People Watching at Starbucks

Unbalanced wooden seat

Silent rain on the window

An enjoyed song played not so loud as to cancel out the rest of the sounds:
--alternate song playing from the ceiling
--coffee order announced
--parent directing their child
--another order taken
--elderly couple chatting quietly
--shuffling feet
--chair scraping
--coffee machine hiss
--friends speaking in serious tones
--student occasionally typing up another line
--rustling paper from a notebook
--laughter from the group that have too many chairs to fit around their small table

Harried and not
Unsure of where to look; watch their phone; chat with company

Wait
Go
Run to the next or wait comfortably

Raindrops pool under the umbrella

Others occupy this same chair, separated by time

Check your watch

Your life is as complex and rich as mine is.  I'm a background character in your day.  Brief proximity.  Quickly forgotten.  I am the color of the wall.

Back to our own world.

Melvin & Me, Part 26: Perks of a Colostomy

So, I did have my colonoscopy a couple of weeks ago, and I have to say it was a pleasant experience.  I know, I know I have a weird definition of fun, but maybe it's because I've had so many of these by this point that it's too familiar to be too much of a bother.

Okay, so coming up to it I was anxious.  Very anxious.  This was the first one that I have done with a colostomy which means that the rules are different.  That unknown is a flavor of unnerving.  I wanted to be in control of the situation, as a means of protecting myself--I tend to assert my bodily autonomy with a practiced kind of force.

But once I was there, I delighted in throwing people off of their autopilot.  A colonoscopy is a pretty standard procedure--however, I do not fit the normal mold anymore, by circumstance and by choice.

The tech brought me back to my room, handed my gown, and gave me instructions to strip down, except that I could leave my bra on.  I started by asking if I really had to take my underwear off, explaining briefly that I had a colostomy.

"And it's completely closed off?"
"Yep, there's no way they're getting in that way."
"...um well..."
"Do you want to go ask someone?"
"Yeah, I think I'll go ask someone."

She came back later apologizing and saying that I probably should.  I complied and then also asked if I could wear the socks that I brought that had the non-stick grip instead of the disposable hospital non-slip kind; I didn't want another pair of these to throw away.  She was also unsure about these, but made the call to allow it.

My actual nurse came in to go over paperwork with me.

"You're the one with the colostomy?"
"Yep."
"And it's completely closed off?"
"It's sealed and permanent."
"Oh, you can totally wear your underwear."
"See, that's what I thought."

The nurse who was actually going to be with me in the procedure came in to join the conversation, get the IV started.  She was talking a mile a minute but not irritatingly so.  I mentioned casually that this is the third ostomy that I've had, and she asked me to explain, which led to a long slew of interruptions where she was assuming my answers and I was patiently correcting her until we had some semblance of the truth, at least.  Finally, we got to the "wow, you've been through the ringer!" point and she seemed to slow down a bit.  I told her that I had ostomy bag changes with me in case they were needed--she suggested that we could baggie one up and bring it in there with us, which I very much appreciated.

Then anesthesia came in to have me sign that paperwork.  After their normal slew of questions and asking me to open my mouth to check my throat (in case emergency intibation became necessary), I threw my second major curveball:  "I know that you said you weren't going to be the person in the room with me, but I want to start this conversation as soon as possible:  I want to be awake for as much of the procedure as I can be."

This was immediately met with confusion, but she was quick to seek clarification and told me that she would make a note and to make sure that I have a conversation with the anesthesiologist in the room.

Eventually I was wheeled into the procedure room.  It's amazing how much more secure you can feel when you're allowed to wear your underwear in and wear your own fluffy (but non-slip) socks.  But I also had my extra ostomy supplies in my hand which helped almost more than everything else.

A tech in there was getting everything ready, wiping down the machines and the like.  Once those tasks were complete, she turned to me and said:  "Okay, now roll over onto your left side."  I immediately asked why.  She started stumbling through an answer and my nurse jumped in to explain that I had a colostomy.  She didn't know, but she was also on autopilot.  I softened a bit and cheerfully explained there was no entrance there anymore and exposed my colostomy bag.

Then, the anesthesilogist came in with "I heard you want to do something a little different."  And he then came over to really talk to me, stating that he wanted to understand what my goals were.  I felt heard and validated in that moment.  What my doctor and I had discussed was a bit of anesthesia to get started, and then having me wake back up sooner, so that I could still see everything and be part of the conversation in the moment.  He was thinking aloud, calculating his values out and I caught "Versed" in the list of medications.  I asked him if that medication was counterproductive to my goals since it stops the brain from forming new memories.  He looked at me again with new eyes, paused, and then explained with a smile that meant I was "in the club" that Versed actually had seven documented uses, which also included anti-anxiety and anti-epileptic (not that they were expecting any seizures today).  Where we ended up was a bolus of everything so I do not remember the insertion, but I was able to be very lucid at the end when they were taking biopsies.

Things were looking good.  And I got to be a part of that.  I am an active part of my own healthcare team.  And it saved my doctor from having to touchbase with me back in my room afterwards, since I was able to see things with her and run my own colon commentary.

It did start to feel uncomfortable right around the end.  I was about to say something when the camera was out.  While they were cleaning everything down, I was congratulating and thanking the team on a job well done and their patience.  I then checked around the ostomy--there was a bit of oozing around it but not too bad.  I asked for the bag to clip back on--the way it had been set down, the contents of the bag had oozed all over itself.  I suggested that we go ahead and just do a bag change.  They assured me that they could wipe it down, but I insisted that I could just go ahead and do the bag change if they could hand me the supplies.  Once again very grateful to be awake and coherent.  It's not that I don't think that they could have put the bag on well, but I know that I will put it on successfully.  Having that control made me feel so much more secure.  

I felt heard.  I felt safe.  AND I got a chance to see that my colon is looking pretty good on the inside as well as I have been feeling on the outside, which is incredibly validating.  

And bonus:  I can add a couple of items to my list of colostomy perks!

• Colonoscopy prep is SO much easier, with minimal sprinting toward the bathroom
• I can wear my underwear through a colonoscopy
• I can literally poop anywhere
• I am entirely desensitized to poop--doesn't faze me at all
• No one can pass the buck on their fart--it's not me unless there's a serious problem, yo
• I have the opportunity to remind people that not everyone faces the same situation
• I have the opportunity to share compassion with others going through significant medical or other life changes with a particular and authentic compassion by identification

And most importantly, I have a significantly improved quality of life.

Our New Favorite Sport

Andy had a tradition growing up where they would watch a great deal of sports, football and NASCAR being particularly influential forces to the Sunday routine.  My father watched football and baseball in our household, but other than the occasional White Sox game, I didn't tend to watch much with him.  Early in our dating and even into our marriage, Andy tried to get me invested in the Bears, but it just didn't seem to take for me.  More often than not, I'd fall asleep a few minutes in.  I did start paying a bit more attention just by proxy, and then started paying more attention to controversies around the players, including a lot of domestic violence, sexual assault, and a whole lot of ugly that I did not want to condone any further.  When more information about concussions started coming out, how players were literally risking their lives, I was even more turned off.  Hearing stories of how players would take pain killers before charging into the fray felt profoundly unsafe, too--pain is your body's way of telling you to STOP, not just an inconvenience to be ignored.  Andy started pulling away from football, too, over time, but Nascar was still a favorite.  Eventually, though, we had further discussions about how wasteful the sport was, how much waste and pollution was encouraged in two dozen cars going round in circles every week.  He started to pull away from that sport, too.

Well, we have found something now that we both enjoy very much:  Overwatch League.

Game-faces on! (including panda slippers)

For those unfamiliar, Overwatch is a video game.  There are a few different ways it is played, but it is always with a team of six against a team of six.  There's one where it's a team equivalent of king of the mountain, where the team is trying to take charge of the same area that the other team is, there are other maps where there is a team defending points or objects while the other team is attacking, either to conquer that area or escort the object (payload) from one area to the other.  Yes, we are watching people play a video game, and I don't see this as much different than watching athletes play a physical game on TV.  However, it has a few other great things in its favor:

• None of the players are going to be physically hurt.  No one is risking their life and health to bring us this entertainment.
• The players can choose from about seventy different characters, which means that the play is as varied as the different skills of those characters, all with vastly different abilities and powers.  Even when they happen to pick the same characters, there are different strategies to use them.  Additionally, the area that they play in, which map that they choose keeps everything fresh, where strategies that worked on one may very well not work well on another.
• So far, comparatively few of them have been involved in domestic abuse scandals or other major legal troubles.  I am not contributing to a culture that lets celebrities off of the hook from real consequences just because they throw a ball really good (poor grammar intended).
• The sport also is actively concerned with their players physical and mental wellbeing.  
• Our favored team, the Chengdu Hunters, is also wonderfully sportsmanlike, complementary of their opponents while still gearing up the excitement for the next match.  
• The sportscasters will interview players in different languages, live-translating their questions and the players' answers, better representing the wide audience that enjoys the game and the sport.  
• Guys, gals, and non-binary pals can all play together in one team.
• The players and casters can laugh at themselves.  Even in some of the screennames persons have chosen for themselves indicate some of this additional levity.  This might seem very minor, but as it stands, a lot of male sports encourage toxic masculinity in a way that is not quite so extreme here (there are definitely a few players that come to mind that break this trend).  Some of this, I think, is due to the mix of cultures present in the group, but it's such a relief to see aggressiveness in a way that's less threatening.

This is not to say that I don't still fall asleep while a match is going on or that there aren't times when I can't follow the action because of how fast some of these players' minds seem to work, but I can still recognize the skill it takes to do what they do and I look forward to having it in the background as white noise or to actively groan and cheer in turn as my team pushes forward.  

The season has just ended for this year, but it's been a lot of fun to find a sport that both Andy and I enjoy and feel better about enjoying.  

Melvin & Me, Part 26: Colonoscopy with a Colostomy

It's that time again, where I'm gearing up for another colonoscopy.  I'm supposed to have one every other year, since with my Crohn's I have a higher propensity to colon cancer than your average bear.  Parts of me don't mind--this one I'm particularly looking forward to so that my doctor and I can really see how my body is doing since my colostomy surgery.  But, the prep is going to be the same frustrating mix of ugh and misery regardless.

For those unfamiliar with colonsocopy as a whole, I would refer you back to this blog post, which outlines the basics from the last time I had one.

Here's what's different--this is my first colonoscopy I've had with an ostomy.  I have no anus to put the camera up anymore; my rectum is permanently sealed.  EVERYTHING comes out of the ostomy.  So how can I even have a colonoscopy?

Whelp, I still have a colon (albeit three fifths of one) and it still needs checking.  The exit may have moved, but the process is otherwise the same.  Rather than laying on my side to allow the team to access my butt, I think I'll be laying on my stomach, exposing Melvin by either taking off the entire bag unit or removing the bag from the flange--this hasn't been made specifically clear, even though I've asked a couple of folks.

Unfortunately, the process if very familiar, but in the same breath, everything is different now.  My prep this time is a whole bottle of Miralax and some Ducolax tablets and as much clear liquid (nothing with red or purple dyes) as I can suck down.  The day before is a purely clear liquid diet, which means I reserve the right to be hungry and cranky in my basement, with exclusive rights to the bathroom and tv.

With the prep process before, when everything was "normal" in terms of typical egress, I had a couple of moments every time to rush to the bathroom, where I felt the heavy rumble settle ominously in my pelvis and new that I needed to find a toilet immediately.  Lots of frantic shuffles to the bathroom.  But I have no sphincter control for Melvin:  everything comes out as it's ready, as peristalsis moves it through my system.  This eliminates the need to run to the bathroom, but the new concerns are A) ensuring that there is not a leak, since this would be a CATASTROPHIC leak and B) emptying the bag frequently.  In some ways, it is more convenient, but still annoying.  The ominous rumble is still there (and general malaise from shedding so much fluid), but I can saunter over to the bathroom to empty out the sloshing bag as I need to.  And my butt isn't chaffed at ALL.  This time, the anxiety has been the unknown rather than urgency.

Here's what else is different:  the truly scarred and angry parts of my colon are gone, the areas that were unyielding and particularly painful, this new reality coupled with my intellectual curiosity means that I have requested to be awake for the procedure.

Other countries do this as the norm--without the anesthesia, you can return back to your day immediately after.  It's more of an uncomfortable pressure than it is a true pain, assuming that you don't have the kinds of problems that I had around my sigmoid colon and rectum.  I have very contently been unconscious for those that were sure to be painful.  But this one, I want to see.  In fact, at Mayos prior to the last connection surgery, we did a mini-scope in the office to check where I had been partially reconnected and I was fine through that process.  I want to talk about things in real-time instead of the pictures afterward.  My doctor recommended that maybe we use some elements to get started, but that she would be fine with me being awake for the end, basically the pulling-out part of the camera where she is also taking the biopsies.  I want to really see how things are looking as they are moving with my breath and my hand against my abdomen pressing down.  These parts of my body that have caused me such anxiety, pain, frustration, and all else, I want to see them for how they are, have compassion for their real face.  Comment on the pseudopolyps (basically pillars of scar tissue), the color of certain spaces, watching it move, I am truly excited about this.

Almost makes the misery of the prep worth it.  Almost.  Well, we'll find out soon enough--I'm heading there early this afternoon.  Just a little more prep to power through yet this morning, with all the nausea and blech that implies.

Melvin & Me, Part 25: Food

Well, the new school year has hit at work, with all of the hair-pulling that implies, and it has also hit my personal life--folks I know are adjusting to new schedules, certain areas of town are a little more populated than they were a couple of weeks ago, and a slew of activities that took a break over the summer have started up again, too, such as Chancel Choir at church.  As part of this, I've started taking a nutrition course and had already read the first two chapter before the class officially started.  I mean, I've only learned about the scientific method a dozen times by this point in my life, what's one more?  ~sarcasm flag

But as we've started into the more specialized material, I have been stewing over the weird relationship I have with food.  I have a WEIRD relationship with food.  And I have every reason to.

I was diagnosed with Crohn's when I was twelve.  In a Crohn's flare-up, I have no appetite, and what food I do eat tends to hurt the entire way through and otherwise little nutrition is absorbed from it.  This means that I've had some specific coaching from my GI doc at different times about what food I should and should not eat.  Losing thirty pounds in a month due to malnutrition because your body won't cooperate, that's not an experience I would wish on anyone.  At these times, I was encouraged to eat fast food if that's what it took to get calories in me.  If ANYTHING sounded appealing, my family would find a way to supply it if at all possible, but there were times when I had to force myself to eat anyway.  Forcing oneself to eat when you're not hungry and you know it's just going to hurt like hell, well, suffice to say I have a hard time making myself eat when I'm not hungry still, even though that particular pain is gone--I remember the fear, fear coupled with despair.

When the flare-up is a little less severe, there were still some rules, like instead of eating the wheat bread that had fibrous chunks therein (the branded "healthier" choice), I was told to go toward the white bread because A) I needed the extra vitamins since I was not absorbing them well at the moment and B) I was going to have more difficulty digesting fibrous things.  Let's add to that the colostomy, where some resources say I should never eat cruciferous things again, that I should stay on the ostomy diet in perpetuity.  I have recieved unsolicited and/or uninformed advice from people working at various health stores, running the concession stand, or suggesitons over the internet insisting that everything that ails me can be cured by **insert miracle product of the week here**.  This has ranged from folks saying that I should stop taking ALL of my Crohn's medication and substitute it with essential oils to the seemingly innocent suggestion of "are you sure you don't want X option?  It's healthier."

"Healthier" is relative, folks.  "Healthier" is meaningless to me in some ways.  I use it as a metric for myself, that I am healthier now than I was three years ago, for example, but I don't apply it to things.  When I am weighing food options, "Healthier" feels strange in my mouth, and one of the larger reasons why I won't like a food is when it has a wonky texture.  Receiving advice around that word from anyone other than my doctor, then, almost feels eating someone's half-chewed food.  "Healthier" also tends to bring with it a level of implied guilt, that I'm not taking care of my body correctly.  I want to enjoy food, but food has so much baggage for me:  why add any additional guilt to that?  I am learning to have more compassion on my body, so sometimes I can frame the conversation that way, that it is a kindness to myself to choose one option over another.  Throw in there that I need to have compassion on my emotional self, too, that a bit of comfort eating could be a different kind of kindness to myself.  All these elements together and I have a thirty minute internal conflict on whether I'm allowed to eat lunch, eat a particular lunch, and if I'll allow myself to be any kind of happy about it.  Even the have a snack vs not having a snack debate in my head is between the survival part of myself that wants to take in calories while it's seemingly safer, the part of my body that wants to just enjoy the taste of something without all the damn drama, and another survival part of me that is protecting the longevity of my body and its goals.

In short, every conversation about my eating habits is by default an emotional one. And I haven't even touched on the constant bombardment of marketing peppered with health buzzwords.  The survival parts of me that are fiercely protective about my bodily automy are on immediate high alert with even an inferred implication that I'm not taking care of my body correctly.  This doesn't mean that I won't talk about it or take suggestion, but that suggestion has to be framed very carefully and with some kind of a credible source.  There is a huge difference between "have you heard about X?" and "you should totally try X!"  The following sentence on either is also very important, having opened a difficult conversation and how they choose to continue, but the way that it is introduced will set me on edge when it's the latter, every time.  I would also stress that anything over text (email, SMS, or whatever) is more likely to be categorized into the hIGh ALeRt! camp of things regardless.  I am not opposed to new ideas; I am very skeptical of all things looking to alter my nutritional intake, particularly something that has no grounding in my particular concerns.

All of these things roiling around in my mind when I'm just trying to enjoy an ice cream cone, when I choose a salad instead of a taco, or when I'm trying to decide what to have for lunch when we come home from work midday or need to find something to eat now because that's when I have a break in the day and not necessarily when I'm hungry.  Now that I'm currently in a better place regarding my health--where I am routinely in less pain and able to get enough calories in--some of these voices are quieter, making room for some that want me to consider my weight and activity.  On the one hand, weight is just an indicator and not the end all and be all--I've had people tell me excitedly that I looked like I had lost weight, and then I painfully  explained to them that this was not a good thing because it was a byproduct of malnutrition caused by my disease, which definitely puts a damper on the conversation.  Actually, I have a few people that ask if they should congratulate me on weight loss or not by checking in whether it's the good kind or the bad kind, and I'm both pleased and touched that they check (it's been a while on that count, though, with summer being as stressful as it has been).

The survival parts of myself are LOUD.  They will berate and roar and demand and chastise and all else to urge me into a particular safe path.  It's like an internal overbearing parent, so intent on protection and fixated on the deatils that this particular part of me has forgotten the real goal of loving myself.  Or as another anaology it's like allergies, where the body is so intent on protecting me from a percieved danger that it makes it hard to breathe.  I appreciate the goal of that protective part of myself, but when we take a step back, the methods are counterproductive toward that goal of self-love, more harmful than it is helpful.  I'm trying to redirect that energy, to condition that protective part of myself into a more constructive help, something outside of panic mode.  Redirecting the inner critic means I can by sympathetic toward the goal but still acknowledge those methods are harmful, pointing that drive to areas that are going to be more helpful and redesigning those methods of expression--how I talk to myself matters.  And the crux of it all is finding the real goal of that voice--keeping me safe--and teaching it how to reach toward that goal with new, compassionate tactics.

It's a process.  I have gained better awareness of these parts as a starting point, but even in knowing the triggers there's a lot of work yet to do.

Boiling Frogs

There's a phrase that has come up a few times in the last while here that is so readily applicable to what myself and others close to me have been feeling that I feel compelled to share it.  Please forgive the inhumane nature of the metaphor.  

If you want to cook a frog, you can't just put the frog into a pot of boiling water.  They'll immediately start attempting their frantic escape, eventually hopping out of the pot to freedom and probably splashing their would-be predator with some boiling water in the process.  Instead, you put the frog in a pot of cold water and gradually turn on the heat.  The frog doesn't realize how hot the water is getting because it has adjusted to the temperature in increments.  

It is HARD to really get the sense of how hot the water is when you're in the middle of the situation, whether it's a stressful job, a toxic relationship, a health-related situation (such as chronic pain), or any number of other things.  When you've been in pain so long that you don't remember what it was like to not be in pain, that's like looking down and noticing that your skin is bright red from the heat of the water.  When you rationalize that this pain isn't so bad because it's not as bad as yesterday, that should be a clue to look over at the thermometer.  Just because you've gotten used to something doesn't mean its a good thing or a healthy thing.  

Let's take work right now for example.  I expect summers at my job to be stressful; it happens every year.  Schools moving to our software are concerned about everything starting off on the right foot, clearing up any weird things that came over from their old software that they had never gotten around to fixing, and making any last-minute changes that their superintendent happened to sneak into the last staff meeting as an innocuous bullet point on the agenda.  Even schools that have been with us for years might have new changes, new programs, new staff, or maybe the school is moving from semesters to trimesters.  Then, there are all of the different first-day-of-school-panic moments, where concerns that might normally be only a minor annoyance take on a new level of urgency.  Everyone knows that their emergency is the only emergency that matters.  It makes sense.  I don't begrudge anyone their panic and their anxiety--they need to feel what they need to feel in those moments.  This means that I am very, very busy from April through August, not only in training up folks for the upcoming year but also addressing those different overarching concerns and whatever else that pop up.  It does mean that part of my job occasionally entails talking someone off of a cliff, reassuring them that we will make that solution together and help them check pieces off of their massive to-do list.  My job is to be calm; my job is to empower people to help themselves; my job is to help find creative solutions to match creative situations.  

I never realize how hot the water is until things start to quiet back down.  I never realized how thin I felt stretched until the bulk of our schools have moved past those first day jitters into their smooth routine.  There simply hasn't been time to check inane things like how hot the water is.  I have three other people that I want to help before I can allow myself to take a bathroom break.  I and others on my team are invested in helping people, and sometimes that means you lose yourself in the details; this isn't necessarily healthy, but it happens.

What are the symptoms of "boiling water" has been a question I have been asking myself recently.  If I can't physically see a thermometer in the pot with me, what other markers do I have?  For me, mental exhaustion has been up there, which means that we tend to eat out more, since I don't have the mental space or energy to make anything at home; I also lose my gym habit.  I start the day off with some tired from the previous day.  Little things that wouldn't bother me suddenly are a little bit harder to move past.

What would be better than waiting for the "check engine" light of my body to turn on (or worse, steam to pour from under the hood) is to be more cognizant of checking in with myself.  My body will tell me where it's needing additional care or compassion.  I tell myself I'm too busy to stop, that I live on kinetic energy and can stay moving as long as I stay moving.  Coming to a standstill frightens me, in some ways, but I can't realize how warm the water is if I don't take time to feel it.  In short, I have a level of fear that I need to fight through in order to give myself enough space to honestly assess what my needs are, particularly when I've been so caught up in helping others work through theirs.  

In therapy, we have discussed how everyone's needs should be considered in a decision, and then my therapist very pointedly reminds me that means my needs should be in there, too.  I struggle with that in quite a few places.  

The water is cooling down a bit--it's still terribly hot, but it is giving me at least some idea of how hot it is, just by comparison.  Again, summer at work always has this element to it--it's to be expected--but I will not be sad to get past September.  It is a cyclical process at my job, but I have also decided that I need to check the water temperature in different places, to check in with myself from time to time overall but also in specific parts of myself.  I'm still learning how to pause and check the water, how to give myself space to do that.  I'll keep you posted.

Permanent Changes--No Peterson Baby, Folks

I have made permanent choices for myself before, the kind of elements that leave a lasting effect on the rest of one's life.  There are events you pick for yourself--such as whether or where you seek higher education--and people that you respond to--such as the friends you keep and whom you love--that certainly shape your life and world, all framed by some of those choices, but there is something very different when it comes to making permanent changes to your body.

There are a few situations where my best choice involved surgery, most notably my choice to have a permanent ostomy as my best course of treatment for my disease.  The choice was purely in my court (with all of my doctors, thankfully), and I could have languished a bit longer, but this was the best decision for my quality of life.  I do not regret it.  Still, all of the rationale and logical backing do not prepare anyone for actually scheduling the date.  There's something that hits home there in a way that I still cannot prepare myself for, even after four or five surgeries.  To a lesser extent, there's still that harsh reality that settled in when I made my tattoo appointment and my Lasik surgery date.  Neither of these two examples were as drastic as my permanent ostomy, but the permanence and recognition that my sense of self was going to have to change with it, that is still a lot to process and digest.

In this vein, I have made another permanent choice in my life:  I have decided that I will never complete a pregnancy; I will never have a biological child.

Nope. Not changing my mind on that one.

And, yes, that even means that were I to become pregnant despite all of my precautions, I would probably get an abortion.  Here's why:  everyone I have talked to that has gone through pregnancy acknowledges that there were permanent, unexpected changes to their body afterward (pelvic floor, vaginal tears, etc.); I have talked to many women that have felt they could not talk about their real frustrations with motherhood and/or any frustrations they had while being pregnant because of social pressures and/or dismissal of those concerns; I have three qualified specialists familiar with me and my case say, on no uncertain terms, that I would have a high risk pregnancy situation if I was able to carry at all; and most importantly, particularly coupled with that high risk situation, going through a pregnancy would absolutely emotionally destroy me.

I mean that last one in particular.  Emphatically.  It would break down all the things that make me who I am, and I would be in agony for (best case scenario) nine months, let alone the recovery time and the significant period of sleep deprivation afterward.  It would have physically killed me at other points in my disease and my life.  Every time I have something as mild as a stomachache, there is a series of mental gymnastics that I go through, where I'm worried that this is something that I need to address immediately because it is the first symptom of another Crohn's flare up.  Every.  Time.  Now, couple that will all of the weirdness that happens to a body that is pregnant.  No thanks.  I cannot willingly subject myself to something that uncertain.  I think this could easily foster resentment to hypothetical child, too, which is three kinds of unfair to hypothetical child.  Even if all of my Crohn's symptoms went away and did not play "catch-up" after and I had that child here in my arms, nope, I cannot say that it outweighs all of the things that could go terribly, terribly wrong.

**I want to emphasize that these are my reasons, but no one needs to have ANY or all of these in order for their decision to not have children be valid.  Full stop.**  No one needs to ride the monogamy escalator for the sake of riding it.  

I have analyzed my wants.  I have analyzed my needs.  I have analyzed my goals, emotional and otherwise.  A biological child is not in the cards for me.  There's some emotional processing to do with that yet, but this is the right decision for me.  Even harvesting eggs is a process, involving many appointments, shots, and drama.  This is not to say that I haven't had doubts, but I know that I have made my decision in this.  Adoption is not off the table, but I will never carry a child.

What does Andy think of this?  Let's ask:

Andy, what do you think of this?
I think that, I mean, it's your body and your decision and I'm glad to be a part of it.  I do not want to put you at risk.  The choice between a hypothetical child and you living, I'm going to choose you every time.  

So, what does that mean for you?
Well, it means that my dreams need to change.  I dreamed of having biological children, passing on traits of my family and yours, seeing my or your eyes reflect back at me through a child's eyes.  If that's not a possibility, then I feel a large responsibility to see that you're kept safe, that [a pregnancy and/or abortion] is not something that we have to deal with.

What do mean by "large responsibility?"
If I am going to stand by my words and say that I won't put your life in danger, then it is up to me to take steps to ensure that [a pregnancy] doesn't happen.  You have decided that you will not complete a pregnancy; I support and respect that decision.  It's OUR responsibility TOGETHER to ensure your safety.  As such, given the various options available in birth control and their associated risks, the most logical step for me was to get a vasectomy.  It's a simple procedure; it's safe; it's effective; and it's FAR less likely to have complications than any permanent solutions for women.  

I love you, in case you weren't sure.  How was the vasectomy?
I can't say it was the most pleasant fifteen minutes of my life.

Only fifteen minutes?
Yep.  For all of the "oh God I can't believe you're doing that?!" from society/friends, it really was not a big ordeal at all.

Are there any details you feel comfortable sharing with us?
Yes, I am more than happy to discuss anything and everything.  What do you want to know?

How long before you could start walking normally and not like a cowboy?
[laughs and puts on best John Wayne voice] Well, pilgrim, I would say from start to finish, um, maybe a week and half?  The worst of it was certainly over in a week.

What was the worst of it?
The worst of it was feeling like you'd just gotten a "dinger" for a week.  So, any time I had to move/walk it was a careful process.  

After that week, any other noticeable symptoms or issues?
The tenderness goes down more and more each day, but otherwise, no.  To be perfectly blunt, everything functions as expected, normal.  

Any suggestions for anyone considering a vasectomy?
I would say, first off, don't get scared by what other people try to put in your head about it.  It is simple.  It is truly not a big deal.  With a skilled urologist, you're out in fifteen minutes.  It's a simple process.  In regards to recovery, follow doctor's orders, don't take things too fast, and get yourself some bags of frozen peas.  Those will be your best friend.  I'm happy to be a resource for those with questions, too, if anyone needs the gory details.  Depending on how active your job is, you may want to think about taking a few days off, just until the initial tenderness goes down.  Oh, and one more piece of advice is to get some supportive underwear--any sort of wiggle is uncomfortable for the first few days.  If you can "contain" yourself, your recovery would be much more manageable.

Anything else you would like to say about the process?
Make sure you and your partner have discussed the permanency of this.  While vasectomies can be successfully reversed, it's not a guarantee.  Act as though it is a permanent change.  

Speaking of communication between partners, is there anything else you'd like to mention?
["Oh yeah" sound in the back of the throat] While it isn't something that you're guaranteed to run into, many offices might require your spouse to be present or sign a waiver to consent to the procedure, knowing that it will make you sterile.  It was an interesting point of empathy for me, to go in that moment "oh, holy crap, this is what it's like to not have full autonomy over my own sexual well-being."  

Anything else at all you'd like to say to the people?
While I've greatly appreciated the support of my confidants and friends, I've more than once heard the phrase "hero" as part of this decision, and I don't feel that it's well-deserved.  Taking care of each other, keeping each other safe and healthy, that's an inherent responsibility in a committed relationship.  All I did was take the best possible step to make sure that happens.  I guess what I'm trying to say with that is men taking responsibility for their part [in pregnancy] should not be such a rarity.  

Thank you for being a wonderful human being and partner.
[uncertain] Thanks.  [brightening] Happy to be in this together with you!