Do you love a good mystery?

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I'll be honest, I actually do not. I like to have all the answers, always be in control -- oldest child syndrome, I guess.

That's why this little story, this mystery, was such a bother to me, a niggling probe at my brain, why? why? why? If you are a regular reader here, this story might bore you, unless you like inconsequential medical mysteries.

I decided to record this story here for someone like me, looking for an answer, but never finding one. I think there are a lot of women out there who might be wondering about the same thing I wondered about, with no answers. And while I'm not a physician, and I don't have all the answers, I'm pretty sure I have the right answer to this one.

Warning: medical details you may or may not want to know about contained within



Three years ago I had surgery to remove my uterus and reconstruct my lower region (yes, great medical terminology there). Apparently I was not so well-constructed in the area surrounding my uterus and basically, the supporting structure gave way. I had a prolapsed uterus and my doctors told me that it wasn't a matter of if it would fall all the way out (while still attached inside), but when. Lovely concept, eh? Though I felt I wasn't in danger of having this happen any time soon, I was also not a spring chicken (medically speaking) and decided that I should probably have this rather extensive surgery while I was still free from the kinds of medical complications that often make surgery risky (high blood pressure, heart problems, lung problems, etc.). Since it was inevitable, I thought I might as well just get it over with while I was young enough to recover rather quickly, and when I could schedule it at my convenience (instead of reacting to a complete prolapse).

I don't remember all of the technical terms used to describe the surgery but it involved removing the uterus and checking the ovaries (which I kept because they looked "good"), tying up the bladder, tying up the cervix and reconstructing the pelvic floor muscles, ligaments, and connective tissue.

The surgery was a rather long one -- four hours if I remember correctly. It was scheduled early in the morning and I anticipated a three-day stay in the hospital afterward. I went in with a bit of trepidation, but a lot of confidence in my surgeon. He was kind, and knowledgeable. I even remember him holding my hand as I went to sleep.

The first thing I remember the moment I woke up in recovery was that I was incredibly dizzy. Definitely groggy, but also incredibly dizzy -- like being on a Merry-Go-Round, but not at all in a good way. The room spun and spun and only by closing my eyes could I slow it at all. But even with my eyes closed I was dizzy. It was awful, absolutely awful.

After I was moved to a room, I was awake enough to inquire (very quietly and very slowly) why I was so dizzy. I was completely prepared for groggy and even a lot of pain, but not at for this dizziness which I had never before experienced in my life. I asked the nurses, I asked my surgeon, I asked anyone who could possibly make it go away. The anesthesiologist thought it was possibly a reaction to the epidural I had which remained in for pain control. I didn't think that was at all a possibility because I had an epidural with each childbirth, but agreed to have the epidural removed just in case. The dizziness remained. The nurses thought maybe it was the pain medicine, so they had the doctor switch me from a drip to an oral medicine. The dizziness remained. I remember that my pastor came in to see me and I could not take Holy Communion due to the nausea from the dizziness, and I asked him to pray for me. I was a desperate woman!

The dizziness remained for the entire hospital stay, and even several days after I came home. Eventually it faded and went away, but the memory was vivid. It was so out of the realm of what I had expected, I knew I would never forget.

Unfortunately, I didn't have to wait long before I experienced it again. If you have been a reader here for a few years, you might remember this incident. I had the exact same symptoms -- intense dizziness -- brought on by bending over with my head upside down, and standing upright quickly. It was only the second time in my life I had felt that way, but it was exactly the way I felt after surgery. After a trip to the ER and the diagnosis of vertigo, I had an appointment with an ENT who told me that he has noticed that once a patient had experienced vertigo one time, it tends to reoccur, often with less provocation that the first time. Because the vertigo I experienced after surgery was never labeled as such, I still didn't really connect the two. I thought what I had done the second time was really the first time. It wasn't until a year or more later, after several more mild episodes, that I realized the first time was really during surgery.

But, why? What in the world had happened during surgery that could have caused such an episode of vertigo? I actually joked that the surgical staff had dropped me on my head. Like most jokes, however, it had a kernel of truth -- could it be that something happened while I was sedated that caused this condition, something which apparently was going to be with me for the rest of my life?





...tipped head down for easier access to the lower abdomen...oh my goodness, could it be? Could it be that my surgery was also performed with my head down? Could it be that being in a head-down position had caused the dizziness, the first episode of vertigo? The doctor never mentioned this was the case, but he did tell me that the surgery could not be done with light sedation (I asked) because the contents of the upper abdomen had to be pushed up toward the lung cavity so he would have room to work, and that required a deep sedation. Could it be that gravity helped push those organs toward the lung cavity because the patient was tipped in a head down position? I certainly would never know since I was completely out from the moment I was rolled into surgery until the moment I woke up in recovery.

After thinking about it for a week or so, I decided to call my physician (a urogynocologist) and just ask. Maybe they wouldn't tell me, but maybe they would.

After a two minute conversation with the office manager, and a brief hold while she asked the doctor, I learned that yes, my surgery was done in a head-down position for easier access to the lower abdomen.

While I can't know absolutely, I feel 99% certain that the position I was in caused the first episode of vertigo during surgery, and have resulted in mild episodes of vertigo since, and probably will for the rest of my life. I can manage it -- I never move my head too fast, don't turn in bed too quickly or sit up too fast. These are all easy things to remember, and now that I have the answer I was looking for, I can absolutely quit wondering "why?".

In the days before I finally called my own doctor I did a lot of internet searching for others who had the same experience. There are a lot of women who woke up from a hysterectomy with vertigo, who were told it was probably the anesthesia, or the pain meds, but none who I read about were told it was the position their head was in during the actual surgery. If you have found my blog searching for reason why you woke up in recovery with a tremendous case of the spins, I suggest you call your doctor and ask the question I asked -- "was your body in a head-down position during surgery?". You might just solve a mystery in the process.

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