It all started on April 25th, 2004, the day I celebrated with my friends my 18th birthday (the age of majority in Brazil).

I went home after the party and woke up during the night with the weirdest pain. I felt some abdominal cramps, but I also had this piercing pain in my shoulder blades, especially when I lay down. My parents took me to the hospital, and the doctors spent many hours testing and prodding, without answers. The pain was getting stronger, to the point I could not even lay in the gurney anymore. Then the doctors decided to do an ultrasound.

We got into the exam room, and the technician started the exam. I remember his face changing when he saw the first images on the screen. He went very quiet. And then he called the doctor in. The doctor gave one look at the screen and turned to my mom and me. ‘There’s some bleeding, we’ll have to operate.’

The gravity of the situation had not hit me yet. ‘Ok, when do we have to do it?’- I said, thinking of my classes schedule for that week. He looked at me in bewilderment. ‘We have to operate right now, your abdomen is full of blood!’

Some 10 minutes later I was in the pre-operative area with my parents. The doctors still didn’t fully understand what was happening, but it seemed that the blood was coming from my ovary. So the idea was to open me and see what was going on.

Before I got in, someone came back with more exam results. He said – ‘the pregnancy test was negative, so we can discard an ectopic pregnancy’. That’s how my dad learned that I had lost my virginity a month before.

The surgery went well. Instead of cutting me open they did small incisions and inserted a camera and small tools (it’s called a laparoscopy), which makes the recovery way faster. I even got to watch the video later, and thought it was awesome – how many people get to see their own body from the inside?

Turns out there was a ruptured vein in my right ovary. As a result, I had lost one litre of blood, almost a quarter of my total blood volume. Despite being anemic, I didn’t need a blood transfusion, since I was healthy and could recover from it. Nothing that a diet of iron supplements, beet soup and beans couldn’t cure (and give me terrible cramps in the process).

As per the cause of it, the doctors thought it was a cyst, but they weren’t sure, and I wasn’t given much of an explanation. ‘This is extremely rare’ one doctor said. ‘It’s like winning the lottery, but backwards.’ He continued, as a way of reassuring me it would never happen again. ‘But take the pill, just in case’ he added.

Seven years later it happened all over again.

In we go again

I was living in São Paulo for exactly one year and had decided to stop the birth control a month before, as a way to deal with migraines. One night I woke up with THE pain. It was precisely the same pain, but I didn’t want to believe it and spent hours trying to convince myself that it was all my imagination. In the morning, as the pain persisted, I gave in and went to the hospital.

I already knew what was wrong with me and I explained it to the hospital staff. Despite that, they spent 7 hours doing tests and tests until I could finally get an ultrasound. Turns out it was the same problem in the same ovary. But this time the bleeding was inside of it and my ovary was inflating like a balloon.

The doctor explained to me that despite that my case wasn’t as serious as last time. The plan was to admit me to the hospital and wait a couple of days, to see if my body could sort it out on its own. The only problem is that there weren’t any beds available in that hospital.

The doctor said that and left me alone in the room when I started to cry. In the morning I had a friend with me, but she had to leave, and my boyfriend at the time lived in another city. I remember feeling desolated and abandoned, as no one was able to tell me what I should do next. This was 5 pm, and I was told that the staff was checking for other hospitals to send me. I sat in one of the chairs in a corner to wait.

My boyfriend flew in that evening and at around 11 pm a staff member told us that they hadn’t found any openings for me in the hospitals of São Paulo. They wanted to try the greater São Paulo area. I said ok. What was I supposed to do?

I felt like a ticking bomb.

At 2 am he came back to say that they could transfer me to the city of São Bernardo do Campo, 32 km away. I remember thinking that now I would be able to rest since we were going by ambulance. I was exhausted, so maybe I could nap. How wrong I was. The ambulance shook so much that I had to hold on to the gurney to not be tossed on the ground.

The second hospital

But at least we got there. We went to the reception and said that I was being transferred from the other hospital. The receptionist told me to go to a room and wait. And then she came in herself. She was the doctor. That was the first sign that something was wrong in that place. But I was already there, so I explained the whole situation to her.

She called in her assistant, who came in wearing a Disney sweatshirt – no white coat. They put me in a gurney in the weirdest position possible and started to examine me, which consisted of them aggressively poking me around everywhere. It obviously hurt when they poked the wrong places, and I started complaining, mostly because I was annoyed with that whole situation.

When we sat back at the table, we had the most surreal dialogue:

– We have to operate you right now – the doctor said.

– But that’s not what the other doctors said – I replied.

– Your belly is full of blood, we have to operate now.

– But that’s not what the ultrasound showed.

– That exam was done in the afternoon, your situation is worse now.

– Ok, but then I want to do another ultrasound before you cut me open.

– There’s no time, the technician would have to come from São Paulo. It could take one hour, and by then you could be dead.

I looked at her in disbelief. Fortunately (or unfortunately) I already knew how it felt like when my abdomen was full of blood. And this was not that. The pain I felt in the morning was gone. Other than the ultrasound showing my ovary being now larger than my uterus, all the other exams were normal. I asked her to excuse me while I went to the corridor to talk in private with my boyfriend.

As soon we stepped out I grabbed him by the collar and said – ‘You’re going to take me out of here. RIGHT NOW.’

I don’t know what came over me at that moment. I’m not the kind of person who grabs others by the collar and bark orders at them. But it reflected how strongly I was feeling that in my guts. My mind was blank. There were no other thoughts in my head other than ‘get out, get out, get out!’

So we went back to the room, and I calmly explained to the doctor that she might be right, but I didn’t feel comfortable doing the surgery there. She said ‘ok, it’s your life. But I can’t discharge you.’ My boyfriend and I looked at each other. ‘So we’re just going to… leave’, I said. And we got up.

The escape

We escaped through the front door, thinking – now what? Even though I didn’t fully believe her, I still had a serious problem of a bleeding ovary that could burst at any moment. It was 3 am and we were in an unfamiliar city. We decided to go back to São Paulo, to the first hospital. The plan was to get in as an emergency case (didn’t she say I was going to die?) so they would have no other choice than to admit me.

We somehow managed to find a taxi (it was 2011, Uber was not a thing). We asked the driver to go to Paulista Avenue (the most famous avenue in the city). The driver fumbled with some gadgets and after a long time told us: ‘Listen, lady, I don’t have this Paulista street on my GPS’. Another moment of my boyfriend and I looking incredulous at each other. ‘Just go to São Paulo!’ we said.

On the way there it was chaos. My phone was dead, my boyfriend’s one had very little battery left and my family kept calling him to know the state of things, while he tried to find which direction to point the driver.

Then a miracle happened.

The friend who had accompanied me to the hospital the day before was still up, checking in on us occasionally. We told her what happened and she started talking to another friend. They were both reporters in the Health desk in the magazine I worked for and knew the ins and outs of São Paulo’s health system.

My friend’s friend, who was on leave with a broken ankle and happened to be awake, started contacting hospitals to see if they had a gynecologist on duty. She found one that could take me in and the information was passed on to us.

We arrived at this third hospital and for the first time in this whole mess I met with a compassionate doctor who was willing to help. She took her time to talk to me, calmly checked my exams and did a decent examination. She said ‘You’re fine. There’s an important problem in your ovary, but it’s not like you’re going to die now. We’re going to admit you in and wait a couple of days to see if we really need to operate‘. ‘But do you have beds available?’ I asked. ‘We’ll make them available’ she said, determined.

That was how, after all this bouncing around, at 5 am I could finally lay my head in a hospital bed and rest. That lasted until 6 am when my parents burst into the room in a state of frantic panic after flying in from my hometown.

The doctors gave it some time, but on the third day it was clear that my body wasn’t going to get rid of the excess blood. So I went in for a second laparoscopy on my right ovary. This time I didn’t get the video, but I got really high coming back from the anesthesia and said some hilarious things to the doctors.

They did some tests and determined that the problem was caused by an ovulation cyst. My right ovary was badly damaged, but they were able to keep it. ‘Do this a third time and we won’t be able to save it’ the doctor said, as if I had caused the whole thing. ‘While you don’t ovulate you should be ok. Start taking the pill and don’t stop this time’. This time I saw it was serious.

Hemorrhagic what?

Since that day, it has been 13 years of me taking the pill, and I had no more episodes of internal bleeding. I’ve never gotten a proper diagnosis, but after doing some digging I found out that it was a ruptured hemorrhagic ovulation cyst.

Here’s how it works:

Hemorrhagic ovulation cysts (or Hemorrhagic Corpus Luteum) are a rare occurrence in women. When it happens it usually goes away unnoticed. But in some cases, it can cause pain or discomfort, which can usually be treated with medication. But in some of those unusual cases though, the bleeding that starts in the corpus luteum can leak to the inside of the body. When that happens the body usually takes care of the problem and absorbs the blood. In some exceptions of those rare cases, though, the bleeding might need surgery, which can usually be done in a somewhat elective way, in its own time. But in some exceptional cases of the unusual cases of the rare cases, the bleeding is so severe that it requires immediate intervention.

And that, ladies and gentlemen, is where I’ve been.

I guess I did win the lottery backwards. Twice.