Anyone had "awake" D&C

[JenaW]

After 11 mos of mid-cycle bleeding and unusually heavy periods, my GYN is recommending a D&C. I have an u/s today to rule out fibroids, and assuming my PAP is normal (it always been) my doc thinks the next step is a D&C to "reset" my uterus and hopefully control the bleeding. I am inclined to just take a "wait and see" approach, but honestly, after 11 mos of this, I am getting tired of it. During my periods, I empty my Diva cup every 1-2 hours for the first 36-48 hours of my period because it is already overflowing/leaking within that time frame. Then I have more bleeding about 2 weeks later. Plus occasional bleeding after intercourse. I'm getting tired of seeing red! However, being married to an anesthesiologist I have an (admittedly irrational) fear of undergoing anesthesia. I DO NOT WANT TO! EVER!! I am fine with a spinal or even local (cervical block) but I want to be completely awake and aware of what is going on. DH does not understand why I want this (it is a control issue thing). He says I can have propofol (twighlight sleep) and it will be over and done with within 15 min. I have participated in over 50 at the other end of the bed, but this will be my first time as a patient. I have a reasonably high pain tolerance, and just think emotionally I would be more comfortable if I am awake through the procedure. Has anyone done this before? I know the OR personnel don't like it, but frankly I don't care what they think. (Is that obnoxious?) Just looking for any BTDT experience with the pain, etc.

Thanks
J

[BayGirl2]

I had a vacuum aspiration for miscarriage about a year ago and I was awake. It was an outpatient procedure and I don't think sedation was even offered as an option. I had pain killers and felt slightly out of it, but was aware of the procedure and talking to the dr. The pain was not overwhelming, no more than cramping like from an IUD insertion or bad period. Afterwards I had basic painkillers for recovery, and it was all very bearable.

Is a sedated D&C in the OR the only option you have been given?

[alexsmommy]

Nope, I've had either general or twilight. I have the opposite reaction - I want to remember/know nothing. The twilight was no different than the general for me in terms of my later recollections - meaning I recall nothing.
I think that given that you know EXACTLY what is going to happen and what to expect it's not unreasonable to be awake. Your understanding of how this might be is going to be much more realistic than someone not in your field.
Sorry things have been so bad - hopefully this will clear things up.

[lilycat88]

I don't blame you. I've never had a D&C so I can't speak to that. But after being the one in a million person with a serious complication (negative pressure pulmonary edema) following general anesthesia for a VERY minor gyn procedure (operative hysteroscopy only with no external incisions), I will explore every option before going under general again. I had general anesthesia 9 times previously with no problem.

[JBaxter]

Ive done the twilight sleep for both mine but they were for m/c ( one scheduled one emergency)

[JenaW]

Is a sedated D&C in the OR the only option you have been given?

No. We haven't really gotten that far in the discussion yet. Honestly, when my doc first suggested it, my first response was, "No way!" But after talking to DH and his reminders of what a PITA this has been, I have been rethinking that. I will wait and see what the blood work and u/s show (whether there is any other underlying issue) and then decide. I am still breastfeeding my youngest (not quite a year old yet) a fair amount. She eats 1-2 tiny meals a day and uses me for the rest of her nutrition. So there is also the possibility that once I wean her, this would all calm down too. However, I don't think either one of us are ready for that yet. I am fairly confident my OB would agree to it, it just depends upon the anesthesiologist I think. And I am hopeful that once I explain my reasoning (however irrational that it is) and the fact that DH is a physician and I am a PA, they will agree. We'll see!

[JenaW]

I think that given that you know EXACTLY what is going to happen and what to expect it's not unreasonable to be awake. Your understanding of how this might be is going to be much more realistic than someone not in your field.
Sorry things have been so bad - hopefully this will clear things up.

that is what I am counting on. I really can't explain why I am so scared of anesthesia. I think part of it is because I hear all the horror stories from hubby, and part of it is because I have been in the OR enough to see how the patients are treated - stupid stuff like comments on how they have shaved their pubic area, or how floppy/perky their breasts are - stuff that is irrevelant but that I don't want to happen. I am not at all concerned that something truly inappropriate will happen. I trust my OB 100%, and I have worked with him enough to know how respected and respectful he is. But I don't want to be unconscious on the table and not have a clue what is going on with my body. Control issues...

[JenaW]

I don't blame you. I've never had a D&C so I can't speak to that. But after being the one in a million person with a serious complication (negative pressure pulmonary edema) following general anesthesia for a VERY minor gyn procedure (operative hysteroscopy only with no external incisions), I will explore every option before going under general again. I had general anesthesia 9 times previously with no problem.

YIKES! see that is part of the other issue. DH always comes home and discusses these rare instances with me, since I am in health care too. "we had this otherwise healthy young woman today we just could not intubate. We finally had to wake her up and do it awake" or "I have no clue why or how she developed pulmonary edema, but instead of going home, she is now sedated in the ICU." It seems like our family has experienced way more than our share of "rare and unusual" medical conditions. I would just rather stack the odds in my favor I guess!

[lilycat88]

Even though I "know" my situation was rare...the anesthesiologist hadn't had it happen to him before...I'm still staying away from general if I can! I woke up enough before they extubated me that I tried to take the endotracheal tube out. When that didn't work, I bit down and inhaled. Drew all kinds of fluid into my lungs. I turned blue...stopped breathing...O2 level went below 20%. Thankfully, my surgeon knew enough to get out of the way and let the anesthesiologist handle things and 3 days drying out my lungs in the hospital fixed everything. I only remember waking up and feeling like I was in a scene from ER!:jammin:

[o_mom]

Even though I "know" my situation was rare...the anesthesiologist hadn't had it happen to him before...I'm still staying away from general if I can! I woke up enough before they extubated me that I tried to take the endotracheal tube out. When that didn't work, I bit down and inhaled. Drew all kinds of fluid into my lungs. I turned blue...stopped breathing...O2 level went below 20%. Thankfully, my surgeon knew enough to get out of the way and let the anesthesiologist handle things and 3 days drying out my lungs in the hospital fixed everything. I only remember waking up and feeling like I was in a scene from ER!:jammin:

Yikes!! I would be freaked out at the thought of GA after that too!

[kdeunc]

I had a D&C for a miscarriage with a cervical block only. The block hurt like the devil and the whole thing was uncomfortable. I was in a situation where general was really not an option (had to leave for my SILs wedding 3 hours away in about 3 hours). I consider myself to have a relatively high pain threshold. I too have a rather irrational fear of general anesthesia and DH is a CRNA. Maybe it is a case of ignorance really would be bliss:)

Good luck with whatever you decide.

[wellyes]

I had a D&C but I was under for it - very glad I was under. But I understand irrational fears too..... however hearing that a pro healthcare worker and wife of an anesthesiologist is so scared of it is not very heartening for us civilians.


I have been in the OR enough to see how the patients are treated - stupid stuff like comments on how they have shaved their pubic area, or how floppy/perky their breasts are - stuff that is irrevelant but that I don't want to happen.

I dunno, the cat is kind of out of the bag on that one, isn't it? If you know the OR workers are thinking that kind of thing - are used to discussing it cattily - what difference does it make if they speak out loud while you're in the room or not?

[JenaW]

I had a D&C for a miscarriage with a cervical block only. The block hurt like the devil and the whole thing was uncomfortable. I was in a situation where general was really not an option (had to leave for my SILs wedding 3 hours away in about 3 hours). I consider myself to have a relatively high pain threshold. I too have a rather irrational fear of general anesthesia and DH is a CRNA. Maybe it is a case of ignorance really would be bliss:)

Good luck with whatever you decide.

If you had to do it again without the same time constraints, knowing the pain and discomfort, would you? Ignorance IS bliss! Sometimes I wish I knew nothing!

[JenaW]

I had a D&C but I was under for it - very glad I was under. But I understand irrational fears too..... however hearing that a pro healthcare worker and wife of an anesthesiologist is so scared of it is not very heartening for us civilians.



I dunno, the cat is kind of out of the bag on that one, isn't it? If you know the OR workers are thinking that kind of thing - are used to discussing it cattily - what difference does it make if they speak out loud while you're in the room or not?

I don't know if I qualify as a pro!! (or are you abbreviating professional?) I guess you are right, it doesn't really matter at all. My OB has already seen everything I have, and realistically, is mine any different than any other woman who has had babies before and has not undergone any nips or tucks? Probably not. In fact, if you ignore the stretch marks and cellulite, I think I look pretty darn good for being pregnant 9 times and birthing 5 babies! I admit all of this is totally irrational! And truly, anesthesia usually is very safe! I have the utmost respect for my husband and most of his co-workers. When he had emergency back surgery, I was with him in the pre-op area until the last possible moment, was allowed to wait in the physician's lounge, and was called into the PACU by the anesthesiologist as soon as they got him there (it was a Sunday, which helped, and there ARE benefits to being a doctor's wife). So other than being in the OR during the case I witnessed nearly everything else. I was so shocked that he was able to be a patient. I think I was more nervous than he was. I really can not explain it. It is not so much that I am worried about complications of having the anesthesia itself, just the lack of control I guess. SIGH.

[BabyMine]

I had a D&C without being put out and I still remember the pain.

[kdeunc]

If you had to do it again without the same time constraints, knowing the pain and discomfort, would you? Ignorance IS bliss! Sometimes I wish I knew nothing!

If I had to do it again I COULD. I think if I had a choice I would choose to be under or at least have some valium on board. That cervical block really was a doozy!

[JenaW]

If I had to do it again I COULD. I think if I had a choice I would choose to be under or at least have some valium on board. That cervical block really was a doozy!

Thanks. That is the kind of BTDT info I need. A close family friend who is also an anesthesiologist (but doesn't work with DH) strongly advised against the cervical block as well. He suggested a straight spinal +/- valium. His concern is that not only can the cervical block be "uncomfortable," many OBs are simply not proficient in it, nor "gentle" when they do it. Not sure about mine.

Thanks for all of the comments. Feel free to add your experience if there are others out there. I'll take all the info I can get. I am so torn about whether or not I actually want to go through with this. The u/s looked normal to my (only slightly trained) eye. No obvious fibroids/polyps or other abnorm. The only thing the tech mentioned of concern was that my lining looked a bit thin for where I am in my cycle. I should get the results of my blood work on Monday, and I will talk with my doc and make a decision then.

[DebbieJ]

I can't imagine being awake for one. I had twilight for mine. I went straight to the L&D floor from the OB's office (how convenient she was attached to the hospital) since I didn't fully miscarry. :(