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Re: Uterine Fibroid
From: cathy (anonymous@obgyn.net)
Mon, 28 Feb 2000 14:33:39 -0600 (CST)
You are absolutely right to be careful about the referrals you get about
surgery! After having been told by two gynecologists that I needed an
abdominal hysterectomy because of the size of my fibroids (2 grapefruit
sized), I lucked into another referral - a specialist in gynecological
laparoscopic procedures. 2 weeks ago I had a supracervical laparoscopic
hysterectomy (LSH) and could not be more pleased with the results. This
was outpatient surgery and I left the clinic less than 12 hours
post-surgical, had a massage the next day and was back in my office 4
days later. I feel great, was able to resume sexual activity 10 days
after surgery and plan to ski at the end of this week. I have virtually
no restrictions on my activities! As a small business owner, minimal
recovery time was extremely important to me professionally. I am an
active 40 year old and would rather spend my time off work doing
something I enjoy. I strongly encourage you to speak with an
experienced laparascopic surgeon before you even consider any other
surgery. If you contact me directly, I will be pleased to refer you to
my doctor and/or tell you more about my experience.
At Wed, 23 Feb 2000, Don , Pat , wrote:
>
>2 questions:
>
> First: I was diagnosed having a uterine fibroid - size of a "golf ball"
>in 1983 when I was pregnant for
> my first son. Successful pregnancy with OBGYN advising hysterectomy
>ASAP. I wanted second
> child, and he suggested that we immediately get pregnant so that we
>could get hysterectomy done.
> Meanwhile, I was to return to him every 6-months for an ultrasounds/pap
>test until next pregnancy was
> done. I agreed; however, we immediately changed
> residence because my husband was transferred to different job/city -
>ended up with different insur-
> ance company and ultimatley new OBGYN. After settling into new home, I
>went to NEW obgyn that I
> was given (HMO). He laughed at the fact that I was there to see him for
>an 8 monht ultrasound/pap
> smear ( was 2 months late). Said that was "old school" OBGYN practice.
>Now, fibroids are not
> reason for hysterecotmies. "Most disappear or dissolve by or during
>menopause. Only 1 percent
> turn cancerous. Not reason for surgery." "Come back in one year -
>unless "symptoms" arise, such
> as excessive bleeding, abdominal pain beyond normal for periods, unusual
>discharge, etc. Don't worry."
>
> I became pregnant for second child 5+ years later. Informed OBGYN that
>I had fibroid. He could not
> find fibroid which had been very obvious before - front - lower left
>side of uterus. Ultrasound proved no
> fibroid. Second pregnancy was normal and successful. Again, we were
>transferred - to another HMO
> and city (new HMO network area). Had to find third OBGYN. First yearly
>pap test showed fibroid same
> place. After pelvic, pap smear and ultrasound, OBGYN suggested
>immediate hysterectomy. Why, I
> asked since I had read enough to know that fibroids do not necessarily
>have to be
> removed. Her answer was that it was large and "calcified" "I would not
>look so good in
> bikini" It was the size of grapefuit but was causing no symptoms.
>Needless to say, I have
> not seen an OBGYN since.
>
>Thus, I have the same question now that I had then. If, in fact, fibroids
>can dissolve during menopause (I will be 49 next month and am having severe
>pre-menopausal symptoms) - why should this fibroid be removed? Is it
>to relieve symptoms of bleeding and discomfort? Or is it that the fibroid
>can become cancerous? Or is it for
>some other reason, other than "my bikini won't look good on me any more"?
>
>My periods are now about 5-7 days long - with "spotting" the next 3 - 5
>days. My cycle starts every 21 - 23 days. I have many syptoms of
>menopause, including mood swings, "abnormal" period lengths, hot flashes,
>sleeplessness, lack of concentration, sleeplessness. Bleeding is very heavy
>first three days and dwindles
>quickly the remainder of my period. Periods may last 5-6 days - or may
>carry on for 8 - 10 days. However, I've never before had heavy bleeding at
>all before now. Small clotting - smaller than a dime - occasionally - not
>every period. However, I've never had clotting before either.
>
>My basic problem is that I have been told by my second OBGYN that there are
>two schools of thought regarding fibroids. The old school is to remove them
>immediately so that cancer has no chance of occurring, and the newer
>medically-schooled people believe that fibroids do not need to be removed
>until they either cause a problem (excessive bleeding, pain, etc) or pap
>smears come back "abnormal". Can anyone tell me when I should take the
>risks of surgery? Are these "schools of thought" driven by med schools or
>HMO's? Can you tell me if I should risk surgery at all? To a physician,
>this may be a "normal" procedure - but never having been through any
>surgery, this is not "normal" to me. It's my female organs we're talking
>about here. I've been told that there are "relatively" few risks to this
>surgery, but I know better than that too. If it were you, HOW would you
>decide which OBGYN to believe? I'm not happy thinking about the risks of
>the surgery - but I'm also not happy worrying that I may end up with cancer.
>How can I assure myself that surgery is or is not the answer? Does
>calcification have anything to do with the risk of cancer? Does size of
>fibroid have anything to do with the risk of cancer? Does bleeding or
>clotting have to do wth risk of cancer? My doctors have asked which
>"symptoms" I have - but have not told me which ones indicate a need for
>surgery. Can you help?
>
>Lastly, if surgery is immenant, how do I choose a good surgeon. And please
>don't tell me to make sure they are "certified and registered" with the
>State. Registration and certification simply mean that they have completed
>the education and have kept their "dues" up to date. Of course, I would do
>that. The real question is: how do I find an experienced, successful
>surgeon. Successful meaning that their patients recover and have a good
>quality of life after surgery? Successful refers to their patients'
>health - not to the doctors wallets. I would appreciate any suggestions or
>answers. Thank you.
--
Cathy Moyer
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