I’m not quite sure how I got in the position I’m in: strapped securely to a gynecology table, naked, and surrounded by doctors and nurses.
I had been home for a couple hours after running a bunch of errands when the cramps hit. Cramps, nausea, vomiting, diarrhea… you name it, I think it was happening. Too weak to drive, and afraid I’d pass out if I tried, I called a paramedic buddy to drive me to the hospital. Wish I’d remembered he was on duty that day, because next thing I know I’ve got 5 firefighters, a cop, 2 paramedics and a student traipsing through my messy house.
They didn’t give me much choice about going to the hospital via ambulance, not that I was going to complain. I wanted to go to the ER! Strong, gentle hands lifted me from the bathroom floor to a gurney, secured me, and wheeled me out of the house and into the waiting ambulance. Hands seemed to be everywhere, taking vital signs, hooking me up to the EKG monitor, placing a nasal cannula with oxygen in my nose, and starting an IV to replace the fluids I’d lost and administering pain and nausea medications.
My buddy rode with me in the back, asking questions about what I’d been doing, how long I’d been sick, etc. Together, we traced it back to the gas station hot dog I’d scarfed down for lunch. Figures!
Arriving at the hospital, they wheeled me in and turned me over to the nurses in a small private room (thankfully! It’s good to be on good terms with the ER nurses!). They helped me into a gown, gave me an emesis bucket, and got another set of vitals while one dragged a doctor into the room.
The doctor did a quick eyes/nose/throat exam, asking questions about what was bothering me. He ordered lab work, which the nurse drew as he continued his exam. He listened to my lungs, my heart, and my abdomen. He wasn’t too happy to be on the receiving end of projectile vomiting when he started palpating my stomach, though!
That’s where things started going downhill quickly. I threw up, and started feeling really weird. I lost control of my bowels, and started having diarrhea, while throwing up again, and started to pass out. They quickly dropped the head of the bed, ripped off the gown, and hooked me back up to the heart monitor. I remember a call going out for more help just before things went black.
I kinda drifted in and out of consciousness. I remember vaguely having another IV put in, an oxygen mask replacing the nasal cannula, and being moved around some. But when I finally woke back up, I was on this gynecology table, strapped down, with several medical personnel around me.
“Hi Megan! Welcome back. You’ve got us worried, hon.” This was coming from Dr. Peters, the doc I had thrown up on. “We have you in the gyn suite. I want Dr. Groves to check you over, make sure there’s nothing going on besides what we think is acute food poisoning, and this will give us the opportunity to fully treat you while you’re in this position.”
I shook my head, trying to get my bearings. My nose was irritated, and I tried to scratch it, only to find that my hands and arms had also been secured out to the sides. I looked at my surroundings, rather stunned to find myself in one of the surgical suites, secured to one of their specialized operating and treatment tables. Straps secured me to the table just over the top of my hips and under my breasts; my arms were secured out to each side. My feet and lower legs had been placed in the foot cradles and secured. As I processed all this, Dr. Groves dropped down the section of table that had supported and extended past my bottom – it was now hanging off the edge of the table and freely available for whatever they had in mind. I was kinda terrified in a way, being secured and unable to move.
Dr. Groves stepped up to the side of the table. “Megan, we’ve got a nasogastric tube in place through your nose and into your stomach, and it’s pumping out as much of the food as it can get. However, we believe that you’ve already digested most of what’s made you so sick. You’re going to be here a while.
“Dr. Peters’ exam showed that you might also have a pelvic mass or ovarian cyst. I’m going to be examining you to make sure that nothing genitourinary or gynecological is also wrong with you. If we need to, we can also start those treatments now, so we can get you back on your feet as soon as possible. Also, we’re going to be measuring all output for the next couple of days, so I’m going to be inserting retention catheters in your bladder and rectum. I’m doing to do that now, so that we can have a nice clean field for examination.
“The exam I’m going to do is going to be rather involved and lengthy. It will probably be uncomfortable at times, but should not be painful. If you are hurting, let me know and we’ll give you some more pain medication. Any questions before we begin?”
I shook my head no, but I also wasn’t sure I really wanted to go through this, not that I had a choice. I trusted Dr. Peters and Dr. Groves to make the best medical decisions for my care and treatment.
Dr. Groves walked back to a nurse at my feet and snapped on some sterile gloves. He took his place on a rolling stool and wheeled himself to sit at my crotch while two nurses adjusted the stirrups, spreading me open very wide. Another gloved nurse came up beside Dr. Groves and scrubbed my whole perineal area top to bottom with betadine. A sterile towel was draped over my crotch, which Dr. Groves used to quickly wipe down and off the excess liquid.
Using one hand, he separated my labia, exposing my urethral opening to his view. A nurse handed him a catheter attached to a drainage bag. With a word of warning to me, he inserted the tip into my urethra and started guiding the tubing into my bladder. I won’t lie and say that it didn’t sting and burn some as he inserted it, and yet the feel of being touched and the lubricant at my urethral opening were strangely… pleasant. I didn’t have long to dwell on that, though, as he deftly inflated the balloon and taped the tubing to my thigh.
Dr. Groves changed gloves and glanced at the scrub nurse who was making notes of the entire exam and procedures. “Melissa, did they get a temp on her?
“No, doctor, there’s not one recorded.”
“Ok, someone find a rectal thermometer. Megan, I’m going to take a rectal temp before we start prepping you for the rectal.” He accepted the thermometer from a nurse and swirled it in some lubricant. “Just relax your bottom as I slip this in.” He inserted the thermometer a good couple inches into her anus and held it in place up against her buttocks, his fingers lightly brushing her anus. After 5 minutes, he removed the thermometer, wiping it off and reading it. “101.6 degrees, Melissa. Megan, you’ve got a fever. I’m going to add an antibiotic to your IV.” He gave a medication order to one of the nurses, who left the suite to get the order filled.
“Megan, I need to do a detailed exam of your rectum, so I’m going to need to clean you out really well. I’m going to give you a series of enemas with a retention nozzle, and when it’s time to expel I’ll hook the nozzle up to a rectal catheter. This will probably take the most time of the whole exam. I’ll keep the solutions very gentle on your system – you’ve been having a lot of diarrhea, I understand, so your system probably doesn’t need much encouragement, just flushing.”
I just sighed. Having multiple things up my bottom was not on my list of desires, but I also knew that enemas would take care of anything still left in my intestinal tract to poop out. I also knew I was in no position or condition to protest. I nodded my head in acquiescence and felt Dr. Groves begin to insert the double-ballooned retention nozzle, inflating first the inner, and then the exterior balloons.
“Here goes,” he announced, and opened the bag on the first liter of warm-water solution. It was a pleasantly warm solution, especially as my fevered, naked body chilled in the cool of the suite. It quickly ran into my body, and he clamped off the bag and the nozzle, announcing that this first liter would only need to be held 5 minutes. “As I increase the amount of water filling your body, though, I’ll also be increasing your hold time.” Five minutes came and went, and he unclamped the nozzle, allowing the expulsion to occur through the rectal tube he had connected.
“It’s looking like I thought. You’re pretty much just diarrhea, no impactions or large fecal materials. I’m going to give you a 2-liter enema now, and follow that up with a 3-liter before we move on to diagnostics.” Dr. Groves connected the new enema bag and started it flowing. This one took longer to administer, and a few cramps were felt by the end. He clamped the bag, saying I would need to hold this one for 15 minutes.
Dr. Groves stood up from the stool, removed his gloves, and picked up a stethoscope from the nearby tray. “While you’re holding that enema, I’m going to start some of the rest of your exam. It gives us something to do while you’re waiting.” He put the earpieces in his ears and started listening to my heart and lungs. “Gurgling away with that enema,” he grinned, as he listened to my abdomen. He checked various pulse points, looked in my mouth, ears, and nose before straightening up to the nurse’s signal.
“Fifteen minutes are up! Let’s let you expel this before we go any further.” The nurse who had signaled him unclamped the tubing and I started to expel the enema solution. Despite the fluid level being greater, this one took barely more time than the one before it to expel.
“Much clearer! I believe that third enema should have you all cleared out, my dear. However, I want to get this enema really high into your intestines, so I’m going to insert a colon tube through your retention nozzle to get it all up high. You might feel this snaking around in your intestines. Don’t worry – these usually don’t cause the cramps some of the other enemas might, and this is just plain water. This will be the longest hold time for you, however.”
I felt him fumbling with the nozzle firmly implanted in my rear end, and then something moving inside. “I’m starting the water now, Megan, to help insert the tube.” I could kind of feel it moving higher and higher in my intestines. This fill took the longest, but it didn’t cramp, as he had promised. “Ok, Megan, 30 minutes until you can expel this last enema. I’m going to continue your exam as we wait.”
He came back around the table and instructed the nurses to carefully move the arm boards so my arms would be behind my head. “Megan, I’m going to conduct a thorough breast exam and start working my way down. Let me know if anything gets to be too uncomfortable.”
I acknowledged him and felt him start to feel first the lymph nodes in my neck, then my thyroid, and then move to the lymph nodes around my collarbone, tracing them into my armpits. Fingers gently, deftly made their way onto first my left breast, and then my right, carefully examining the tissue for abnormalities.
His hands made their way down, palpating my distended abdomen, feeling for lumps and enlargements where there shouldn’t be any, and evaluating the effectiveness of the solution percolating in my intestines. “Everything seems to be normal so far, Megan, and I believe we got the enema solution in well as I had hoped. Your thirty minutes are up, so let’s get you drained and unplugged so we can finish your exam.”
He unclamped the tubing, and the water started flowing into a basin placed under my bottom. He removed the colon tube as I expelled, and let my system finish draining out the water it had held.
Satisfied I was empty, he deflated the balloons on the retention nozzle and removed it. “Megan, I’m going to start with a pelvic exam before doing your rectal exam – let your bottom rest up for a bit.”
I just nodded. I wanted to let my whole body rest for a long while, but knew that getting the exam over would let that rest come sooner.
Dr. Groves touched my inner thighs with a warning before trailing down to my mons pubis. I kept it either trimmed really short or shaved. I wasn’t sure if I was embarrassed about this or not, until he made a comment about not needing to shave me, because I had done such a thorough job. I know I blushed under his touch.
His fingers made their way carefully down my labia to the curves of my buttocks, and then traced their way back up. He separated them, palpating them again before stretching them open wide to reveal my inner labia, urethral opening, and vagina. He palpated the external region of my anatomy before sticking a fingertip in my vaginal introitus to palpate the glands just inside. Satisfied everything looked good so far, he removed his finger and asked for a speculum.
The nurse ran a metal graves through some warm water and handed it to Dr. Groves. “Megan, I’m going to introduce a speculum into your vagina now. You’re doing well for me.” He separated my labia again with one hand, placed a finger at the bottom of my vagina to provide a slight traction, and inserted the speculum, rotating it into place. He proceeded to open and secure it and moved one of the many surgical overhead lights into position for best possible illumination.
I felt the speculum as it was inserted and opened, stretching me open very wide, and then the heat from the bright lights on my pelvis. The chill that rippled through my body made my nipples stand up at attention - something I saw he noticed before focusing his attention on the interior of my vagina.
“Normal coloring of vaginal mucosa, good tone, cervix well presented. Swab, please.” He accepted a couple swabs and scrapers. “Megan, I’m going to do a pap smear and get some samples for the lab. You might feel a bit of pinching.” He took multiple samples from my cervix before closing the speculum and withdrawing it, only to pick up a second speculum. “Megan, I’m going to insert what we call a Collin speculum. It opens the vagina from side to side instead of top to bottom. I just want to visualize your vagina walls better. This may be more uncomfortable for you.”
He inserted the speculum and started opening it. It felt very strange, opening me the way it did, and got uncomfortable before he finished opening it, but he was mercifully brief in this exam, looking around and quickly closing and removing the speculum.
“You’re doing great, Megan. I’m going to do a bimanual exam now. Let me know if anything hurts, okay?”
I nodded, and felt him insert two well-lubricated fingers into my vagina while his other hand rested just above my mons. He started feeling around inside, and while it has never been a pleasant experience, was okay until he got to my right ovary. It hurt so bad, I think I would have jumped off the table if not for the restraints. “Whoa, Megan. Sorry. Let’s get some pain meds on board, and I’ll want to do an ultrasound of your ovary. Melissa, 5 mg Morphine, IV push. Megan, let me finish up your exam, okay?” He finished his internal exam and removed his fingers while the nurse administered the narcotic.
“Megan, your right ovary is definitely enlarged. I will do an ultrasound to determine the size, extent, and treatment options here in a little while, but I want to move on to your rectal exam now. Is the medication helping?” I nodded, giving myself willingly over to the haze of the medication. I heard the clanking of metal and closed my eyes, willing myself to relax.
Dr. Groves gloved up and took a big bit of KY on his finger. “Megan, I’m going to start with a digital rectal exam. Relax your anus for me.” He pressed the pad of his finger on my rosebud and slowly entered. He felt around the walls as far as he could reach before removing his finger. He changed his gloves and reached for the anoscope.
“Megan, we’re going to position the table up a little higher to give better access to your rectum. You’ll feel the head of the table dropping down as your bottom is raised.” The table started positioning so that my head was down towards the floor and my legs up in the air. I felt the repositioning of the lights on my crotch, and heard the sounds of equipment being prepared.
“Megan, I’m going to first examine your rectum with an anoscope, followed by a sigmoidscope. These will be uncomfortable, but they will give me the look I need. I want you to relax your anus, now, so I can insert the anoscope.” I felt metal, cold, at my bottom and relaxed as best I could. The anoscope passed into my rectum to its hilt, and the obturator was removed. I felt cool air and hollow as Dr. Groves examined my rectal walls, removing the anoscope slowly as he did so.
“Looking good so far, Megan. I’m going to do the sigmoidoscopy now. This will be the most uncomfortable part, but hang with me, ok?” I’m not sure he saw my nod, but I felt the tip of the sigmoidscope placed at my anus and slowly be introduced. I knew about the scopes being used for colonoscopies, so I was well aware this was not going to be a quickie procedure.
The entire procedure took about 20 minutes, and I’m rather glad to say that I fell asleep for a little while during it. I woke up with a bit of a start when the table started moving my head up and feet down to a more horizontal position.
“Megan, you did great. Your colon looks fine, so I don’t think we have anything to worry about there. I’m going to insert a couple of suppositories to soothe back there, and then we’re going to ultrasound that ovary.” I felt the suppositories entering my rectum followed by his finger, which he left in place for a good couple of minutes before removing it.
One of the nurses wheeled over an ultrasound machine. Dr. Groves selected the transvaginal probe, making sure it had a sheath over it and squirted a gob of KY on the top. “Relax for me, Megan, this will take just a couple minutes.” He inserted the probe and started getting images.
My vagina felt so full with the probe inside, and it was painful to have it pressing up against the ovary as much as it was able. I was whimpering with the pain, and he ordered more morphine, apologizing but stating he needed to get the images so as to treat me properly.
Finally done, he removed the probe and wiped some of the excess gel from my perineum with a wipe. Dr. Groves rounded the table and came to stand by my head. “Megan, your exam is complete. I concur with both the food poisoning diagnosis and the pelvic mass. You have a large cyst on your right ovary that needs to be removed – just the cyst, not the ovary! Since we already have you in the suite, I want to go ahead and do the surgery now. I’ve asked the nurse to call in the team, so we should be ready to go in about 20 minutes.”
I nodded. “Sure, go ahead and get it taken care of.”
Dr. Groves nodded at the nurses, who were cleaning up from the exam, and they started pulling out surgical packs and prepping for the operation. I was hooked up to monitoring equipment: a pulse-ox on my finger, EKG electrodes on my chest, my abdomen and crotch scrubbed with betadine and alcohol. Something slender and cold was inserted abruptly in my rectum – “It’s a continual thermometer probe, hon,” – and the table was raised again to make it easier for the team to access my pelvic area.
Dr. Groves inserted a large speculum into my vagina and cranked it open. He helped adjust the drapes being put over me, drapes that left my crotch and pelvis in full, open view while covering up everything else. “Megan, I’m going to go scrub in now. This is Dr. Andrews. He’s your anesthesiologist for the surgery.”
Dr. Andrews smiled behind his mask. “Megan, good to meet you. I’ll be putting you under today.” He asked me questions about my health, past surgeries, allergies, etc. Dr. Groves came back in, gowned and gloved, and leaned over to look at me. “Megan, we’re going to get started. Have a good sleep, and we’ll get you fixed up.”
Dr. Andrews settled a mask over my face and pushed medications into my IVs. I drifted off to sleep, and the surgery commenced.
When I woke, I had tubes everywhere: IVs, nasal tube, oxygen tubing, catheter, the rectal thermometer probe, and a couple of surgical drains. Dr. Groves was there, and he explained everything that had occurred. The cyst was large, and while it wasn’t causing my illness it would have been causing discomfort and needed to be removed.
I was in the hospital for a week before I was well enough and healed enough to go home. But I don’t think I’ll ever forget that exam!