are you kidding?

Back down we went. I gave my name and was told to have a seat. Twenty minutes later, I hear, "Ms. Paragano?" I hopped to my feet to meet the face that belonged to the voice. "Ok, you can go to your appointment on the 6th floor now."


"That's it? I was just there and they sent me down here."

"Yeah, I just needed to approve you before you could check in."

Honestly, I was so angry. I was now 30 minutes late for my appointment with Dr. Carter, Sex Guru, just so a woman in the financial department could keep me waiting forever to do absolutely nothing. I didn't even have to fill out paperwork!

For the second time in a half hour, we stepped off the elevator onto the 6th floor. Dr. Carter took us into her office right away. She was a tall, thin woman with long, blonde hair and a gentle face. I liked her immediately. She handed me a questionnaire to fill out at some point before leaving the office, and I quickly glanced at the writing. "In the last month, how satisfied have you been with sexual intercourse?" "Do you have difficulty getting sexually aroused?" "Do you have pain during or after intercourse?" Should be a fun little quiz. I'll save that for later.

"So," Dr. Carter started, "I see you're having a radical hysterectomy, including removal of the ovaries?" I nodded. "And you've already retrieved eggs for the future?" Another nod. "And you'll need chemo and radiation therapy?" A third nod. "That's a lot to deal with in a short time. Anything else?" "Yeah," I said with a forced smile, "We're getting married in less than three months. Great timing, huh?" Her smile turned to sympathy then back to a smile. "So how do you feel about everything that's going on right now? Are you ok?"

I couldn't speak. I just shook my head.

"No, not at all."

"I'm sure. It's not going to be easy. What have you heard about what your sex life will be like after surgery and radiation?" She asked bluntly.

It took me a few minutes to get the words out because my friend, the lump, was strangling my voice. As Dr. Carter waited, she searched her closet for a box of tissues which she promptly found and placed in front of me.

"I've heard it's gonna suck and I'll need to wear a dilator forever and it'll never feel good again." I grabbed a handful of tissues and pressed under my eyes so I could save whatever makeup was left on my lids. She looked a little stunned and a bit puzzled.

"Who told you that? Did you read it online? You know they only put the horror stories online, right? People who have problems want to tell the world, but the ones who don't have any issues have nothing to say."

Jimmi jumped in, "That's what I've been trying to tell her! She doesn't listen to me!"

I wiped my nose. "But Dr. Sidebotham said sex would be just bearable. She said I'd find a happy medium."

"It will be different," Dr. Carter assured me, "but different doesn't have to mean bad. If you take the right steps and use the tools we give you, you can have a very successful sexual relationship."

Tools? What tools?

"The first thing you need to know is the difference between moisturizer and lubrication. You can lubricate all you want during sex, and it will make everything slippery and fun, but unless you moisturize, you're not helping the tissues to stretch. Because you're having your ovaries removed, you won't have the hormones that normally keep the vaginal walls moist. If the walls are dry, they won't stretch and sex will be uncomfortable. We suggest you use a moisturizing suppository at bedtime 3-5 times per week to keep things from getting dry."

Ok. Nighttime routine: Brush teeth. Wash face. Moisturize face. Moisturize hands. Moisturize vagina?? I suppose I can squeeze that in. No pun intended.

"Also, you don't wear the dilator. You use it for about 15 minutes every other night." I think she saw the confusion on my face. "Would you like to see what a dilator looks like? Sometimes it helps and makes it a little less scary."

As Dr. Carter reached back into her closet, I peeked over at Jimmi who looked like he would rather have been anywhere else but in that room. It's not that he wasn't interested in what she had to say, he just attaches a weird stigma to therapists of any kind. He's fine with medical doctors, but psychologists are not his thing.

I looked back at Dr. Carter who was opening a pink and white box to reveal what looked like a medium-sized makeup bag. She unzipped it and pulled out four white cylinders in four different sizes: small, medium, large and OH MY GOD!

Dr. Carter held them up and explained, "When a radical hysterectomy is performed, the top part of your vagina is removed. It's not much, but some women can feel the shortening during intercourse. The main problem occurs after radiation when the tissues really shrink down. The area needs to be stretched in all directions. You'll start with the smallest one, add some lubrication, insert it as far as it will go, then tighten the vaginal muscles around it, then release them. You'll do that a few times until you can push it in a little deeper, then do it again. You can also move it around to stretch the area in all directions. Once you've gotten used to the smallest one, you'll move up a size. Then you'll do the same thing with the next size up, and so on. In time, if you do it every other day, you shouldn't have any discomfort during intercourse."

I looked at the medical dildos she was holding in front of me. I eyed each one, pointed to the OH MY GOD size, glanced at Jimmi, and said with a smirk, "I don't think I'll need that one."

Jimmi's jaw dropped, "You see what I have to deal with?" Dr. Carter laughed with us and joked, "Hey, it's always better to over-stretch!"

Dr. Carter gave me a few more handouts and booklets to go with the pile I have accumulating at home. A few about the surgery, a bunch about radiation, a packet about chemotherapy and random extras from here and there. I wondered when I'd have a free minute to read them all.

"Look, this is not going to be fun. I can empathize with you, but I can't tell you I know what you're going through, because I don't. I'm sure you have more on your plate than you think you can handle. We're all here to help you. Call anyone on your team if you have any questions. We'll get you through it."

She wished us luck and we headed out into the waiting room where I sat and finished the paperwork about all things sexual. I felt a tinge of sadness each time I checked a box the said "Completely Satisfied" because I know that statement will never be true again.

And here I sit in the final countdown. In five days, my life will change forever. I'll have no choice but to live with it. I really hope Jimmi can do the same.

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