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questions from recent surgery (long)From: Adriana (anonymous@obgyn.net)Fri Apr 9 19:26:38 1999
Hi! I just had my second surgery last Thursday and I have a few questions about what the surgeon said. I haven't talked to her very much and I have my follow up appointment on Tuesday and I would like to go into it with as much information as possible. A little history: I have suffered from Endo since I was 12 but got the pat on the head from doctors and was told all women have pain with their periods. It wasn't until I started suffering bouts of extreme pain that caused me to lose consciousness and the appearance of a very large tumor on my left ovary before I was taken seriously. In October '97 I had a laparotomy where they removed my entire left ovary and left broad ligament and the pathology report stated I had Endo. I switched doctors and started on a course of progesterone. I had an ultrasound last March that showed my appendix was inflamed and rigid but it was determined I didn't have appendicitis. I have had constant upper right quadrant pain since the last surgery that does not respond well to NSAIDs. I finally got into the OR last Thursday (April fools!) where we were going to try pain mapping. They couldn't even get the scope in because my omentum was completely adhered to the abdominal wall. They spent most of the two hours freeing that up. But the amount of adhesions was extensive and the appendix was retrocecal and completely adhered to the cecum and the abdominal wall. It was too difficult to remove under the scope. The left tube was completely adhered to the abdominal wall and the omentum and looked like a fat sausage - completely unlike the right tube which looked like a long, slim finger. There were some spots of Endo under the right ovary, which were cauterized. To sum up, there was little active visible disease but a ton of adhesions. Here are my questions: Is it possible to tell the difference between adhesions caused by previous surgeries and those caused by Endo? Despite the fact that there were few lesions is the disease still considered as serious with all the adhesions? Is there active disease at the base of adhesions caused by both Endo and previous surgeries (or just Endo adhesions)? Is there any advantage to excising the adhesions at the base instead of just cutting them? Or are you just promoting the growth of new adhesions by cutting tissue? Can they reattach if they are only cut? I still have the pain in the upper right quadrant so that was not resolved by the surgery. I also have pain where the omentum was cut and cauterized. I appreciate any information or advice any of you can give me. After having lived through a laparotomy and then having the laparoscopy I will never have open surgery again if I can avoid it. The difference in recovery time and pain level is amazing! Any other thoughts you might have about my situation or questions I haven't thought of yet would be greatly appreciated. Thanks in advance for your help, Adriana
-- Adriana Dawes
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