Before I left the gynecologist’s office, I made an appointment for an ultrasound for the next morning. Later it occurred to me that I hadn’t been told to drink lots of water beforehand. I was even more confused when the administrative assistant and the ultrasound technician both asked me if I needed to use the bathroom.

“Don’t you need the person to have a full bladder so you can see?” I asked the technician. I told her about my previous experiences.

“No, we don’t have to do it that way anymore,” she replied.

As she went about her preparations, the back of my mind mulled this. The technology hadn’t changed that much, so I was mystified by the change in direction. Hesitatingly, I asked what was different now that a full bladder is no longer required.

“With a vaginal ultrasound, a full bladder would just get in the way,” she explained.

A vaginal ultrasound? I’d never had one and wasn’t going to now, I thought, as I eyed a wand sticking up from the machine with suspicion.

I told her I wanted an abdominal ultrasound only.

“Well, that’s a problem because I won’t be able to see what I need,” she said, explaining why and adding a discreet reference to the size of my stomach.

“I won’t have it done.”

“I’m not comfortable doing an abdominal only because it’s not going to show what we need to see.”

“And I’m not comfortable with a vaginal ultrasound.”

After a few rounds, it became clear we had reached an impasse.

She paused in her preparations, and I could see her mentally weighing how to handle this. I couldn’t be talked or forced into a vaginal ultrasound, yet I wouldn’t there if the gynecologist hadn’t wanted a look. She sighed.

“Tell you what,” she said. “I’ll look to see how much water you need to drink, and we’ll try it.”

So she looked. And looked again. And kept looking without stopping to have me drink water.

“Can you see anything?” I asked.

“Yes. I can see your left ovary, which is good. Your uterus is so large that this is going to work out fine. The only thing that the vaginal ultrasound would have picked up that this can’t is your cervix, which your doctor can see during an exam.” She paused and said brightly, “See, the patient knows best!”

“I don’t know anything,” I said, “except that I wouldn’t like a vaginal ultrasound.”

She laughed. “No one likes it!”

She told me there are two fibroids to the left and either a third large one or a large cluster of several smaller ones. She gave me the measurements, which I was not in a position to write down. I remember, I think, three inches by four inches and four inches by four inches for two of them. Cumulatively, the measurements would be about 10 inches each way. She confirmed my doctor’s estimation that the uterus is the size of a 20-week pregnancy. With ruler in hand, I can see why that would be considered “enormous” or “huge” and how it might cause bladder and other discomfort. Next week the gynecologist will tell me what she thinks.

A UFE is starting to look like a possibility . . .