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Re: Pain in legs and three dr's, ten years and nothing...
From: Alyson (anonymous@obgyn.net)
Tue Apr 3 14:45:46 2007
I'm going to jump back in here. It is my understanding that Dr. Cook
uses laser excision and ablation (aka vaporization). He believes the
combination is the most effective method of removal because in his
opinion there are some areas that cannot or should not be excised.
Doctors such as Dr. Albee strictly perform excision and may use either
the CO2 laser or the other methods and do not think vaporization is
effective. I believe D's quote from Dr. Cook is referring to
electrocautery being unacceptable as it only coaglulates or burns the
implant. Think of electrocautery as the tool a welder uses to melt a
piece of metal and the laser as the tool that would be used to cut
through a piece of metal.
That said, I want to reiterate that I am not saying that Laura's pain is
not or cannot be caused by the endo. Its just my opinion that sometimes
it is necessary to confirm or rule out other things that can be
mimicking the same symptoms in order to get to the correct treatment.
Have a great day ladies!
Alyson
At Tue, 3 Apr 2007, Elisa wrote:
>
>Hi D & Dr. Daiter~
>
>As always I so appreciate all the options available to better assist us
>all. I am a little confused on these last two posts if you could help
>clarify. Dr. Daiter's suggestion is excision can be done with laser?
>Correct? D's information with Dr. Cook's is it can't?
>
>I just want to make sure that is clarified so when we here we are having
>excised does that mean we should be asking our Dr.'s which exision
>method they will be using? I know dissection is to cut away, and I
>believe exisision was to remove, but now I am stummped on these topic :)
>
>Thanks to you both for helping on this. Welcome Dr. Daiter to the
>forum as well. I see that you came very highly recommended as well.
>
>Have a good day everyone!
>
>--
>Elisa
>
>At Tue, 3 Apr 2007, D wrote:
>>
>>My understanding is that vaporization and excision are two distinct
>>methods - excision can't be accomplished by vaporizing because by
>>definition excision is cutting. Lasers may be used to excise as well as
>>vaporize, but the two methods are quite distinct. Please see Dr. Cook's
>>site regarding the excision and vaporization of endo:
>>
>>http://www.pelvicpain.com/EVE_Procedure.html
>>
>>"The two techniques that remove endometriosis from the body include
>>excision (cutting the tissue out) and vaporization (the endometriosis is
>>vaporized; it is not burned). Coagulation or cauterization of the
>>tissue with monopolar, bipolar instruments or underpowered lasers is
>>unacceptable and not part of the EVE Procedure™. These latter
>>techniques result in a high rate of recurrence and/or incomplete removal
>>of the endometriosis...
>>
>>Excision can be accomplished with scissors, the Carbon 13 CO2 laser,
>>harmonic scalpel, and high current pure cut electrosurgery. When used
>>in a line the laser acts like a pair of invisible light scissors and can
>>be used to perform excision. The Carbon 13 CO2 laser has the advantage
>>over the other methods in that it requires one less incision for the
>>patient and frees up one of the surgeon’s hands to operate more
>>effectively.
>>
>>The Carbon 13 CO2 laser is a surgical tool that can also vaporize tissue
>>(when the laser beam is moved back and forth over the tissue rather than
>>in a single line)."
>>
>>At Tue, 3 Apr 2007, Eric Daiter, MD wrote:
>>>
>>>Endometriosis can cause a wide variety of pain (especially throughout
>>>the pelvis and lower abdomen but also including pain that radiates down
>>>the legs) and/or infertility (often without association with pain).
>>>Endometriosis in the cul de sac behind the uterus and in the region
>>>behind where the ovaries are generally located often cause the leg pain
>>>as well as "irritable bowel syndrome." Excision ("removal," which can be
>>>performed by qualified surgeons by vaporizing the endometriosis to its
>>>deepest involvement using the laser at ultrapulse power settings) is
>>>usually possible and almost always results in a dramatic reduction in
>>>pain. You might see the links on my website for some additional
>>>information, at infertilitytutorials.com
>>>At Tue, 3 Apr 2007, D wrote:
>>>>
>>>>Endo in the retroperitoneal areas (behind the pelvic cavity) can cause
>>>>back, hip, and leg pain. Most doctors don't even look back there, and
>>>>aren't comfortable operating in the area - there are a lot of delicate
>>>>structures like ureters that can be damaged. If you haven't seen an
>>>>endo specialist, someone whose practice is centered on removing endo by
>>>>laparoscopic excision, I suggest it, as they are most likely to be able
>>>>to help you.
>>>>
>>>>If you look back on this list there were some other posts concerning
>>>>back/hip/leg pain and endo in the past month or two with more info.
>>>>
>>>>In the meantime, if you are having issues with pain that your regular
>>>>doctors are not treating adequately a referral to pain management can
>>>>really help.
>>>>
>>>>At Tue, 3 Apr 2007, Alyson wrote:
>>>>>
>>>>>It is entirely possible that the endo is causing the back, leg, and hip
>>>>>pain. I went around and around with docs too and finally went to a
>>>>>reproductive endocrinologist. He kind of looked at the big picture and
>>>>>sent me off to all of the doctors he thought I needed to see. One of
>>>>>which was a rheumatologist. I have been having low back pain, hip pain,
>>>>>and pain down the inside and outside of both legs, along with broad
>>>>>pelvic pain. Turns out I have fibromyalgia. Tada! Now that we are
>>>>>attempting to manage that I can definately tell the difference between
>>>>>the fibro pain and the endo pain. Again, it may be the endo causing
>>>>>your pain, because it often does cause pain in those areas. But, it
>>>>>might be worth ruling out fibromyalgia or other joint/connective
>>>>>tissue/muscle disorders.
>>>>>Just an idea.
>>>>>Alyson
>>>>>
>>>>>At Mon, 2 Apr 2007, Laur wrote:
>>>>>>
>>>>>>I am so happy to have found this sight. After all these years with
>>>>>>adenymyosis and endo I feel almost sane again. I have had right side
>>>>>>pain and back pain on and off all these years trying to hold off the
>>>>>>hyst.
>>>>>>
>>>>>>Now at age 48 the endo comes back again with a vengence and different,
>>>>>>in that it started at the back ...went to the hip and down the right leg
>>>>>>with swelling.
>>>>>>
>>>>>>My OB GYN said it is probably diverticulitis, refers me to GI dr. who
>>>>>>orders everything but tests to r/o stomach related causes. GI advises
>>>>>>it is probably muscles LOL and refers to PCP who discovers I am
>>>>>>pre-diabetic or possibly diabetic and possible overactive thyroid.
>>>>>>
>>>>>>Get the picture ladies, everything but the pain, the awful pain that has
>>>>>>cost me a great job. This pain is on both sides of my right leg and so
>>>>>>bad yesterday it literally went numb, I was dragging it around the
>>>>>>kitchen when making lunch.
>>>>>>
>>>>>>I cannot believe the amount of posts I have read in the archives that
>>>>>>contain leg and back pain. Point of this post:
>>>>>>
>>>>>>To introduce myself and thank all of you for being here.
>>>>>>And wondering if anyone had anything like what I am going through.
>>>>>>Interesting enough when they did the abdominal CT they found both
>>>>>>ovaries contained two cysts each and my uterus is quite retroverted.
>>>>>>What am I missing here, that three dr's dismissed this as a possiblity?
>>>>>>Is it their lack of knowledge.
>>>>>>
>>>>>>Thanks in advance, I look forward to "talking" with you in posts and
>>>>>>helping where I can.
>>>>
>>>>--
>>>>Find an endo specialist in the ERC's EndoDocs group:
>>>>http://groups.yahoo.com/group/EndoDocs/
>>>>
>>>>Try an excellent endo support group:
>>>>http://groups.yahoo.com/group/erc/
>>>>
>>>--
>>>Eric Daiter, MD
>>>
>>--
>>Find an endo specialist in the ERC's EndoDocs group:
>>http://groups.yahoo.com/group/EndoDocs/
>>
>>Try an excellent endo support group:
>>http://groups.yahoo.com/group/erc/
>>
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